1
|
Szewczyk D, Sadura-Sieklucka T, Tarnacka B, Sokołowska B. Is there a connection between spine alignment, chest mobility, shoulder joint and respiratory parameters of patients with ankylosing spondylitis? Rheumatol Int 2024; 44:1481-1486. [PMID: 38914771 PMCID: PMC11222267 DOI: 10.1007/s00296-024-05642-0] [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: 03/06/2024] [Accepted: 06/05/2024] [Indexed: 06/26/2024]
Abstract
INTRODUCTION Ankylosing spondylitis is chronic progressive disease, which decrease functions of musculoskeletal system including chest area. Those changes influences respiratory mechanics, worsen conditions of proper ventilation of lungs. OBJECTIVES Rating of functional and respiratory parameters and dependence between them at patients with ankylosing spondylitis. MATERIALS & METHODS The study included 45 patients with diagnosed ankylosing spondylitis. Chest and upper limbs mobility, resting spinal curvature alignment were assessed, and respiratory parameters were measured in a plethysmographic chamber JAGGER MasterScreen Body. RESULTS Ankylosing spondylitis patients had lower respiratory parameters especially sReff, and FRC. Restriction of chest and upper limbs mobility was also demonstrated. Forward head extension was observed based on the occipital wall test. Correlations between functional parameters and correlations between functional and respiratory parameters were shown, in particular MIP, MEP, sReff, Rtot, TLC, ERV. CONCLUSIONS The study confirmed a decrease in functional and respiratory parameters in the examined patients with ankylosing spondylitis compared to the applicable standards. A significant relationship was found between functional parameters in the upper body and respiratory parameters, which worsen with increasing thoracic dysfunction. The obtained results indicate the directions of therapy that should be taken into account to improve respiratory parameters and reduce respiratory dysfunction in these patients. Chest-focused physiotherapy appears to be an important element in improving function in patients with ankylosing spondylitis.
Collapse
Affiliation(s)
- Daniel Szewczyk
- Department of Rehabilitation, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Teresa Sadura-Sieklucka
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
| | | | - Beata Sokołowska
- Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| |
Collapse
|
2
|
Kolnes LJ, Stensrud T, Andersen OK. A multidimensional strategy to managing dysfunctional breathing and exercise-induced laryngeal obstruction in adolescent athletes. BMC Sports Sci Med Rehabil 2024; 16:13. [PMID: 38212851 PMCID: PMC10782679 DOI: 10.1186/s13102-023-00804-2] [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: 08/14/2023] [Accepted: 12/28/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Exercise induced laryngeal obstruction (EILO) causes inspiratory distress in the upper airway in many adolescent athletes. The nature of EILO is not fully understood, and effective management strategies are lacking. This study aimed to assess the effectiveness of a multidimensional individually tailored intervention, including Norwegian Psychomotor Physiotherapy (NPMP), elements of cognitive behavioural therapy and a rehabilitation plan, in reducing inspiratory distress and dysfunctional breathing in adolescent athletes with EILO. METHODS A mixed methods design, which combined qualitative and quantitative research, was used. Data, including subjective experiences of respiratory distress, findings from body examinations and objective measurements of lung function and aerobic capacity were gathered before and after a five month intervention involving 18 participants. RESULTS Following the intervention, the participants showed a reduction in respiratory distress and anxiousness associated with their breathing difficulties. Furthermore, the participants reported to be more in control of their breathing. The body assessments revealed a more functional breathing motion and improved posture, which imply that the breathing was less thoracic and more diaphragmatic in rest and exercise in all participants after the intervention. CONCLUSIONS Our results suggest that a multidimensional individually tailored intervention, including NPMP based physiotherapy, cognitive behavioural therapy elements, and a rehabilitation plan may reduce inspiratory distress and dysfunctional breathing in athletes with EILO. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration and Results system NCT06033755, date of registration: September12, 2023. Retrospectively registered.
Collapse
Affiliation(s)
- Liv-Jorunn Kolnes
- Faculty of Health, VID Specialized University, Diakonveien 12-18, 0370, Oslo, Norway.
| | - Trine Stensrud
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | |
Collapse
|
3
|
Yousefiyan R, Kordi Yoosefinejad A, Jalli R, Rezaei I. Comparison of breathing pattern and diaphragmatic motion in patients with unilateral cervical radiculopathy and asymptomatic group. BMC Pulm Med 2023; 23:498. [PMID: 38071289 PMCID: PMC10710721 DOI: 10.1186/s12890-023-02804-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The associations between neck pain and respiratory dysfunction were clarified in patients with neck pain. There is dearth of evidence on pulmonary dysfunction and diaphragmatic excursion in patients with unilateral cervical radiculopathy (CR). The purpose of this study was to compare the breathing pattern and diaphragmatic excursion in patients with unilateral CR with those in an asymptomatic group. METHODS Twenty-five patients with unilateral CR and 25 asymptomatic individuals aged between 30 and 55 participated in this study. Diaphragmatic motion, breathing pattern, active cervical range of motion and kinesiophobia were investigated in both groups by using fluoroscopy, manual assessment of respiratory motion (MARM), cervical range of motion device, and Tampa scale of kinesiophobia. Statistical significance was set at 0.05. RESULTS No statistically significant differences were found between the two groups with regard to sex, age and body mass index. The mean excursion of the hemi diaphragm on the involved side (the side of CR) was significantly lower than that on the uninvolved side in patients with unilateral CR with a large effect size. The excursion of the involved hemi diaphragm in patients was reduced compared to the matched hemi diaphragm in the control group. There was no significant difference between the hemi diaphragms excursion in the control group. The results of the MARM variables showed that the volume of breathing and the percentage rib cage motion in normal and deep breathing were significantly different between the two groups, but there was no significant difference in the balance of breathing between the two groups. Additionally, the active cervical range of motion was reduced in these patients in comparison to the control group, and it was less on the involved side than on the uninvolved side. CONCLUSION The results of this study revealed a dysfunctional breathing pattern in normal and deep breathing and a unilateral reduction in diaphragmatic excursion on the side of radiculopathy in patients with unilateral CR compared to the control group.
Collapse
Affiliation(s)
- Raziyeh Yousefiyan
- Student Research Committee, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Kordi Yoosefinejad
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, 1 Abivardi Avenue, Chamran Blvd, P.O. Box: 71345-1733, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Jalli
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Rezaei
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, 1 Abivardi Avenue, Chamran Blvd, P.O. Box: 71345-1733, Shiraz, Iran.
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
4
|
Chand, Vaish H. Effect of diaphragmatic breathing, respiratory muscle stretch gymnastics and conventional physiotherapy on chest expansion, pulmonary function and pain in patients with mechanical neck pain: A single group pretest-posttest quasi-experimental pilot study. J Bodyw Mov Ther 2023; 36:148-152. [PMID: 37949552 DOI: 10.1016/j.jbmt.2023.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/22/2021] [Accepted: 07/04/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND There is evidence that mechanical neck pain results in respiratory dysfunction. Physiotherapy management for mechanical neck pain is well documented but the evidence regarding inclusion of breathing strategies to improve pulmonary functions in mechanical neck pain patients is scarce. OBJECTIVE To investigate the combined effect of diaphragmatic breathing, respiratory muscles stretch gymnastics (RMSG) and conventional physiotherapy on chest expansion, pulmonary function and pain in patient with mechanical neck pain. METHOD Thirteen patients with mechanical neck pain (18-35years) with neck pain history of ≥ three months and NPRS (numeric pain rating scale) score ≥3 were recruited for this single group pre pretest-posttest quasi experimental pilot study. Informed consent was taken from all participants. After initial screening and assessment, diaphragmatic breathing, RSMG (5 patterns) and conventional physiotherapy (hot pack and TENS for 10 min) were given for one week. Chest expansion, spirometry (FEV1, FVC, FEV1/FVC, PEFR), NDI (neck disability index) and NPRS were assessed on baseline and after one week following the intervention. RESULTS The normality of data was tested by using Shapiro-wilk test and the data was found to be normally distributed. Paired t-test was used to compare the baseline and post intervention values. Diaphragmatic breathing, RMSG and conventional physiotherapy had significant effect on chest expansion, FEV1, NPRS and NDI in patients with mechanical neck pain. CONCLUSION The rehabilitation strategies should emphasize breathing exercises to improve the lung function and pain scores in addition to conventional physiotherapy in rehabilitation of mechanical neck pain patients.
Collapse
Affiliation(s)
- Chand
- BPT Intern, MMIPR, Markandeshwar (Deemed to be University), Mullana, Ambala, India
| | - Hina Vaish
- School of Health Sciences, CSJM University, Kanpur, India.
| |
Collapse
|
5
|
Chen Z, Falla D, Elgueta Cancino E, A Deane J. Can baseline features predict a reduction in pain and disability following neck-specific exercise in people with chronic non-specific neck pain?: A systematic review and meta-analysis protocol. BMJ Open 2023; 13:e074494. [PMID: 37429689 PMCID: PMC10335581 DOI: 10.1136/bmjopen-2023-074494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
INTRODUCTION Neck-specific exercises (NSEs) are commonly used for the treatment of chronic non-specific neck pain (CNSNP). However, it remains unclear whether baseline features can predict the response to neck-specific exercise (NSE) in people with CNSNP. This systematic review aims to assess whether baseline features such as age, gender, muscle activity, fatigability, endurance and fear of movement can predict pain and disability reduction following a NSE intervention. METHODS AND ANALYSIS This systematic review and meta-analysis will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols guidelines checklist. The Web of Science, PubMed, Scopus, MEDLINE, Embase and CINAHL databases; key journals; and grey literature will be searched up until June 2023, including medical subject heading terms and keywords combinations. Included studies will investigate an association between the baseline features and pain and disability outcomes following NSE in people with CNSNP. Two independent reviewers will oversee the searching, screening, data extraction and assessment of risk of bias. The risk of bias will be assessed using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) and Risk-Of-Bias tool for randomised trials 2 (ROB 2). The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE). Using standardised forms, details regarding study characteristics, baseline features (predictive factors), intervention, primary outcome and effect size (OR and 95% CI of each predictive factor and p value) will be extracted from included studies. Meta-analyses will be considered, if the studies are sufficiently homogeneous and if three or more studies investigate the same or comparable factors that predict the same response (pain intensity or disability). In the event that less than three studies investigated the same factors, a narrative synthesis will be conducted. ETHICS AND DISSEMINATION Ethical approval will not be required as this review will be based on published studies. The results of this study will be submitted to a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER CRD42023408332.
