Differences In Neck Research Articles

Minimally invasive posterior cervical foraminotomy vs. anterior cervical discectomy and fusion in the treatment of patients with single-level unilateral cervical radiculopathy.

The aim of this study was to observe the clinical efficacy and safety of minimally invasive posterior cervical foraminotomy (MI-PCF) and anterior cervical discectomy and fusion (ACDF) in the treatment of single-level unilateral cervical radiculopathy (SLUCR). We retrospectively analyzed 81 patients with SLUCR in two hospitals from February 2020 to February 2022, including the MI-PCF group (n=40) and the ACDF group (n=41). The differences in neck and shoulder pain, visual analog score (VAS), upper limb radiating pain (VAS), and neck disability index (NDI) were compared. Operative time, intraoperative bleeding, hospital stay, and complications were also compared between the two groups. The degree of neck and shoulder pain relief at 1 day postoperatively was better in the ACDF group than in the MI-PCF group (p<0.05), while there were no significant differences between the two groups in terms of neck and shoulder pain relief at 1 month, 3 months, 6 months, and 12 months postoperatively, (p>0.05). There were no significant differences in the relief of upper limb radiating pain and the decrease of NDI scores between the two groups at 1 day, 1 month, 3 months, 6 months, and 12 months after surgery (p>0.05). The patients in MI-PCF group had shorter operative time, less bleeding, and shorter hospital stay, which were statistically different (p<0.05). There was no statistical difference in the complication rate between the two groups, (p>0.05). The clinical efficacy and safety of MI-PCF and ACDF in the treatment of SLUCR are satisfactory, meanwhile, MI-PCF has shorter operative time, less bleeding and shorter hospital stay than ACDF, which is worthy of clinical promotion.

Anterior vs Posterior Surgery for Patients With Degenerative Cervical Myelopathy: An Observational Study From the Canadian Spine Outcomes and Research Network.

The advantages and disadvantages of anterior vs posterior surgical approaches for patients with progressive degenerative cervical myelopathy (DCM) remain uncertain. Our primary objective was to evaluate patient-reported disability at 1 year after surgery. Our secondary objectives were to evaluate differences in patient profiles selected for each approach in routine clinical practice and to compare neurological function, neck and arm pain, health-related quality of life, adverse events, and rates of reoperations. We analyzed data from patients with DCM who were enrolled in an ongoing multicenter prospective observational cohort study. We controlled for differences in baseline characteristics and numbers of spinal levels treated using multivariable logistic regression. Adverse events were collected according to the Spinal Adverse Events Severity protocol. Among 559 patients, 261 (47%) underwent anterior surgery while 298 (53%) underwent posterior surgery. Patients treated posteriorly had significantly worse DCM severity and a greater number of vertebral levels involved. After adjusting for confounders, there was no significant difference between approaches for odds of achieving the minimum clinically important difference for the Neck Disability Index (odds ratio 1.23, 95% CI 0.82 to 1.86, P = .31). There was also no significant difference for change in modified Japanese Orthopedic Association scores, and differences in neck and arm pain and health-related quality of life did not exceed minimum clinically important differences. Patients treated anteriorly experienced greater rates of dysphagia, whereas patients treated posteriorly experienced greater rates of wound complications, neurological complications, and reoperations. Patients selected for posterior surgery had worse DCM and a greater number of vertebral levels involved. Despite this, anterior and posterior surgeries were associated with similar improvements in disability, neurological function, pain, and quality of life. Anterior surgery had a more favorable profile of adverse events, which suggests it might be a preferred option when feasible.

