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Sremakaew M, Konghakote S, Uthaikhup S. A cluster analysis of cervicocephalic kinesthetic sensibility in persons with nonspecific neck pain. Physiother Theory Pract 2024; 40:1952-1960. [PMID: 37357940 DOI: 10.1080/09593985.2023.2229422] [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: 03/13/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Inter-individual variability may contribute to impaired cervicocephalic kinesthetic sensibility (CKS) in patients with nonspecific neck pain. OBJECTIVES To identify subgroups of participants with nonspecific neck pain based on cervical joint position errors (JPEs) and to determine potential factors associated with identified subgroups. METHODS One hundred participants with nonspecific neck pain (unidentified pathoanatomical cause) and 50 controls were recruited. JPEs were measured in cervical extension and rotation, using a laser pointer. JPEs were expressed as absolute (AEs), constant (CEs), and variable (VEs) errors. Clinical characteristics were pain intensity, duration, disability, side of pain, dizziness, psychological features, and range of motion. All tests were performed within 1 day. A cluster analysis was conducted based on AEs. A logistic regression was used to identify factors associated with the cluster groups. RESULTS Analysis divided neck pain participants into two groups: cluster 1 with greater impaired CKS (n = 36) and cluster 2 with lesser impaired CKS (n = 64). The AEs (all cervical movements) and CE (left rotation) were larger in cluster 1 than 2 (p ≤ .002). Overall, participants in clusters 1 and 2 had larger AEs, CEs, and VEs than controls (p ≤ .04). The presence of dizziness was a risk factor associated with cluster 1 (OR=2.5, p = .04). The other characteristics were not associated with the cluster groups (p ≥ .09). CONCLUSION The AEs identified two subgroups of patients with nonspecific neck pain. Participants in subgroup 1 had greater impaired CKS, and participants in subgroup 2 had lesser impaired CKS. Dizziness was a potential risk factor associated with greater impaired CKS.
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Affiliation(s)
- Munlika Sremakaew
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Supatcha Konghakote
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sureeporn Uthaikhup
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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Leonet-Tijero L, Corral-de-Toro J, Rodríguez-Sanz J, Hernández-Secorún M, Abenia-Benedí H, Lucha-López MO, Monti-Ballano S, Müller-Thyssen-Uriarte J, Tricás-Vidal H, Hidalgo-García C, Tricás-Moreno JM. Interexaminer Reliability and Validity of Quantity of Cervical Mobility during Online Dynamic Inspection. Diagnostics (Basel) 2022; 12:diagnostics12020546. [PMID: 35204635 PMCID: PMC8870754 DOI: 10.3390/diagnostics12020546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Physical therapists routinely measure range of motion (ROM) of cervical spine. The reliability of the cervical range of motion (CROM) device has been demonstrated in several studies, but current evidence on the validity and reliability of the visual inspection is contradictory. The aim is to assess the validity and interexaminer reliability of the online visual inspection of active cervical ROM in physiotherapy students. Methods: Flexion, extension, both lateral flexions and rotations of a single participant were measured using CROM. Online visual inspection of 18 physiotherapy students against CROM was registered. Results: The validity, against CROM, of the online visual inspection of the active ROM ranged from good to excellent (Intraclass Correlation Coefficient (ICC) 0.83–0.97). Interexaminer reliability of the online visual inspection had favorable outcomes in all cervical movements in the three physiotherapy courses (ICC 0.70–0.96), with the visual inspection of the rotations being the most reliable (ICC 0.93–0.97). Interexaminer reliability of the classification of mobility was poor to good (Kappa 0.03–0.90). Conclusions: The interexaminer reliability and validity of the quantification of active cervical movement during online visual inspection was shown to be good to excellent for flexion-extension and lateral flexions and excellent for rotations.
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Affiliation(s)
- Leire Leonet-Tijero
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
| | - Jaime Corral-de-Toro
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - Jacobo Rodríguez-Sanz
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, 08195 Barcelona, Spain;
- ACTIUM Functional Anatomy Group, 08028 Barcelona, Spain
| | - Mar Hernández-Secorún
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - Hugo Abenia-Benedí
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - María Orosia Lucha-López
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
- Correspondence: (M.O.L.-L.); (C.H.-G.); Tel.: +34-976761760 (M.O.L.-L.); +34-976764430 (C.H.-G.)
| | - Sofía Monti-Ballano
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - Julián Müller-Thyssen-Uriarte
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - Héctor Tricás-Vidal
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
| | - César Hidalgo-García
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
- Correspondence: (M.O.L.-L.); (C.H.-G.); Tel.: +34-976761760 (M.O.L.-L.); +34-976764430 (C.H.-G.)
| | - José Miguel Tricás-Moreno
- Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (L.L.-T.); (J.C.-d.-T.); (M.H.-S.); (H.A.-B.); (S.M.-B.); (J.M.-T.-U.); (J.M.T.-M.)
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain;
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Abstract
Telerehabilitation is now a mainstay in health care delivery, with recent trends pointed to continued expansion in the future. Physical therapy (PT) being provided via telehealth, also known as virtual PT, has been demonstrated to provide functional improvements and satisfaction for the consumer and provider, and is applicable in various physical therapy treatment diagnostic areas. Research and technology enhancements will continue to offer new and innovative means to provide physical therapy. This article further provides points to make virtual PT successful and highlights some recommended equipment and outcome recommendations. The future is bright for providing virtual PT.