Collapse
Affiliation(s)
- Ziyan Chen
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Edith Elgueta Cancino
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andrés Bello, Santiago, Chile
| | - Janet A Deane
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
6
|
Türkmen C, Köse N, Bal E, Bilgin S, Çetin H, Zengin HY, Gümeler E, Mut M. Effects of Two Exercise Regimes on Patients with Chiari Malformation Type 1: a Randomized Controlled Trial. CEREBELLUM (LONDON, ENGLAND) 2023; 22:305-315. [PMID: 35325392 DOI: 10.1007/s12311-022-01397-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
This study aims to measure the effects of two different exercise programs on neck pain, proprioception, balance, coordination, posture, and quality of life in patients with Chiari malformation (CM) type 1. Sixteen patients were randomized to two different exercise programs: a tailored exercise protocol for CM (TEP-CM) and cervical spinal stabilization exercises (CSSE). Both exercise programs were implemented by a physiotherapist 3 days a week for 6 weeks. The primary outcome was Neck Disability Index. Secondary outcomes were visual analogue scale for pain, joint position sense error measurement, Berg Balance Scale, Time Up and Go Test, International Coordination Ataxia Rating Scale, PostureScreen Mobile, and Short Form-36. Assessments were done immediately before and after the intervention programs. Both groups showed significant improvement in Neck Disability Index, and some secondary outcome measures (P < 0.05). However, there were no statistical differences in post-intervention changes between the groups (P > 0.05). This is the first study to examine the effects of different exercise programs on symptoms in patients with CM type 1. Our preliminary findings indicate that exercise programs can improve pain, balance, proprioception, posture, coordination, and quality of life in CM type 1. Therefore, exercise should be considered safe, beneficial, and low-cost treatment option for CM type 1 patients without surgical indications.
Collapse
Affiliation(s)
- Ceyhun Türkmen
- Faculty of Health Sciences, Çankırı Karatekin University, 18200 Sıhhiye St., Çankırı, Turkey.
| | - Nezire Köse
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Ercan Bal
- Department of Neurosurgery, Ankara Yıldırım Beyazıt University, Ankara, 06100, Turkey
| | - Sevil Bilgin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Hatice Çetin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Hatice Yağmur Zengin
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Ekim Gümeler
- Department of Radiology, Faculty of Medicine, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| | - Melike Mut
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Samanpazari, Ankara, 06100, Turkey
| |
Collapse
|
7
|
Jeyaraj DV, Abishek JR. Effect of neck rehabilitation exercise and breathing exercise on visual complaints in individuals with idiopathic chronic neck pain. ASIAN JOURNAL OF PHARMACEUTICAL RESEARCH AND HEALTH CARE 2023. [DOI: 10.4103/ajprhc.ajprhc_91_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
|
8
|
Malátová R, Bahenský P, Rost M, Marko D. Breathing pattern and its evaluation by muscle dynamometer md03. Proc Inst Mech Eng H 2022; 236:1777-1782. [DOI: 10.1177/09544119221129324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of the study was to determine the proportion of engagements of individual breathing sectors during 1-min physically active breathing at rest in 163 healthy, physically active participants (students of Physical Education and Sport). The research analyzed breathing movements through the muscle dynamometer MD03 (Hitron, Plzeň, Czech Republic). The proportion of engagements of the individual breathing sector in the group analyzed was determined based on measurement results. The lower breathing sector was engaged at 29.2%, the middle breathing sector at 31.0%, and the upper breathing sector at 39.8%. The largest observed difference between the involvement of individual breath sectors was 10.6% between the lower and upper breathing sectors. The muscle dynamometer MD03 may be instrumental for practising both localized breathing and full breath.
Collapse
Affiliation(s)
- R Malátová
- Department of Sports Studies, University of South Bohemia, Faculty of Education, České Budějovice, Czech Republic
| | - P Bahenský
- Department of Sports Studies, University of South Bohemia, Faculty of Education, České Budějovice, Czech Republic
| | - M Rost
- Department of Plant Production, University of South Bohemia, Faculty of Agriculture, České Budějovice, Czech Republic
| | - David Marko
- Department of Sports Studies, University of South Bohemia, Faculty of Education, České Budějovice, Czech Republic
| |
Collapse
|
9
|
Graciosa MD, Schivinski CIS, Manoel EDJ, Ries LGK. Jaw and neck muscle activity during chewing and craniocervical dysfunction index in children, adolescents, and adults with and without cystic fibrosis: a comparative analysis. Cranio 2022:1-10. [PMID: 36178327 DOI: 10.1080/08869634.2022.2128587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To compare masticatory muscle activity between people with cystic fibrosis (pwCF) and healthy controls and to verify whether craniocervical dysfunction is associated with the presence of CF. METHODS Fifty-six participants were assessed and divided into pwCF and healthy control (HC) groups, each one composed of 13 children and adolescents at 9 (SD 3) years old and 15 adults at 25 (SD 6) years old. Craniocervical Dysfunction Index assessed symptoms of dysfunction and cervical spine mobility. Electromyography was used to evaluate the jaw and neck muscle activity during chewing. RESULTS Muscle activity during chewing was not statistically different between groups. Prevalence of craniocervical dysfunction was 75% for pwCF vs 64% for healthy controls. Individuals with CF are 1.53 [1.260, 1.870] times more likely to have reduced cervical mobility compared to healthy controls (p = 0.000). CONCLUSION These results reinforce the need for musculoskeletal disorders treatment in the management of pwCF.
Collapse
Affiliation(s)
- Maylli Daiani Graciosa
- Department of Physiotherapy, Center of Health Sciences and Sport, State University of Santa Catarina, Florianópolis, Brazil
| | | | - Edison de Jesus Manoel
- Department of Pedagogy, School of Physical Education and Sports, University of São Paulo, São Paulo, Brazil
| | - Lilian Gerdi Kittel Ries
- Department of Physiotherapy, Center of Health Sciences and Sport, State University of Santa Catarina, Florianópolis, Brazil
| |
Collapse
|
10
|
Anwar S, Arsalan A, Zafar H, Ahmad A, Hanif A. Effects of breathing reeducation on cervical and pulmonary outcomes in patients with non specific chronic neck pain: A double blind randomized controlled trial. PLoS One 2022; 17:e0273471. [PMID: 36006997 PMCID: PMC9409509 DOI: 10.1371/journal.pone.0273471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/01/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this randomized controlled trial was to study effects of breathing reeducation in the treatment of patients with non specific chronic neck pain. METHODS A total of sixty eight eligible patients with chronic neck pain were randomly allocated to breathing reeducation (BR) group (n = 34) and routine physical therapy (RPT) group (n = 34). Clinical outcomes were neck pain measured through visual analogue score, cervical active range of motion through CROM device, strength of neck muscles through hand held dynamometer and endurance of neck muscles measured through craniocervical flexion test. The neck disability was measured through neck disability index (NDI) and pulmonary outcomes such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio were measured through Spirolab 4. The outcomes were assessed at baseline and at 4 and at 8 weeks from baseline. RESULTS There were significant improvements in the BR group compared with the RPT group (P = 0.002) for cervical flexion, extension (P = 0.029), endurance (P = 0.042), strength of neck flexors (P <0.001), neck extensors (P = 0.034). Likewise there was a significant change in NDI (P = 0.011), FEV1 (P = 0.045), FVC (P <0.001), and FEV1/FVC ratio (P <0.001) in the BR group compared with the RPT group. The cervical side flexion and rotation showed no significant difference in breathing reeducation group with p > 0.05. CONCLUSION Breathing reeducation combined with routine physical therapy is an effective treatment in patients with non specific chronic neck pain. TRIAL REGISTRATION IRCT 20200226046623N1, https://www.irct.ir/trial/46240.
Collapse
Affiliation(s)
- Sahreen Anwar
- Department of Physical Therapy, Independent Medical College Faisalabad, Faisalabad, Pakistan
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Asadullah Arsalan
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Hamayun Zafar
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ashfaq Ahmad
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Asif Hanif
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
| |
Collapse
|
11
|
Dağ F, Taş S, Çimen ÖB. Pulmonary Functions in Patients With Chronic Neck Pain: A Case-Control Study. J Manipulative Physiol Ther 2022; 45:290-297. [DOI: 10.1016/j.jmpt.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 06/08/2021] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
|
12
|
Diaphragmatic Mobility and Chest Expansion in Patients with Scapulocostal Syndrome: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10050950. [PMID: 35628087 PMCID: PMC9141335 DOI: 10.3390/healthcare10050950] [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: 04/04/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 11/24/2022] Open
Abstract
Scapulocostal syndrome (SCS) is a subset of myofascial pain syndrome affecting the posterior shoulder and upper back area. Some of the affected muscles are attached to the rib cage, which may affect diaphragmatic mobility and chest expansion. The purpose of this study was to investigate the characteristics of diaphragmatic mobility and chest expansion in patients with SCS. Twenty-nine patients with SCS and twenty-nine healthy participants of a similar age, gender, weight, and height were included in the study. All participants were evaluated for diaphragmatic mobility (DM) by real-time ultrasound (RTUS) and for chest expansion (CE) using a cloth tape measure. An independent t-test was used to compare the outcome variables between groups. The DM value in the SCS group was 46.24 ± 7.26 mm, whereas in the healthy group it was 54.18 ± 9.74 mm. The DM value was lower in the SCS group compared to in healthy participants (p < 0.05). Chest expansion at the axilla, the fourth intercostal space (4th ICS), and the xiphoid level in the SCS group was 7.26 ± 1.13, 6.83 ± 0.94, and 6.86 ± 1.25, respectively, while chest expansion at the axilla, 4th ICS, and xiphoid level in the healthy group was 7.92 ± 1.39, 7.54 ± 1.43, and 8.13 ± 1.32, respectively. Chest expansion at the 4th ICS and the xiphoid level in the SCS group was significantly lower than in the healthy group (p < 0.05). Patients with SCS presented a decrease in diaphragmatic mobility and chest expansion. Therefore, SCS treatment programs ought to add breathing exercises to improve lung expansion.
