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Carrasco-Uribarren A, Pardos-Aguilella P, Jiménez-Del-Barrio S, Cabanillas-Barea S, Pérez-Guillén S, Ceballos-Laita L. Cervical manipulation versus thoracic or cervicothoracic manipulations for the management of neck pain. A systematic review and meta-analysis. Musculoskelet Sci Pract 2024; 71:102927. [PMID: 38492291 DOI: 10.1016/j.msksp.2024.102927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/16/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Cervical and thoracic thrust or non-thrust manipulations have shown to be effective in patients with neck pain, but there is a lack of studies comparing both interventions in patients with neck pain. OBJECTIVE To investigate the effects of cervical thrust or non-thrust manipulations compared to thoracic or cervicothoracic manipulations for improving pain, disability, and range of motion in patients with neck pain. DESIGN Systematic review and meta-analysis. METHOD Searches were performed in PubMed, PEDro, Cochrane Library, CINHAL, and Web of Science databases from inception to May 22, 2023. Randomized clinical trials comparing cervical thrust or non-thrust manipulations to thoracic or cervicothoracic manipulations were included. Methodological quality was assessed with PEDro scale, and the certainty of evidence was evaluated using GRADE guidelines. RESULTS Six studies were included. Meta-analyses revealed no differences between cervical thrust or non-thrust manipulations and thoracic or cervicothoracic manipulations in pain intensity, disability, or cervical range of motion in any plane. The certainty of evidence was downgraded to very low for pain intensity, to moderate or very low for disability and to low or very low for cervical range of motion. CONCLUSION There is moderate to very low certainty evidence that there is no difference in effectiveness between cervical thrust or non-thrust manipulations and thoracic or cervicothoracic manipulations for improving pain, disability, and range of motion in patients with neck pain. PROSPERO REGISTRATION CRD42023429933.
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Affiliation(s)
- Andoni Carrasco-Uribarren
- Departamento de Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad Internacional de Cataluña, Barcelona, España
| | - Pilar Pardos-Aguilella
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
| | - Sandra Jiménez-Del-Barrio
- Grupo de Investigación Clínica en Ciencias de la Salud, Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Valladolid, Soria, España.
| | - Sara Cabanillas-Barea
- Departamento de Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad Internacional de Cataluña, Barcelona, España
| | - Silvia Pérez-Guillén
- Departamento de Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad Internacional de Cataluña, Barcelona, España
| | - Luis Ceballos-Laita
- Grupo de Investigación Clínica en Ciencias de la Salud, Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Valladolid, Soria, España
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Nakazato T, Quezada P, Gutiérrez C, Romaní F. Chronic Neck Pain Prevalence Before and After COVID-19 Restrictions and Its Relationship With Digital Device Screen Viewing: A Population Study. Ann Rehabil Med 2024; 48:124-134. [PMID: 38644637 PMCID: PMC11058364 DOI: 10.5535/arm.230030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/15/2024] [Accepted: 03/19/2024] [Indexed: 04/23/2024] Open
Abstract
OBJECTIVE To estimate the prevalence of chronic neck pain (CNP) among the adult population in Peru during the post-coronavirus disease 2019 (COVID-19) restriction period compared with that during the pre-pandemic period and evaluate its association with prolonged digital devices connected to the internet (DDCI) screen viewing. METHODS We conducted a cross-sectional study using a representative sample of adults living in Peru in November 2022. A structured survey was employed to identify CNP, and the exposure variable was set as the duration of DDCI screen viewing. The McNemar test was used to compare CNP prevalence pre- and post-COVID-19 restrictions, and ordinal logistic regression was used to evaluate its association with prolonged screen viewing. RESULTS A total of 1,202 individuals participated, with 52.8% females and 79.9% residing in urban areas. Following the restrictions, the prevalence of CNP occurring daily or almost daily and at least once a week was 14.8% and 27.8%, respectively (95% confidence Interval [95% CI], 12.6-17.3 and 24.9-30.9), representing a significant increase (p<0.001) compared with pre-pandemic estimates. Notably, among those viewing DDCI screens for ≥8 hours, the odds ratio for CNP frequency escalation compared with those who did not or rarely view screens was 1.61 (95% CI, 1.04-2.50; p=0.033). CONCLUSION Approximately 4 of 10 adults in Peru experienced CNP following the lifting of COVID-19 social restrictions, more than double the pre-pandemic prevalence. Furthermore, prolonged viewing of DDCI screens increased the risk of having this condition.
