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Bohlen L, Schwarze J, Richter J, Gietl B, Lazarov C, Kopyakova A, Brandl A, Schmidt T. Effect of osteopathic techniques on human resting muscle tone in healthy subjects using myotonometry: a factorial randomized trial. Sci Rep 2022; 12:16953. [PMID: 36217012 PMCID: PMC9551048 DOI: 10.1038/s41598-022-20452-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/13/2022] [Indexed: 12/29/2022] Open
Abstract
Musculoskeletal disorders (MSDs) are highly prevalent, burdensome, and putatively associated with an altered human resting muscle tone (HRMT). Osteopathic manipulative treatment (OMT) is commonly and effectively applied to treat MSDs and reputedly influences the HRMT. Arguably, OMT may modulate alterations in HRMT underlying MSDs. However, there is sparse evidence even for the effect of OMT on HRMT in healthy subjects. A 3 × 3 factorial randomised trial was performed to investigate the effect of myofascial release (MRT), muscle energy (MET), and soft tissue techniques (STT) on the HRMT of the corrugator supercilii (CS), superficial masseter (SM), and upper trapezius muscles (UT) in healthy subjects in Hamburg, Germany. Participants were randomised into three groups (1:1:1 allocation ratio) receiving treatment, according to different muscle-technique pairings, over the course of three sessions with one-week washout periods. We assessed the effect of osteopathic techniques on muscle tone (F), biomechanical (S, D), and viscoelastic properties (R, C) from baseline to follow-up (primary objective) and tested if specific muscle-technique pairs modulate the effect pre- to post-intervention (secondary objective) using the MyotonPRO (at rest). Ancillary, we investigate if these putative effects may differ between the sexes. Data were analysed using descriptive (mean, standard deviation, and quantiles) and inductive statistics (Bayesian ANOVA). 59 healthy participants were randomised into three groups and two subjects dropped out from one group (n = 20; n = 20; n = 19-2). The CS produced frequent measurement errors and was excluded from analysis. OMT significantly changed F (-0.163 [0.060]; p = 0.008), S (-3.060 [1.563]; p = 0.048), R (0.594 [0.141]; p < 0.001), and C (0.038 [0.017]; p = 0.028) but not D (0.011 [0.017]; p = 0.527). The effect was not significantly modulated by muscle-technique pairings (p > 0.05). Subgroup analysis revealed a significant sex-specific difference for F from baseline to follow-up. No adverse events were reported. OMT modified the HRMT in healthy subjects which may inform future research on MSDs. In detail, MRT, MET, and STT reduced the muscle tone (F), decreased biomechanical (S not D), and increased viscoelastic properties (R and C) of the SM and UT (CS was not measurable). However, the effect on HRMT was not modulated by muscle-technique interaction and showed sex-specific differences only for F.Trial registration German Clinical Trial Register (DRKS00020393).
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Affiliation(s)
- Lucas Bohlen
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany.