Collapse
|
13
|
Nair SP, Panchabhai CS, Panhale V. Chronic neck pain and respiratory dysfunction: a review paper. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2022. [DOI: 10.1186/s43161-022-00078-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Neck pain is one of the most frequently reported musculoskeletal complaints among adults; its prevalence in the world is ranging from 16.7 to 75.1%. It can have an impact on a person’s physical, psychological, and social well-being. Along with pain, disability, muscle weakness, and alterations in the posture, neck pain patients are likely to develop affection of the respiratory function as reported in numerous studies. However, these patients are primarily managed with a musculoskeletal perspective with little or no emphasis to the changes observed in the respiratory system. There is a paucity of literature evaluating the need for respiratory rehabilitation in these patients.
Main body
All relevant published literature related to respiratory dysfunction in patients with chronic neck pain were critically reviewed in this study. Patients having chronic neck pain were found to have alterations in respiratory function in terms of reduced lung volumes, reduced chest mobility, and decreased respiratory muscle strength. Various factors such as decreased cervical range of motion, decreased strength of deep neck flexors and extensors, forward head posture, and pain are known to cause these dysfunctions. Respiratory system intervention in the form of breathing re-education and respiratory exercises are significantly proven to improve treatment outcomes.
Conclusion
There is limited literature relating to respiratory dysfunction and its management in neck pain patients. Incorporation of both respiratory and musculoskeletal assessments can enhance their treatment outcomes. Additionally, it can be suggested to consider intervention in the form of respiratory rehabilitation while strategizing treatment goals for these patients.
Collapse
|
14
|
Anwar S, Arsalan SA, Zafar H, Ahmed A, Gillani SA, Hanif A. Effects of breathing re-education on endurance, strength of deep neck flexors and pulmonary function in patients with chronic neck pain: A randomised controlled trial. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1611. [PMID: 35547963 PMCID: PMC9082229 DOI: 10.4102/sajp.v78i1.1611] [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: 07/23/2021] [Accepted: 02/15/2022] [Indexed: 11/19/2022] Open
Abstract
Background People with chronic neck pain show decreased endurance and strength of cervical muscles with compromised respiratory function. There is little evidence that improvement in breathing function of people with neck pain can help in enhancing cervical muscle strength and pulmonary function. The objective of this our clinical trial was to examine the effects of breathing re-education combined with physiotherapy on endurance and strength of deep neck flexors, and pulmonary function in patients with chronic neck pain. Methods/design In this double blind randomised clinical trial, 30 patients with chronic neck pain (25-50 years old) were randomly allocated to two groups. Group A, physiotherapy (n = 15), and Group B, breathing re-education (n = 15). The duration of intervention was eight weeks with treatment five days a week. The endurance was measured with the craniocervical flexion test, strength with a handheld dynamometer (Baseline USA) and pulmonary functions with the Spiro lab 4 (USA) at baseline, at week four and at week eight of the intervention. Discussion There was a significant between group improvement in the strength of deep neck flexors and forced vital capacity (FVC) in Group B p = 0.0001 and p = 0.0200 (p ˂ 0.05) respectively. Intergroup comparisons showed no significant differences for endurance, cervical extensor strength, Forced Expiratory Volume in one second (FEV1), and FEV1/FVC percentage. Conclusion Our study concluded that breathing re-education combined with other physiotherapy management is effective for improving the strength of neck flexors and increasing FVC in people with chronic neck pain. Clinical implication Breathing re-education may be part of physiotherapy management in patients with chronic neck pain. Trial Registration Iranian Registry of Clinical Trials, IRCT20200226046623N1, https://www.irct.ir/trial/46240.
Collapse
Affiliation(s)
- Sahreen Anwar
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
| | - Syed A Arsalan
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
| | - Hamayun Zafar
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ashfaq Ahmed
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
| | - Syed A Gillani
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
| | - Asif Hanif
- Department of Biostatistics, Faculty of Rehabilitation Sciences, University of Lahore, Lahore, Pakistan
| |
Collapse
|
15
|
Kolnes LJ. Stressed and Distressed: Potential Underpinnings of Exercise-Related Inspiratory Distress in Adolescent Sport Performers. Phys Ther 2022; 102:6398921. [PMID: 34662404 DOI: 10.1093/ptj/pzab242] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/23/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022]
Abstract
UNLABELLED Many adolescent sport performers present with exercise-related respiratory symptoms consistent with exercise-induced laryngeal obstruction (EILO). The pathogenic underpinnings of EILO are not fully resolved, and existing behavioral management includes therapies targeting laryngeal physiology whereas surgical interventions target laryngeal anatomical anomalies. Recent findings from research and clinical practice indicate that psychological stress and thoracic breathing co-occur with laryngeal tightness in adolescent sport performers with EILO. This Perspective article theorizes on this potential coexistence. It discusses possible underpinnings of respiratory symptoms (including EILO) and thoracic breathing in adolescent sport performers by considering the effects of various stressors to which adolescent sport performers are exposed, and the impact these may have on the breathing, including in terms of laryngeal narrowing. The effect of stress on the breathing is examined in light of the reciprocal communication between the brain and the body and the relationship between psychological stress and stress responses in the respiratory system mediated by the autonomic nervous system. To inform decision-making and clinical awareness in this area, it may be worth expanding the focus from targeting mainly laryngeal structures to also include constrictions of the airways and the effects of thoracic breathing on the larynx during exercise. The importance of considering respiratory distress from a multidimensional perspective, and of incorporating the complexity of sport performers' psychological and physical experiences in the management of their health and well-being, is emphasized. IMPACT This Perspective adds to the understanding of respiratory distress in populations other than adults, which is important and necessary. LAY SUMMARY Adolescent sport performers are exposed to a number of stressors that may affect breathing and laryngeal narrowing, which in turn may have implications for the management of their overall health and well-being.
Collapse
Affiliation(s)
- Liv-Jorunn Kolnes
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| |
Collapse
|
16
|
The correlation between scapulocostal syndrome and masticatory myofascial pain on selected pain and functional parameters- an observational study. J Bodyw Mov Ther 2022; 29:198-205. [PMID: 35248271 DOI: 10.1016/j.jbmt.2021.09.023] [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] [Received: 09/15/2020] [Revised: 07/06/2021] [Accepted: 09/24/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Although scapulocostal syndrome (SCS) and masticatory myofascial pain (MMP) occur in different regions, the concept of myofascial linkage and neurophysiology may be proven per the connection of the two disorders. Therefore, this study aimed to investigate the correlation between SCS and MMP on selected pain and functional parameters. METHOD 75 participants with SCS participated in the protocol. The diagnosis of SCS was considered by the presence of muscle referred pain in the medial scapular muscles. All participants were measured for pain intensity, pressure pain threshold (PPT), and craniovertebral angle (CV-angle) for pain and functional parameters related to SCS. They were measured for pain intensity, PPT, and mouth distance for the pain and functional parameters related to MMP. The diagnosis of MMP was considered by the presence of muscle tenderness of the masticatory muscle and the decreasing of mouth opening distance. The correlation between SCS and MMP was determined using Pearson's correlation coefficient and Spearman's correlation. RESULTS Participants exhibiting SCS were diagnosed for MMP at 74.67%. The results showed positive correlations in pain intensity and PPT between SCS and MMP (r = 0.367, r = 0.478, p < 0.01), PPT of SCS, and mouth distance amid both pain-free and maximum mouth opening conditions, respectively (r = 0.290, r = 0.282, p < 0.05). CONCLUSION In conclusion, SCS and MMP present an association with each other in terms of both selected pain, and functional parameters. Thus, a treatment program for SCS patients should be concerned with the masticatory muscles even if they did not report any pain at the jaw area.
Collapse
|
17
|
Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial. Turk J Phys Med Rehabil 2021; 67:291-299. [PMID: 34870115 PMCID: PMC8606989 DOI: 10.5606/tftrd.2021.6397] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/23/2020] [Indexed: 11/27/2022] Open
Abstract
Objectives
This study aims to investigate how exercise programs not directly applied to the cervical spine affect office workers with forward head posture (FHP).
Patients and methods
Between March 2018 and June 2018, a total of 32 office workers with FHP (13 males, 19 females; mean age 36.63 years; range, 23 to 57 years) were randomized either to experimental (n=16) or control groups (n=16). Scapular stabilization and thoracic extension exercises were applied to the experimental group and cervical stabilization and stretching exercises to the control group. The results of the pre-intervention and after six weeks measurement of the craniovertebral angle (CVA), respiration, pain, and disability were compared and analyzed.
Results
For intra-group comparison, both groups showed significant differences (p<0.05) in CVA, forced expiratory volume at 1 sec (FEV1), Visual Analog Scale (VAS), and neck disability index at pre- and post-intervention, while only the experimental group showed a significant difference (p<0.05) in maximum inspiratory pressure, maximum expiratory pressure, and forced vital capacity. For inter-group comparison, a significant difference (p<0.05) between FEV1 and VAS was observed.
Conclusion
The combination of scapular stabilization and thoracic extension exercises, not directly applied to the cervical spine, has an effect on improving the posture, respiration, neck pain, and disability in office workers with FHP.
Collapse
|
18
|
Ortiz-Rubio A, Torres-Sánchez I, Cabrera-Martos I, López-López L, Rodríguez-Torres J, Granados-Santiago M, Valenza MC. Respiratory disturbances in fibromyalgia: A systematic review and meta-analysis of case control studies. Expert Rev Respir Med 2021; 15:1217-1227. [PMID: 33857393 DOI: 10.1080/17476348.2021.1918547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Fibromyalgia is a debilitating syndrome characterized by diffuse and chronic musculoskeletal pain.Objective: To perform a systematic review and meta-analysis of case-control studies to explore the respiratory disturbances among persons with fibromyalgia.Study appraisal and synthesis method: This review was performed in accordance with PRISMA guidelines (PROSPERO; identification number CRD: 42,020,196,835). We systematically searched seven electronic databases for articles published before December 2020.Eligibility criteria: Case-control studies comparing adults with fibromyalgia syndrome and healthy individuals with regard to the respiratory disturbances.Results: A total of six studies were included in the quantitative analysis. Pooled analysis showed that persons with fibromyalgia reported reduced chest expansion (MD -0.72, 95% CI, -1.70 to 0.27, I2 = 95%, p = 0.016), maximum expiratory pressure (MD -10.67, 95% CI, -18.62 to -2.72, I2 = 77%, p = 0.009), maximum inspiratory pressure (MD 11.04, 95% CI, -14.45 to -7.62, I2 = 0%, p < 0.001) and maximal voluntary ventilation (MD 11.79, 95% CI, -16.80 to -7.78, I2 = 0%, p < 0.001).Conclusion: Persons with fibromyalgia experience respiratory disturbances, such as reduced chest expansion, maximum expiratory pressure, maximum inspiratory pressure, and maximal voluntary ventilation.
