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Muacevic A, Adler JR. Measuring the Efficacy of Myofascial Rollers and Post-isometric Relaxation Technique in Relieving Pain Intensity and Postural Deviation Using Plumb Line Assessment for the Treatment of Upper Cross Syndrome in Dental Undergraduate (UG) Students. Cureus 2022; 14:e29831. [PMID: 36337788 PMCID: PMC9626377 DOI: 10.7759/cureus.29831] [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: 09/15/2022] [Accepted: 10/02/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In today's world, the upper cross syndrome is growing more common and becoming very prevalent among dental undergraduate practitioners. One of the most important conditions for which dentists seek physiotherapy treatment is neck pain. It is characterized by overactive pectoralis and trapezius muscles. It is frequently linked to poor posture in dental students' daily life, causing them to miss their work. OBJECTIVES The first objective of our study was to find the efficacy of myofascial rollers and post-isometric relaxation technique along with conventional therapy for pain relief and correction of postural deviation in undergraduate dental students. And, the second objective of the study was to compare the effect of myofascial rollers and post-isometric relaxation techniques in upper cross syndrome. METHODS The study was conducted with pre-test and post-test methods. The study consisted of 80 participants who were included based on our inclusion and exclusion criteria. The study sample was randomly assigned into two groups. Each group consisted of a total of 40 participants. Group A was treated using myofascial rollers and hot packs, and Group B was treated using the post-isometric relaxation technique and hot packs. Patients were asked to mark their intensity of pain on the Numerical Pain Rating Scale and an assessment of postural deviations (in mm) was noted through a plumb line in the posture grid. Posture assessment was done in lateral view. The protocol covered four weeks of treatment based on the defined protocol. Finally, the t-square test and Chi-square test were used to compare the difference in the result. Also, the level of significance was kept at <0.05. RESULT Statistical analysis was done using descriptive and inferential statistics using student paired, unpaired, and chi-square test. IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States) was used. The Numerical Pain Rating Scale showed mean deviations of (4.15±1.29) for Group A and (3.30±1.01) for Group B. Plumb line assessment showed mean deviations of (9.09±4.31) for Group A and (6.33±2.36) for Group B. Also, Numerical Pain Rating Scale showed (t=3.26, p=0.002) and Plumb line deviation showed (t=3.57, p=0.001). CONCLUSION Through our study, we conclude that statistically no significant differences were found in pre-intervention and post-intervention, but myofascial rollers gave better results as compared to the post-isometric relaxation technique in alleviating pain and correcting postural deviation.
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Santiago-Reynoso GM, Alvarado-Luna AE, Fernandez-Matias R, Pecos-Martin D, Gallego-Izquierdo T. Transcultural adaptation of the neck disability index to mexican spanish and assessment of its psychometric properties. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:2654-2660. [PMID: 33944998 DOI: 10.1007/s00586-021-06835-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 02/27/2021] [Accepted: 04/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To transculturally adapt the Neck Disability Index to Mexican Spanish (NDI-Mx) and to evaluate its psychometric properties. METHODS Translation and transcultural adaptation of the NDI were conducted according to published guidelines. The test-retest reliability of the NDI-Mx was assessed with intraclass correlation coefficient (ICC3,1), the student t-test, standard error of measurement, minimal detectable change and Bland-Altman plot. Cronbach's α coefficient was used to evaluate internal consistency. Floor and ceiling effects were also evaluated. Convergent validity was assessed by comparison of the NDI-Mx with the Northwick Park Neck Pain Questionnaire (NPQ) through the Spearman correlation coefficient. Finally, a confirmatory factor analysis (CFA) was conducted. RESULTS The sample was composed of 113 subjects (38 men and 75 women) with a mean age of 30 (SD, 12.19) years. All items of the NDI-Mx showed good test-retest reliability (ICC3,1 = 0.86) and good internal consistency (Cronbach's α = 0.85). Floor and ceiling effects were not observed. There was good convergent validity with a high correlation between NDI-Mx and NPQ (ρ = 0.83). The CFA revealed that a one-factor solution fitted adequately the data (χ2(32) = 41.18, p = .13). CONCLUSION The NDI-Mx seems to be a valid and reliable tool that can be used in clinical practice and research on Mexican populations with neck pain.