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Affiliation(s)
- Tomas Nakazato
- Facultad de Medicina Humana, Universidad de Piura, Lima, Perú
| | - Pablo Quezada
- Facultad de Medicina Humana, Universidad de Piura, Lima, Perú
| | - César Gutiérrez
- Facultad de Medicina Humana, Universidad de Piura, Lima, Perú
| | - Franco Romaní
- Facultad de Medicina Humana, Universidad de Piura, Lima, Perú
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Yoshida R, Kuruma H. Intra- and Inter-rater Reliability of the Lumbar-Locked Thoracic Rotation Test in Patients With Neck Pain. Cureus 2024; 16:e56407. [PMID: 38638709 PMCID: PMC11023911 DOI: 10.7759/cureus.56407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
PURPOSE Neck pain is a common musculoskeletal disorder. Therefore, establishing effective physical therapy for neck pain is one of the most important issues. In addition, in physical therapy for neck pain, it is important to evaluate the thoracic spine, which is an adjacent region of the neck. The lumbar-locked rotation test is designed to evaluate the rotational range of the thoracic spine. However, the reliability of the test when performed on patients with neck pain has not been confirmed. OBJECTIVE We aimed to determine the intra- and inter-rater reliability of the lumbar-locked rotation test in patients with neck pain. METHODS In this study involving 43 patients, two separate examiners measured thoracic spine rotation. Both examiners conducted three measurements for each side, before and after a five-minute interval. Reliability was assessed using various intra-class correlation coefficient (ICC) models. RESULTS The intra-rater reliability showed ICC values of 0.99 for both examiners. The inter-rater reliability showed ICC values of 0.98 for both right and left thoracic rotations. CONCLUSION The findings strongly suggest that the lumbar-locked rotation test has high within-session intra- and inter-rater reliability for patients with neck pain. This test can be considered a reliable method of measuring the thoracic spine rotational range of motion in patients with neck pain in clinical practice.
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Affiliation(s)
- Ryota Yoshida
- Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, JPN
| | - Hironobu Kuruma
- Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, JPN
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Ichikawa K, Otsuka T, Abduh HAM, Kuruma H. Assessing validity of thoracic spine rotation range of motion measurement methods: comparison of magnetic resonance imaging and clinical measurements. J Phys Ther Sci 2024; 36:95-101. [PMID: 38434995 PMCID: PMC10904216 DOI: 10.1589/jpts.36.95] [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: 10/11/2023] [Accepted: 11/25/2023] [Indexed: 03/05/2024] Open
Abstract
[Purpose] This work was designed to establish criteria for assessing common clinical measurement methods for thoracic spinal rotation angles by comparing their results with magnetic resonance imaging measurements. [Participants and Methods] Twenty-six healthy participants underwent thoracic rotation angle assessments using an electronic goniometer in three positions: lumbar-locked, seated, and half-kneeling. We compared these results with measurements obtained by magnetic resonance imaging. [Results] A moderate but significant positive correlation was observed between the thoracic rotation angle measured by magnetic resonance imaging and the lumbar-locked rotation test. The respective 95% confidence intervals of these correlation coefficients were 0.09 and 0.72. Bland-Altman analysis revealed a fixed error in the lumbar-locked rotation test, suggesting that the test tended to overestimate thoracic rotation compared with magnetic resonance imaging, but proportional errors could not be definitively identified. [Conclusions] Thoracic spine rotation angles measured using magnetic resonance imaging aligned closely with previously reported results. Notably, although measurements obtained by the lumbar-locked rotation test correlated with magnetic resonance imaging results, they exhibited fixation errors. Functional tests (seated and half-kneeling) showed limited correlations with magnetic resonance imaging results. The influence of adjacent joints on clinical measurements should be considered.