Collapse
Affiliation(s)
- Araceli Ortiz-Rubio
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - Irene Torres-Sánchez
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - Irene Cabrera-Martos
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - Laura López-López
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - Janet Rodríguez-Torres
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| | - María Granados-Santiago
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain.,Department of Nursing, School of Health Sciences, University of Granada, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
| |
Collapse
|
19
|
Alonazi A, Almutairi W, Bains G, Daher N, Alismail A. Effects of smartphone addiction on children's lung function. Pediatr Int 2021; 63:323-330. [PMID: 32614490 DOI: 10.1111/ped.14367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 06/16/2020] [Accepted: 06/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND With an increase in smartphone usage, constant neck flexion can lead to improper posture, which may impact on lung function. Therefore, the purpose of this study was to examine and compare the craniovertebral angle (CVA) and lung function between addicted and non-addicted boys and girls aged between 8-13 years who use smartphones for long periods of time. METHODS A cross-sectional study was conducted on 24 boys and 26 girls (mean age 10.5 ± 1.6 years and body mass index 18.6 ± 3.0 kg/m2) . Participants were assigned to two groups based on their scores on the Smartphone Addiction Scale-Short Version (SAS-SV) for Adolescents: addicted group (score > 32, n = 32) and non-addicted group (score ≤ 32, n = 18). The outcome variables were CVA, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), maximal voluntary ventilation (MVV), maximum inspiratory pressures (PImax), and maximum expiratory pressures (PEmax). RESULTS There was a significant difference in mean CVA between addicted and non-addicted boys (49.4 ± 6.7 vs 55.5 ± 7.6, η2 = 0.9, P = 0.03) and girls (47.3 ± 6.3 vs 52.9 ± 6.1, η2 = 0.9, P = 0.02). Mean FVC, FEV1, and FEV6 were significantly lower in addicted versus non-addicted boys (P = 0.04, P = 0.05, and P = 0.02, respectively). PImax was significantly less in addicted compared to non-addicted girls (55.2 ± 16.4 vs 65.3 ± 13.8, η2 = 0.7, P = 0.05). CONCLUSION Our findings showed that children addicted to smartphones (when using the SAS-SV as an indicator for addiction) revealed lower CVA and lung function results. Therefore, education on proper posture while holding smartphones is essential to the children's postural and lung function status.
Collapse
Affiliation(s)
- Asma Alonazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Riyadh, Saudi Arabia
| | - Waleed Almutairi
- Department of Cardiopulmonary Sciences, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - Gurinder Bains
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - Noha Daher
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - Abdullah Alismail
- Department of Cardiopulmonary Sciences, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| |
Collapse
|
20
|
Simoni G, Bozzolan M, Bonnini S, Grassi A, Zucchini A, Mazzanti C, Oliva D, Caterino F, Gallo A, Da Roit M. Effectiveness of standard cervical physiotherapy plus diaphragm manual therapy on pain in patients with chronic neck pain: A randomized controlled trial. J Bodyw Mov Ther 2021; 26:481-491. [PMID: 33992285 DOI: 10.1016/j.jbmt.2020.12.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 12/12/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Literature concerning the effect of diaphragm treatment to reduce neck pain symptoms is scarce. Aim of this trial was to investigate the effects of diaphragm manual therapy associated with standard physiotherapy treatment on pain in patients with Chronic Neck Pain (CNP). METHODS In a private practice clinic, subjects with CNP were randomly assigned to receive three 30-min treatment sessions of standard cervical physiotherapy and Diaphragm Manual Therapy (DMT) or Sham Diaphragm Technique (SDT). Participants and assessors were blinded to the assignment. Primary outcome was pain, secondary outcomes were cervical active range of motion, pain pressure threshold, disability and quality of life measured at baseline, before and after each session, at 3 and 6-months. Adverse events were monitored. A non-parametric multivariate approach (combined permutation test) was applied to assess the effect of the treatment on all the outcomes. An intention to treat analysis was performed. RESULTS Forty patients were randomly allocated to DMT and SDT groups. Combined permutation test showed a significant higher improvement in DMT group compared to SDT group (p-value = 0.0002). The between-group comparisons on single outcomes showed a statistically significant improvement only for pain pressure threshold on upper trapezius (adjusted p-value = 0.029). No adverse events related to the intervention were registered. CONCLUSIONS In patients with CNP, addition of diaphragm manual techniques to standard cervical treatment seems to give a better global outcome, but this improvement is of unclear clinical relevance; the primary outcome seems not to have a role. Further studies are needed to confirm and clarify these results. TRIAL REGISTRATION Release Date: July 18, 2017 Registered in ClinicalTrial.gov database ID: NCT03223285A.
Collapse
Affiliation(s)
- G Simoni
- Physiotherapist Freelance in Ferrara, Italy; School of Physiotherapy University of Ferrara, Italy.
| | - M Bozzolan
- Azienda Ospedaliero Universitaria S.Anna Ferrara, Italy; School of Physiotherapy University of Ferrara, Italy.
| | - S Bonnini
- Department of Economics and Management, University of Ferrara, Italy.
| | - A Grassi
- Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| | - A Zucchini
- Physiotherapist Freelance in Bologna, Italy.
| | - C Mazzanti
- Physiotherapist Freelance in Ferrara, Italy.
| | - D Oliva
- Physiotherapist Freelance in Savona, Italy; Escuela deOsteopatia de Madrid, Italy.
| | - F Caterino
- Physiotherapist Freelance in Bologna, Italy.
| | - A Gallo
- Physiotherapist Freelance in Ferrara, Italy.
| | - M Da Roit
- School of Physiotherapy University of Ferrara, Italy; Azienda ULSS 1 Dolomiti, Italy.
| |
Collapse
|
21
|
Tsiringakis G, Dimitriadis Z, Triantafylloy E, McLean S. Motor control training of deep neck flexors with pressure biofeedback improves pain and disability in patients with neck pain: A systematic review and meta-analysis. Musculoskelet Sci Pract 2020; 50:102220. [PMID: 32827852 DOI: 10.1016/j.msksp.2020.102220] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/26/2020] [Accepted: 07/04/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The effects of motor control training with pressure biofeedback on neck pain and disability of patients with neck pain is a field that has drawn a lot of research interest. Therefore, the aim of this study was to conduct, for the first time, a systematic review and meta-analysis for examining whether motor control training of deep neck flexors with pressure biofeedback improves pain and disability in patients with neck pain. METHODS The systematic review and meta-analysis were performed according to PRISMA guidelines. The databases PubMED, MEDLINE, EBSCOhost, Google scholar, SportDiscus, COCHRANE and EMBASE were searched for studies related to the research question. PEDro scale was used for examining methodological quality. A random effects model was used for data meta-analysis. RESULTS Seventeen studies were included for qualitative synthesis and 10 were selected for further quantitative synthesis. Motor control training of deep neck flexors with pressure biofeedback was found to have equal or better effectiveness on neck pain intensity and disability in comparison to other control interventions. The meta-analyses show that motor control training of deep neck flexors with pressure biofeedback is more effective than strength-endurance training of cervical muscles for improving pain (Hedges' g = 0.323, 95% CI 0.04-0.60, I2 = 50.94%) and disability (Hedges g = 0.401, 95% CI 0.12-0.68, I2 = 53.44%) in patients with neck pain. CONCLUSIONS Motor control training of deep neck flexors with pressure biofeedback is an effective intervention for improving pain intensity and disability in patients with neck pain and preferable to strength-endurance training of cervical muscles.
Collapse
Affiliation(s)
- Georgios Tsiringakis
- Physiotherapy Department, Allied Health Professions Department, Sheffield Hallam University, UK.
| | - Zacharias Dimitriadis
- Health and Quality of Life Assessment Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Greece
| | - Evripidis Triantafylloy
- Physiotherapy Department, Allied Health Professions Department, Sheffield Hallam University, UK
| | - Sionnadh McLean
- Physiotherapy Department, Allied Health Professions Department, Sheffield Hallam University, UK
| |
Collapse
|
22
|
Saglam M, Firat T, Vardar-Yagli N, Calik-Kutukcu E, Delioglu K, Inal-Ince D, Tunc Y, Arikan H, Kayi-Cangir A. Respiratory Dysfunction in Individuals With Thoracic Outlet Syndrome. J Manipulative Physiol Ther 2020; 43:606-611. [PMID: 32829949 DOI: 10.1016/j.jmpt.2019.10.006] [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: 12/31/2018] [Revised: 10/14/2019] [Accepted: 10/22/2019] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The purpose of this study was to compare pulmonary function and respiratory muscle strength and endurance in individuals with thoracic outlet syndrome (TOS) and healthy participants. METHODS Sixty-two individuals with TOS (mean age 30.81 ± 10.69 years; 10 male, 52 female) and 47 healthy individuals (mean age 30.64 ± 9.16 years; 14 male, 33 female) participated in this study. Pulmonary function testing was performed using a spirometer. Respiratory muscle strength (maximal inspiratory pressure [MIP] and maximal expiratory pressure [MEP]) were measured using a mouth pressure device. Respiratory muscle endurance was tested at 35% MIP and measured as the time in seconds from the start of the test to voluntary exhaustion. RESULTS Age distribution and physical characteristics were similar between the groups (P > .05). All pulmonary function parameters except for peak expiratory flow rate were similar in patients with TOS and healthy controls (P > .05). Patients with TOS had significantly lower peak expiratory flow rate, MIP, MIP%, MEP, MEP%, and respiratory muscle endurance compared with controls (P < .05). Forty-six patients with TOS (74.2%) had MIP values below the lower limit of the 95% CI of the control group (97.05-113.88 cmH2O), and 53 patients with TOS (85.2%) had MEP values below the lower limit of the 95% CI of the control group (124.74-146.49 cmH2O). CONCLUSION Expiratory flow rate and respiratory muscle strength and endurance may be adversely affected in TOS. Trunk muscles perform both postural and breathing functions. Therefore, disruption in one function may negatively affect the other.