| | - Jonah Schwarze
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany
| | - Jannik Richter
- Osteopathie Schule Deutschland, Hamburg, Germany
- Dresden International University, Dresden, Germany
| | - Bernadette Gietl
- Osteopathie Schule Deutschland, Hamburg, Germany
- Dresden International University, Dresden, Germany
| | - Christian Lazarov
- Osteopathie Schule Deutschland, Hamburg, Germany
- Dresden International University, Dresden, Germany
| | - Anna Kopyakova
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Andreas Brandl
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany
| | - Tobias Schmidt
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Albuquerque PMNM, Da Silva EPC, Melo TMDS, Montenegro EJN, de Oliveira DA, Guerino MR, De Siqueira GR. Inter-rater Accuracy and Reliability of a Palpation Protocol of the C7 Spinous Process Comprising a Combination of 3 Traditional Palpation Techniques. J Manipulative Physiol Ther 2022; 45:227-234. [PMID: 35879125 DOI: 10.1016/j.jmpt.2022.06.001] [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: 10/01/2019] [Revised: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the accuracy and intrarater reliability of a palpatory protocol based on a combination of 3 palpatory methods to identify both the C7 spinous process (C7 SP) and the factors that affect the errors and inaccuracy of palpation. METHODS Twenty-five women between the ages of 18 and 60 years were submitted to a palpation protocol of the C7 SP, and a radiopaque marker was fixed on the skin at the possible location of the vertebrae. A radiograph and a photograph of the cervical spine were obtained in the same posture by a first rater. A second rater performed the same palpation protocol and took a second photograph. The accuracy and measurement error of the palpation protocol of C7 SP were assessed through radiographic images. The inter-rater reliability was estimated by the interclass correlation coefficient and assessed using photographs of each rater. The Pearson's correlation coefficients (r), the Fisher exact test, and the χ2 test were used to identify the factors associated with the error and inaccuracy of palpation. RESULTS Accuracy of the C7 palpation was 76% with excellent reliability (interclass correlation coefficient = 0.99). There was a moderate correlation between weight and the measurement of palpation error (r = -0.6; P = .003). One hundred percent of inaccuracy palpation was related to the increased soft-tissue thickness (P = .005) in the cervical region. CONCLUSION The palpation protocol described in this study was accurate and presented excellent reliability in identifying the C7 SP. Increased weight and dorsocervical fat pad were associated to error and palpation inaccuracy, respectively.
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Affiliation(s)
| | | | - Thania M de S Melo
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Eduardo J N Montenegro
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Daniella A de Oliveira
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Marcelo R Guerino
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Gisela R De Siqueira
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
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Ferreira APA, Zanier JFC, Santos EBG, Ferreira AS. Accuracy of Palpation Procedures for Locating the C1 Transverse Process and Masseter Muscle as Confirmed by Computed Tomography Images. J Manipulative Physiol Ther 2022; 45:337-345. [PMID: 36175313 DOI: 10.1016/j.jmpt.2022.07.005] [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: 01/07/2020] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the accuracy of palpation methods for locating the transverse processes of the first cervical vertebra and masseter muscle using radiographic images as the gold-standard method and the association between personal characteristics with the observed accuracy. METHODS This was a single-blinded, diagnostic accuracy study. Ninety-five participants (49 women, 58 ± 16 years of age) were enrolled in this study. A single examiner palpated the neck and face region of all participants to identify the transverse processes of the first cervical vertebra and masseter muscles bilaterally. In sequence, participants underwent a multislice computed tomography scan for assessment of the superimposed inner body structure. Two radiologists assessed the computed tomography images using the same criteria and were blinded regarding each other's assessment and the anatomic landmarks under investigation. The palpation accuracy was calculated as the proportion of the correctly identified landmarks in the studied sample. The correlation of the palpation outcome (correct = 1; incorrect = 0) with age, sex (male = 1; female = 0), and body mass index was investigated using the point-biserial correlation coefficient. RESULTS The right and left transverse processes were correctly located in 76 (80%) and 81 (85%) participants, respectively, and bilaterally in 157 events (83%), as evaluated by the consensus of the 2 radiologists. The masseter muscles were correctly localized bilaterally in 95 of 95 (100%) participants. Body mass showed statistical evidence of a weak, positive correlation with the correct location of the transverse processes of the first cervical vertebra at the right body side (r = .219; 95% confidence interval, 0.018-0.403; P = .033). CONCLUSION Palpation methods used in this study accurately identified the location of the first cervical vertebra spinous processes and the masseter muscles.
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Affiliation(s)
- Ana Paula A Ferreira
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro, Brazil; Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy; Visiting Fellow, ARCCIM, University of Technology Sydney, Sydney, Australia; Instituto Brasileiro de Osteopatia, Rio de Janeiro, Brazil.
| | - José Fernando C Zanier
- University Hospital Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eduardo Brown G Santos
- University Hospital Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Arthur S Ferreira
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro, Brazil.