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Affiliation(s)
- Kazuna Ichikawa
- Department of Physical Therapy, Tokyo Metropolitan
University: 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Takuya Otsuka
- Department of Physical Therapy, Tokyo Metropolitan
University: 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
| | | | - Hironobu Kuruma
- Department of Physical Therapy, Tokyo Metropolitan
University: 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
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Chand, Vaish H. Effect of diaphragmatic breathing, respiratory muscle stretch gymnastics and conventional physiotherapy on chest expansion, pulmonary function and pain in patients with mechanical neck pain: A single group pretest-posttest quasi-experimental pilot study. J Bodyw Mov Ther 2023; 36:148-152. [PMID: 37949552 DOI: 10.1016/j.jbmt.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/22/2021] [Accepted: 07/04/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND There is evidence that mechanical neck pain results in respiratory dysfunction. Physiotherapy management for mechanical neck pain is well documented but the evidence regarding inclusion of breathing strategies to improve pulmonary functions in mechanical neck pain patients is scarce. OBJECTIVE To investigate the combined effect of diaphragmatic breathing, respiratory muscles stretch gymnastics (RMSG) and conventional physiotherapy on chest expansion, pulmonary function and pain in patient with mechanical neck pain. METHOD Thirteen patients with mechanical neck pain (18-35years) with neck pain history of ≥ three months and NPRS (numeric pain rating scale) score ≥3 were recruited for this single group pre pretest-posttest quasi experimental pilot study. Informed consent was taken from all participants. After initial screening and assessment, diaphragmatic breathing, RSMG (5 patterns) and conventional physiotherapy (hot pack and TENS for 10 min) were given for one week. Chest expansion, spirometry (FEV1, FVC, FEV1/FVC, PEFR), NDI (neck disability index) and NPRS were assessed on baseline and after one week following the intervention. RESULTS The normality of data was tested by using Shapiro-wilk test and the data was found to be normally distributed. Paired t-test was used to compare the baseline and post intervention values. Diaphragmatic breathing, RMSG and conventional physiotherapy had significant effect on chest expansion, FEV1, NPRS and NDI in patients with mechanical neck pain. CONCLUSION The rehabilitation strategies should emphasize breathing exercises to improve the lung function and pain scores in addition to conventional physiotherapy in rehabilitation of mechanical neck pain patients.
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Affiliation(s)
- Chand
- BPT Intern, MMIPR, Markandeshwar (Deemed to be University), Mullana, Ambala, India
| | - Hina Vaish
- School of Health Sciences, CSJM University, Kanpur, India.
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Bellosta-López P, Simonsen MB, Palsson TS, Djurtoft C, Hirata RP, Christensen SWM. Validity of an inertial measurement unit for the assessment of range and quality of movement during head and thoracic spine movements. Musculoskelet Sci Pract 2023; 66:102826. [PMID: 37433251 DOI: 10.1016/j.msksp.2023.102826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/12/2023] [Accepted: 07/06/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Patients with spinal pain often exhibit movement limitations and altered motor control, which can be challenging to measure accurately in clinical practice. Inertial measurement sensors present a promising new opportunity to develop valid, low-cost, and easy-to-use methods for assessing and monitoring spinal motion in a clinical setting. AIM This study aimed to investigate the agreement of an inertial sensor and a 3D camera system for assessing the range of motion (ROM) and quality of movement (QOM) in head and trunk single-plane movements. METHODS Thirty-three healthy, pain-free volunteers were included. Each participant performed movements of the head (cervical flexion, extension, and lateral flexion) and trunk (trunk flexion, extension, rotation, and lateral flexion), which were simultaneously recorded by a 3D camera system and an inertial measurement unit (MOTI, Aalborg, Denmark). Agreement and consistency were analyzed for ROM and QOM by determining intraclass correlation coefficients (ICC), mean bias, and with Bland-Altman plots. RESULTS The agreement between systems was excellent for all movements (ICC between 0.91 and 1.00) for ROM and good to excellent for the QOM (ICC between 0.84 and 0.95). The mean bias for all movements (0.1-0.8°) was below the minimum acceptable difference between devices. The Bland-Altman plot indicated that MOTI systematically measured a slightly greater ROM and QOM than the 3D camera system for all neck and trunk movements. CONCLUSION This study showed that MOTI is a feasible and potentially applicable option to assess ROM and QOM for head and trunk movements in experimental and clinical settings.