Collapse
Affiliation(s)
- Melda Saglam
- Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Tuzun Firat
- Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Naciye Vardar-Yagli
- Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ebru Calik-Kutukcu
- Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Kivanc Delioglu
- Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Deniz Inal-Ince
- Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yasin Tunc
- Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hulya Arikan
- Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | | |
Collapse
|
23
|
Ha SY, Sung YH. A temporary forward head posture decreases function of cervical proprioception. J Exerc Rehabil 2020; 16:168-174. [PMID: 32509702 PMCID: PMC7248444 DOI: 10.12965/jer.2040106.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/27/2020] [Indexed: 12/19/2022] Open
Abstract
Increased use of smartphones can cause abnormal alignment of head and neck, resulting in forward head posture (FHP). This can lead to change in the structures and function of the cervical vertebrae. The purpose of this study was to determine the impact on deep neck flexor muscles, proprioception, vestibular function, and balance of subjects with induced FHP by using smartphone. Twenty-two healthy persons were randomly divided into two groups. The FHP group maintained a craniovertebral angle (CVA) of <49° and a normal head posture group maintained a CVA of >50° watching the smartphone for 40 min. We measured the area of the longus colli and longus capitis muscles, cervical joint position sense, Romberg test, subjective visual vertical test, and subjective visual horizontal test. There was no significant difference in the deep neck flexor muscles, vestibular function, and static balance between the groups. However, there was a significant difference in the cervical proprioception (P<0.05). Proprioception may be considered to be the most influential factor in induced FHP by smartphone viewing.
Collapse
Affiliation(s)
- Sun-Young Ha
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea.,Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, Korea
| |
Collapse
|
24
|
Arias-Buría JL, Monroy-Acevedo Á, Fernández-de-Las-Peñas C, Gallego-Sendarrubias GM, Ortega-Santiago R, Plaza-Manzano G. Effects of dry needling of active trigger points in the scalene muscles in individuals with mechanical neck pain: a randomized clinical trial. Acupunct Med 2020; 38:380-387. [PMID: 32228029 DOI: 10.1177/0964528420912254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study was to compare the effects of dry needling (DN) versus pressure release over scalene muscle trigger points (TrPs) on pain, related disability, and inspiratory vital capacity in individuals with neck pain. METHODS In this randomized, single-blind trial, 30 patients with mechanical neck pain and active TrPs in the scalene musculature were randomly allocated to trigger point dry needling (TrP-DN; n = 15) or pressure release (n = 15) groups. The DN group received a single session of DN of active TrPs in the anterior scalene muscles, and the pressure release group received a single session of TrP pressure release over the same muscle lasting 30 s. The primary outcome was pain intensity as assessed by a numerical pain rate scale (NPRS, 0-10). Secondary outcomes included disability (neck disability index, NDI) and inspiratory vital capacity. Outcomes were assessed at baseline and 1 day (immediately post), 1 week, and 1 month after the treatment session. Data were expressed as mean score difference (Δ) and standardized mean difference (SMD). RESULTS Patients receiving DN exhibited a greater decrease in pain intensity than those receiving TrP pressure release at 1 month (Δ 1.2 (95% CI-1.8, -0.6), p = 0.01), but not immediately (1 day) or 1 week after. Patients in the DN group exhibited a greater increase in inspiratory vital capacity at all follow-up time points (Δ 281 mm (95% CI 130, 432) immediately after, Δ 358 mm (95% CI 227, 489) 1 week after, and Δ 310 mm (95% CI 180, 440) 1 month after treatment) than those in the pressure release group (p = 0.006). Between-group effect sizes were large at all follow-up time points (1.1 > SMD > 1.3) in favor of DN. CONCLUSION This trial suggests that a single session of DN over active TrPs in the scalene muscles could be effective at reducing pain and increasing inspiratory vital capacity in individuals with mechanical neck pain. Future studies are needed to further confirm these results.
Collapse
Affiliation(s)
- José L Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.,Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.,Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.,Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Gustavo Plaza-Manzano
- Department Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| |
Collapse
|
25
|
Cheon JH, Lim NN, Lee GS, Won KH, Lee SH, Kang EY, Lee HK, Cho Y. Differences of Spinal Curvature, Thoracic Mobility, and Respiratory Strength Between Chronic Neck Pain Patients and People Without Cervical Pain. Ann Rehabil Med 2020; 44:58-68. [PMID: 32130839 PMCID: PMC7056330 DOI: 10.5535/arm.2020.44.1.58] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/09/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the differences of spinal curvature, thoracic sagittal mobility, and respiratory strength between patients with chronic neck pain (CNP) and people without cervical pain, and to determine the correlation between respiratory strength and thoracic mobility in CNP patients. METHODS A total of 78 participants were finally included in this study, of whom 30 had no cervical pain and 48 had CNP. The Neck Disability Index (NDI), cervical lordotic curvature, thoracic kyphotic curvature, thoracic sagittal range of motion (ROM), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were measured and analyzed. RESULTS In males, thoracic sagittal ROMMEP-MIP and MEP showed a significant difference between the no cervical pain group and the CNP group. In females, thoracic kyphotic curvature, thoracic sagittal ROMMEP-MIP, MIP, and MEP were significantly different between the no cervical pain group and the CNP group. Thoracic kyphotic curvature was significantly correlated with MEP and MIP in all population groups, and significantly correlated with NDI in the female group. Thoracic sagittal ROMMEP-MIP had a significant linear relationship with NDI, MEP, and MIP in all population groups. CONCLUSION The thoracic mobility during forced respiration was reduced in patients with CNP and was correlated with respiratory strength. Changes in the biomechanics of the cervicothoracic spine and rib cage due to CNP may contribute to impairment of respiratory strength.
Collapse
Affiliation(s)
- Ji Hong Cheon
- Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Na Na Lim
- Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Geun Su Lee
- Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Ki Hong Won
- Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Sung Hoon Lee
- Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Eun Young Kang
- Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Hyun Kyung Lee
- Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Younkyung Cho
- Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea
| |
Collapse
|
26
|
Cho J, Lee E, Lee S. Upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise in individuals with forward head posture: A randomized clinical trial investigating their effectiveness. J Back Musculoskelet Rehabil 2019; 32:595-602. [PMID: 30584118 DOI: 10.3233/bmr-181228] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although commonly utilized treatments, no study has directly compared the effectiveness of joint mobilization and stabilization exercise in individuals with forward head posture (FHP). OBJECTIVE This study aimed to investigate the effects of upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise (DCFE) in individuals with FHP. METHODS Thirty-one participants with FHP were randomized into the mobilization (n= 15) or exercise (n= 16) group. The treatment period was 4 weeks with follow-up assessment at 4 weeks and 6 weeks after the initial examination. Outcomes assessed included the craniovertebral angle (CVA), numeric pain rating scale (NPRS), respiratory function, and the global rating of change (GRC). RESULTS Participants in the mobilization group demonstrated significant improvements (p< 0.05) in CVA, NPRS, and respiratory function, as compared to those in the exercise group. In addition, 9 of 15 (60%) participants in the mobilization group, as compared to 4 of 16 participants (25%) in the exercise group, had a GRC score of +4 or higher. CONCLUSIONS The combination of upper cervical and upper thoracic spine mobilization indicated better overall short-term outcomes in CVA, NPRS, respiratory function, and GRC compared with DCFE in individuals with FHP.
Collapse
Affiliation(s)
- Juchul Cho
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Korea.,Department of Rehabilitation Medicine, Wellciti Hospital, Daejeon, Korea
| | - Eunsang Lee
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Korea
| | - Seungwon Lee
- Department of Physical Therapy, Sahmyook University, Seoul, Korea
| |
Collapse
|
27
|
Uysal SC, Tüzün EH, Eker L, Angın E. Effectiveness of the muscle energy technique on respiratory muscle strength and endurance in patients with fibromyalgia. J Back Musculoskelet Rehabil 2019; 32:411-419. [PMID: 30475751 DOI: 10.3233/bmr-181287] [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: 02/04/2023]
Abstract
BACKGROUND Fibromyalgia is characterized by a chronic and common musculoskeletal system pain that affects cervical mobility and inspiration. This may cause changes in thoracic mechanics. OBJECTIVE To investigate the effectiveness of the muscle energy technique applied to cervical accessory respiratory muscles on respiratory muscle strength and endurance in patients with fibromyalgia. METHODS The participants were 37 women diagnosed with fibromyalgia. They were assessed for their respiratory muscle strength, respiratory muscle endurance, pain and fatigue severity, flexibility and disability. The muscle energy technique was applied to the scalene, upper trapezius, and sternocleidomastoid muscles after a superficial heat application. The treatment was continued for 3 weeks with 3 sessions per week. RESULTS After the treatment, expiratory muscle strength and respiratory muscle endurance increased significantly. Severity of pain and fatigue and disability were reduced, cervical flexibility increased significantly (p< 0.05). The effect size was r⩾ 0.4 for all the variables. CONCLUSION The muscle energy technique applied to cervical accessory respiratory muscles in patients with fibromyalgia who had complaints in the neck and back region positively increased respiratory muscle strength and endurance, cervical flexibility, and decrease pain intensity, fatigue and disability. It is recommended that subsequent randomized studies are carried out with a placebo control group.
Collapse
|
28
|
Koseki T, Kakizaki F, Hayashi S, Nishida N, Itoh M. Effect of forward head posture on thoracic shape and respiratory function. J Phys Ther Sci 2019; 31:63-68. [PMID: 30774207 PMCID: PMC6348172 DOI: 10.1589/jpts.31.63] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 10/07/2018] [Indexed: 01/16/2023] Open
Abstract
[Purpose] This study investigated the effect of forward head posture on upper and lower
thoracic shape in adults to better understand the relationship between a forward head
posture and respiratory function. [Participants and Methods] Fifteen healthy males were
recruited after obtaining informed consent from all participants. All participants were
instructed to respire in both the forward and neutral head postures while seated.
Respiratory function was assessed using spirometry. Thoracic shape during respiration was
assessed using 23 markers on both the upper and the lower thorax and compared between the
2 postures. [Results] Forced vital capacity, expiratory and inspiratory reserve volumes,
forced expiratory volume at 1 second, and the peak flow rate observed with the forward
head posture were significantly lower than that with the neutral head posture. The upper
thorax showed a greater forward shift and the lower thorax showed a greater forward and
inward shift with the forward head posture than with the neutral head posture. No
significant difference in upper thoracic mobility was observed during respiration between
the forward head posture and the neutral head posture. However, mobility of the lower
thorax during respiration was significantly reduced with the forward head posture.
[Conclusion] The forward head posture causes expansion of the upper thorax and contraction
of the lower thorax, and these morphological changes cause decreased respiratory
function.