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Alexander N, Rastelli A, Webb T, Rajendran D. The validity of lumbo-pelvic landmark palpation by manual practitioners: A systematic review. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2020.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Maddaluno MLM, Ferreira APA, Tavares ACLC, Meziat-Filho N, Ferreira AS. Craniocervical Posture Assessed With Photogrammetry and the Accuracy of Palpation Methods for Locating the Seventh Cervical Spinous Process: A Cross-sectional Study. J Manipulative Physiol Ther 2021; 44:196-204. [PMID: 33461748 DOI: 10.1016/j.jmpt.2020.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/17/2019] [Accepted: 07/26/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this study was to compare craniocervical posture assessed by photogrammetry using 2 distinct palpation methods for locating the spinous process of the seventh cervical vertebra (C7SP). METHODS This cross-sectional study was conducted in 2 phases. In phase I (n = 42), the assessor's accuracy in locating the C7SP using the flexion-extension and the modified thorax-rib static methods was compared to radiography. In phase II (n = 68), the craniocervical posture was analyzed with photogrammetry after palpation using the 2 methods. Neck pain intensity and disability were also determined. RESULTS The accuracy in locating the C7SP was higher using the modified thorax-rib static method (67%, 95% confidence interval [CI], 55-79) compared to the flexion-extension method (38%, 95% CI, 26-50, P = .016). Lower values of the craniocervical angle were obtained with the flexion-extension method than the modified thorax-rib static method (mean difference = -1.1°, 95% CI, -1.6 to -0.6, P < .001). However, both palpation methods resulted in similar classifications of participants as with or without forward head posture (P = .096). Weak correlations were observed between the craniocervical angle and neck pain intensity (ρ = -0.088 and -0.099, respectively) and disability (ρ = -0.231 and -0.249, respectively). CONCLUSION Craniocervical angles obtained using palpation methods with different accuracies were different, although the magnitude of the difference was insufficient to lead to different classifications of a forward head posture in adults with mild neck pain and disability. Craniocervical posture was weakly correlated with neck-pain intensity and disability.
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Affiliation(s)
- Maria Letizia M Maddaluno
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brazil
| | - Ana Paula A Ferreira
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brazil
| | - Ana Carolina L C Tavares
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brazil
| | - Ney Meziat-Filho
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brazil
| | - Arthur S Ferreira
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brazil.
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Takatalo J, Ylinen J, Pienimäki T, Häkkinen A. Intra- and inter-rater reliability of thoracic spine mobility and posture assessments in subjects with thoracic spine pain. BMC Musculoskelet Disord 2020; 21:529. [PMID: 32778081 PMCID: PMC7418198 DOI: 10.1186/s12891-020-03551-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 07/31/2020] [Indexed: 11/17/2022] Open
Abstract
Background The thoracic spine (TS) has been neglected in the study of the spine despite its essential role in the stability and posture of the entire spinal complex. Therefore, there is an inevitable need to investigate the reproducibility of different thoracic spinal posture measures used in subjects with TS pain. Methods Thirty-two subjects (16 females and 16 males, mean age 39 years) were evaluated by two physiotherapists on the same day to gauge inter-rater reliability and on two consecutive days to gauge intra-rater reliability. TS posture was assessed by observation, and thoracic spine mobility was measured by manual assessment of segmental flexion and extension mobility in a seated position. Additionally, posterior-to-anterior accessory mobility in a prone position was assessed manually. Moreover, cervicothoracic flexion in a seated position, thoracic posture, and thoracic flexion and extension mobility in a standing position were assessed with a tape measure, and flexion and extension mobility in a seated position and TS posture in seated and standing positions were measured with an inclinometer. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), mean difference (MD), Bland-Altman (B&A) plot features and coefficient of repeatability (CR) were calculated. Results The mean and standard deviation (SD) of the duration of TS pain was 22 (SD 45) months, with the intensity of pain being rated at 27 (SD 21) mm on a visual analogue scale (VAS). Intra-rater reliability was very strong (ICC ≥ 0.80) for the evaluation of seated and standing upper TS posture, standing whole TS posture and seated lower TS posture with an inclinometer. Moreover, TS posture evaluation with a measuring tape, posture inspection in a seated position, and manual assessment of segmental extension were found to have very strong intra-rater reliability. Inter-rater reliability was very strong for inclinometer measurements of standing and seated upper TS posture as well as standing whole TS posture. Conclusion Intra-rater reliability was higher than inter-rater reliability in most of the evaluated measurements. Overall, posture measurements with an inclinometer were more reliable than mobility measurements with the same instrument. The manual assessments can be used reliably when same evaluator performs the examination. Trial registration Clinical Trials, NCT01884818. Registered 24 June 2013, https://clinicaltrials.gov/ct2/show/NCT01884818?cond=thoracic+spine&cntry=FI&rank=1
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Affiliation(s)
- Jani Takatalo
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyväskylä, Finland. .,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - Jari Ylinen
- Central Finland Central Hospital, Jyväskylä, Finland
| | - Tuomo Pienimäki
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyväskylä, Finland.,Central Finland Central Hospital, Jyväskylä, Finland
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Ernst MJ, Sommer BB, Meichtry A, Bauer CM. Intra-rater reliability of determining positions of cervical spinous processes and measuring their relative distances : An update to define rigid bodies of the cervical spine in a movement laboratory setting. BMC Res Notes 2019; 12:265. [PMID: 31088571 PMCID: PMC6515637 DOI: 10.1186/s13104-019-4299-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/03/2019] [Indexed: 11/10/2022] Open
Abstract
Objectives A reliable detection of bony landmarks of the spine is necessary in order to determine rigid bodies and to reduce the variability of marker placement in a movement laboratory setting. In a first study on the thoracic and lumbar spine, we demonstrated that placing markers on their relative positions between two major landmarks was superior to palpation of specific bony landmarks. The aims of this study were to examine the intra-rater reliability when palpating for spinous processes (SPs) of the second (C2) and seventh cervical vertebrae (C7), to determine the distances between C2 and C7 and the relative position of C7 along the length between C2 and the posterior superior iliac spine (PSIS) level. Results The intra-rater reliability in determining the distance between C2 and C7 was found to be substantial, with an intra-rater reliability of 0.75 (95% confidence limits 0.55–0.99) and a standard error of the measurement of 0.34 cm. The relative distance of C7 along the total C2–PSIS length was estimated to be 11.5%. The determination of the relative positions of spinal landmarks through measurement is considered superior to their palpation, because it relies on a reproducible and comparable definition of rigid bodies.
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Affiliation(s)
- Markus J Ernst
- Institute of Physiotherapy, Zurich University of Applied Sciences, Technikumstrasse 71, 8401, Winterthur, Switzerland.
