Cervical Muscles Research Articles

Muscle strength, balance and upper extremity function are not predictors of cervical proprioception in healthy young subjects

Purpose/Aim: The aim of this study is to examine the relationship between cervical proprioception sense and balance, hand grip strength, cervical region muscle strength and upper extremity functionality in healthy young subjects. Methods: A total of 200 people with a mean age of 20.8 ± 1.8 participated in the study. Cervical proprioception sense of the participants was evaluated with Cervical Joint Position Error Test (CJPET), balance with Biodex Stability System, hand grip strength with hand dynamometer, and upper extremity functionality with Perdue Pegboard test. The relationship of variables with cervical proprioception was evaluated with Pearson Correlation analysis. Results: According to this study results, there was no significant relationship between CJPET (extension, left rotation, right rotation) and sub-parameters of dynamic balance (anteroposterior, mediolateral, overall), cervical muscle strength and hand grip strength (p > 0.05). There was a significant correlation between CJPET flexion and static balance variables (p < 0.05). Conclusion: According to this study, there is no relationship between cervical proprioception and balance, hand grip muscle strength, cervical region muscle strength and upper extremity functionality in healthy young subjects.

Cervical neuro-musculoskeletal impairments in people with cervicogenic headache: a systematic review and meta-analysis

Background: People with cervicogenic headache (CGH) typically present with headache symptoms similar to other headache forms but with distinguishing features of neuro-musculoskeletal impairments. With current diagnostic criteria it is unclear which impairments are important for CGH diagnosis. Objective: To comprehensively review the evidence for cervical neuromusculoskeletal impairments in people with a diagnosis of CGH when compared to asymptomatic controls. Methods: Eight databases were searched for relevant studies evaluating neuro-musculoskeletal impairments in people with CGH. Risk-of-bias and overall quality of the evidence were assessed and meta-analyses performed. Results: Sixteen studies were included, the majority with low risk of bias. In comparison with asymptomatic controls the subjects with CGH presented with reduced combined cervical flexion-extension ROM (MD −9.26˚, 95% CI: −12.24˚, −6.27˚, I2 = 6%), side flexion ROM (MD: −2.97˚, 95% CI: 5.48˚, −0.46˚, I2 = 51%), and rotation ROM (MD: −13.57, 95% CI: −16.10, −11.03, I2 = 99%). Upper cervical rotation ROM was markedly reduced towards the headache side (MD: −15.07˚, 95% CI: −16.61˚, −13.53˚, I2 = 68%). Similarly, cervical flexor (MD: −33.70˚, 95% CI: −47.23˚, −20.16˚, I2 = 0%) and extensor strength (MD: −55.78, 95% CI: −77.56, −34.00, I2 = 0%) was reduced in subjects with CGH along with reduced craniovertebral angle. Kinaesthetic sense was not significantly impaired in subjects with CGH. The overall rating score for certainty of evidence was high to very low for all assessed outcomes. Conclusion: People with CGH have significantly decreased cervical ROM and muscle function with level of evidence ranging from high to very low.

Exploratory Study on Central Sensitization and Bioelectrical Activity of the Selected Masticatory Muscles in Subjects with Myopia

Myopia is one of the most common eye disorders involving abnormal focusing of light rays. The studies recognize the association between the stomatognathic and visual systems. This compound may have a neurological basis associated with disorders such as central sensitization. The main aim of this study was to evaluate the influence of central sensitization on the bioelectrical activity of selected muscles of the masticatory organ in subjects with myopia. Selected masticatory and cervical spine muscles were analyzed using an eight-channel BioEMG III electromyograph. Central sensitization was analyzed using the central sensitization inventory. Statistical analysis revealed significantly higher scores on the central sensitization inventory in subjects with axial myopia compared to subjects without refractive error. Repeated positive correlations were observed in the sternocleidomastoid muscle activity and negative correlations in the digastric muscle activity during open and closed eyes in myopic subjects. Subjects with myopia have an increased score in the central sensitization inventory. The increase in the central sensitization inventory score is connected with the changes within the electromyographic activity of the masticatory and neck muscles. The effect of central sensitization on masticatory muscle activity in myopic subjects requires further study.