Impact of Jaw Functional Status on Neck Flexor Endurance among Females

Background: Opening and closing of the mouth, biting, and chewing are all sensory-motor tasks that require both jaw and neck muscles to be contracted simultaneously. The postural stability of healthy people can be modified by changes in the position of the jaw. Objective: To determine the impact of jaw functional status on neck flexor endurance among females and also to determine the association of neck flexion endurance with age and BMI. Methods: It was a cross-sectional study in which the convenient sampling technique was used. It included 32 healthy females between 18-25 years of age. The study was conducted at the skills Lab of Shalamar School of Allied Health Sciences, Lahore. After consent from participants the neck flexor endurance test was performed in two positions: with the resting jaw (position I), and the jaw clenched maximally (position II) in the supine position. Time was recorded by the stopwatch to see how long the participant was able to maintain in these positions. The same test was performed again with five minutes gap in both positions of the jaw. Results: It shows that there was a significant difference in neck holding time between the resting jaw position and clenched jaw position. After five minutes of rest the neck holding time in both positions was decreased but it was statistically not significant. There was weak and inverse relationship between neck flexion endurance and age (r=-0.0264) and weak but direct relationship between neck flexion endurance and BMI (r=0.283) Conclusion: The neck holding time in the clenched jaw position is less than the resting jaw position; this shows that a sensory-motor relationship exists between the neck and jaw. Variation in jaw positioning impacts neck flexor endurance.

The effect of tablet tilt angles and time on posture, muscle activity, and discomfort at the neck and shoulder in healthy young adults.

Although young adults regularly perform tablet writing, biomechanics during the tablet writing with different tilt angles has not been studied. The objective of this study was to compare posture, muscle activity, and discomfort at the neck and shoulder between tablet writing with 0° (horizontal) and 30° tablet tilt angles over 40 minutes in healthy young adults. Twenty participants wrote continuously for 40 minutes on a tablet with both tilt angles in a randomized order. Between conditions, there was a 5-minute activity break. Differences in neck and shoulder posture, muscle activity, and discomfort between both tablet tilt angles and changes in the outcomes every 10 minutes over 40 minutes were investigated. With the tilted tablet, there were lower neck flexion (Z = -4.637, P<0.001), lower shoulder extension (Z = -3.734, P<0.001), and lower neck Visual Analogue Scale (VAS) (left; Z = -4.699, P<0.001 and right; Z = -3.874, P<0.001) as compared to the no tilt condition. However, the right upper trapezius muscle activity was higher in the tilted condition as compared to the no tilt one. Over 40 minutes, the neck VAS (left; χ2(4) = 30.235, P<0.001 and right; χ2(4) = 32.560, P<0.001) and heart rate variability (χ2(4) = 12.906, P = 0.012) showed notable increases after 20 minutes compared to baseline. In conclusion, adjusting the tablet tilt to 30° and limiting time spent to 20 minutes are recommended for young adults during the tablet writing to prevent neck problems.

Neck and Shoulder Morbidity in Patients with Oral Cancer and Clinically Negative Node Neck Status: A Comparison between the Elective Neck Dissection and Sentinel Lymph Node Biopsy Strategies.

The choice for the most optimal strategy for patients with a cT1-2N0 carcinoma of the oral cavity, sentinel lymph node biopsy (SLNB) or elective neck dissection (END), is still open for debate in many head and neck cancer (HNC) treatment centers. One of the possible benefits of the less invasive SLNB could be reduced neck and shoulder morbidity. Recent studies have shown a benefit in favor of SLNB the first year after intervention, but the long-term consequences and differences in neck morbidity remain unclear. This cross-sectional study aimed to research differences in neck and shoulder morbidity and Health-Related Quality of Life (HR-QoL) in patients with a cT1-2N0 carcinoma of the oral cavity, treated with either END or SLNB. Neck and shoulder morbidity and HR-QOL were measured with patient-reported questionnaires (SDQ, SPADI, NDI, NDII, EORTC-QLQ-C30, EORTC-QLQ-HN35) and active range of motion (AROM) measurements. In total 18 patients with END and 20 patients with SLNB were included. We found no differences between END and SLNB for long-term neck morbidity, shoulder morbidity, and HR-QOL. The significant differences found in the rotation of the neck are small and not clinically relevant.

Management of Patients with Cervicofacial Edema and Paresthesia during Perioperative Period of Transoral Endoscopic Thyroidectomy.

