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Threesittidath K, Chaibal S, Nitayarak H. Effects of 1-hour computer use on ulnar and median nerve conduction velocity and muscle activity in office workers. J Occup Health 2024; 66:uiae023. [PMID: 38710168 PMCID: PMC11195575 DOI: 10.1093/joccuh/uiae023] [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: 09/25/2023] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVES To compare the effects of 1-hour computer use on ulnar and median nerve conduction velocity and muscle activity in office workers with symptomatic neck pain and asymptomatic office workers. METHODS A total of 40 participants, both male and female office workers, with symptomatic neck pain (n = 20) and asymptomatic (n = 20), were recruited. Pain intensity, ulnar nerve conduction velocity, median nerve conduction velocity, and muscle activity were determined before and after 1 hour of computer use. RESULTS There was a significant increase in pain intensity in the neck area in both groups (P < .001). The symptomatic neck pain group revealed a significant decrease in the sensory nerve conduction velocity of the ulnar nerve (P = .008), whereas there was no difference in the median nerve conduction velocity (P > .05). Comparing before and after computer use, the symptomatic neck pain group had less activity of the semispinalis muscles and higher activity of the anterior scalene muscle than the asymptomatic group (P < .05). The trapezius and wrist extensor muscles showed no significant differences in either group (P > .05). CONCLUSIONS This study found signs of neuromuscular deficit of the ulnar nerve, semispinalis muscle, and anterior scalene muscle after 1 hour of computer use among office workers with symptomatic neck pain, which may indicate the risk of neuromuscular impairment of the upper extremities. The recommendation of resting, and encouraging function and flexibility of the neuromuscular system after 1 hour of computer use should be considered.
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Affiliation(s)
- Kanruethai Threesittidath
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Thai Buri, Tha Sala District, Nakhon Si Thammarat, Thailand 80160
- Movement Science and Exercise Research Center, Walailak University, Thai Buri, Tha Sala District, Nakhon Si Thammarat, Thailand 80160
| | - Supattra Chaibal
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Thai Buri, Tha Sala District, Nakhon Si Thammarat, Thailand 80160
- Movement Science and Exercise Research Center, Walailak University, Thai Buri, Tha Sala District, Nakhon Si Thammarat, Thailand 80160
| | - Haifah Nitayarak
- Movement Science and Exercise Research Center, Walailak University, Thai Buri, Tha Sala District, Nakhon Si Thammarat, Thailand 80160
- Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Karnjanavanich Road, Hat Yai, Songkhla, Thailand 90110
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Lee JH, Jeon HS, Park JH, Kim JH, Kwon OY, Choi WJ, Kim YH, Kim JM. Effects of 4-week downhill treadmill walking on the vertebral angle and postural muscle activity in participants with thoracic kyphosis and forward head posture: A comparative longitudinal study. J Back Musculoskelet Rehabil 2024; 37:707-713. [PMID: 38160339 DOI: 10.3233/bmr-230187] [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] [Indexed: 01/03/2024]
Abstract
BACKGROUND Maintaining correct posture and optimal spine function has become an important issue due to the increased use of computers and smartphones. OBJECTIVE To investigate the effect of a 4-week downhill treadmill exercise (DTWE) program on participants with thoracic kyphosis and forward head posture (FHP). METHODS Twenty-eight male participants were randomly assigned to the DTWE (n= 14) or standard treadmill walking exercise (STWE) (n= 14) group. They performed 30-minute exercise three times a week for 4 weeks. The vertebral angle was measured using a three-dimensional (3D) motion analysis system. Surface electromyography (EMG) was performed to record muscle activity in the thoracic erector spinae (TES), sternocleidomastoid muscle (SCM), and cervical erector spinae (CES). RESULTS The DTWE group showed significant increases in the craniovertebral angle (CVA) and TES EMG activity and significant decreases in the thoracic kyphosis angle and SCM and CES EMG activity compared with those shown by the STWE group following the intervention (p< 0.05). However, lumbar lordosis or pelvic tilt angles did not differ significantly between the groups after the intervention (p> 0.05). CONCLUSIONS DTWE can be effective in reducing thoracic kyphosis and FHP without causing compensatory movements of the lumbar spine and pelvis.
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Affiliation(s)
- Jun-Hyeok Lee
- Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Kangwon-do, Korea
| | - Hye-Seon Jeon
- Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Kangwon-do, Korea
| | - Joo-Hee Park
- Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Kangwon-do, Korea
| | - Ji-Hyun Kim
- Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Kangwon-do, Korea
| | - Oh-Yun Kwon
- Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Kangwon-do, Korea
| | - Woochol Joseph Choi
- Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Kangwon-do, Korea
| | - Young-Ho Kim
- Department of Biomedical Engineering, Yonsei University, Wonju, Kangwon-do, Korea
| | - Jong-Man Kim
- Department of Biomedical Engineering, Yonsei University, Wonju, Kangwon-do, Korea
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Sedaghati P, Derakhshan KF, Ahmadabadi S, Moghaddam SRR. Effects of corrective and breathing exercises on respiratory function of older adults with a history of COVID-19 infection: a randomized controlled trial. BMC Complement Med Ther 2023; 23:199. [PMID: 37328735 DOI: 10.1186/s12906-023-04031-7] [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: 02/17/2023] [Accepted: 06/09/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Patients with a history of COVID-19 infection may suffer from different physical problems. This study aimed to investigate the effect of corrective and breathing exercises on improving respiratory function among patients with a history of COVID-19 infection. METHODS In this clinical trial study, thirty elderlies with a history of COVID-19 disease were divided into two groups (mean age 63.60 ± 3.56 experimental, 59.87 ± 2.99 control groups) based on the study inclusion criteria. Exercise interventions included two sections- breathing exercises and corrective exercises in the cervical and thoracic spine. The spirometry test, craniovertebral angle, and thoracic kyphosis test were used. To evaluate differences between variables, paired-samples t-test and ANCOVA were used (p-value < 0.01). Also, Eta-squared was measured to assess the effect size. RESULTS Results showed a significant difference between the two groups in craniovertebral angle (P = 0.001), thoracic kyphosis (P = 0.007), and respiratory capacity including Forced expiratory volume in one second (FEV1) (P = 0.002), FEV1/FVC (P = 0.003), Peripheral oxygen saturation (SPO2) (P = 0.001), while no significant differences were observed between two groups in terms of chest anthropometric indices (P > 0.01). The Eta-squared value of 0.51 for the Craniovertebral angle and the SPO2 indicates a large effect size. CONCLUSIONS The results showed the combination of corrective and breathing exercises could improve pulmonary function and correct cervical and thoracic posture in patients with a history of COVID-19 infection. Therefore, corrective and breathing exercises can be helpful as a complementary treatment along with pharmaceutical therapy to reduce chronic pulmonary complications in patients infected with COVID-19. TRIAL REGISTRATION This research was registered in the Iranian Registry of Clinical Trials (IRCT registration number: IRCT20160815029373N7, First trial registration: 23/08/2021, Registration date: 01/09/2021).