A Novel Device for Assessment and Treatment of Upper Cervical Spine: Test–Retest Reliability Study

Neck pain is one of the most frequent reasons for consultation in primary care. Clinicians evaluate different variables, including movement and cervical strength, to determine the prognosis of patients. Usually, the tools employed for this purpose are expensive and bulky, or more than one is needed. This study aims to describe a novel device designed to assess the cervical spine and describe its test-retest reliability. The Spinetrack device was designed to measure the strength of deep cervical flexor muscles and the chin-in and chin-out movement of the upper cervical spine. A test-retest reliability study was developed. The flexion, extension and strength needed to move the Spinetrack device were registered. Two measurements were developed, with one week between each assessment. Twenty healthy subjects were evaluated. The strength of the deep cervical flexor muscles in the first measurement was 21.18 ± 3.15 Newtons, the displacement movement during chin-in movement was 12.79 mm ± 3.46 and the displacement during chin-out movement was 35.99 mm ± 4.44. The test-retest reliability of strength was ICC 0.97 (95% CI (0.91-0.99)). The Spinetrack device has shown excellent test-retest reliability values for the measurement of the strength of the cervical flexor muscles and for the chin-in and chin-out movements.

Abstract P4-07-10: Effect of acupuncture and exercise therapy on muscular strength, lymphedema and quality of life in breast cancer survivors: randomized clinical trial

Abstract Introduction: The continuous advance in the early detection and treatment of breast cancer has significantly reduced mortality and, consequently, increased the number of survivors with treatment side effects that act on the quality of life, such as lymphedema, loss of upper limb strength, shoulder dysfunction, decreased functional capacity, flexibility, and joint mobility. Exercise therapy is a recognized practice for the rehabilitation of these disorders; however, acupuncture needs to be better evaluated to compare its equivalence with classical therapy. Objective: To compare three distinct rehabilitation treatments (exercise therapy, acupuncture and Stiper®) in women undergoing breast cancer surgery, assessing strength, lymphedema and quality of life. Methods: Seventy-nine women with pain above 3 on the visual analogue pain scale (VAS) and with more than 90 days of surgery were included. They were divided into three groups that received weekly treatment for 10 weeks: group I (G1) treated with standard, pre-defined exercise therapy, based on stretching of the cervical muscles, shoulder girdle and shoulder ROM exercises with a duration of 30 minutes, group II (G2) treated with 30 minutes of acupuncture using predefined points and group III (G3) treated with the same acupuncture points as group II, however, using the Stiper® (silicon oxide micronized quartz pellet) in place of needles. Results: Sixty-seven patients completed the treatment, being 26 from G1, 23 from G2 and 18 from G3. There was an improvement in upper limb muscle strength over time in all groups, except for abduction and internal rotation movements. During treatment, there was no increase in the number of patients with lymphedema and there was no statistical difference between the groups. Regarding the EORTC QLQ-C30 quality of life questionnaire, nine of the fifteen factors analyzed showed significant differences between sessions. The factors that did not have significant differences between the three groups were Social Function, Nausea and Vomiting, Dyspnea, Loss of Appetite, Constipation and Diarrhea. Conclusion: The rehabilitation of physical dysfunctions in women who survived breast cancer through exercise therapy, acupuncture and Stiper® in upper limb muscle strength, lymphedema and quality of life, proved to be effective, without difference between groups, which leads to the conclusion that acupuncture didn’t show superiority of results when compared with exercise therapy, thus being an effective approach for the rehabilitation of these women. Citation Format: Patricia Santolia, Gil Facina, Cinira Haddad, Samantha K. Lopes de Almeida Rizzi, Afonso Nazário, Simone Elias. Effect of acupuncture and exercise therapy on muscular strength, lymphedema and quality of life in breast cancer survivors: randomized clinical trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-10.