Objective To analyze the clinical intervention effect of transoral endoscopic thyroidectomy on the neck and face during perioperative period. Method From January 2019 to January 2020, 60 patients included in this study were randomly divided into observation group and control group according to the ratio of 1 : 1, with 30 cases in each group. Both groups underwent rapid surgical intervention during the perioperative period. The patients in the observation group received neck and face management. The degree of jaw swelling, the degree of facial microexpression completion, and the changes in jaw and neck sensation were compared between the two groups. Results There was no significant difference in neck and face swelling, pain, facial microexpression, and feeling between the two groups before operation. Patients with facial I/II swelling degree in the observation group were significantly more than in the control group, and the patients with III swelling degree were less than in the control group. There was significant difference for facial swelling between the two groups in the three intervention periods after the operation, and the difference was statistically significant (P < 0.05). The scores of facial microexpression in the observation group were higher than those in the control group during the three postoperative intervention periods, with statistical significance (P < 0.05). There was no significant difference in the pain score of the first day after surgery between the two groups (P = 0.298). In the other two postoperative intervention periods, the pain score of the observation group was lower than that of the control group, with a statistically significant difference, and the difference was statistically significant (P < 0.05). The threshold of chin and neck sensory pressure in the two groups was statistically significant (P < 0.05) except that the “cheek in area 4” (P = 0.290). Conclusion The results showed that these interventions, such as the elevation of bed after operation, 24-hour intermittent cryotherapy, ice cubes in mouth, and the “meter” functional training, have good clinical effects on the symptoms of facial swelling and abnormal sensation of neck and face. It can accelerate the speed of edema dissipation, improve the patients' postoperative comfort, and improve the satisfaction and quality of life of patients with the effect of surgery and beauty.

MP10-11 USING WEARABLE TECHNOLOGY TO DETERMINE RELATIONSHIP BETWEEN NECK POSTURE AND PAIN DURING UROLOGIC OPEN AND ROBOTIC SURGERY

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (MP10)1 Sep 2021MP10-11 USING WEARABLE TECHNOLOGY TO DETERMINE RELATIONSHIP BETWEEN NECK POSTURE AND PAIN DURING UROLOGIC OPEN AND ROBOTIC SURGERY Joseph Bigham, Edward Chang, Mathew Sorensen, Howard Chansky, and Scott Telfe Joseph BighamJoseph Bigham More articles by this author , Edward ChangEdward Chang More articles by this author , Mathew SorensenMathew Sorensen More articles by this author , Howard ChanskyHoward Chansky More articles by this author , and Scott TelfeScott Telfe More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001983.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Chronic neck pain is the most prevalent work-related musculoskeletal issue among surgeons. 70% of urologists experience neck pain while 17% report degenerative cervical spine disease. Many attribute this pain to non-ergonomic positions while operating. Our goal was to use wearable technology to quantify the relationship between neck posture and pain during open and robotic surgery. METHODS: Subjects included urologic faculty and residents from one institution who spent at least 1 day per week performing surgery for ≥6 hours. Data were collected from subjects on 2 separate days (Sept 2019 to Oct 2020). The Neck Disability Index, a validated questionnaire assessing baseline neck pain, and 0-10 numeric analogue pain scales were completed by participants throughout their workday. Those with pre-existing cervical spinal conditions were excluded. Neck posture was measured in real time while operating using inertial measurement devices attached at the occipital protuberance and 7th cervical vertebrae. A mixed effect model was used to determine the relationship between neck posture and pain scores. Neck posture and pain were then compared between open vs robotic surgery and faculty vs residents. RESULTS: A total of 30 participants were included in the study (21 faculty, 9 residents). 202 hours of data were collected. Neck pain was found to be correlated with longer duration of severe neck flexion, defined as ≥30° (p=0.01). Surgeons performing open procedures spent on average 147 minutes with their heads in neck flexion postures of ≥30° compared to 68 minutes for those performing robotic procedures. This greater duration and degree of neck flexion was associated with increased neck pain (p=0.007) (Figure). Surgeons performing open procedures reported a mean increase in neck pain of 2.0 on the pain scale, compared to 1.3 for those performing robotic procedures (p=0.04). There were no differences in neck flexion/pain when faculty and residents were compared. CONCLUSIONS: Real time measurements of neck flexion during urologic surgery show that longer duration and greater degree of neck flexion were associated with increased neck pain. Urologists spend more time in severe neck flexion during open surgery compared to robotic surgery, increasing their risk of work-related neck pain. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e172-e173 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joseph Bigham More articles by this author Edward Chang More articles by this author Mathew Sorensen More articles by this author Howard Chansky More articles by this author Scott Telfe More articles by this author Expand All Advertisement Loading ...