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Affiliation(s)
- Pablo Bellosta-López
- Universidad San Jorge. Campus Universitario, Autov. A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain.
| | - Morten Bilde Simonsen
- Department of Materials and Production, Faculty of Engineering and Science, Aalborg University, Aalborg, Denmark
| | - Thorvaldur Skuli Palsson
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
| | - Chris Djurtoft
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Center for General Practice at Aalborg University, Aalborg, Denmark
| | - Rogerio Pessoto Hirata
- ExerciseTech Research Group, Department of Health Science and Technology Aalborg University, Denmark
| | - Steffan Wittrup McPhee Christensen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
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Moustafa IM, Shousha T, Arumugam A, Harrison DE. Is Thoracic Kyphosis Relevant to Pain, Autonomic Nervous System Function, Disability, and Cervical Sensorimotor Control in Patients with Chronic Nonspecific Neck Pain? J Clin Med 2023; 12:jcm12113707. [PMID: 37297903 DOI: 10.3390/jcm12113707] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
There is great interest in thoracic kyphosis, as it is thought to be a contributor to neck pain, neck disability, and sensorimotor control measures; however, this has not been completely investigated in treatment or case control studies. This case control design investigated participants with non-specific chronic neck pain. Eighty participants with a defined hyper-kyphosis (>55°) were compared to eighty matched participants with normal thoracic kyphosis (<55°). Participants were matched for age and neck pain duration. Hyper-kyphosis was further categorized into two distinct types: postural kyphosis (PK) and Scheuermann's kyphosis (SK). Posture measures included formetric thoracic kyphosis and the craniovertebral angle (CVA) to assess forward head posture. Sensorimotor control was assessed by the following measures: smooth pursuit neck torsion test (SPNT), overall stability index (OSI), and left and right rotation repositioning accuracy. A measure of autonomic nervous system function included the amplitude and latency of skin sympathetic response (SSR). Differences in variable measures were examined using the Student's t-test to compare the means of continuous variables between the two groups. One-way ANOVA was used to compare mean values in the three groups: postural kyphosis, Scheuermann's kyphosis, and normal kyphosis group. Pearson correlation was used to evaluate the relationship between participant's thoracic kyphosis magnitude (in each group separately and as an entire population) and their CVA, SPNT, OSI, head repositioning accuracy, and SSR latency and amplitude. Hyper-kyphosis participants had a significantly greater neck disability index compared to the normal kyphosis group (p < 0.001) with the SK group having greatest disability (p < 0.001). Statistically significant differences between the two kyphosis groups and the normal kyphosis group for all the sensorimotor measured variables were identified with the SK group having the most decreased efficiency of the measures in the hyper-kyphosis group, including: SPNT, OSI, and left and right rotation repositioning accuracy. In addition, there was a significant difference in neurophysiological findings for SSR amplitude (entire sample of kyphosis vs. normal kyphosis, p < 0.001), but there was no significant difference for SSR latency (p = 0.07). The CVA was significantly greater in the hyper-kyphosis group (p < 0.001). The magnitude of the thoracic kyphosis correlated with worsening CVA (with the SK group having the smallest CVA; p < 0.001) and the magnitude of the decreased efficiency of the sensorimotor control measures and the amplitude and latency of the SSR. The PK group, overall, showed the greatest correlations between thoracic kyphosis and measured variables. Participants with hyper-thoracic kyphosis exhibited abnormal sensorimotor control and autonomic nervous system dysfunction compared to those with normal thoracic kyphosis.
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Affiliation(s)
- Ibrahim M Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Tamer Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Deed E Harrison
- CBP Nonprofit (A Spine Research Foundation), Eagle, ID 83616, USA
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Grasser P, Neto FR, Veloso JHCL, Gomes Costa RR, Dorneles JR. Mechanical diagnosis and therapy in musculoskeletal pain of individuals with spinal cord injury. J Spinal Cord Med 2023:1-9. [PMID: 37116180 DOI: 10.1080/10790268.2023.2197818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
CONTEXT/OBJECTIVE Musculoskeletal pain (MSKP) has high prevalence in individuals with spinal cord injury (SCI). Mechanical Diagnosis and Therapy (MDT) is a method focused on identifying the pain source in the musculoskeletal system and presents good results in pain relief in people without neurological impairment. However, no studies have investigated the use of MDT in SCI population. The objective was to evaluate the applicability and outcomes of MDT treatment in pain relief and independence improvement in daily activities of individuals with SCI presenting MSKP. DESIGN Single-arm trial. SETTING Rehabilitation Hospital. PARTICIPANTS Twenty-four individuals with SCI who presented MSKP. INTERVENTION MDT-certified physical therapist conducted assessments and treatments of pain according to the MDT approach. OUTCOMES MEASURES Numeric rating scale (NRS) was used to measure pain and Pain Disability Index (PDI) and Patient-Specific Functional Scale (PSFS) to evaluate daily activities. RESULTS Significant median decreases were found for NRS (from 7 to 2) and PDI (from 27 to 8) after MDT, whereas PSFS score presented a significant mean increase (from 3.2-7.7). The average decrease in pain after MDT treatment was 70.9% (5.36 on the NRS). CONCLUSION MDT can reduce pain and enhance independence in daily activities in individuals with SCI and MSKP.