Abstract P4-07-43: Effect of acupuncture and exercise therapy in rehabilitation of physical disfunctions in breast cancer survivors: randomized clinical trial

Abstract Introduction: The treatment of breast cancer can trigger physical dysfunctions and psychological difficulties such as pain, depression, limitation of upper limb function and shoulder range of motion (ROM) deficits. Exercise therapy is a treatment well established in the literature for these disorders and another form of treatment is acupuncture. However, most studies using acupuncture only assess pain. Objective: To compare three distinct rehabilitation treatments (exercise therapy, acupuncture and Stiper®) in women undergoing breast cancer surgery, assessing pain, depression, upper limb function and range of motion parameters (ROM). Methods: Seventy-nine women with pain above 3 on the visual analogue pain scale (VAS) and with more than 90 days of surgery were included. They were divided into three groups that received weekly treatment for 10 weeks: group I (G1) treated with standard, pre-defined exercise therapy, based on stretching of the cervical muscles, shoulder girdle and shoulder ROM exercises with a duration of 30 minutes, group II (G2) treated with 30 minutes of acupuncture using predefined points and group III (G3) treated with the same acupuncture points as group II, however, using the Stiper ® (silicon oxide micronized quartz pellet) in place of needles. Results: Sixty-seven patients completed the treatment, being 26 from G1, 23 from G2 and 18 from G3. There was an improvement of pain over time in all groups (first session compared with the fifth (p &amp;lt; 0.001) and with the tenth (p &amp;lt; 0.001), but not between groups. There was a statistically significant difference in depressive symptoms using the Beck questionnaire over time in the three groups (between the first and tenth sessions (p = 0.001), between the first and fifth sessions (p = 0.052), but not between groups. Regarding the DASH questionnaire for shoulder function, there were significant differences overtime at all evaluated moments (p&amp;lt; 0.001), but not between groups. There was a statistically significant difference in ROM over time in the three groups, but not between groups. Conclusion: The rehabilitation of physical dysfunctions in women who survived breast cancer through exercise therapy, acupuncture and Stiper® in pain, depression, upper limb function and ROM, proved to be effective, without statistically difference between the groups, which in leads to the conclusion that acupuncture don’t showed the superiority of results when compared with exercise therapy, thus being an effective approach in the rehabilitation of these women. Citation Format: Patricia Santolia, Gil Facina, Cinira Haddad, Afonso Nazário, Samantha K. Lopes de Almeida Rizzi, Simone Elias. Effect of acupuncture and exercise therapy in rehabilitation of physical disfunctions in breast cancer survivors: randomized clinical trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-43.

Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study

BackgroundOutcome assessment in stroke patients is essential for evidence-based stroke care planning. Computed tomography (CT) is the mainstay of diagnosis in acute stroke. This study aimed to investigate whether CT-derived cervical fat-free muscle fraction (FFMF) as a biomarker of muscle quality is associated with outcome parameters after acute ischemic stroke.MethodsIn this retrospective study, 66 patients (mean age: 76 ± 13 years, 30 female) with acute ischemic stroke in the anterior circulation who underwent CT, including CT-angiography, and endovascular mechanical thrombectomy of the middle cerebral artery between August 2016 and January 2020 were identified. Based on densitometric thresholds, cervical paraspinal muscles covered on CT-angiography were separated into areas of fatty and lean muscle and FFMF was calculated. The study cohort was binarized based on median FFMF (cutoff value: < 71.6%) to compare clinical variables and outcome data between two groups. Unpaired t test and Mann-Whitney U test were used for statistical analysis.ResultsNational Institute of Health Stroke Scale (NIHSS) (12.2 ± 4.4 vs. 13.6 ± 4.5, P = 0.297) and modified Rankin scale (mRS) (4.3 ± 0.9 vs. 4.4 ± 0.9, P = 0.475) at admission, and pre-stroke mRS (1 ± 1.3 vs. 0.9 ± 1.4, P = 0.489) were similar between groups with high and low FFMF. NIHSS and mRS at discharge were significantly better in patients with high FFMF compared to patients with low FFMF (NIHSS: 4.5 ± 4.4 vs. 9.5 ± 6.7; P = 0.004 and mRS: 2.9 ± 2.1 vs.3.9 ± 1.8; P = 0.049). 90-day mRS was significantly better in patients with high FFMF compared to patients with low FFMF (3.3 ± 2.2 vs. 4.3 ± 1.9, P = 0.045).ConclusionCervical FFMF obtained from routine clinical CT might be a new imaging-based muscle quality biomarker for outcome prediction in stroke patients.