A comparison of apparent neck and back angles before, during and after canine hydrotherapy

Research examining canine hydrotherapy is distinctly lacking despite the increasing use of hydrotherapy as a rehabilitation tool and as part of a fitness programme. Due to this paucity of research, the aim of this study was to examine differences in apparent neck and back angles of dogs both before, during and after hydrotherapy sessions. Anecdotally, these are the anatomical locations where concern of injury risk lies. Thirty-one dogs were filmed trotting both prior to and post participation in hydrotherapy as well as during the hydrotherapy session. Data were then analysed using Dartfish software. There was no significant difference in the neck angle of the dogs between swimming and trotting (P=0.859) however, dogs had a significantly greater back angle when swimming compared to trotting (P=0.05). The use of buoyancy aids during hydrotherapy, showed no significant difference in neck or back angles compared with no buoyancy aids. This study begins to provide evidence on the effect of hydrotherapy on canine kinematics. It can be used to inform rehabilitation and fitness regimes for dogs with the aim to improve the long-term health and welfare of dogs.

Magnification loupes influence on neck and trunk flexion of dental hygienists while scaling-A pilot study.

Work-related musculoskeletal disorders (MSDs) are common in the dental hygiene profession. Awkward postures contribute to MSDs and magnification loupes have been suggested to reduce this risk factor and minimize MSDs. After IRB approval, 24 hygienists were enrolled in the study: twelve hygienists wearing loupes with a standard manufacturer determined declination angle (control) and 12 hygienists wearing loupes with a custom measured declination angle (experimental). To measure changes in neck and trunk flexion, accelerometers were placed on the occipital region of head, cervical vertebrae C5, and thoracic vertebrae T5 and baseline posture was recorded. Typodonts with artificial calculus simulated the oral environment. Participants were randomly assigned to wear their designated loupes during the first or second trial of the experiment and scaled in each quadrant (UR, LR, UL, LL) of the mouth for two minutes. Participants completed the scaling task twice: in the loupes and no loupes condition in a counterbalanced order. Three-way mixed design ANOVA was used to determine posture differences in neck and trunk posture. Those wearing custom loupes (M=16.52, SD=6.40) had significantly less trunk flexion while scaling compared to hygienists wearing standard loupes (M=22.27, SD=6.40), F(1, 22)=7.14, P=.01. Neck flexion was not significantly affected while scaling between loupes vs no loupes or loupes type condition, (P's>.05). Posture was partially impacted by loupes type. Custom loupes resulted in less trunk flexion. Neck flexion was not affected by either loupes type.

Performance, carcass traits, and non-carcass components of feedlot finished lambs from different residual feed intake classes