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Affiliation(s)
- Parisa Sedaghati
- Department of Sports Injuries and Corrective Exercise, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran.
| | - Korosh Fakhimi Derakhshan
- Pediatric Pulmonologist, Pediatric Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Somayeh Ahmadabadi
- Department of Physical Education and Sports Sciences, Farhangian University, Tehran, Iran
| | - Seyed Reza Rahimi Moghaddam
- Council of Strategic Studies and Researches of the General Administration of Sports and Youth of Guilan Province, Rasht, Iran
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Panihar U, Joshi S. Systematic review and meta-analysis on efficacy of various exercise programs to improve postural parameters, pain and disability in neck. COMPARATIVE EXERCISE PHYSIOLOGY 2023. [DOI: 10.3920/cep220074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
Forward head posture is a common abnormal posture characterised by weakness of muscle around neck and shoulder. Persistent forward head posture can impair respiratory functions and cervical proprioception. The aim of this systematic review and meta-analysis is to determine the effectiveness of exercises to improve the forward head posture. The online literature search performed on various databases, i.e. PubMed, Cochrane, PEDro, Science Direct and Scopus databases resulted in 601 articles, but only 11 articles were found relevant to perform meta-analysis. The primary outcome measure was craniovertebral angle and other outcome measures were neck pain, cranial angle, cranial rotation angle and Neck Disability Index (NDI). Methodological quality of studies was assessed by PEDro scoring and risk of bias assessment was performed using Cochrane collaboration tool of risk of bias. Results of meta-analysis revealed that craniovertebral angle (CVA), cranial rotation angle (CRA), visual analogue scale and NDI improved significantly (P<0.00001) in forward head posture participants who followed any type of exercise regime compared to the participants who did not follow any exercise program. However, cranial angle was not found significantly (P=0.73) improved in exercise groups. Exercises are effective in improving postural parameters, such as CVA, CRA and pain and neck disability in subjects with forward head posture. Systematic analysis registry at PROSPERO: CRD42020175372
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Affiliation(s)
- U. Panihar
- Department of Physiotherapy, Guru Jambheshwar University of Science & Technology, Hisar, Haryana 125001, India
| | - S. Joshi
- Department of Physiotherapy, Guru Jambheshwar University of Science & Technology, Hisar, Haryana 125001, India
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Is Neck Pain Related to Sagittal Head and Neck Posture?: A Systematic Review and Meta-analysis. Indian J Orthop 2023; 57:371-403. [PMID: 36825268 PMCID: PMC9941407 DOI: 10.1007/s43465-023-00820-x] [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] [Received: 11/18/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023]
Abstract
Background Neck pain (NP) is common in all age groups and adversely affects the patients' entire lifestyle. There exists inconclusive evidence relating faulty craniocervical posture with pain-related disability. This review aims to determine whether sagittal head and neck posture differs in NP and pain-free subjects, to critically appraise the correlation of posture with NP. Methods Of 3796 articles identified at primary search from CINAHL, PubMed, Google Scholar, EMBASE, 26 were included based on eligibility criteria. Mean pooled difference (MPD) and effect size (ES) were calculated to establish relationship among studies, to assess postural correlation with NP measures [Visual Analogue Scale (VAS), Numeric Pain Rating Scale (NPRS), neck disability index (NDI), Northwick Park NP Questionnaire (NPQ)] and for age- and gender-wise variation. Risk of bias was assessed using Newcastle-Ottawa Quality Assessment Scale. Results Craniovertebral angle (CVA) had a significant MPD of - 2.93(95% CI - 4.95 to - 0.91). Sagittal head angle (SHA) and forward head posture (FHP) had an insignificant MPD of 1.15 (95% CI - 1.16 to 3.46) and - 0.26 (95% CI - 1.89 to 1.36), respectively. Age- and gender-wise CVA difference was found to be 2.36° and 2.57°, respectively. ES was significant for correlation between CVA and pain intensity [NPRS: - 0.44 (95% CI - 0.61 to - 0.26); VAS: - 0.31 (95% CI - 0.46 to - 0.16)], and between CVA and disability [NDI: - 0.18 (95% CI - 0.31 to - 0.05); NPQ: - 0.47 (95% CI - 0.61 to - 0.320)]. Conclusion CVA differs for age, gender, and pain vs pain-free subjects, and correlates negatively with NP measures. Other surrogate measures (SHA, cranial and cervical angles, FHP) warrant further research. PROSPERO Registration PROSPERO 2021 CRD42021275485.