The Influence of Visual Input on Electromyographic Activity and Patterns of Masticatory and Cervical Spine Muscles in Emmetropic Caucasian Subjects by Gender

(1) Background: The objective of the research was to analyze the change of visual input on electromyographic activity and patterns of masticatory and cervical spine muscles in emmetropic Caucasian subjects by gender. Supposedly, visual input should not influence activity and electromyographic patterns of masticatory and cervical spine muscles in emmetropic Caucasian subjects by gender. (2) Methods: After applying the inclusion criteria, 50 emmetropic Caucasian subjects were included in the study. Four muscle pairs were analyzed: the temporalis muscle (TA), the masseter muscle (MM), the digastric muscle (DA), and the sternocleidomastoid muscle (SCM), during resting and functional activity. (3) Results: It was observed that there were no significant statistical differences in activity and bioelectrical patterns between open and closed eyes in women and men, with the exception of clenching on dental cotton rollers in DA-left and DA mean between tests in women. The observed statistical results had a small effect size, successively equal to 0.32 and 0.29. (4) Conclusions: Changes in the influence of visual input do not affect electromyographic activity and patterns of masticatory and cervical spine muscles in emmetropic Caucasian women and men.

Ultrasound Imaging and Guidance for Cervical Myofascial Pain: A Narrative Review

Cervical myofascial pain is a very common clinical condition in the daily practice of musculoskeletal physicians. Physical examination is currently the cornerstone for evaluating the cervical muscles and identifying the eventual presence of myofascial trigger points. Herein, the role of ultrasound assessment in precisely localizing them is progressively mounting in the pertinent literature. Moreover, using ultrasound, not only the muscle tissue but also the fascial and neural elements can be accurately located/evaluated. Indeed, several potential pain generators, in addition to paraspinal muscles, can be involved in the clinical scenario of cervical myofascial pain syndrome. In this article, the authors extensively reviewed the sonographic approach for cervical myofascial pain in order to better diagnose or guide different procedures that can be performed in the clinical practice of musculoskeletal physicians.

The fatty infiltration into cervical paraspinal muscle as a predictor of postoperative outcomes: A controlled study based on hybrid surgery.

The cervical paraspinal muscle (CPM) has an essential role in positioning, stabilizing and directing the cervical spine. However, information is lacking regarding the influence of CPM on outcomes following anterior cervical surgery. This study aims to evaluate the association of fatty infiltration (FI) of CPM with postoperative outcomes in patients undergoing hybrid surgery (HS) and analyze the relationship between FI and cross-sectional area (CSA) of CPM. A retrospective analysis was performed on 110 consecutive patients undergoing continuous 2-level HS. According to Goutallier classification of multifidus FI, the patients were divided into normal, moderate, and severe groups. Image J software was employed to outline and analyze CPM. Clinical outcomes and radiographic parameters were collected and evaluated for relevant comparisons. Visible FI was identified in 69.1% of patients (76/110), with a propensity in elderly patients (p = 0.053). No statistically significant differences were presented among the three groups regarding pre- and postoperative clinical evaluation scores. The cervical lordosis was significantly higher in the normal group before surgery (p = 0.029). Likewise, the sagittal vertical axis (SVA) was significantly higher in the severe group than the normal group at the final follow-up (p = 0.046). The function spine unit angle and disc angle of arthroplasty levels were significantly lower in the severe group than the normal group at follow-ups. Moreover, after correction according to vertebral body area, no statistically significant relationship existed between CSA ratio and FI grade. CPM degeneration is common and age-related in patients with cervical disc degenerative disease. More importantly, there was a significant positive correlation between severe FI of CPM and postoperative sagittal balance disorder, particularly in C2-7 SVA and segmental alignment of arthroplasty level. Meanwhile, FI of CPM appears to have no impact on clinical outcomes and reveals small correlations to CSA.