This study aimed to assess the performance, carcass traits, and non-carcass components of feedlot finished Texel crossbred lambs from different residual feed intake classes (RFI). Forty-seven uncastrated male Texel crossbred lambs (¾ Texel + ¼ Pantaneira) tested here were 4-month-old with an initial weight of 29.9 ± 5.5 kg. The lambs were confined for 70 days for individual dry matter intake (DMI) and average daily gain (ADG) assessment. The diet containing corn silage was provided as roughage, while the concentrate consisted of corn grain, soybean meal, urea, and mineral mixture with a 40:60 roughage to concentrate ratio and 76.34% total digestible nutrients (TDN). After confinement for 70 days, the lambs were slaughtered to assess carcass traits and non-carcass components. Based on the RFI, lambs were divided into three classes according to the standard deviation (sd): Positive RFI (inefficient, 0.5 above the mean), Negative RFI (efficient, 0.5 below the mean), and Medium RFI (intermediate). Classes with Negative (efficient) and Positive RFI (inefficient) showed no differences in ADG (0.321 vs 0.306 kg; P &gt; 0.05). Dry matter intake (g d-1), and percentage of body weight (BW) differed significantly between the RFI classes (P &lt; 0.05). Compared to lambs in the inefficient class, those in the efficient class (Negative RFI) showed a 9% reduction in DMI and had the same ADG. The lambs in either Positive or Negative RFI classes showed no weight differences between non-carcass components (P &gt; 0.05). The RFI classes showed no differences in shrunk body weight, hot carcass weight, hot dressing, and weight of commercial cuts (P &gt; 0.05). They showed no differences in neck, shoulder + shank, loin, rack, flank steak, rack cap off, and leg weights (P &gt; 0.05). Our results indicate that improvement in feed efficiency, as a function of the RFI index, does not compromise performance and carcass traits of Texel crossbred lambs.

Geographic health disparities in the Los Angeles pediatric neck abscess population

ObjectiveTo assess geographical sociodemographic differences in neck abscesses that require surgical drainage in Los Angeles.Study Design: retrospective review. MethodsWe reviewed the medical records of 119 consecutive pediatric patients at Children's Hospital Los Angeles (CHLA) from 2014 to 2017 with a diagnosis of a neck abscess requiring incision and drainage. Sociodemographic information including zip code of residence was extracted and analyzed with Chi-square, Fisher's exact test, and multivariate logistic regression. ResultsThe average age of patients with a neck abscess in this study was 3.4 years old, 53.8% were female, 54.6% were Hispanic, and 82.5% had public health insurance. 79% of patients had an abscess located in the superficial neck, and 10.1% had an abscess located in the retropharyngeal space. There were no significant differences in gender, race, type of health insurance, or income between patients that lived within 10 miles of CHLA versus those that lived farther than 10 miles. On multivariate analysis, zip codes with a high volume of neck abscesses were more likely to be lower income neighborhoods. Gender, race, type of health insurance, and distance from CHLA were not associated with zip codes with a high volume of neck abscesses. ConclusionGeographic areas in the greater Los Angeles community with a high volume of neck abscesses requiring incision and drainage at our institution were associated with lower income neighborhoods. Level of evidenceIV.

Effect of aquomanual therapy on pain and physical function of patients with chronic musculoskeletal disorders: A pilot study using quantitative and qualitative methods

IntroductionAquomanual therapy, which combines aquatic and manual therapy, aims to treat pain and improve physical function in individuals with chronic musculoskeletal disorders. This study aimed to verify the effectiveness of aquomanual therapy and document the participants’ experiences and opinions. MethodsAquomanual therapy was applied to individual participants (10 community-dwelling adults with chronic musculoskeletal disorders) in an indoor swimming pool in the aquatic therapy room of the hospital three times per week for 8 weeks. This study used a mixed method prospective descriptive design. And, we used the visual analog scale to assess pain, a goniometer to measure range of motion (ROM), the Fatigue Severity Scale (FSS) to assess fatigue, and the Short Form-36 Health Status Questionnaire (SF-36) to assess quality of life and qualitative symptoms through in-depth individual interviews. ResultsOn the FSS, there were significant differences in neck, shoulder, and back pain (p<0.05) and ROM of the neck, shoulder, and back (p<0.05) but not in ROM of neck flexion. On the SF-36, there were significant differences in General health, Physical functioning, Role-physical, Bodily pain, and Vitality (p<0.05) but no statistically significant increase in Role-emotional, Social functioning, or Mental health. Qualitative data collected in the in-depth individual interviews included: 1) decreased pain; 2) relaxation and relief of tiredness; 3) ease of use; 4) understanding the correct posture; and 5) novelty and enjoyment. ConclusionsAquomanual therapy may relieve pain in and increase physical function of patients with chronic musculoskeletal disorders and was received positively.