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Affiliation(s)
| | | | - Ruben Fernandez-Matias
- Research Institute of Physiotherapy and Pain, University of Alcala., 28805, Alcala de Henares, Madrid, Spain
| | - Daniel Pecos-Martin
- University of Alcala, Physiotherapy and Pain Group, Department of Physical Therapy, Campus Universitario. Ctra., Madrid-Barcelona, km, 33600, 28871, 28805, Alcala de Henares, Madrid, Spain.
| | - Tomas Gallego-Izquierdo
- University of Alcala, Physiotherapy and Pain Group, Department of Physical Therapy, Research Institute of Physiotherapy and Pain., 28805, 28871, Alcala de Henares, Madrid, Spain
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Romero Del Rey R, Saavedra Hernández M, Rodríguez Blanco C, Palomeque Del Cerro L, Alarcón Rodríguez R. Short-term effects of spinal thrust joint manipulation on postural sway in patients with chronic mechanical neck pain: a randomized controlled trial. Disabil Rehabil 2020; 44:1227-1233. [PMID: 32730089 DOI: 10.1080/09638288.2020.1798517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Our aim was to compare the efficacy of spinal manipulation of the upper cervical spine (C1-C2) on postural sway in patients with chronic mechanical neck pain with the application of a combination of cervical (C3-C4), cervicothoracic (C7-T1) and thoracic spine (T5-T6) thrust joint manipulation. METHODS One hundred eighty-six (n = 186) individuals with chronic mechanical neck pain were randomised to receive an upper cervical spine manipulation (n = 93) or three different spinal manipulation techniques applied to the cervical spine, cervicothoracic joint and thoracic spine (n = 93). Measures included the assessment of stabilometric parameters using the Medicapteurs S-Plate platform. Secondarily, neck pain was analysed using the Numeric Pain Rating Scale. RESULTS We observe a decrease in the length of the centre of pressure path, average speed, medio-lateral and antero-posterior displacement with statistically significant results (p < 0.05) in the upper cervical manipulation group. Both interventions are equally effective in reducing neck pain after fifteen days (p < 0.001). CONCLUSION The application of upper cervical thrust joint manipulation is more effective in improving stabilometric parameters in patients with chronic mechanical neck pain. Trial registration: The study was registered in the Australian and New Zealand Clinical Trial Registry (no. ACTRN12619000546156).Implications for rehabilitationPatients who suffer from neck pain exhibit increased postural sway than asymptomatic subjects.Both spinal manipulation treatments applied in this study are equally effective in reducing neck pain.Spinal manipulation treatment on the upper cervical spine improves postural stability parameters.
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Affiliation(s)
- Raúl Romero Del Rey
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
| | - Manuel Saavedra Hernández
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.,Escuela de Osteopatía de Madrid, Madrid, Spain
| | - Cleofás Rodríguez Blanco
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - Luis Palomeque Del Cerro
- Escuela de Osteopatía de Madrid, Madrid, Spain.,Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
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Giacalone A, Febbi M, Magnifica F, Ruberti E. The Effect of High Velocity Low Amplitude Cervical Manipulations on the Musculoskeletal System: Literature Review. Cureus 2020; 12:e7682. [PMID: 32426194 PMCID: PMC7228797 DOI: 10.7759/cureus.7682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In manual therapy, high velocity low amplitude (HVLA) cervical manipulation techniques are frequently used, but often the physiological and biomechanical effects that can be obtained are not completely clear. The techniques are mostly used for the treatment of biomechanical joint dysfunction, but little is yet known about the possibility of using them in order to achieve better performance on healthy subjects. The objective of the study is to describe how cervical manipulation can impact on a musculoskeletal disorder. A systematic search was carried out on the Pubmed electronic database from the beginning of January to March 2020. Two independent reviewers conducted the screening process through the PRISMA diagram to determine the eligibility of the articles. The inclusion criteria covered randomized controlled trial (RCT) manuscripts published in peer-reviewed journals with individuals of all ages from 2005 to 2020. The included intervention was thrust manipulation or HVLA directed towards the cervical spine region. After reviewing the literature, 21 of 74 articles were considered useful and relevant to the research question. The results of the research show that HVLA techniques, on subjects with musculoskeletal disorders, are able to influence pain modulation, mobility and strength both in the treated area and at a distance. Cervical manipulations are effective in management of cervicalgia, epicondylalgia, temporomandibular joint disorders and shoulder pain. With regard to results on strength in healthy subjects, given the divergent opinions of the authors, we cannot yet state that manipulation can significantly influence this parameter. Cervical manipulations can also have risks for the patient if applied when not appropriate but the frequency of complications due to vertebral manipulation are very low. However, the manipulation techniques might be limited by low patients tolerance or the presence of contraindications. In addition, the optimal number of manipulations to be performed and the long-term benefits produced are unknown.