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The association between forward head posture and masticatory muscle pressure pain thresholds in patients with temporomandibular joint dissorders: a cross-sectional observational study. Clin Oral Investig 2023; 27:353-360. [PMID: 36241923 DOI: 10.1007/s00784-022-04739-9] [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: 11/03/2021] [Accepted: 10/02/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Forward head posture (FHP) is common in patients with temporomandibular joint disorders (TMDs); however, whether it contributes to TMD symptoms remains unclear. The aim of this study was to investigate the association between (1) FHP and masticatory muscle pressure pain thresholds (PPTs) and (2) neck muscle and masticatory muscle PPTs. MATERIALS AND METHODS A total of 145 patients diagnosed with TMD were recruited between December 2020 and April 2021. Data regarding FHP and neck and masticatory muscle PPTs were collected. FHP was characterized by the craniocervical angle (CVA) measured between the horizontal line through C7 and the line between the tragus of the ear and C7. Patients were divided into either the FHP group (CVA ≤ 51°) or the non-FHP group. Differences in the masseter and temporalis muscle PPTs between the two groups were analyzed using the Mann-Whitney U test. The correlation between the CVA, neck, and masticatory muscle PPTs in all patients was determined by Spearman's correlation analysis. RESULTS There were 70 patients in the FHP group and 75 patients in the non-FHP group. No significant difference in masseter and temporalis muscle PPTs was found between the two groups (p > 0.05). No correlation was found between FHP and masticatory muscle PPTs (p > 0.05). A significant association was found between the neck muscle and masticatory muscle PPTs (p < 0.05). The C5-C6 pillar and masticatory PPTs were either moderately (r = 0.435, masseter muscle) or strongly (r = 0.608, temporalis muscle) correlated, while the correlation between the trapezius and masticatory muscles was moderate (r = 0.378, masseter muscle and r = 0.461, temporalis muscle). CONCLUSION FHP was not directly associated with masticatory muscle PPTs. Masticatory muscle PPTs were strongly or moderately associated with neck muscle PPTs. Therefore, the presence of neck pain, not the degree of FHP, in patients with TMD is of significance. CLINICAL RELEVANCE In TMD treatment, we should pay attention to and actively relieve neck pain.
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Pinloche L, Souvignet S, Germain M, Monteil K, Hautier C. The short-term effect of a myofascial protocol versus light touch applied to the cervical spine towards the prevention of balance disorders in the elderly: protocol of a randomised controlled trial. Chiropr Man Therap 2022; 30:33. [PMID: 36045446 PMCID: PMC9429471 DOI: 10.1186/s12998-022-00446-0] [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: 04/13/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background Falling is a major trauma that can occur with aging, leading to very significant psychological and physical health effects with financial and societal consequences. It is therefore essential to explore therapeutic treatments that can reduce this risk. Some recognized effective treatments exist, concerning in particular the re-education of the muscles of the lower limbs. However, to our knowledge, none of them focus on the cervical spine although the latter is located at an essential physiological crossroads. Manual therapy, which has already demonstrated its impact on pain and balance parameters in the elderly, could be a painless and non-invasive tool of choice in addressing this problem. Methods Interventional study (not related to a health product), monocentric, prospective, controlled, randomized double-blind (patient and evaluator performing the measurements). The experiment will take place over three measurement periods on D0, D7 and D21. On D0 subjects will be randomized in 2 groups: experimental and placebo group. Both groups will be assessed on: Short Physical Performance Battery test score, walking speed, lower limb strength, balance, heart rate variability and cervical spine strength and mobility. Then the experimental group will receive a myofascial release protocol applied to the cervical spine and the placebo group will receive a placebo light touch protocol. The intervention will be followed by the same measurements as before. This schedule will be reproduced on D7. On D21, only one assessment will be done. Discussion This study started in 2020 but could not go beyond the inclusion phase due to the COVID pandemic. It is envisaged that recruitment could resume during 2022. Trial registration: Registered by the Comité de Protection des Personnes—Sud Méditerranée; under the title “Prévention des troubles de l’équilibre chez le senior: influence de la thérapie manuelle appliquée au rachis sur les paramètres statiques et dynamiques», n° 19.12.27.47.259 in date of February 4, 2020. Registered by ClinicalTrials.gov ID: NCT05475652; under the title « The Influence of Manual Therapy Applied to the Cervical Spine in the Prevention of Balance Disorders in the Elderly (ManEq)”.
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Ramadan SM, El Gharieb HA, Labib AM, Embaby EA. Short-term effects of instrument-assisted soft tissue mobilization compared to algometry pressure release in tension-type headache: a randomized placebo-controlled trial. J Man Manip Ther 2022:1-10. [PMID: 35674120 DOI: 10.1080/10669817.2022.2082637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
PURPOSES To compare the effectiveness of instrument-assisted soft tissue mobilization (IASTM) and pressure algometry with sham ultrasound (control group) on the clinical measures of headache, pressure pain threshold (PPT) of upper trapezius and suboccipital muscles and cervical alignment in patients with tension type headache (TTH). METHODS Seventy-two patients with TTH of both genders were randomly allocated to 3 experimental groups: a) the IASTM group (n=24), b) pressure algometry group (n=24), and c) sham ultrasound control group (n=24). Headache frequency and disability, pressure pain threshold of upper trapezius and suboccipital muscles, cervical lordosis angle (CA) and anterior head translation (AHT) were measured four weeks before and after intervention. Moreover, headache frequency was followed up for two more weeks after intervention. RESULTS Statistically significant improvements (P <0.05; effect size ranges 1.1-1.9) were observed in all outcome measures following IASTM compared to the other two intervention methods. In the IASTM group, the headache frequency decreased from 15 to 2 days/month. Also, headache disability decreased from 19 to 10. Further, CA increased from 17.5° to 31.4° and AHT decreased from 24.1 to 15.5 mm. The pressure algometry group showed significantly lower headache frequency at the follow-up (P < 0.01) than the sham ultrasound control group. However, Similar findings in the other evaluated outcomes were found between the pressure algometry and sham ultrasound control groups (P ˃ 0.05). CONCLUSION The results of the present study indicate the effectiveness of IASTM in improving headache symptoms and cervical alignment in patients with TTH.