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Affiliation(s)
- Poliana Grasser
- Spinal Cord Injury Department, Sarah Network of Rehabilitation Hospital, Brasilia, Brazil
| | - Frederico Ribeiro Neto
- Spinal Cord Injury Department, Sarah Network of Rehabilitation Hospital, Brasilia, Brazil
| | - João H C L Veloso
- Spinal Cord Injury Department, Sarah Network of Rehabilitation Hospital, Rio de Janeiro, Brazil
| | - Rodrigo R Gomes Costa
- Spinal Cord Injury Department, Sarah Network of Rehabilitation Hospital, Brasilia, Brazil
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Breast Hypertrophy: A Real Pain in the Back. Plast Reconstr Surg 2023; 151:498-508. [PMID: 36730482 DOI: 10.1097/prs.0000000000009906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Bilateral breast hypertrophy comes with signs and symptoms ranging from mild to debilitating. Bilateral breast reduction (BBR) is one of the most frequently performed plastic surgery procedures, and its effects on parameters such as spinal balance, paraspinal muscle function, and physical performance have not been thoroughly evaluated. The objective of this study was to evaluate the effects of BBR using advanced spine imaging modalities, and pain resolution. METHODS A prospective, observational, cohort study was carried out at the McGill University Health Centre. The following measures were recorded preoperatively and postoperatively for each patient: patient questionnaires (BREAST-Q and Pain), magnetic resonance imaging, and EOS low-radiation spinal scan. RESULTS Significant postoperative pain reduction was recorded, and there was up to 148% improvement in physical tests. Improvement in all questionnaire and BREAST-Q categories was documented. Preoperative and postoperative magnetic resonance imaging did demonstrate a statistically significant absence of permanent anatomical skeletal sequelae. Postoperative improvement in thoracic kyphosis was documented. CONCLUSIONS Quality-of-life scores are uniformly improved following BBR. Key findings following BBR include significant pain reduction and no evidence of spinal skeletal change. This is a finding of major importance in view of the practice of many insurance companies/third-party payer and health care systems that use the Schnur scale. The Schnur scale associates a weight for resection with body size that is not directly predictive of pain relief. This may indicate the need for more precise or different guidelines based on these quantitative findings. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Moustafa IM, Shousha TM, Walton LM, Raigangar V, Harrison DE. Reduction of Thoracic Hyper-Kyphosis Improves Short and Long Term Outcomes in Patients with Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. J Clin Med 2022; 11:jcm11206028. [PMID: 36294349 PMCID: PMC9604450 DOI: 10.3390/jcm11206028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/22/2022] Open
Abstract
This study investigates thoracic hyper kyphosis (THK) rehabilitation using the Denneroll™ thoracic traction orthosis (DTTO). Eighty participants, with chronic non-specific neck pain (CNSNP) and THK were randomly assigned to the control or intervention group (IG). Both groups received the multimodal program; IG received the DTTO. Outcomes included formetric thoracic kyphotic angle ICT—ITL, neck pain and disability (NDI), head repositioning accuracy (HRA), smooth pursuit neck torsion test (SPNT) and overall stability index (OSI). Measures were assessed at baseline, after 30 treatment sessions over the course of 10 weeks, and 1-year after cessation of treatment. After 10 weeks, the IG improved more in neck pain intensity (p < 0.0001) and NDI (p < 0.001). No differences were found for SPNT (p = 0.48) and left-sided HRA (p = 0.3). IG improved greater for OSI (p = 0.047) and right sided HRA (p = 0.02). Only the IG improved in THK (p < 0.001). At 1-year follow-up, a regression back to baseline values for the control group was found for pain and disability such that all outcomes favored improvement in the IG receiving the DTTO; all outcomes (p < 0.001). The addition of the DTTO to a multimodal program positively affected CNSNP outcomes at both the short and 1-year follow-up.