Collapse
Affiliation(s)
- Taiichi Koseki
- Department of Anatomy, Tokyo Medical University, Japan.,Department of Rehabilitation, Hiroo Orthopedics, Japan
| | - Fujiyasu Kakizaki
- Graduate School of Health Care Sciences, Bunkyo Gakuin University, Japan
| | - Shogo Hayashi
- Department of Anatomy, School of Medicine, International University of Health and Welfare: 4-3 Kozunomori, Narita, Chiba 286-8686, Japan
| | - Naoya Nishida
- Department of Anatomy, Tokyo Medical University, Japan.,Department of Rehabilitation, Sonoda Second Hospital, Japan
| | - Masahiro Itoh
- Department of Anatomy, Tokyo Medical University, Japan
| |
Collapse
|
29
|
Kolnes LJ, Stensrud T. Exercise-induced laryngeal obstruction in athletes: Contributory factors and treatment implications. Physiother Theory Pract 2018; 35:1170-1181. [PMID: 29757061 DOI: 10.1080/09593985.2018.1474306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Otherwise healthy adolescent athletes presenting with respiratory symptoms consistent with exercise-induced laryngeal obstruction (EILO) are frequently encountered in clinical practice. The symptoms are often incorrectly considered to result from exercise-induced asthma, and may be wrongly treated as such. Given the potential implications for health and performance if EILO is left untreated, a more comprehensive understanding of contributory mechanisms is essential in order to create appropriate treatment procedures. Informed by knowledge from physical therapy, as well as the fields of voice rehabilitation and vocal pedagogy, this theoretical article presents a novel way of understanding and managing EILO by exploring bodily mechanisms and structures that may disturb laryngeal function during strenuous exercise. Firstly, the status quo of the EILO diagnosis, its aetiology and treatment options are reviewed. Secondly, considerations associated with laryngeal structures and mechanisms, and their potential influence on laryngeal movement and sensitivity are examined. Thirdly, the manner in which postural de-alignment and breathing pattern may interfere with laryngeal functioning will be discussed. Finally, interventions for voice disorders and singing and the relevance of these for EILO are evaluated. It is argued that clients with EILO should undergo a thorough physical examination to identify constrictions in the body as a whole - such as postural de-alignments and a dysfunctional breathing pattern - as these are hypothesized as playing a critical role in laryngeal tightness during exercise. Physical therapists possess particular skills and competence with regard to examining breathing patterns and postural de-alignments, and should be included in the treatment process of EILO.
Collapse
Affiliation(s)
- Liv-Jorunn Kolnes
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Department of health, Norwegian Institute of Sports Medicine, Oslo, Norway
| | - Trine Stensrud
- Department of Sports medicine, The Norwegian School of Sport Sciences, Oslo, Norway
| |
Collapse
|
30
|
Kang JI, Jeong DK, Choi H. Correlation between pulmonary functions and respiratory muscle activity in patients with forward head posture. J Phys Ther Sci 2018; 30:132-135. [PMID: 29410583 PMCID: PMC5788792 DOI: 10.1589/jpts.30.132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 10/24/2017] [Indexed: 12/02/2022] Open
Abstract
[Purpose] The purpose of this study is to determine the effect that secondary postural
deformities and chronic postural abnormalities have on lung capacity, as well as correlate
the activity of the respiratory muscles. The results provide basic objective data about
the forward head posture and respiratory muscle activity that can be used in clinical
situations. [Subjects and Methods] The subjects used in this study were 24 patients aged
25 to 35 years old who visited a hospital in Jeollanam-do Province, Korea, between
September 2015 and January 2016. The patients were diagnosed with forward head posture
because the vertical line between the acromion process and the external acoustic meatus
was at least 5 cm. We measured the craniovertebral angle, pulmonary functions, and
respiratory muscle activity of the subjects for correlation analysis. [Results] A positive
correlation was found between the craniovertebral angle and the forced vital capacity
(r=0.63), while a negative correlation was found between the craniovertebral angle and the
sternocleidomastoid muscle (r=–0.77). The craniovertebral angle and the anterior scalene
muscle showed a negative correlation (r=–0.65). There were positive correlations between
the forced vital capacity and the sternocleidomastoid muscle (r=0.71), and between the
forced vital capacity and the anterior scalene muscle (r=0.59). [Conclusion] Severe
forward head posture increased the activities of the sternocleidomastoid muscles and the
anterior scalene muscles, and decreased the forced vital capacity. Thus, it is necessary
to develop more efficient interventions for managing forward head posture based on
pulmonary function and the activity of the respiratory synergist muscles.
Collapse
Affiliation(s)
- Jeong-Il Kang
- Department of Physical Therapy, Sehan University: 1113 Noksaek-ro, Samho-eup, Yeongam-gun, Jeollanam-do, Republic of Korea
| | - Dae-Keun Jeong
- Department of Physical Therapy, Sehan University: 1113 Noksaek-ro, Samho-eup, Yeongam-gun, Jeollanam-do, Republic of Korea
| | - Hyun Choi
- Department of Physical Therapy, Mokpo Mirae Hospital, Republic of Korea
| |
Collapse
|
31
|
Kim MS, Cha YJ, Choi JD. Correlation between forward head posture, respiratory functions, and respiratory accessory muscles in young adults. J Back Musculoskelet Rehabil 2017; 30:711-715. [PMID: 28453447 DOI: 10.3233/bmr-140253] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Forward head posture (FHP) causes changes in the strengths and rigidities of cervical muscles. OBJECTIVE The aim of this study was to investigate correlations between FHP and respiratory functions and the muscle activities of respiratory accessory muscles in young adults in their 20s. METHODS A volunteer sample of 33 healthy young adults participated in this study. Craniovertebral angle (CVA), cranial rotational angle (CRA), vital capacity (VC), forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), peak expiratory flow (PEF), maximal voluntary ventilation (MVV), and sternocleidomastoid (SCM) and upper trapezius activity ratios were measured. RESULTS Significant positive correlations were found between CVA and VC, FVC, FEV1, PEF, and MVV, and a significant negative correlation was found between CVA and SCM activity ratio. Significant negative correlations existed between CRA and VC and FVC, and significant positive correlations between CRA and SCM and upper trapezius activity ratios. CONCLUSION FHP may act to lower respiratory functions, and thus, the maintenance of correct head posture is required to prevent such functional reductions.
Collapse
|
32
|
Lee KS, Lee JH. Effect of maitland mobilization in cervical and thoracic spine and therapeutic exercise on functional impairment in individuals with chronic neck pain. J Phys Ther Sci 2017; 29:531-535. [PMID: 28356648 PMCID: PMC5361027 DOI: 10.1589/jpts.29.531] [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: 07/05/2016] [Accepted: 12/14/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study evaluated joint mobilization and therapeutic exercise applied to the
cervical spine and upper thoracic spine for functional impairment caused by chronic neck
pain. [Subjects and Methods] Eighteen study subjects were randomly assigned to two groups
of nine people each. Therapeutic exercise only was applied to the cervical and upper
thoracic spine for Group I, while both therapeutic exercise and joint mobilization were
applied to Group II. The visual analog scale, neck disability index, active cervical range
of motion, static balance capacity, and muscle tone were assessed with a pre-test. The
intervention was carried out for 60 minutes a day, three times a week, for two weeks for
each group, followed by a post-test using the same protocol as the pre-test. [Results] The
visual analog scale, neck disability index, and active cervical range of motion improved
significantly in both groups. Group II improved significantly more on right lateral
flexion and rightward rotation. Muscle tone improved significantly in the upper trapezius
in both groups. [Conclusion] The joint mobilization and therapeutic exercise for
functional impairments caused by chronic neck pain had a significant effect on several
types of functional impairment.
Collapse
Affiliation(s)
- Keun-Su Lee
- Department of Physical Therapy, Graduate School of Health Sciences, Cheongju University, Republic of Korea
| | - Joon-Hee Lee
- Department of Physical Therapy, Cheongju University, Republic of Korea
| |
Collapse
|
33
|
Kahlaee AH, Ghamkhar L, Arab AM. The Association Between Neck Pain and Pulmonary Function. Am J Phys Med Rehabil 2017; 96:203-210. [DOI: 10.1097/phm.0000000000000608] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
34
|
Kong YS, Kim YM, Shim JM. The effect of modified cervical exercise on smartphone users with forward head posture. J Phys Ther Sci 2017; 29:328-331. [PMID: 28265167 PMCID: PMC5332998 DOI: 10.1589/jpts.29.328] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/11/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to evaluate the effect of modified cervical
exercise and determine whether such exercise improves the range of motion of the cervical
movement in smartphone users with forward head posture. [Subjects and Methods] Some 32
subjects with forward head posture participated in this study. They were randomly
allocated to three groups, and the modified cervical exercises were performed either once,
twice, or three times per day. The exercise program was followed for four weeks and then
the joint range of motion of the participants was measured. [Results] A significantly
increased range of motion was seen in all three groups that performed the modified
cervical exercises. The analysis of the effects among the three groups indicated that the
greatest effect was seen in Group C, members of which performed the modified exercises
three times per day. In addition, a significant difference was found between Group A and
Group C in terms of the inter-group results. [Conclusion] According to the results of this
study, although the modified cervical exercises were performed for only a relatively short
duration (four weeks), the exercises brought about an improvement in the forward head
posture that was induced by using a smartphone.
Collapse
Affiliation(s)
- Yong-Soo Kong
- Department of Physical Therapy, Gangneung Yeongdong College, Republic of Korea
| | - Yu-Mi Kim
- Department of Physical Therapy, College of Health and Science, Kangwon National University, Republic of Korea
| | - Je-Myung Shim
- Department of Physical Therapy, College of Health and Science, Kangwon National University, Republic of Korea
| |
Collapse
|
35
|
Şaş S, Toprak Çelenay Ş, Özer Kaya D. The effects of balneotherapy on acute, process-related, and cumulative peripheral cardiac responses and pulmonary functions in patients with musculoskeletal disorders. Turk J Med Sci 2016; 46:1700-1706. [PMID: 28081312 DOI: 10.3906/sag-1505-31] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 02/22/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM This study aimed to evaluate the effects of balneotherapy on acute, process-related, and cumulative peripheral cardiac responses and pulmonary functions in patients with musculoskeletal disorders. MATERIALS AND METHODS Ninety-eight patients with musculoskeletal disorders referred to physiotherapy with balneotherapy were recruited. The patients received balneotherapy for 20 min 5 times per week for 2 weeks. Blood pressure and pulse were measured at the 0th, 5th, 10th, 20th, and 30th minutes during the 1st and 10th sessions. All patients were subjected to pulmonary function testing before balneotherapy and after the 10th session. RESULTS It was found that systolic blood pressure decreased between the 10th and 20th minutes of the 1st session and between the 10th and 20th minutes and the 20th and 30th minutes of the 10th session (P < 0.05). Diastolic blood pressure (DBP) decreased and pulse increased during balneotherapy (P < 0.05). DBP increase and pulse decrease were observed during recovery time (P < 0.05). The blood pressure decreased and the pulse increased after the 1st session and after the 10th session (P < 0.05). Pulmonary function improved after balneotherapy (P < 0.05). Conclusions: Balneotherapy may be effective for improving peripheral cardiopulmonary responses in patients with musculoskeletal disorders.