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The effectiveness of a multimodal approach in the treatment of patients with upper crossed syndrome: A randomized controlled trial. J Bodyw Mov Ther 2022; 32:130-136. [DOI: 10.1016/j.jbmt.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 05/03/2022] [Accepted: 05/15/2022] [Indexed: 11/17/2022]
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Effects of Occlusal Splints on Spinal Posture in Patients with Temporomandibular Disorders: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10040739. [PMID: 35455916 PMCID: PMC9027546 DOI: 10.3390/healthcare10040739] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/05/2022] [Accepted: 04/12/2022] [Indexed: 12/15/2022] Open
Abstract
There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web of Science, and Scopus were systematically searched from inception until 5 January 2022 to identify observational studies with a longitudinal study design presenting: patients with diagnosis of TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); occlusal splint therapy as intervention; postural assessment as outcome. Out of 133 records identified, 104 were suitable for data screening, and only 7 articles were included satisfying the eligibility criteria. We found that occlusal splints might have a positive effect on posture in TMD patients, albeit there is little evidence of appropriate investigation for postural assessment. This systematic review suggested that the occlusal splint might be considered a non-invasive therapeutic approach for patients with TMD. However, the low number of studies with high-quality methodology in these patients showed an urgent need for further research using combined force platform stabilometry and kinematic evaluation of the spine to investigate the impact of occlusal splints on posture.
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Therapeutic routine with respiratory exercises improves posture, muscle activity, and respiratory pattern of patients with neck pain: a randomized controlled trial. Sci Rep 2022; 12:4149. [PMID: 35264713 PMCID: PMC8907211 DOI: 10.1038/s41598-022-08128-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/02/2022] [Indexed: 11/08/2022] Open
Abstract
Neck pain and forward head posture (FHP) are typical in prolonged smartphone users and need to be targeted for treatment. We aimed to compare the effect of a routine therapeutic program with and without respiratory exercises on smartphone users with FHP and non-specific chronic neck pain (NSCNP). Sixty patients (aged 24.7 ± 2.1 years) with FHP and NSCNP were randomly assigned to the routine therapeutic program (n = 20), combined respiratory exercises with a routine therapeutic program (n = 20), or control (n = 20) groups. At baseline, there was no difference among groups at all variables. Each programme was implemented three times a week for eight weeks. Primary Outcome was pain measured by visual analogue scale (VAS), and secondary ones were forward head angle, the activity of specific muscles, and respiratory patterns, measured by photogrammetry, electromyography and manual, respectively. All outcomes were measured at baseline and eight weeks post-treatment. We used the repeated measures analysis of variance to examine the interaction between time and group, paired t-test for intragroup comparison, one-way analysis of variance for intergroup comparison, and Tukey post hoc test at a significant level 95% was used. There were significant differences in the combined group compared with the routine therapeutic group (P = 0.03) for diaphragm muscle activation, respiratory balance (P = 0.01), and the number of breaths (P = 0.02). There were significant within-group changes from baseline to post-treatment in the combined group for all outcomes above, but no changes in the therapeutic exercise routine group. Despite respiratory pattern, none of the secondary outcomes proved to be superior in the combination group compared to the routine therapeutic program in smartphone users with FHP and NSCNP. Future studies with longer follow-up assessments could strengthen these results. Trial registration: Current Controlled Trials using the IRCT website with ID number of, IRCT20200212046469N1 “Prospectively registered” at 04/03/2020.
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Lin G, Wang W, Wilkinson T. Changes in deep neck muscle length from the neutral to forward head posture. A cadaveric study using Thiel cadavers. Clin Anat 2022; 35:332-339. [PMID: 35038194 PMCID: PMC9304288 DOI: 10.1002/ca.23834] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/30/2021] [Accepted: 01/07/2022] [Indexed: 11/11/2022]
Abstract
Forward head posture (FHP) is one of the most common postural deviations. Deep neck muscle imbalance of individuals with FHP is of primary concern in clinical rehabilitation. However, there is scarce quantitative research on changes in deep neck muscle length with the head moving forward. This study aimed to investigate changes in deep neck muscle length with different severity levels of FHP. Six Thiel‐embalmed cadavers (four males and two females) were dissected, and 16 deep neck muscles in each cadaver were modeled by a MicroScribe 3D Digitizer in the neutral head posture, slight FHP, and severe FHP. The craniovertebral angle was used to evaluate the degrees of FHP. Quantitative length change of the deep neck muscles was analyzed using Rhinoceros 3D. In slight FHP significant changes in length occurred in four muscles: two shortened (upper semispinalis capitis, rectus capitis posterior minor) and two lengthened (longus capitis, splenius cervicis). In severe FHP all occipital extensors were significantly shortened (10.6 ± 6.4%), except for obliquus capitis superior, and all cervical extensors were significantly lengthened (4.8 ± 3.4%), while longus capitis (occipital flexor) and the superior oblique part of the longus colli (cervical flexor) were lengthened by 8.8 ± 3.8% and 4.2 ± 3.1%, respectively. No significant length change was observed for the axial rotator. This study presents an alternate anatomical insight into the clinical rehabilitation of FHP. Six muscles appear to be important in restoring optimal head posture, with improvements in FHP being related to interventions associated with the occipital and cervical extensors.