| | - Bettina B Sommer
- Institute of Physiotherapy, Zurich University of Applied Sciences, Technikumstrasse 71, 8401, Winterthur, Switzerland
| | - André Meichtry
- Institute of Physiotherapy, Zurich University of Applied Sciences, Technikumstrasse 71, 8401, Winterthur, Switzerland
| | - Christoph M Bauer
- Institute of Physiotherapy, Zurich University of Applied Sciences, Technikumstrasse 71, 8401, Winterthur, Switzerland
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Lemeunier N, Jeoun EB, Suri M, Tuff T, Shearer H, Mior S, Wong JJ, da Silva-Oolup S, Torres P, D'Silva C, Stern P, Yu H, Millan M, Sutton D, Murnaghan K, Cȏté P. Reliability and validity of clinical tests to assess posture, pain location, and cervical spine mobility in adults with neck pain and its associated disorders: Part 4. A systematic review from the cervical assessment and diagnosis research evaluation (CADRE) collaboration. Musculoskelet Sci Pract 2018; 38:128-147. [PMID: 30455032 DOI: 10.1016/j.msksp.2018.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the reliability and validity of clinical tests to assess posture, pain location, and cervical spine mobility in adults with grades I-IV neck pain and associated disorders (NAD). METHODS We systematically searched electronic databases to update the systematic review of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Eligible reliability and validity studies were critically appraised using modified versions of the QAREL and QUADAS-2 instruments, respectively. Evidence from low risk of bias studies were synthesized following best evidence synthesis principles. RESULTS We screened 14302 articles, critically appraised 46 studies, and found 32 low risk of bias articles (14 reliability and 18 validity studies). We found preliminary evidence of: 1) reliability of visual inspection, aided with devices (CROM and digital caliper) to assess head posture; 2) reliability and validity of soft tissue palpation to locate tender/trigger points in muscles; 3) reliability and validity of joint motion palpation to assess stiffness and pain provocation in combination; and 4) range of motion tests using visual estimation (in cervical extension only) or devices (digital caliper, goniometer, inclinometer) to assess cervical mobility. CONCLUSIONS We found little evidence to support the reliability and validity of clinical tests to assess head posture, pain location and cervical mobility in adults with NAD grades I-III. More advanced validity studies are needed to inform the clinical utility of tests used to evaluate patients with NAD.
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Affiliation(s)
- N Lemeunier
- Institut Franco-Européen de Chiropraxie, 72 chemin de la Flambère, 31300, Toulouse, France; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada.
| | - E B Jeoun
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - M Suri
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - T Tuff
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - H Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - S Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - J J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - S da Silva-Oolup
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - P Torres
- Rehabilitation Centre, San Cristobal Clinic, Santiago Spine Group, Santiago, Chile
| | - C D'Silva
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, L1H 7K4, Canada
| | - P Stern
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - H Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada
| | - M Millan
- Cabinet d'expertise médicale, Castres, France
| | - D Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada
| | - K Murnaghan
- Librarian, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - P Cȏté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, L1H 7K4, Canada
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Póvoa LC, Ferreira APA, Zanier JFC, Silva JG. Accuracy of Motion Palpation Flexion-Extension Test in Identifying the Seventh Cervical Spinal Process. J Chiropr Med 2018; 17:22-29. [PMID: 29628805 DOI: 10.1016/j.jcm.2017.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 11/18/2017] [Accepted: 11/20/2017] [Indexed: 10/17/2022] Open
Abstract
Objective The aim of this study was to evaluate the accuracy of a motion palpation procedure, the flexion-extension test, in localizing the spinous process of the seventh cervical vertebra (C7). Methods We analyzed 101 adult participants with metal markers that permitted the identification of the C7 spinous process. This analysis occurred during a flexion-extension test and was confirmed by radiography. Data sample characteristics were analyzed by descriptive statistics, and the relationship between independent variables (weight, height, sex, age, and body mass index [BMI]) and dependent variables (coincidence between the most prominent vertebra and the stationary vertebra, as determined by the flexion-extension test) was determined via logistic regression. Results The sample population was 48.5% male with a mean age of 56.8 years (standard deviation, ±14.9) and a mean BMI of 25.54 kg/m2 (standard deviation, ±5.5). In 54.5% of cases, the C7 spinous process was correctly identified by the flexion-extension test. The agreement between the flexion-extension test and radiography in accuracy of localization of the C7 spinous process was significant (P = .021), as was the correct localization of C7 (P = .05). Conclusion The localization of the C7 spinous process was more accurate in individuals with a BMI <25 kg/m2 and whose most prominent vertebra coincided with the stationary vertebra as determined by the flexion-extension test.