＜Editors' Choice＞ Neck pain after cervical laminoplasty is associated with postoperative atrophy of the trapezius muscle.

Cervical laminoplasty is a safe and effective treatment for cervical myelopathy. However, it has a higher frequency of postoperative axial pain than other methods. A variety of causes of postoperative axial pain have been reported, but these have not been fully elucidated. This study aimed to investigate the association between postoperative axial pain and changes in the posterior neck muscles before and after surgery. The study included 93 patients with cervical myelopathy who underwent surgery at our institute between June 2010 and March 2013. The patients with greater preoperative and 1-year postoperative neck pain visual analog scale scores comprised the neck pain group. The cross-sectional area of the cervical posterior extensor muscles and the trapezius muscle were measured by magnetic resonance imaging before and 1 year after surgery at the C3/4, C4/5, and C5/6 levels to compare with neck pain. The total cross-sectional area atrophy rate (C3/C4, C4/C5, and C5/C6) of the trapezius muscle was significantly larger in patients with neck pain (12.8 ± 13.2) than in those without (6.2 ± 14.4; p<0.05). The cross-sectional area atrophy rate of the trapezius muscle at only the C5/6 level was significantly higher in patients with neck pain (16.7 ± 11.7) compared to those without (3.3 ± 14.4; p<0.001). No significant differences were found in the cross-sectional areas of the cervical posterior extensor muscles. Trapezius atrophy, especially at the lower cervical vertebrae, was associated with neck pain after cervical laminoplasty.

Short-term effects of Kinesio taping combined with cervical muscles multi-angle isometric training in patients with cervical spondylosis

ObjectiveThe purpose of this study was to investigate the efficacy of Kinesio taping (KT) combined with multi-angle isometric resistance training for cervical spondylosis.MethodsSixty-one patients were divided into two groups by random number table method. Both groups were given multi-angle isometric training, the patients in the observation group were supplemented with Kinesio taping. Before and after treatment, the symptoms of cervical spine function were evaluated in two groups by visual analogue scale (VAS), cervical dysfunction index (NDI), cervical range of motion and muscle stiffness.ResultsAfter 3 weeks of treatment, VAS, NDI scores and the cervical range of motion were significantly better than before (P < 0.05). The range of anterior flexion and extension was significantly larger than the control group (P < 0.05), but the range of other motions were not certain. The muscle stiffness in KT group were significantly lower than the control group.ConclusionKinesio taping combined with multi-angle isometric resistance training can further alleviate the clinical symptoms and correct the neck abnormal posture. But its effects on the range of cervical motion remain uncertain.

Initial clinical experiences of the muscle-preserving double door cervical laminoplasty with adjustable mini plates.

Shirashi's double door laminoplasty method was a popular decompression procedure for cervical myelopathy. In this paper, we introduced a modified double door laminoplasty based on Shirashi's method with preliminary results. This study retrospectively analyzed 22 patients who underwent modified double door laminoplasty. During procedure, a single segment of the unilateral lamina was separated from the cervical semispinalis muscle and the multifidus muscle space for the preparation of lamina groove. A self-developed mini titanium plate was used to fix the inner side of the spinous process to complete the fixation after open-door process. The VAS, JOA scores and QoL scale were recorded for pain assessment, neurological and functional recovery. The overall curvature and range of motion of C2-C7 were measured with x-ray images. Changes in sagittal diameter of spinal canal were measured by CT scans. MRI was used to measure the cross-sectional area of cervical paravertebral muscles. All 22 patients successfully recovered with this procedure. The mean operation time, blood loss and follow-up durations were 117 ± 25 min, 149 ± 32 ml and 16.1 ± 3.6 months respectively. The preoperative, 3-month postoperative and 12-month postoperative JOA scores were 9.35 ± 3.25, 13.74 ± 4.86 and 15.73 ± 5.19 respectively. with improvement rates of 57.4% and 83.4%. Mean VAS scores before, 3 months after and 12 months after surgery were 1.81 ± 0.79, 2.82 ± 1.56 and 2.18 ± 1.34 respectively. The C2-7 lordotic angle and overall range of motion shows no statistical difference preoperatively and 12 post-surgery. The average sagittal diameter of the cervical spinal canal was enlarged from 9.15 ± 1.55 mm to 14.25 ± 1.46 mm. The average area of cervical paravertebral volume measured preoperatively and 3 months post operation was 84% of pre-operative value respectively. This value was improved to 93% of the preoperative value at 12 months post-surgery. This paper introduced initial experience on a modified posterior cervical double-door laminoplasty that was based on Shirashi's method, featuring creating bilateral laminar grooves on both sides and fixing central gap with self-developed mini plates. This procedure prevented obvious axial symptoms and improved patients' quality of life, which provided a baseline for further research with larger cohorts.