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Affiliation(s)
- Guohao Lin
- Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Weijie Wang
- Department of Orthopaedic and Trauma Surgery, School of Medicine, University of Dundee, Dundee, UK
| | - Tracey Wilkinson
- Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Dundee, UK
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Aggarwal A, Nair A, Palekar T, Bhamare D. Effect of suboccipital release technique in forward head posture: A comparative study. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_665_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tapanya W, Puntumetakul R, Swangnetr Neubert M, Boucaut R. Influence of neck flexion angle on gravitational moment and neck muscle activity when using a smartphone while standing. ERGONOMICS 2021; 64:900-911. [PMID: 33428546 DOI: 10.1080/00140139.2021.1873423] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
This study compares the effects of different neck flexion angles on neck gravitational moment and muscle activity of users that stand and operate a smartphone. Thirty-two healthy young adult smartphone users performed texting tasks for three minutes at four different neck flexion angles (0°, 15°, 30°, and 45°) while standing. Neck gravitational moment and cervical erector spinae (CES) and upper trapezius (UT) activity were investigated. When the neck flexion angle increased, the gravitational moment of the neck increased significantly. The muscle activity of CES significantly increased when the neck flexion angle increased, whereas that of UT decreased. The lowest gravitational moment of the neck at 0° flexion was consistent with the lowest CES muscle activity and the lowest neck discomfort score. In conclusion, for texting while standing, adults should maintain their neck posture at 0° flexion to reduce the gravitational force acting on the cervical spine and alleviate neck discomfort. Practitioner Summary: During smartphone use when standing, excessive neck flexion (30° and 45° flexion) should be avoided. The suggested neck posture when operating a smartphone while standing is 0° flexion. Abbreviations: CES: cervical erector spinae; UT: upper trapezius; COG: centre of gravity; MSDs: musculoskeletal disorders; CROM: cervical range of motion; sEMG: surface electromyography; VAS: visual analogue scale; MVCs: maximum voluntary contractions.
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Affiliation(s)
- Weerasak Tapanya
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Rungthip Puntumetakul
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Manida Swangnetr Neubert
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Department of Production Technology, Faculty of Technology, Khon Kaen University, Khon Kaen, Thailand
| | - Rose Boucaut
- University of South Australia: Allied Health and Human Performance, iCAHE (International Centre for Allied Health Evidence), Adelaide, Australia
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Kim SY, An CM, Cha YS, Kim DH. Effects of sling-based manual therapy on cervicothoracic junction in patients with neck pain and forward head posture: A randomized clinical trial. J Bodyw Mov Ther 2021; 27:447-454. [PMID: 34391270 DOI: 10.1016/j.jbmt.2021.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/17/2021] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effect of 4 weeks of sling-based manual therapy on the cervicothoracic junction (CTJ) area in patients with neck pain and forward head posture. DESIGN Single-blind randomized controlled trial. SETTING Outpatient, Chonbuk National University hospital, Republic of Korea. SUBJECTS A total of 22 participants with neck pain (Numeric Pain Rating Scale >3) and forward head posture (craniovertebral angle <51) were randomly assigned to a CTJ group or a control group (n = 11 each). INTERVENTION In the control group, joint mobilization and motor control training was applied for the upper cervical spine (C0-C1). The CTJ group applied the same intervention to the upper cervical spine and cervicothoracic junction (C7-T3). MAIN MEASURES Numeric pain rating scale and neck disability index, craniovertebral angle, active range of motion, and muscle activity were evaluated before and after 4 weeks of intervention. RESULT The CTJ group participants showed significant improvement in the craniovertebral angle and cervical extension range after the intervention than the control group (P = 0.025, P = 0.001). While both groups presented significant differences after the intervention regarding Numeric pain rating scale, neck disability index, and muscle activity (sternocleidomastoid and anterior scalene muscle), there were no statistically significant differences between the groups (P > 0.05). CONCLUSION Our results suggest that the CTJ and the upper cervical region in patients with neck pain and forward head posture represent an area which if approached by manual therapy, improves cervical mobility and posture.
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Affiliation(s)
- Suhn-Yeop Kim
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea.
| | - Chang-Man An
- Department of Physical Therapy, Chonbuk National University Hospital, Republic of Korea.
| | - Yoon-Sang Cha
- Department of Physical Therapy, Chonbuk National University Hospital, Republic of Korea.
| | - Dae-Hyun Kim
- Department of Physical Therapy, Chonbuk National University Hospital, Republic of Korea.
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Mylonas K, Angelopoulos P, Billis E, Tsepis E, Fousekis K. Combining targeted instrument-assisted soft tissue mobilization applications and neuromuscular exercises can correct forward head posture and improve the functionality of patients with mechanical neck pain: a randomized control study. BMC Musculoskelet Disord 2021; 22:212. [PMID: 33612123 PMCID: PMC7898422 DOI: 10.1186/s12891-021-04080-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 02/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background The purpose of this study was to evaluate the short- and intermediate-term effects of the combined application of instrument-assisted soft tissue mobilization (IASTM) techniques and neuromuscular exercises of the cervical and thoracic area on the improvement of the functionality of patients with mechanical neck pain and accompanying forward head posture (FHP). Methods Twenty patients with neck pain and FHP were randomized and received eight treatment sessions of either targeted IASTM in combination with neuromuscular exercises (Group A) or a classical massage and the same set of exercises (Group B). The cervical vertebral angle (CVA), cervical range of motion (ROM) and strength, pain (visual analogue scale-VAS), and neck disability index (NDI) were measured throughout the treatment period and in the two- and four-week post-treatment periods. Results The combined application of IASTM and neuromuscular exercises contributed to a significantly greater improvement in CVA (Group A: + 7,2 deg vs Group B: + 1,1 deg) and NDI (Group A:-25,2 vs Group B:-5,8) than massage and the application of the same exercises. Both interventions improved cervical ROM and strength in the short term. Pain was also significantly improved in both groups in both the short (Group A VAS: − 5,97 vs Group B VAS: − 3,1) and intermediate term (Group A VAS:-5,5 vs Group B:-1,5). Conclusions Combining IASTM and exercises for the cervical and thoracic area can induce positive postural adaptations and improve the functional status of neck pain patients. Trial registration ISRCTN, ISRCTN54231174. Registered 19 March 2020 - Retrospectively registered.