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Affiliation(s)
- Andrea Giacalone
- Industrial Engineering Technologies for Sports Medicine and Rehabilitation, University of Rome Tor Vergata, Rome, ITA
| | - Massimiliano Febbi
- Industrial Engineering Technologies for Sports Medicine and Rehabilitation, University of Rome Tor Vergata, Rome, ITA
| | - Fabrizio Magnifica
- Neurology, Sapienza University, Rome, ITA.,Aerospace Medicine, Diagnostic Therapeutic and Rehabilitative Aeromedical Center, Italian Air Force, Rome, ITA
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Bayattork M, Seidi F, Minoonejad H, Andersen LL, Page P. The effectiveness of a comprehensive corrective exercises program and subsequent detraining on alignment, muscle activation, and movement pattern in men with upper crossed syndrome: protocol for a parallel-group randomized controlled trial. Trials 2020; 21:255. [PMID: 32164773 PMCID: PMC7069207 DOI: 10.1186/s13063-020-4159-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 02/11/2020] [Indexed: 11/13/2022] Open
Abstract
Background Upper crossed syndrome (UCS) refers to specific altered muscle activation and changed movement patterns along with some postural deviations in the upper quarter of the body. This syndrome might contribute to the dysfunction of the cervicothoracic and glenohumeral joints. Objectives The present study will aim to investigate the effectiveness of a comprehensive corrective exercises program (CCEP) and subsequent detraining on alignment, muscle activation and movement pattern in men with UCS. Methods/design This is a parallel-group randomized controlled trial. Participants will be 22 men aged 18 to 28 years who are suffering from UCS. Participants in the intervention group will conduct CCEP (three times a week for 8 weeks), followed by 4 weeks of detraining. The control group will do their daily activities. Participants will be randomized (1:1) into the intervention or the control group. The primary outcome will be upper trapezius activations. Secondary outcomes consist of electromyography of middle and lower trapezius and serratus anterior muscles, scapular dyskinesis test, forward head and shoulder angles, thoracic kyphosis angle, and neck flexion pattern test. Discussion We propose to evaluate the effectiveness of a randomized controlled trial of a CCEP in men with UCS on their alignment, selected muscle activations, and relevant movement patterns. Results from our trial may provide new insights into the effects of exercise not only on the alignment but also on muscle activation and movement patterns that are important outcomes for people with postural malalignments and, if successful, could assist therapists in evidence-based clinical decision-making. Trial registration Iranian Registry of Clinical Trials, IRCT20181004041232N1. Registered on 26 October 2018.
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Affiliation(s)
- Mohammad Bayattork
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.,Sport Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran
| | - Foad Seidi
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.