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Affiliation(s)
- Mark A Havran
- Department of Veterans Affairs, Des Moines, IA, USA; Rehabilitation and Extended Care (117CLC) VA Central Iowa HCS, 3600 30th Street, Des Moines, IA 50310, USA.
| | - Douglas E Bidelspach
- Department of Veterans Affairs, 1700 South Lincoln Avenue, Lebanon, PA 17042, USA
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Reliability of an Integrated Inertial Sensor for the Continuous Measurement of Active Cervical Range of Motion in a Group of Younger and Elderly Individuals. J Funct Morphol Kinesiol 2020; 5:jfmk5030058. [PMID: 33467273 PMCID: PMC7739228 DOI: 10.3390/jfmk5030058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to evaluate the test-retest reliability of an integrated inertial sensor (IIS) for cervical range of motion assessment. An integrated inertial sensor was placed on the forehead center of thirty older adults (OA) and thirty younger adults (YA). Participants had to perform three continuous rotations, lateral bandings and flexion-extensions with their head. Test-retest reliability was assessed after 7 days. YA showed moderate to good agreement for rotation (0.54-0.82), lateral bending (0.74-0.8), and flexion-extension (0.74-0.81) movements and poor agreement for zero point (ZP). OA showed moderate to good agreement for rotation (0.65-0.86), good to excellent agreement in lateral bending (0.79-0.92), and poor to moderate agreement for flexion-extension (0.37-0.72). Zero point showed poor to moderate agreement. In conclusion, we can affirm that this IIS is a reliable device for cervical range of motion assessment in young and older adults; on the contrary, the ZP seems to be unreliable and the addition of an external reference point could help the subject to solve this shortcoming and reduce possible biases.
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Devaraja K. Approach to cervicogenic dizziness: a comprehensive review of its aetiopathology and management. Eur Arch Otorhinolaryngol 2018; 275:2421-2433. [PMID: 30094486 DOI: 10.1007/s00405-018-5088-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/06/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Though there is abundant literature on cervicogenic dizziness with at least half a dozen of review articles, the condition remains to be enigmatic for clinicians dealing with the dizzy patients. However, most of these studies have studied the cervicogenic dizziness in general without separating the constitute conditions. Since the aetiopathological mechanism of dizziness varies between these cervicogenic causes, one cannot rely on the universal conclusions of these studies unless the constitute conditions of cervicogenic dizziness are separated and contrasted against each other. METHODS This narrative review of recent literature revisits the pathophysiology and the management guidelines of various conditions causing the cervicogenic dizziness, with an objective to formulate a practical algorithm that could be of clinical utility. The structured discussion on each of the causes of the cervicogenic dizziness not only enhances the readers' understanding of the topic in depth but also enables further research by identifying the potential areas of interest and the missing links. RESULTS Certain peculiar features of each condition have been discussed with an emphasis on the recent experimental and clinical studies. A simple aetiopathological classification and a sensible management algorithm have been proposed by the author, to enable the identification of the most appropriate underlying cause for the cervicogenic dizziness in any given case. However, further clinical studies are required to validate this algorithm. CONCLUSIONS So far, no single clinical study, either epidemiological or interventional, has incorporated and isolated all the constitute conditions of cervicogenic dizziness. There is a need for such studies in the future to validate either the reliability of a clinical test or the efficacy of an intervention in cervicogenic dizziness.
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Affiliation(s)
- K Devaraja
- Department of Otorhinolaryngology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India.
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Mousavi-Khatir R, Talebian S, Toosizadeh N, Olyaei GR, Maroufi N. Disturbance of neck proprioception and feed-forward motor control following static neck flexion in healthy young adults. J Electromyogr Kinesiol 2018; 41:160-167. [PMID: 29935422 DOI: 10.1016/j.jelekin.2018.04.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/22/2018] [Accepted: 04/23/2018] [Indexed: 11/16/2022] Open
Abstract
The highly complex proprioceptive system provides neuromuscular control of the mobile cervical spine. Static neck flexion can induce the elongation of posterior tissues and altered afferent input from the mechanoreceptors. The purpose of this study was to examine the effect of prolonged static neck flexion on neck proprioception and anticipatory postural adjustments. Thirty-eight healthy participants (20 females and 18 males) between the ages of 20-35 years with no history of neck, low back, and shoulder pain enrolled in this study. Neck proprioception and anticipatory muscle activity were tested before and after 10-min static neck flexion. For assessment of neck proprioception, each participant was asked to perform 10 trials of the cervicocephalic relocation test to the neutral head position after active neck rotation to the left and right sides. Anticipatory postural adjustments were evaluated during a rapid arm flexion test. Following the flexion, the absolute and variable errors in head repositioning significantly increased (p < 0.05). The results also showed that there was a significant delay in the onset of myoelectric activity of the cervical erector spinae muscles after flexion (p = 0.001). The results of this study suggested that a 10-min static flexion can lead to changes in the neck proprioception and feed-forward control due to mechanical and neuromuscular changes in the viscoelastic cervical spine structures. These changes in sensory-motor control may be a risk factor for neck pain and injury.
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Affiliation(s)
- Roghayeh Mousavi-Khatir
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran; Department of Physical Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran.
| | - Saeed Talebian
- Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences: Pich Shemiran, Tehran, Iran.
| | - Nima Toosizadeh
- Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, United States; Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States.
| | - Gholam Reaza Olyaei
- Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences: Pich Shemiran, Tehran, Iran.
| | - Nader Maroufi
- Department of Physical Therapy, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
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