Collapse
Affiliation(s)
- Senem Şaş
- Training Research Hospital, Ahi Evran University, Kırşehir, Turkey
| | - Şeyda Toprak Çelenay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yıldırım Beyazıt University, Ankara, Turkey
| | - Derya Özer Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İzmir Kâtip Çelebi University, İzmir, Turkey
| |
Collapse
|
36
|
Wirth B, Ferreira TD, Mittelholzer M, Humphreys BK, Boutellier U. Respiratory muscle endurance training reduces chronic neck pain: A pilot study. J Back Musculoskelet Rehabil 2016; 29:825-834. [PMID: 27002668 DOI: 10.3233/bmr-160695] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Patients with chronic neck pain show also respiratory dysfunctions. OBJECTIVE To investigate the effects of respiratory muscle endurance training (RMET) on chronic neck pain. METHODS In this pilot study (single-subject design: 3 baseline measurements, 4 measurements during RMET), 15 neck patients (49.3 ± 13.7 years; 13 females) conducted 20 sessions of home-based RMET using a SpiroTiger® (normocapnic hyperpnoea). Maximal voluntary ventilation (MVV), maximal inspiratory (Pimax) and expiratory (Pemax) pressure were measured before and after RMET. Neck flexor endurance, cervical and thoracic mobility, forward head posture, chest wall expansion and self-assessed neck disability [Neck Disability Index (NDI), Bournemouth questionnaire] were weekly assessed. Repeated measure ANOVA (Bonferroni correction) compared the first and last baseline and the last measurement after RMET. RESULTS RMET significantly increased MVV (p= 0.025), Pimax (p= 0.001) and Pemax (p< 0.001). During RMET, neck disability significantly decreased (NDI: p= 0.001; Bournemouth questionnaire: p= 0.002), while neck flexor endurance (p< 0.001) and chest wall expansion (p< 0.001) increased. The changes in respiratory and musculoskeletal parameters did not correlate. CONCLUSIONS RMET emerged from this pilot study as a feasible and effective therapy for reducing disability in patients with chronic neck pain. The underlying mechanisms, including blood gas analyses, need further investigation in a randomized controlled study.
Collapse
Affiliation(s)
- B Wirth
- Motor Control and Learning, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland.,Department of Chiropractic Medicine, University Hospital Balgrist, Zurich, Switzerland
| | - T Duarte Ferreira
- Exercise Physiology Lab, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland
| | - M Mittelholzer
- Exercise Physiology Lab, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland
| | - B K Humphreys
- Department of Chiropractic Medicine, University Hospital Balgrist, Zurich, Switzerland
| | - U Boutellier
- Exercise Physiology Lab, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland
| |
Collapse
|
37
|
Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Respiratory dysfunction in patients with chronic neck pain: What is the current evidence? J Bodyw Mov Ther 2016; 20:704-714. [DOI: 10.1016/j.jbmt.2016.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 01/16/2016] [Accepted: 01/30/2016] [Indexed: 11/24/2022]
|
38
|
Exercise and physical therapy help restore body and self in clients with severe anorexia nervosa. J Bodyw Mov Ther 2016; 21:481-494. [PMID: 28750954 DOI: 10.1016/j.jbmt.2016.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/21/2016] [Accepted: 09/02/2016] [Indexed: 11/18/2022]
Abstract
Exercise in the context of anorexia nervosa is a multifaceted endeavour surrounded by controversy and uncertainty. A broader comprehension of this poorly understood phenomenon is required. Informed by the findings of a body examination of six individuals with anorexia nervosa, as well as exercise science, phenomenology and neurocognition, the purpose of this article is to elaborate on the potential role of exercise and physical therapy in the treatment of anorexia nervosa. The findings of the body assessment include constriction of posture, muscles and pattern of breathing. These bodily restraints are not necessarily merely associated with high levels of exercise, they may also reflect psychological strain accompanying the illness. The restricted breathing in particular is assumed to be associated with difficult thoughts and suppressed feelings. Based on the results of the body examination, as well as medical and psychological considerations accompanying the illness, it is suggested that interventions should focus on improving postural stability and restoring related muscular function. Integral to engaging in these activities, the potential to integrate proprioceptive information in this process may generate a more coherent experience of the body, as well as of the self, in these clients. Accordingly, constrictions of the body may have a vital role in constraining the experience of the self. As such, addressing bodily restraints in these clients may facilitate the experience of being the subject causing and controlling the movements. This is in marked contrast to clients' previous exercise experiences, which were associated with compulsion, rigidity and the absence of coherence and control.
Collapse
|
39
|
Smoliga JM, Mohseni ZS, Berwager JD, Hegedus EJ. Common causes of dyspnoea in athletes: a practical approach for diagnosis and management. Breathe (Sheff) 2016; 12:e22-37. [PMID: 27408644 PMCID: PMC4933616 DOI: 10.1183/20734735.006416] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Key points Educational aims Dyspnoea during exercise is a common chief complaint in athletes and active individuals. It is not uncommon for dyspnoeic athletes to be diagnosed with asthma, “exercise-induced asthma” or exercise-induced bronchoconstriction based on their symptoms, but this strategy regularly leads to misdiagnosis and improper patient management. Dyspnoea during exercise can ultimately be caused by numerous respiratory and nonrespiratory conditions, ranging from nonpathological to potentially fatal in severity. As, such it is important for healthcare providers to be familiar with the many factors that can cause dyspnoea during exercise in seemingly otherwise-healthy individuals and have a general understanding of the clinical approach to this patient population. This article reviews common conditions that ultimately cause athletes to report dyspnoea and associated symptoms, and provides insight for developing an efficient diagnostic plan. Dyspnoea, fatigue and underperformance are often interrelated symptoms in athletes, and may have various causeshttp://ow.ly/4nsYnk
Collapse
Affiliation(s)
- James M Smoliga
- Dept of Physical Therapy, High Point University, High Point, NC, USA
| | - Zahra S Mohseni
- Dept of Biology, North Carolina State University, Raleigh, NC, USA
| | | | - Eric J Hegedus
- Dept of Physical Therapy, High Point University, High Point, NC, USA
| |
Collapse
|
40
|
Lee J, Hwang S, Han S, Han D. Effects of stretching the scalene muscles on slow vital capacity. J Phys Ther Sci 2016; 28:1825-8. [PMID: 27390425 PMCID: PMC4932066 DOI: 10.1589/jpts.28.1825] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 03/12/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to examine whether stretching of the scalene
muscles would improve slow vital capacity (SVC). [Subjects and Methods] The subjects of
this study were 20 healthy female students to whom the study’s methods and purpose were
explained and their agreement for participation was obtained. The SVC was measured using
spirometry (Pony FX, COSMED Inc., Italy). The intervention used was stretching of the
scalene muscles. Stretching was carried out for 15 min, 10 times at per each portion of
scalene muscles: the anterior, middle, and posterior parts. [Results] Expiratory vital
capacity (EVC) and tidal volume (Vt) noticeably increased after stretching. However, there
were no changes in any of the SVC items in the control group. [Conclusion] This study
demonstrated that stretching of the scalene muscles can effectively improve SVC. In
particular, we confirmed that stretching of the scalene muscles was effective in
increasing EVC and Vt, which are items of SVC.
Collapse
Affiliation(s)
- Juncheol Lee
- Department of Physical Therapy, Graduate School, Daegu University, Republic of Korea
| | - Sehee Hwang
- Department of Physical Therapy, College of Health and Welfare, Silla University, Republic of Korea
| | - Seungim Han
- Department of Physical Therapy, College of Health and Welfare, Silla University, Republic of Korea
| | - Dongwook Han
- Department of Physical Therapy, College of Health and Welfare, Silla University, Republic of Korea
| |
Collapse
|
41
|
Kang KW, Jung SI, Lee DY, Kim K, Lee NK. Effect of sitting posture on respiratory function while using a smartphone. J Phys Ther Sci 2016; 28:1496-8. [PMID: 27313358 PMCID: PMC4905897 DOI: 10.1589/jpts.28.1496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/01/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate respiratory function in different
sitting postures while using a smartphone. [Subjects and Methods] Fifty healthy volunteers
were recruited. Participants were divided into 2 groups, a control group of participants
who spent time as they liked for 1 hour, and a smartphone group of participants who spent
time using a smartphone in a sitting position for 1 hour. To investigate changes in
respiratory function, we measured forced vital capacity, forced expiratory volume in 1
second, ratio of forced expiratory volume in 1 second to forced vital capacity, and peak
expiratory flow. [Results] There was a statistically significant difference in forced
vital capacity and forced expiratory volume in 1 second between the control group and
smartphone group. [Conclusion] The clinical implication of our findings is that the
posture assumed while using a smartphone leads to reduced respiratory function.
Collapse
Affiliation(s)
- Kyung Woo Kang
- Department of Physical Therapy, College of Health and Therapy, Daegu Haany University, Republic of Korea
| | - Sang In Jung
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Do Youn Lee
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Kyoung Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Na Kyung Lee
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| |
Collapse
|
42
|
Mohan V, Ahmad NB, Tambi NB. Effect of respiratory exercises on neck pain patients: A pilot study. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.poamed.2016.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
43
|
Han J, Park S, Kim Y, Choi Y, Lyu H. Effects of forward head posture on forced vital capacity and respiratory muscles activity. J Phys Ther Sci 2016; 28:128-31. [PMID: 26957743 PMCID: PMC4755989 DOI: 10.1589/jpts.28.128] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/14/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated the effects of forward head posture on forced vital capacity and deep breathing. [Subjects] Twenty-six subjects, divided into the two groups (normal and forward head posture groups), participated in this study. [Methods] Forced vital capacity and forced expiratory volume in 1 second were measured using respiratory function instrumentation that met the American Thoracic Society's recommendation for diagnostic spirometry. Accessory respiratory muscle activity during deep breathing was measured by electromyography. A Mann-Whitney test was used to compare the measure variables between the normal and forward head posture group. [Results] Forced vital capacity and forced expiratory volume in 1 second were significantly lower in the forward head posture group than in the normal group. Accessory respiratory muscle activity was also lower in the forward head posture group than in the normal group. In particular, the sternocleidomastoid and pectoralis major activity of the forward head posture group was significantly lower than that of normal group. Activities of the other muscles were generally decreased with forward head posture, but were not significantly different between the two groups. [Conclusion] These results indicate that forward head posture could reduce vital capacity, possibly because of weakness or disharmony of the accessory respiratory muscles.