| | - Hooman Minoonejad
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, DK-9220, Aalborg, Denmark
| | - Phil Page
- Performance Health, Baton Rouge, Louisiana, USA
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Pochon L, Peterson CK, Sutter R, Del Grande F, Ulbrich EJ, Pfirrmann CW. Hip MRI findings and outcomes following imaging-guided hip injections. Br J Radiol 2020; 93:20190817. [PMID: 31899657 DOI: 10.1259/bjr.20190817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To determine if MRI findings prior to intra-articular corticosteroid hip infiltration are related to treatment outcomes. METHODS This prospective outcome study with retrospective MRI evaluation includes 100 consecutive patients with MRI within 6 months before a therapeutic intra-articular hip injection. Labrum, bone marrow, acetabular and femoral cartilage abnormalities were assessed by two radiologists blinded to patient outcomes: the proportion reporting "improvement" on the Patient's Global Impression of Change (PGIC) scale at 1 day, 1 week and 1 month follow-up were compared based on MRI findings using χ2. The t-test was used to compare pain change scores with MRI abnormalities. RESULTS Patients with a normal labrum in the posterosuperior quadrant were more likely to report PGIC "improvement" at 1 week compared to labral degeneration (p = 0.048). Significant differences in pain change scores were found at all time points for the labral anteroinferior quadrant (p = 0.001, 1 day; p = 0.010, 1 week; p = 0.034, 1 month) with the highest reduction in patients with labral degeneration. Females were 2.80 times more likely to report clinically relevant "improvement" at 1 day (p = .049) and 2.90 times more likely to report clinically relevant "improvement" at 1 month (p = .045). CONCLUSION Cartilage defects and marrow abnormalities were not associated with outcomes. Patients with a normal labrum in the posterosuperior quadrant had better outcomes at 1 week. Patients with labral degeneration of the anteroinferior quadrant had higher levels of pain reduction at all time points. Females were significantly more likely to report PGIC "improvement". ADVANCES IN KNOWLEDGE A significant treatment outcome was observed amongst gender, although there were no significant differences in the MRI findings.
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Affiliation(s)
- Laura Pochon
- Cabinet aux 4 mains, Fischergässli 33, 3280 Murten, Switzerland
| | | | - Reto Sutter
- Department of Radiology, University Hospital Balgrist University of Zürich Forchstrasse 340 8008, Zürich, Switzerland
| | - Filippo Del Grande
- Department of Radiology, Regional Hospital Via Tesserete 46 6900, Lugano, Switzerland
| | - Erika J Ulbrich
- Department of Radiology, University Hospital Zürich Rämistrasse 100 8091, Zürich, Switzerland
| | - Christian W Pfirrmann
- Department of Radiology, University Hospital Balgrist University of Zürich Forchstrasse 340 8008, Zürich, Switzerland
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Tarola G, Phillips RB. Chiropractic Response to a Spontaneous Vertebral Artery Dissection. J Chiropr Med 2015; 14:183-90. [PMID: 26778932 DOI: 10.1016/j.jcm.2015.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 10/13/2015] [Accepted: 10/13/2015] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The purpose of this case report is to describe a case in which early detection and proper follow-up of spontaneous vertebral artery dissection led to satisfactory outcomes. CLINICAL FEATURES A 34-year old white woman reported to a chiropractic clinic with a constant burning pain at the right side of her neck and shoulder with a limited ability to turn her head from side to side, periods of blurred vision, and muffled hearing. Dizziness, visual and auditory disturbances, and balance difficulty abated within 1 hour of onset and were not present at the time of evaluation. A pain drawing indicated burning pain in the suboccipital area, neck, and upper shoulder on the right and a pins and needles sensation on the dorsal surface of both forearms. Turning her head from side-to-side aggravated the pain, and the application of heat brought temporary relief. The Neck Disability Index score of 44 placed the patient's pain in the most severe category. INTERVENTION AND OUTCOME The patient was not treated on the initial visit but was advised of the possibility of a vertebral artery or carotid artery dissection and was recommended to the emergency department for immediate evaluation. The patient declined but later was convinced by her chiropractor to present to the emergency department. A magnetic resonance angiogram of the neck and carotid arteries was performed showing that the left vertebral artery was hypoplastic and appeared to terminate at the left posterior inferior cerebellar artery. There was an abrupt moderately long segment of narrowing involving the right vertebral artery beginning near the junction of the V1 and V2 segments. The radiologist noted a concern regarding right vertebral artery dissection. Symptoms resolved and the patient was cleared of any medications but advised that if symptoms reoccurred she was to go for emergency care immediately. CONCLUSION Recognition and rapid response by the chiropractic physician provided the optimum outcome for this particular patient.
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Affiliation(s)
- Gary Tarola
- Private Practice, Lehigh Valley Medical Network, Allentown, PA
| | - Reed B Phillips
- Adjunct Faculty, Southern California University of Health Sciences, Whittier, CA
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