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Affiliation(s)
- Konstantinos Mylonas
- Human Evaluation and Rehabilitation Laboratory, Physical Therapy Department, School of Health Rehabilitation Sciences, University of Patras, Psaron 6, 25100, Egio, Greece
| | - Pavlos Angelopoulos
- Human Evaluation and Rehabilitation Laboratory, Physical Therapy Department, School of Health Rehabilitation Sciences, University of Patras, Psaron 6, 25100, Egio, Greece
| | - Evdokia Billis
- Human Evaluation and Rehabilitation Laboratory, Physical Therapy Department, School of Health Rehabilitation Sciences, University of Patras, Psaron 6, 25100, Egio, Greece
| | - Elias Tsepis
- Human Evaluation and Rehabilitation Laboratory, Physical Therapy Department, School of Health Rehabilitation Sciences, University of Patras, Psaron 6, 25100, Egio, Greece
| | - Konstantinos Fousekis
- Human Evaluation and Rehabilitation Laboratory, Physical Therapy Department, School of Health Rehabilitation Sciences, University of Patras, Psaron 6, 25100, Egio, Greece.
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Effects of Neuromuscular Electrical Stimulation (NMES) Plus Upper Cervical Spine Mobilization on Forward Head Posture and Swallowing Function in Stroke Patients with Dysphagia. Brain Sci 2020; 10:brainsci10080478. [PMID: 32722243 PMCID: PMC7464773 DOI: 10.3390/brainsci10080478] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/15/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022] Open
Abstract
After a stroke, forward head posture occurs, resulting in swallowing dysfunction. Neuromuscular electrical stimulation (NMES) combined with upper cervical spine mobilization has demonstrated enhanced recovery of the swallowing function in stroke patients. This study investigated the therapeutic effects of NMES in conjunction with upper cervical mobilization in stroke patients with dysphagia. Thirty-four stroke patients were recruited (in a randomized controlled clinical trial) and divided into an experimental group (n = 17; NMES plus upper cervical spine mobilization) and a control group (n = 17; NMES plus sham mobilization). Forward head posture was measured by craniocervical flexion test (CCFT) and craniovertebral angle (CVA). Swallowing function was measured by variations in video fluoroscopic dysphagia scale (VDS) and penetration–aspiration scale (PAS) scores using the video fluoroscopic swallowing study (VFSS). All measurements were done at baseline and after four weeks of NMES plus mobilization. A significant increase was observed in CCFT, CVA, VDS (total VDS score, oral stage score, pharyngeal stage score), and PAS score in all variations in the experimental group. The CCFT, CVA, pharyngeal stage score, total VDS, and PAS score were significantly higher in the experimental group when compared to the control group. NMES plus upper cervical spine mobilization can be regarded as a promising method to improve swallowing function and forward head posture changes in stroke patients with dysphagia.
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18
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Is cervical region tightness related to vagal function and stomach symptoms? Med Hypotheses 2020; 142:109819. [PMID: 32408072 DOI: 10.1016/j.mehy.2020.109819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/19/2020] [Accepted: 05/05/2020] [Indexed: 11/21/2022]
Abstract
The vagal nerve is a cranial nerve that carries mainly parasympathetic fibers (average 75%) with both sensory and motor functions. The vagal nerve contains a complex neuro-endocrine-immune network. The majority, at least 66%, of the gastric myenteric neurons receive direct cholinergic excitatory stimulation from the pre-enteric vagal nerve. Changes in vagal function may cause stomach problems, although the mechanisms that change the vagal function have not yet been fully illuminated. Considering the course of the vagal nerve in the cervical region, it is thought that conditions such as stiffness, tightness and decreased elasticity in this region may compress the vagal nerve andmay affect vagal function. According to this hypothesis, neuroinflammation and hyperalgesia may occur in the vagal nerve under mechanical pressure, resulting in increased complaints of pain and burning in the stomach increases. However, as the vagal nerve has various effects on the motility of the stomach and vagal dysfunction affects the motor function of the stomach, relaxation techniques applied to the soft tissues of the cervical region will provide mechanical relief in the nerve. Thus, the vagal nerve will be decompressed and be able to function optimally. According to our clinical observations, in patients whose soft tissues in the cervical region are relaxed, gastric symptoms are decreased. Based on research results and clinical experience, cervical region tightness can be considered to cause stomach problems through the vagal nerve, and soft tissue relaxation of the cervical region can be a promising treatment method for stomach symptoms.
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Martinez-Merinero P, Nuñez-Nagy S, Achalandabaso-Ochoa A, Fernandez-Matias R, Pecos-Martin D, Gallego-Izquierdo T. Relationship between Forward Head Posture and Tissue Mechanosensitivity: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9030634. [PMID: 32120895 PMCID: PMC7141123 DOI: 10.3390/jcm9030634] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 01/19/2023] Open
Abstract
The relationship between forward head posture (FHP) and neck pain is not clear. FHP could possibly increase the mechanosensitivity of cervical tissues, which could lead to the development of pain depending on the adaptation capability of the central nervous system. The purpose of this study was to analyse the influence of FHP in the mechanosensitivity of articular, muscular, and neural tissues related to the cervical spine. The pressure pain threshold was bilaterally measured in different muscles and nerves and the second cervical vertebrae. The cervical spine’s range of movement was also examined. The measurements were obtained from people with (n = 32) and without (n = 64) FHP. The analyses included a 2-by-2 mixed analysis of variance (ANOVA), pairwise comparisons with Bonferroni correction, and point-biserial correlation coefficients. Subjects with FHP showed a less pressure pain threshold (PPT) in all locations except for the upper trapezius and scalenus medius muscles. They also showed less extension and right-rotation range of motion. There was no association between FHP, neck pain, disability, and headache. Nevertheless, more research is needed to evaluate the relationship between FHP, tissue mechanosensitivity, and neck pain.