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Affiliation(s)
- Ibrahim Moustafa Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Giza 12511, Egypt
| | - Tamer Mohamed Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Giza 12511, Egypt
| | - Lori M. Walton
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Veena Raigangar
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Deed E. Harrison
- Private Practice and CBP Non-Profit, Inc., Eagle, ID 83616, USA
- Correspondence:
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11
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Lee JH, Kang KC, Kim KT, Kim YC, Chang TS. Extent and characteristic of relationships in canal dimension and canal body ratio between cervical and lumbar spine. Sci Rep 2021; 11:18471. [PMID: 34531481 PMCID: PMC8445999 DOI: 10.1038/s41598-021-98038-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022] Open
Abstract
A known prevalence of concurrent cervical and lumbar spinal stenosis was shown to be 5–25%, but there is a lack of evidence regarding direct relationships in canal dimension and canal-body ratio between cervical and lumbar spine. Total 247 patients (mean age: 61 years, male: 135) with cervical and lumbar computed tomography scans were retrospectively reviewed. Midsagittal vertebral body and canal diameters in reconstructed images were measured at all cervical and lumbar vertebrae, and canal-body ratios were calculated. The canal diameter and ratio were also compared according to the gender and age, and correlation analysis was performed for each value. There were significant correlations between cervical (C3–C7) and lumbar (L1–L5) canal dimension (p < 0.001). C5 canal diameter was most significantly correlated with L4 canal diameter (r = 0.435, p < 0.001). Cervical canal-body ratios (C3–C7) were also correlated with those of lumbar spine (L1–L5) (p < 0.001). The canal-body ratio of C3 was most highly correlated with L3 (r = 0.477, p < 0.001). Meanwhile, mean canal-body ratios of C3 and L3 were significantly smaller in male patients than female (p = 0.038 and p < 0.001) and patient’s age was inversely correlated with C5 canal diameter (r = − 0.223, p < 0.001) and C3 canal-body ratio (r = − 0.224, p < 0.001). Spinal canal dimension and canal-body ratio have moderate degrees of correlations between cervical and lumbar spine and the elderly male patients show the tendency of small canal diameter and canal-body ratio. This relationship of cervical and lumbar spine can be an important evidence to explain to the patients.
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Affiliation(s)
- Jung-Hee Lee
- Department of Orthopaedic Surgery, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, 23 Kyungheedaero, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Kyung-Chung Kang
- Department of Orthopaedic Surgery, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, 23 Kyungheedaero, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| | - Ki-Tack Kim
- Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yong-Chan Kim
- Department of Orthopaedic Surgery, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, 23 Kyungheedaero, Dongdaemun-gu, Seoul, 02447, Republic of Korea.,Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Tae-Soo Chang
- Department of Orthopaedic Surgery, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, 23 Kyungheedaero, Dongdaemun-gu, Seoul, 02447, Republic of Korea
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Katsumi K, Hirai T, Yoshii T, Maki S, Mori K, Nagoshi N, Nishimura S, Takeuchi K, Ushio S, Furuya T, Watanabe K, Nishida N, Watanabe K, Kaito T, Kato S, Nagashima K, Koda M, Ito K, Imagama S, Matsuoka Y, Wada K, Kimura A, Ohba T, Katoh H, Matsuyama Y, Ozawa H, Haro H, Takeshita K, Watanabe M, Matsumoto M, Nakamura M, Yamazaki M, Okawa A, Kawaguchi Y. The impact of ossification spread on cervical spine function in patients with ossification of the posterior longitudinal ligament. Sci Rep 2021; 11:14337. [PMID: 34253758 PMCID: PMC8275804 DOI: 10.1038/s41598-021-93602-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. The bridging of ossified lesions to the vertebral body gradually increases, thereby decreasing the mobility of the cervical spine; thus, cervical spine function may decrease over time. However, cervical spine function in patients with cervical OPLL has not been evaluated in large prospective studies. Therefore, we conducted a prospective multicenter study to clarify whether ossification spread can influence cervical spine function and quality of life (QOL) in patients with cervical OPLL. In total, 238 patients (162 men, 76 women; mean age, 63.9 years) were enrolled from 16 institutions. Each patient underwent whole spine computed tomography and was evaluated for cervical spine function and QOL using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). In the multivariate regression analysis, a higher neck VAS score and a larger number of bridge formations of OPLL in the whole spine were significant predictors of adverse outcomes related to cervical spine function. This is the first prospective multicenter study to reveal the impact of ossification spread on cervical spine function. These findings are important to understand the natural course of OPLL and can serve as controls when evaluating postoperative cervical spine function.