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Affiliation(s)
- Luciana C Póvoa
- Rehabilitation Science Postgraduate Program, Human Analysis Movement Lab, Augusto Motta University Center, Rio de Janeiro, Brazil.,Brazilian Osteopathic Institute, Rio de Janeiro, Brazil.,Department of Radiology, Estado do Rio de Janeiro Universtiy, Rio de Janeiro, Brazil.,Human Analysis Movement Lab, Praça das Nações, Rio de Janeiro, Brazil
| | - Ana P A Ferreira
- Rehabilitation Science Postgraduate Program, Human Analysis Movement Lab, Augusto Motta University Center, Rio de Janeiro, Brazil.,Brazilian Osteopathic Institute, Rio de Janeiro, Brazil.,Department of Radiology, Estado do Rio de Janeiro Universtiy, Rio de Janeiro, Brazil.,Human Analysis Movement Lab, Praça das Nações, Rio de Janeiro, Brazil
| | - José F C Zanier
- Department of Radiology, Estado do Rio de Janeiro Universtiy, Rio de Janeiro, Brazil
| | - Julio G Silva
- Human Analysis Movement Lab, Praça das Nações, Rio de Janeiro, Brazil.,Department of Physical Therapy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Ferreira APA, Póvoa LC, Zanier JF, Ferreira AS. Locating the Seventh Cervical Spinous Process: Accuracy of the Thorax-Rib Static Method and the Effects of Clinical Data on Its Performance. J Manipulative Physiol Ther 2017; 40:98-105. [DOI: 10.1016/j.jmpt.2016.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 07/28/2016] [Accepted: 10/11/2016] [Indexed: 11/29/2022]
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McKenna L, Cornwall X, Williams S. Differences in Scapular Orientation Between Standing and Sitting Postures at Rest and in 120° Scaption: A Cross-Sectional Study. PM R 2016; 9:579-587. [PMID: 27721004 DOI: 10.1016/j.pmrj.2016.09.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 09/15/2016] [Accepted: 09/17/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Scapular orientation may be influenced by static body posture (sitting and standing) and contribute to the development of shoulder pain. Therefore, a consistent body posture should be considered when assessing scapular orientation as well as enhancing optimal scapular positioning. OBJECTIVE To determine whether there are differences in scapular orientation between standing, neutral sitting, and habitual sitting, while adjusting for spinal posture. DESIGN A single group randomized repeated measures study. SETTING University laboratory. PARTICIPANTS Twenty-eight participants with shoulder pain were recruited from the community. METHODS Scapular orientation between standing and seated positions was compared, with the arm by the side and at 120° of glenohumeral scaption. Thoracic kyphosis and lumbar lordosis angles were used as covariates. MAIN OUTCOME MEASUREMENTS Scapular elevation, lateral translation, upward rotation, and posterior tilt. RESULTS Scapular orientation was marginally but significantly different between sitting postures for lateral translation (mean 0.5 cm; 95% confidence interval [95% CI] 0.2-0.7 cm); P < .001), upward rotation (mean 3°; 95% CI 1.1-5.0°; P < .001), and posterior tilt (mean 2.3°; 95% CI 0.2-4.3°; P = .009) in the arm by side position. A small-but-significant difference between standing and neutral sitting was found for upward rotation (mean 1.8°; 95% CI 0-3.7°; P = .02), and between standing and habitual sitting for lateral translation (mean 0.6 cm; 95% CI 0-1.1 cm; P =.02) in the arm by side position. CONCLUSIONS The results of this study suggest that scapular orientation can be slightly affected by body posture, although the clinical relevance is uncertain. To enhance scapular upward rotation or posterior tilt, it may be preferable to place the patient in neutral sitting. LEVEL OF EVIDENCE Not applicable.
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Affiliation(s)
- Leanda McKenna
- School of Physiotherapy and Exercise Science, Curtin University of Technology, GPO Box U1987, Perth, Western Australia 6845(∗).
| | - Xavier Cornwall
- School of Physiotherapy and Exercise Science, Curtin University of Technology, Perth, Western Australia(†)
| | - Sian Williams
- School of Physiotherapy and Exercise Science, Curtin University of Technology, Perth, Western Australia(‡)
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