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Affiliation(s)
- Patricia Martinez-Merinero
- Department of Physiotherapy, Faculty of Biomedical and Health Sciencies, Universidad Europea de Madrid, 28670 Madrid, Spain
- Research Institute of Physiotherapy and Pain, University of Alcalá, 28805 Madrid, Spain
| | - Susana Nuñez-Nagy
- Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain
| | | | | | - Daniel Pecos-Martin
- Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain
- Physiotherapy and Pain Group, University of Alcalá, 28871 Madrid, Spain
- Correspondence:
| | - Tomas Gallego-Izquierdo
- Research Institute of Physiotherapy and Pain, University of Alcalá, 28805 Madrid, Spain
- Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain
- Physiotherapy and Pain Group, University of Alcalá, 28871 Madrid, Spain
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Arshadi R, Ghasemi GA, Samadi H. Effects of an 8-week selective corrective exercises program on electromyography activity of scapular and neck muscles in persons with upper crossed syndrome: Randomized controlled trial. Phys Ther Sport 2019; 37:113-119. [DOI: 10.1016/j.ptsp.2019.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/15/2019] [Accepted: 03/16/2019] [Indexed: 12/21/2022]
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Suvarnnato T, Puntumetakul R, Uthaikhup S, Boucaut R. Effect of specific deep cervical muscle exercises on functional disability, pain intensity, craniovertebral angle, and neck-muscle strength in chronic mechanical neck pain: a randomized controlled trial. J Pain Res 2019; 12:915-925. [PMID: 30881101 PMCID: PMC6411318 DOI: 10.2147/jpr.s190125] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background Exercise is known to be an important component of treatment programs for individuals with neck pain. The study aimed to compare the effects of semispinalis cervicis (extensor) training, deep cervical flexor (flexor) training, and usual care (control) on functional disability, pain intensity, craniovertebral (CV) angle, and neck-muscle strength in chronic mechanical neck pain. Methods A total of 54 individuals with chronic mechanical neck pain were randomly allocated to three groups: extensor training, flexor training, or control. A Thai version of the Neck Disability Index, numeric pain scale (NPS), CV angle, and neck-muscle strength were measured at baseline, immediately after 6 weeks of training, and at 1- and 3 -month follow-up. Results Neck Disability Index scores improved significantly more in the exercise groups than in the control group after 6 weeks training and at 1- and 3-month follow-up in both the exten-sor (P=0.001) and flexor groups (P=0.003, P=0.001, P=0.004, respectively). NPS scores also improved significantly more in the exercise groups than in the control group after 6 weeks’ training in both the extensor (P<0.0001) and flexor groups (P=0.029. In both exercise groups, the CV angle improved significantly compared with the control group at 6 weeks and 3 months (extensor group, P=0.008 and P=0.01, respectively; flexor group, P=0.002 and 0.009, respectively). At 1 month, the CV angle had improved significantly in the flexor group (P=0.006). Muscle strength in both exercise groups had improved significantly more than in the control group at 6 weeks and 1- and 3-month follow-up (extensor group, P=0.04, P=0.02, P=0.002, respectively; flexor group, P=0.002, P=0.001, and 0.001, respectively). The semispinalis group gained extensor strength and the deep cervical flexor group gained flexor strength. Conclusion The results suggest that 6 weeks of training in both exercise groups can improve neck disability, pain intensity, CV angle, and neck-muscle strength in chronic mechanical neck pain. Trial registration NCT02656030
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Affiliation(s)
- Thavatchai Suvarnnato
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand,
| | - Rungthip Puntumetakul
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand,
| | - Sureeporn Uthaikhup
- School of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Rose Boucaut
- School of Health Sciences (Physiotherapy), University of South Australia, Adelaide, SA, Australia
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Kim DH, Kim SY. Comparison of immediate effects of sling-based manual therapy on specific spine levels in subjects with neck pain and forward head posture: a randomized clinical trial. Disabil Rehabil 2019; 42:2735-2742. [DOI: 10.1080/09638288.2019.1571638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Dae-Hyun Kim
- Department of Physical Therapy, Chonbuk National University Hospital, Republic of Korea
- Department of Physical Therapy, The Graduate School, Daejeon University, Republic of Korea
| | - Suhn-Yeop Kim
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Republic of Korea
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Otsudo T, Akasaka K, Hattori H, Hasebe Y, Tamura A, Hall T. Three-Dimensional Motion Analysis of the 2nd Cervical Spinous Process at End Range Cervical Rotation in Different Scapular Positions Using 3D Digitizer. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9835846. [PMID: 30225266 PMCID: PMC6129316 DOI: 10.1155/2018/9835846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 07/12/2018] [Accepted: 08/01/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The study used a 3D digitizer to determine three-dimensional motion analysis of the 2nd cervical (C2) spinous process at end range cervical rotation with the scapula in different positions. METHODS 30 healthy adults participated in this study. Different scapula positions were adopted bilaterally and positioned passively at normal resting, depression, adduction, and abduction. Under each scapula position, bilateral end range cervical rotation and displacement of the C2 spinous process were analyzed by a 3D digitizer. RESULTS Displacement of the C2 spinous process relative to the occiput was significantly correlated with range of cervical rotation under all scapular positions (p<0.05). However, there were no significant differences between end range cervical rotation and displacement of the C2 spinous process relative to the occiput in any scapular position. CONCLUSION These results suggest that measurement of upper cervical mobility using the 3D digitizer is a reliable method that holds promise in the evaluation of people with cervical spine disorders.