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Affiliation(s)
- Keiichi Katsumi
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinkocho, Chuo-ku, Niigata, Niigata, 950-8556, Japan. .,Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata, Niigata, 951-8510, Japan. .,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan.
| | - Takashi Hirai
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Toshitaka Yoshii
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Satoshi Maki
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-0856, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo , Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Soraya Nishimura
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo , Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kazuhiro Takeuchi
- Department of Orthopedic Surgery, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Okayama, Okayama, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Shuta Ushio
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-0856, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kei Watanabe
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata, Niigata, 951-8510, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Norihiro Nishida
- Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo , Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Satoshi Kato
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1, Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Katsuya Nagashima
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kenyu Ito
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-0065, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-0065, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Yuji Matsuoka
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kanichiro Wada
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 53 Honcho, Hirosaki, Aomori, 036-8203, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Atsushi Kimura
- Department of Orthopaedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Tetsuro Ohba
- Department of Orthopedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo-ku, Yamanashi, 409-3898, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Hiroyuki Katoh
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1143, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Yukihiro Matsuyama
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3125, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Hiroshi Ozawa
- Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Hirotaka Haro
- Department of Orthopedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo-ku, Yamanashi, 409-3898, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Katsushi Takeshita
- Department of Orthopaedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masahiko Watanabe
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1143, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo , Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo , Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Yoshiharu Kawaguchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan.,Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
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Kelani TD, Lee A, Walker M, Koizia LJ, Dani M, Fertleman MB, Kedgley AE. The Influence of Cervical Spine Angulation on Symptoms Associated With Wearing a Rigid Neck Collar. Geriatr Orthop Surg Rehabil 2021; 12:21514593211012391. [PMID: 34017614 PMCID: PMC8114308 DOI: 10.1177/21514593211012391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Rigid cervical spine collars can be used to maintain the position of the cervical spine following injury or surgery. However, they have been associated with difficulty swallowing, pressure sores and pain, particularly in older patients. We aimed to investigate the relationship between cervical spine angulation, a rigid neck collar and neck pain in healthy young and older adults. Methods: Twenty healthy young adults aged 25 ± 3 years and 17 healthy older adults aged 80 ± 8 years were tested. Magnetic resonance imaging scans of their cervical spines were taken before and after the rigid neck collar was worn for 1 hour. Measurement of vertebral angulation involved digitization of the scans and joint angle calculations using image processing software. Pain was quantified before and after the collar was worn, using a visual analogue scale. Results: Pain scores increased in the young group after the collar was worn (p = 0.001). The older group showed no difference in pain score after the collar was worn. Statistical tests showed no significant correlations between the change in cervical angles and the change in pain scores after the collar was worn. Discussion: The aging process may contribute to the changing distribution of subcutaneous tissue and increase risk of symptoms associated with wearing a collar. Oesophageal compression is not a result of collar use. Conclusion: There is no correlation between cervical spine vertebrae angulation and symptoms associated with wearing a neck collar. Generally, older individuals have greater cervical lordosis angles, and more straight and lordotic neck shapes. Older individuals may be more prone to skin-interface pressures from the neck collar than younger individuals.
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Affiliation(s)
- Taiwo D Kelani
- Department of Bioengineering, Imperial College London, White City, London, UK
| | - Annabelle Lee
- Geriatric Medicine, Imperial College NHS Trust, London, UK
| | - Miny Walker
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - Louis J Koizia
- Department of Bioengineering, Cutrale Perioperative and Ageing Group, Imperial College London, White City, London, UK
| | - Melanie Dani
- Department of Bioengineering, Cutrale Perioperative and Ageing Group, Imperial College London, White City, London, UK
| | - Michael B Fertleman
- Department of Bioengineering, Cutrale Perioperative and Ageing Group, Imperial College London, White City, London, UK
| | - Angela E Kedgley
- Department of Bioengineering, Imperial College London, White City, London, UK
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