The quality of life of patients with coronary artery disease before and after coronary artery bypass graft

Heart is one of the vital organs in the human body which is a durable organ and efficient pump. The human heart works tirelessly from the moment of formation and it begins beating until the moment it stops. On an average life time, the human heart beats more than twenty two and half billion times without taking rest. The heart beats continuously and unlike other muscles of the body, it cannot stop to rest when tired and worn from work. Research Approach: This study adopted a non experimental descriptive and comparative survey approach.The study was conducted at the cardio thoracic surgical out patient department of one of the selected hospital at Sahdol.The population comprised of all patients with coronary artery bypass graft attending the cardio thoracic surgical outpatient department of the selected hospital at Sahdol at the time of the study.The sample consisted of 75 patients with coronary artery bypass graft based on the criteria for sample selection. Non probability convenient sampling technique was adopted for the selection of sample. 64 samples (85.3%) were able to carry out the household activities such as cooking, washing the cloth, sweeping, grinding, ironing, gardening, minor repairing work at home moderately well and 11(14.7%) were able to perform these activities very well before surgery. However after the surgery the percentage of samples who performed the household activities very well increased by 5.3%.cBefore surgery 59 samples (78.7%) showed good interest in reading newspaper and watching TV. However after surgery this number reduced to 51, a reduction of 10.7%. that majority of the samples (84-94.7%) had good social well being before surgery. However after surgery the samples showed moderate quality of life in social wellbeing. Statistically there was no significant difference between the mean score of personal and household activities ( t-0.239 and 0.054,df=74,p&amp;#60;0.0 ) before and after surgery and there was significant difference between the mean score of outdoor and other activities (t-3.17and3.8,df=74,p&amp;#60;0.01 ) before and after surgery. The study concludes that the quality of life of patients who had undergone coronary artery bypass graft was better before surgery but after surgery the quality of life was better in physical well being whereas psychological and social wellbeing was reduced.

A clinical case of a developmental disorder of the nervous system with involuntary movements associated with the spectrum of GNAO1-associated diseases

Nervous Developmental Disorder with Involuntary Movements (NEDIM) (OMIM 617493) is a rare movement disorder in children on the spectrum of GNAO1-associated movement disorders. With NEDIM, movement disorders appear in early childhood, progress and lead to disability. The disease is caused by pathogenic heterozygous variants in the GNAO1 gene and has an autosomal dominant mode of inheritance. The epidemiology of NEDIM has not yet been established. Clinical symptoms are extensive, ranging from severe motor and cognitive impairment with self-injurious behaviour and seizures to a mild phenotype of movement disorders without mental retardation and seizures. Some patients develop epilepsy. Hyperkinetic syndrome in most children is manifested with chorea, athetosis, dystonia, and ballism, affecting the muscles of the body, limbs and face. According to MRI, in some patients, gradually progressive atrophy of the brain substance is visualized. Currently, the disease has no developed pathogenetic methods of therapy. Treatment is symptomatic, including various drug regimens to reduce the severity of movement disorders and seizures. Management of nutrition of the patient and the prevention of secondary complications of movement disorders are also important. In foreign sources there is described the experience of using topiramate and teterabenazine, as well as deep brain stimulation (DBS), which demonstrate a good effect in the form of a significant reduction in the frequency of dystonic storms and the severity of motor disorders. The article presents a clinical case of diagnosis and treatment of a child with this disease, and also current trends in therapy.