A Comparative Study on Growth of Circumference of Different Body Part Influenced by Their Living Altitudes

PURPOSE: The purpose of the study was to find out the difference in circumference of different parts of body of 16 years old boys of four different altitudes of Darjeeling, West Bengal, India. METHOD: The samples are school students. Researcher had taken 100 male students each from Sukhia Pokhari Higher Secondary School (Alt.-7200 ft.), Trunbull higher Secondary school (Alt.-6700 ft.), Jnanpith High school(Alt.-3000 ft.) and Kadamtala High School(Alt.-430 ft.). Researcher had measured height and weight as personal data measured circumference of head, neck, arm relax, flex arm, waist, gluteal, calf and ankle. RESULTS: It has been observed that there were significant differences in neck, wrist and calf circumference. CONCLUSIONS: Different growth pattern were observed among four different altitudes. This research paper also reveals the effect of altitude on growth pattern of adolescents.

Neck and shoulder muscle activity among ophthalmologists during routine clinical examinations

Muscular demands during common clinical ophthalmologic activities may contribute to the high prevalence of musculoskeletal health outcomes observed among ophthalmologists and other eye care physicians. Characterizations of the muscle activation patterns in the live ophthalmologic environment are lacking. This study was conducted to (i) characterize the frequencies and durations of common activities performed by ophthalmologists during routine clinical examinations, (ii) characterize neck and shoulder muscle activation patterns during the whole clinical work day, and (iii) explore differences in neck and shoulder muscle activation patterns between common clinical activities. Fifteen ophthalmologists performed routine patient examinations in an outpatient ophthalmology clinic while continuous surface electromyography measurements of the upper trapezius and anterior deltoid muscles were obtained. Results indicated that while computer use was the most frequently performed clinical activity, use of the indirect ophthalmoscope, followed by use of the slit lamp biomicroscope, required greater muscular demands than computer use or other clinical activities. Results provide evidence that the clinical activities of indirect ophthalmoscope and slit lamp biomicroscope use are appropriate for ergonomic intervention.

The Relationship between Neck Pain and Cervical Alignment in Young Female Nursing Staff.

ObjectiveDegenerative changes in the cervical spine are commonly accompanied by cervical kyphosis which can cause neck pain. This study examined the relationship between neck pain and cervical alignment.MethodsA total of 323 female nursing staff from our hospital were enrolled. Sagittal radiographs of the cervical spine, Body Mass Index (BMI), Visual Analogue Scale (VAS) measures of neck and arm pain, Neck Disability Index (NDI) and the Short Form (36) Health Survey (SF-36 scores) were obtained and reviewed retrospectively. Global lordosis (GL) of the cervical spine was measured on radiograph images. Correlations between GL and questionnaire scores were investigated using the following three methods : 1) correlation between GL and questionnaire scores among the entire sample; 2) subgroup analysis of patients with "kyphosis (KYP) : GL scores<0" vs. those with "lordosis (LOR) : GL scores>0" on questionnaire measures; and 3) subgroup analysis of patients with pain vs. those without pain, on GL and questionnaire measures.ResultsThere was no significant correlation between GL and any questionnaire measure. There was a significant difference between the mean GLs of the KYP and LOR groups, but there were no group differences in BMI, age or any questionnaire measures. There was no difference between the pain (n=92) and pain-free (n=231) groups in age, BMI or GL, but there were differences in neck, and arm pain, and physical function and NDI scores.ConclusionsOur data suggest that kyphotic deformity was not associated with neck pain.