Collapse
Affiliation(s)
- Jintae Han
- Department of Physical Therapy, College of Science, Kyungsung University, Republic of Korea
| | - Soojin Park
- Department of Physical Therapy, College of Science, Kyungsung University, Republic of Korea
| | - Youngju Kim
- Department of Physical Therapy, Graduate School of Clinical Pharmacy and Health, Kyungsung University, Republic of Korea
| | - Yeonsung Choi
- Department of Physical Therapy, College of Science, Kyungsung University, Republic of Korea
| | - Hyeonnam Lyu
- Department of Physical Therapy, College of Science, Kyungsung University, Republic of Korea
| |
Collapse
|
44
|
Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Clinical assessment of the deep neck flexors: Which test is best? INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2015. [DOI: 10.12968/ijtr.2015.22.10.458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Zacharias Dimitriadis
- Physiotherapist, Manchester Academic Health Sciences Centre, University of Manchester, UK and Physiotherapy Department, School of Health and Caring Professions, TEI Sterea Ellada, Lamia, Greece
| | - Eleni Kapreli
- Physiotherapist, Physiotherapy Department, School of Health and Caring Professions, TEI Sterea Ellada, Lamia, Greece
| | - Nikolaos Strimpakos
- Physiotherapist, Manchester Academic Health Sciences Centre, University of Manchester, UK and Physiotherapy Department, School of Health and Caring Professions, TEI Sterea Ellada, Lamia, Greece
| | - Jacqueline Oldham
- Professor in physiology, Manchester Academic Health Sciences Centre, University of Manchester, UK
| |
Collapse
|
45
|
Kim SY, Kim NS, Kim LJ. Effects of cervical sustained natural apophyseal glide on forward head posture and respiratory function. J Phys Ther Sci 2015; 27:1851-4. [PMID: 26180334 PMCID: PMC4499997 DOI: 10.1589/jpts.27.1851] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/07/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To determine the effects of cervical sustained natural apophyseal glide on forward head posture and respiratory function. [Subjects and Methods] Thirty male and female adults in their 20s with forward head posture were included in the study. The subjects were divided randomly into experimental and control groups (n=15 each). Subjects in the experimental group performed cervical sustained natural apophyseal glide three times/week for four weeks while subjects in the control group did not perform the intervention. The craniovertebral angle, forced vital capacity and forced expiratory volume in the first second, as well as the % predicted value of each measurement were assessed to determine the changes in respiration functions before and after the exercise. [Results] The craniovertebral angle four weeks after the experiment was increased in the experimental group, whereas the control group showed no significant difference compared to baseline. The forced vital capacity, forced expiratory volume in the first second, and the % predicted values thereof were significantly increased in the experimental group four weeks after the experiment, but not in the control group. [Conclusion] Cervical sustained natural apophyseal glide was determined to be effective in improving neck posture and respiratory functions for patients with forward head posture.
Collapse
Affiliation(s)
- Se-Yoon Kim
- Mirae Health Medical Center, Republic of Korea
| | - Nan-Soo Kim
- Department of Physical Therapy, College of Health and Science, Catholic University of Pusan, Republic of Korea
| | - Laurentius Jongsoon Kim
- Department of Physical Therapy, College of Health and Science, Catholic University of Pusan, Republic of Korea
| |
Collapse
|
46
|
Wirth B, Amstalden M, Perk M, Boutellier U, Humphreys BK. Respiratory dysfunction in patients with chronic neck pain - influence of thoracic spine and chest mobility. ACTA ACUST UNITED AC 2014; 19:440-4. [PMID: 24835338 DOI: 10.1016/j.math.2014.04.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 04/04/2014] [Accepted: 04/17/2014] [Indexed: 11/28/2022]
Abstract
Patients with chronic neck pain exhibit various musculoskeletal deficits and respiratory dysfunction. As there is a link between thoracic and cervical spine motion, the aim of this study was to investigate the relationship between thoracic spine and chest mobility with respiratory function and neck disability. Nineteen patients with chronic neck pain (7 male, 46.6 ± 10.5 years) and 19 healthy subjects (7 male, 46.5 ± 9.9 years) participated. Spirometry was conducted to determine maximal voluntary ventilation (MVV), maximal inspiratory (Pimax) and maximal expiratory pressure (Pemax). Thoracic spine mobility was measured using the Spinal Mouse(®). Chest expansion was assessed by subtracting chest circumference during maximal inspiration and expiration. Neck function was investigated by examining range of motion, forward head posture, neck flexor muscle synergy endurance and self-assessment (Neck disability index (NDI)). Correlation analyses and multiple linear regression analyses were conducted using MVV, Pimax and Pemax as independent variables. Thoracic spine mobility during flexion and chest expansion correlated significantly to MVV (r = 0.45 and 0.42), all neck motions (r between 0.39 and 0.59) and neck muscle endurance (rS = 0.36). Pemax and Pimax were related to NDI (r = -0.58 and -0.46). In the regression models, chest expansion was the only significant predictor for MVV, and Pemax was determined by neck muscle endurance. These results suggest that chronic neck pain patients should improve the endurance of the neck flexor muscles and thoracic spine and chest mobility. Additionally, these patients might benefit from respiratory muscle endurance training, possibly by increasing chest mobility and Pemax.
Collapse
Affiliation(s)
- B Wirth
- Motor Control and Learning, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland.
| | - M Amstalden
- Motor Control and Learning, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland
| | - M Perk
- Exercise Physiology Lab, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland
| | - U Boutellier
- Exercise Physiology Lab, Institute for Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland
| | - B K Humphreys
- Department of Chiropractic, Balgrist Hospital, Zurich, Switzerland
| |
Collapse
|
47
|
|
48
|
Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Respiratory weakness in patients with chronic neck pain. ACTA ACUST UNITED AC 2012. [PMID: 23199797 DOI: 10.1016/j.math.2012.10.014] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Respiratory muscle strength is one parameter that is currently proposed to be affected in patients with chronic neck pain. This study was aimed at examining whether patients with chronic neck pain have reduced respiratory strength and with which neck pain problems their respiratory strength is associated. In this controlled cross-sectional study, 45 patients with chronic neck pain and 45 healthy well-matched controls were recruited. Respiratory muscle strength was assessed through maximal mouth pressures. The subjects were additionally assessed for their pain intensity and disability, neck muscle strength, endurance of deep neck flexors, neck range of movement, forward head posture and psychological states. Paired t-tests showed that patients with chronic neck pain have reduced Maximal Inspiratory (MIP) (r = 0.35) and Maximal Expiratory Pressures (MEP) (r = 0.39) (P < 0.05). Neck muscle strength (r > 0.5), kinesiophobia (r < -0.3) and catastrophizing (r < -0.3) were significantly associated with maximal mouth pressures (P < 0.05), whereas MEP was additionally negatively correlated with neck pain and disability (r < -0.3, P < 0.05). Neck muscle strength was the only predictor that remained as significant into the prediction models of MIP and MEP. It can be concluded that patients with chronic neck pain present weakness of their respiratory muscles. This weakness seems to be a result of the impaired global and local muscle system of neck pain patients, and psychological states also appear to have an additional contribution. Clinicians are advised to consider the respiratory system of patients with chronic neck pain during their usual assessment and appropriately address their treatment.
Collapse
Affiliation(s)
- Zacharias Dimitriadis
- Physiotherapy Department, Technological Educational Institute of Lamia, 3rd km Old National Road Lamia-Athens, 35100 Lamia, Greece.
| | | | | | | |
Collapse
|
49
|
Lee Y, Gong W, Kim B. Correlations between Cervical Lordosis, Vital Capacity, T-spine ROM and Equilibrium. J Phys Ther Sci 2011. [DOI: 10.1589/jpts.23.103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yoonmi Lee
- Department of Occupational Therapy, GumiCollege
| | - Wontae Gong
- Department of Physical Therapy, Gumi College
| | - Byungkon Kim
- Department of Physical Therapy, Daegu Health College
| |
Collapse
|
50
|
Kapreli E, Vourazanis E, Billis E, Oldham JA, Strimpakos N. Respiratory Dysfunction in Chronic Neck Pain Patients. A Pilot Study. Cephalalgia 2009; 29:701-10. [DOI: 10.1111/j.1468-2982.2008.01787.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this pilot study was to add weight to a hypothesis according to which patients presenting with chronic neck pain could have a predisposition towards respiratory dysfunction. Twelve patients with chronic neck pain and 12 matched controls participated in this study. Spirometric values, maximal static pressures, forward head posture and functional tests were examined in all subjects. According to the results, chronic neck patients presented with a statistically significant decreased maximal voluntary ventilation ( P = 0.042) and respiratory muscle strength (Pimax and Pemax), ( P = 0.001 and P = 0.002, respectively). Furthermore, the current study demonstrated a strong association between an increased forward head posture and decreased respiratory muscle strength in neck pateits. The connection of neck pain and respiratory function could be an important consideration in relation to patient assessment, rehabilitation and consumption of pharmacological agents.
Collapse
Affiliation(s)
- E Kapreli
- Department of Physiotherapy, T.E.I of Lamia, Greece
| | - E Vourazanis
- Department of Physiotherapy, T.E.I of Lamia, Greece
| | - E Billis
- Department of Physiotherapy, Branch Department of Aigion, T.E.I of Patras, Greece
| | - JA Oldham
- Centre for Rehabilitation Science, University of Manchester, Manchester, UK
| | - N Strimpakos
- Department of Physiotherapy, T.E.I of Lamia, Greece
- Centre for Rehabilitation Science, University of Manchester, Manchester, UK
| |
Collapse
|