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Affiliation(s)
- Takahiro Otsudo
- School of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, 981 Kawakado, Moroyama City, Iruma-Gun, Saitama 350-0496, Japan
| | - Kiyokazu Akasaka
- School of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, 981 Kawakado, Moroyama City, Iruma-Gun, Saitama 350-0496, Japan
| | - Hiroshi Hattori
- Kawagoe Clinic, Saitama Medical University, 21-7 Wakitahonchyo, Kawagoe City, Saitama 350-1123, Japan
| | - Yuki Hasebe
- Department of Rehabilitation, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe City, Saitama 350-8550, Japan
| | - Akihiro Tamura
- Sekishindo Hospital, 25-19 Wakitahonchyo, Kawagoe City, Saitama 350-1123, Japan
| | - Toby Hall
- School of Physiotherapy and Exercise Science, Curtin University, Kent Street, Bentley, Perth, Western Australia 6102, Australia
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López-de-Uralde-Villanueva I, Candelas-Fernández P, de-Diego-Cano B, Mínguez-Calzada O, Del Corral T. The effectiveness of combining inspiratory muscle training with manual therapy and a therapeutic exercise program on maximum inspiratory pressure in adults with asthma: a randomized clinical trial. Clin Rehabil 2018; 32:752-765. [PMID: 29318917 DOI: 10.1177/0269215517751587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate whether the addition of manual therapy and therapeutic exercise protocol to inspiratory muscle training was more effective in improving maximum inspiratory pressure than inspiratory muscle training in isolation. DESIGN This is a single-blinded, randomized controlled trial. SUBJECTS In total, 43 patients with asthma were included in this study. INTERVENTIONS The patients were allocated into one of the two groups: (1) inspiratory muscle training ( n = 21; 20-minute session) or (2) inspiratory muscle training (20-minute session) combined with a program of manual therapy (15-minute session) and therapeutic exercise (15-minute session; n = 22). All participants received 12 sessions, two days/week, for six weeks and performed the domiciliary exercises protocol. MAIN MEASURES The main measures such as maximum inspiratory pressure, spirometric measures, forward head posture, and thoracic kyphosis were recorded at baseline and after the treatment. RESULTS For the per-protocol analysis, between-group differences at post-intervention were observed in maximum inspiratory pressure (19.77 cmH2O (11.49-28.04), P < .05; F = 22.436; P < .001; η2p = 0.371) and forward head posture (-1.25 cm (-2.32 to -0.19), P < .05; F = 5.662; P = .022; η2p = 0.13). The intention-to-treat analysis showed the same pattern of findings. CONCLUSION The inspiratory muscle training combined with a manual therapy and therapeutic exercise program is more effective than its application in isolation for producing short-term maximum inspiratory pressure and forward head posture improvements in patients with asthma.
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Affiliation(s)
- Ibai López-de-Uralde-Villanueva
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,2 Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,3 Instituto de investigación para la salud (IdiPAZ), Hospital La Paz, Madrid, Spain
| | - Pablo Candelas-Fernández
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Beatriz de-Diego-Cano
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Orcález Mínguez-Calzada
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Tamara Del Corral
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,2 Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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Adams A, Eschman J, Ge W. Acupressure for chronic low back pain: a single system study. J Phys Ther Sci 2017; 29:1416-1420. [PMID: 28878474 PMCID: PMC5574337 DOI: 10.1589/jpts.29.1416] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 05/26/2017] [Indexed: 02/01/2023] Open
Abstract
[Purpose] Low back pain (LBP) is the leading cause of global disability. Acupressure is a manual approach that can be used for self-management of LBP. The purpose of the study was to determine the effectiveness of acupressure in treating chronic LBP. [Subjects and Methods] The research design was a single system study utilizing an AB design. The subject was recruited using convenience sampling. During phase A, the subject received traditional physical therapy interventions. During phase B, the subject received acupressure in addition to traditional physical therapy interventions. Outcomes included the Visual Analog Scale (VAS), the Patient Specific Functional Scale (PSFS), and the Oswestry Disability Index (ODI). [Results] For the VAS, the pain was 38.8 mm at baseline, decreased to 11.3 mm after phase A, and decreased to 2.5 mm after phase B. For the PSFS, the subject's function was 5/10 at baseline, remained the same after phase A, and increased to 9/10 after phase B. For the ODI, the subject's disability was moderate (30%) at the baseline, decreased to minimal (14%) after phase A, and completely resolved (0%) after phase B. [Conclusion] The data indicated that integrating acupressure in physical therapy could reduce pain, increase function, and decrease disability.
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Affiliation(s)
- Angela Adams
- Department of Physical Therapy, Youngstown State University, USA
| | | | - Weiqing Ge
- Department of Physical Therapy, Youngstown State University, USA.,Eschman Physical Therapy, LLC, USA
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Yang DJ, Kang DH. Comparison of muscular fatigue and tone of neck according to craniocervical flexion exercise and suboccipital relaxation in cervicogenic headache patients. J Phys Ther Sci 2017; 29:869-873. [PMID: 28603362 PMCID: PMC5462689 DOI: 10.1589/jpts.29.869] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 02/13/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study was conducted to compare and analyze influence of craniocervical flexion and suboccipitalis relaxation in cervicogenic headache patients of their cervical muscular fatigue, tone, and headache intensity. [Subjects and Methods] 30 patients with cervicogenic headache were selected and 10 subjects per group were randomly assigned to control group, craniocervical flexion exercise group, and suboccipitalis relaxation group. Intervention for each group was provided 5 times a week for 4 weeks. Muscular tone test and muscular fatigue test were conducted on both sides of upper trapezius and sternocleidomastoideus and visual analogue sclae on the headache intensity was conducted before the intervention, after 2 weeks, and after 4 weeks. [Results] Difference from intervention was significant in muscular fatigue of upper trapezius and sternocleidomastoideus, muscular tone of sternocleidomastoideus, and headache intensity. Correlation between intervention duration and the groups showed significant difference in muscular fatigue, muscular tone, and headache intensity except left upper trapezius muscle. [Conclusion] From this study, 4 week application of crainiocervical flexion exercise and suboccipitalis relaxation on cervicogenic headache patients was found to be effective in decrease of muscular fatigue of upper trapezius and sternocleidomastoideus, muscular tone of sternocleidomastoideus, and headache intensity.
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Affiliation(s)
- Dae Jung Yang
- Department of Physical Therapy, Sehan University, Republic of Korea
| | - Da Haeng Kang
- Department of Physical Therapy, Dongshin University, Republic of Korea
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