A Comparative Study on Circumference of Selected Body Parts of 13 Years Old Boys of Four Different Altitudes of Darjeeling District

The purpose of the study was to find out the difference in circumference of different Body parts of 13 years old boys of Darjeeling. The samples are school students. Researcher had taken 100 male students each from Sukhia Pokhari Higher Secondary School (Alt.-7200 ft.), Trunbull higher Secondary school (Alt.-6700 ft.), Jnanpith High school (Alt.-3000 ft.) and Kadamtala High School(Alt.-430 ft.). Researcher had measured height and weight as personal data measured circumference of head, neck, arm relax, flex arm, waist, gluteal, calf and ankle.It has been observed that there were significant differences in neck, wrist and calf circumference.

Effects of neck pain on reaching overhead and reading: a case–control study of long and short neck flexion

BackgroundReaching overhead and reading are tasks that many individuals encounter daily. The level of difficulty of these tasks increases if an individual has neck pain. This study determined the neck movement patterns during these two tasks by comparing neck flexion of individuals with and without neck pain.MethodsThis case control study used the portable video technology, Dartfish ProSuite 5.5 Video Software, to analyse neck flexion movement patterns. Healthy individuals and individuals with neck pain were videotaped while they completed two tasks: reaching overhead from a standing position and reading from a sitting position. A single position of interest was selected for analysis from both tasks. The degree of neck flexion presented by the participant in this position at the beginning and end of the task was recorded. The angle change between these two time points was calculated for each participant. Differences between groups were determined by comparing the average flexion angle changes in groups by t-tests.ResultsThe average angle change experienced by controls and neck pain participants during the overhead reaching tasks were very similar and a significant difference was not observed. The average angle changes experienced by the two groups during the reading task were more variable, but not significantly different. A t-test comparing average neck flexion angle change during dominant arm elevation for controls (m = −5.28˚, sd = 31.14) and neck pain participants (m = 5.07˚, sd = 32.41) revealed a mean between group difference of −10.34˚ (t17 = −0.688, p = 0.5003). The average neck flexion angle change during long neck flexion was not statistically different between controls (m = 10.08˚, sd = 18.89) and neck pain participants (m = 4˚, sd = 18.18); although the mean between group difference was 6.08˚ (t17 = 0.6856, p = 0.5022).ConclusionsTask performance is highly variable between individuals making it difficult to assess the impact of neck pain on small samples even with detailed motion analysis. Despite this, there was a difference in neck posture during reaching activities between controls and patients with neck pain. Neck pain can therefore influence the movement patterns used during daily activities. This has implications for primary and secondary prevention.

Some anatomical and morphometric observations in the transverse foramina of the atlas among Kenyans

The transverse foramen, which transmits the vertebral vessels, is the result of special formation of the cervical transverse processes. It is formed by a vestigial costal element fused to the body of the originally true transverse process of the vertebra. In the atlas, where the vertebral artery exits the transverse foramen to enter the cranium, many bony variations have been described, and some are attributable to tortuosity of the vessel, as well as stress forces on the neck. The transverse foramen of the atlas has not been studied in terms of shape, morphometry, presence or absence and bilateral differences. This may shed light on the side differences in neck and vertebra-basilar pathology. A hundred and two atlases obtained from the Osteology Department of National Museums of Kenya were observed for presence, shape and variations of the transverse foramen. Accessory transverse foramina were noted, as well as missing foramina. Anteroposterior and mediolateral diameters of the foramina were taken and the area calculated. Out of the 102 vertebra studied (204 foramina transversaria), 8 incomplete foramina were observed, 6 on the right side and 2 bilateral. There were 4 double transverse foramina observed, 1 on the left and 3 on the right side. All atlases had foramina transversaria. The foramina categorized into types 1 to 5 using a recognized criterion. On the right side, type 4 was predominant (40.2%), while on the left, types 2 and 5 were predominant (39.2% each). Morphometrically, the right and left transverse foramina had mean cross-sectional area of 36.30mm2 and 37.20mm2 respectively. The presence of variations in the foramen transversaria is predominant on the right side. Further, the right foramina have a smaller cross-sectional area. These should be taken into account during posterior cervical approaches, as well as during evaluation of cervicogenic syndromes. Keywords: Atlas vertebrae, transverse foramina, morphometry