Effects of typing positions on the upper trapezius and neck extensor muscles electromyography in office employees: A single-blind cross-sectional study.

Holding incorrect postures over a long period could lead to chronic nonspecific neck pain (CNNP) in office employees. The present study aimed to evaluate the effects of different typing positions on the activity of the neck extensor and upper trapezius (UT) muscles of office employees diagnosed with CNNP. This assessor-blinded cross-sectional study was performed on 22 female subjects with the mean age of 39.95±5.30 years. The neck extensors and UT muscle activities of the participants were assessed in the upright, forward, and slouching postures by electromyography (EMG). In addition, neck proprioception and the performance of the cervical stabilizer muscles were evaluated using an inclinometer and biofeedback pressure unit, respectively. A significant difference was observed between the cervical erector spine (CES) and UT muscle activities in the upright, forward, and slouching typing positions (P < 0.05). In addition, a difference was observed between the upright and slouching postures in these muscles. A positive correlation was denoted between CES muscle activity in the slouching and forward postures and the activation index of neck muscles (P < 0.05). Furthermore, a significant, negative correlation was observed between the UT muscle activity in the slouching posture and neck proprioception (P < 0.05). A positive correlation was also noted between the pain index and repositioning error rates (P < 0.05). CES muscle activity increased in a forward head posture, which could damage neck proprioception through causing early fatigue and stimulating a cumulative damage cycle.

Assessing the Effectiveness of Helfer Skin Tap Technique on Pain Reduction among Children Undergoing Intramuscular Vaccination in FLACC Numerical Pain Scale

Introduction: Intra muscular vaccination is complex technique used to deliver vaccines among children deep into the large muscles of the body. Pain at injection site is one of the most commonly-reported local reactions associated with administration of a vaccine. It is more painful when combination of more than two vaccines injected at a time among children. Pain management in invasive procedure is a challenge to the nurse. Hence, complementary therapy like Helfer skin tap technique has its own significance and provides a mechanical stimulation and distraction during intramuscular vaccination and thus helps to decrease pain as described by gate control theory which keeps the muscles relaxed while administering IM injection. Objective: A study to assess the effectiveness of Helfer skin taps technique on pain reduction among children undergoing intramuscular vaccination at district hospital Waidhan, Singrauli. Method: The study involved quasi experimental posttest only design with non-probability purposive sampling method. The data was collected from 60 Children’s undergoing intramuscular vaccination. Intervention: In Helfer skin tap technique Intramuscular vaccination is done by tapping to the injection site by using palmer aspect of the hand about three times and inserting the needle without the feeling of pain and removing the needle by tapping the area again three times. Tools: Standardized FLACC 0-10 numerical pain scale used to assess the pain reduction among children undergoing intramuscular vaccination. Results: The data collected was analyzed using descriptive and inferential statistics. The study shows using standard technique in control group 27 children had moderate pain (90%), 3 children had severe pain (10%) while in experimental group 17 had moderate pain (57%), 8 had severe pain (26%) and 5 had mild pain (17%). Analysis among experimental group by using paired‘t’ test found significant value 5.94 at p&lt;0.05 level. The study shows that after the procedure observation intramuscular vaccination is less painful in experimental group as compare to control group among children. Interpretation &amp; Conclusion: The study shows that Helfer skin tap technique was more effective on pain reduction undergoing intramuscular vaccination than the usual standard technique used among children.

The relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity: a retrospective study

BackgroundSpinal alignment in patients with adult spinal deformity (ASD) changes between rest and during gait. However, it remains unclear at which point the compensated walking posture breaks down and how muscles respond. This study used time-synchronized electromyography (EMG) to investigate the relationship between dynamic spinal alignment and muscle activity during maximum walking duration to reveal compensation mechanisms.MethodsThis study collected preoperative three-dimensional gait analysis data from patients who were candidates for corrective surgery for ASD from April 2015 to May 2019. We preoperatively obtained dynamic spinal alignment parameters from initiation to cessation of gait using a motion capture system with time-synchronized surface integrated EMG (iEMG). We compared chronological changes in dynamic spinal alignment parameters and iEMG values 1) immediately after gait initiation (first trial), 2) half of the distance walked (half trial), and 3) immediately before cessation (last trial).ResultsThis study included 26 patients (22 women, four men) with ASD. Spinal sagittal vertical axis distance during gait (SpSVA) increased over time (first vs. half vs. last, 172.4 ± 74.8 mm vs. 179.9 ± 76.8 mm vs. 201.6 ± 83.1 mm; P < 0.001). Cervical paravertebral muscle (PVM) and gluteus maximus activity significantly increased (P < 0.01), but thoracic and lumbar PVM activity did not change. Dynamic spinal alignment showed significant correlation with all muscle activity (cervical PVM, r = 0.41–0.54; thoracic PVM, r = 0.49–0.66; gluteus maximus, r = 0.54–0.69; quadriceps, r = 0.46–0.55) except lumbar PVM activity.ConclusionSpinal balance exacerbation occurred continuously in patients with ASD over maximum walking distance and not at specific points. To maintain horizontal gaze, cervical PVM and gluteus maximus were activated to compensate for a dynamic spinal alignment change. All muscle activities, except lumbar PVM, increased to compensate for the spinal malalignment over time.

Quantification of Ride Comfort Using Musculoskeletal Mathematical Model Considering Vehicle Behavior

This research aims to quantify driver ride comfort due to changes in damper characteristics between comfort mode and sport mode, considering the vehicle’s inertial behavior. The comfort of riding in an automobile has been evaluated in recent years on the basis of a subjective sensory evaluation given by the driver. However, reflecting driving sensations in design work to improve ride comfort is abstract in nature and difficult to express theoretically. Therefore, we evaluated the human body’s effects while driving scientifically by quantifying the driver’s behavior while operating the steering wheel and the behavior of the automobile while in motion using physical quantities. To this end, we collected driver and vehicle data using a motion capture system and vehicle CAN and IMU sensors. We also constructed a three-dimensional musculoskeletal mathematical model to simulate driver movements and calculate the power and amount of energy per unit of time used for driving the joints and muscles of the human body. Here, we used comfort mode and sport mode to compare damper characteristics in terms of hardness. In comfort mode, damper characteristics are soft and steering stability is mild, but vibration from the road is not easily transmitted to the driver making for a lighter load on the driver. In sport mode, on the other hand, damper characteristics are hard and steering stability is comparatively better. Still, vibration from the road is easily transmitted to the driver, which makes it easy for a load to be placed on the driver. As a result of this comparison, it was found that a load was most likely to be applied to the driver’s neck. This result in relation to the neck joint can therefore be treated as an objective measure for quantifying ride comfort.

DESIGN AND CONSTRUCTION OF A PROTOTYPE OF A LOW-COST HAND PROSTHESIS IN A 3D PRINTER

This study aims to present the design and implementation of a low-cost prosthesis prototype that covers the basic movement needs, built using 3D printing. The development of this prototype, in particular, focuses on low-income people, especially children with some amputation or malformation in their upper extremities. First, an electromyograph was developed to capture the electrical signals produced by the muscles of the body as they move and to amplify them for further processing by an Arduino development board that works as the central system of the prosthesis. With the electromyograph designed and built, we proceeded to design the mechanical part of the prosthesis in SolidWorks software and prototype it in a 3D printer. The first tests conducted with the finished prototype yielded various data regarding the treatment of the signals used to make modifications and reach the necessary performance. With this work, it is possible to develop a basic prosthesis prototype that helps low-income children who are victims of amputations or malformations to meet their basic motor needs and demonstrate once again that the implementation of engineering provides solutions to local and global problems. Keywords: Electromyograph, Signals, 3D Printer, Hand Prosthesis, Electrodes DOI： https://doi.org/10.35741/issn.0258-2724.58.3.20