Statistical shape modeling of proximal femoral shape deformities in Legg–Calvé–Perthes disease and slipped capital femoral epiphysis

The current understanding of morphological deformities of the hip such as femoroacetabular impingement (FAI), Legg-Calvé-Perthes disease (LCPD), and slipped capital femoral epiphysis (SCFE) is based on two-dimensional metrics, primarily involving the femoral head, that only partially describe the complex skeletal morphology. This study aimed to improve the three-dimensional (3-D) understanding of shape variations during normal growth, and in LCPD and SCFE, through statistical shape modeling. Thirty-two patients with asymptomatic, LCPD, and SCFE hips, determined from physical andradiographic examinations, were scanned using 3-D computed tomography (CT) at a voxel size of (0.5-0.9mm)(2) in-plane and 0.63mm slice thickness. Statistical shape modeling was performed on segmented proximal femoral surfaces to determine modes of variation and shape variables quantifying 3-D shape. In addition, conventional variables were determined for all femora. Proximal femur shape was described by eight modes of variation and corresponding shape variables. Statistical shape variables were distinct with age and revealed coordinated, growth-associated differences in neck length-to-width ratio, femoral head medialization, and trochanter protrusion. After size and age-based shape adjustment, diseased proximal femora were characterized by shape variables distinct from those of asymptomatic hips. The shape variables defined morphology in health and disease, and were correlated with certain conventional variables of shape, including neck-shaft angle, head diameter, and neck diameter. 3-D quantitative analyses of proximal femoral bone shape during growth and in disease are useful for furthering the understanding of normal and abnormal shape deviations which affect cartilage biomechanics and risk of developing osteoarthritis.

Posters. P18 Ergonomic microscopes: can they reduce the risks of work‐related musculo‐skeletal disorders?

Introduction Microscopy work places a high level of musculo‐skeletal stress on the body of the user. Indeed, there are certain types of neck–shoulder disorders associated with microscope operation, especially during cytology work. This field study was carried out to investigate the differences in upper trapezius muscle activity, posture, pain and perceived exertion in cytologists while scanning cervical screening slides using both standard and ergonomic microscopes.Method The study employed a two‐period crossover experimental design. Thirteen cytologists (mean age 36.1 ± 8.8 years) from one acute NHS Trust consented to participate. Subjects screened eight slides with each microscope while four different measurements were taken: bilateral upper trapezius electromyography; posture, using a Rapid Upper Limb Assessment (RULA); pain, using a body part discomfort diagram and Visual Analogue Scale; and rating of perceived exertion (Borg CR‐10 RPE Scale).Results The results demonstrated that when operating the ergonomic microscope, there was significantly less upper trapezius activity for both the right (P = 0.015) and left (P = 0.000) shoulders, signifying reductions of 64% and 62%, respectively. However, there was not a statistically significant difference in postures adopted between the microscopes, using RULA (P = 0.173). Neither were there any statistically significant differences in neck (P = 0.084), upper back (P = 0.098) or lower back (P = 0.625) pain when using the ergonomic microscope, although, a statistically significant reduction in shoulder pain was reported (P = 0.043). Finally, the results revealed that the ergonomic microscope required significantly less perceived exertion to operate than the standard microscope (P = 0.009). An additional important finding was that screening took approximately 40 s less per slide using the ergonomic microscope.Discussion This study indicated that the ergonomic microscope was preferable to the standard microscope in terms of upper trapezius muscle activity, shoulder pain and perceived exertion. These findings have important implications for cytologists, of whom the majority are currently using standard microscopes, in terms of reducing potential risk factors for the development of work‐related musculo‐skeletal disorders. Furthermore, this evidence supports the ergonomic recommendations delineated in the National Health Services Cervical Screening Programme Standards (NHSCSP 1997).Relevance to industry Cytology laboratories should give close consideration to the types of microscopes purchased. Consideration should be given to adapting existing microscope workstations by providing microscopists with angle‐adjustable arm supports.