Flexor Endurance Test Research Articles

Do patients with low back pain and central sensitization have differences in physical fitness?

IntroductionLow back pain is one of the main musculoskeletal complaints, and may be associated with central sensitization (CS). The physical capacity of patients with low back pain and CS is not very clear. MethodsA cross-sectional study, with 92 patients divided into two groups according to their risk of CS. The patient's physical capacity ability was assessed using 6-min walking test (6MWT); timed up and go test (TUG); sit-to-stand test (STS); and trunk flexor, extensor and side-bridge endurance tests. In addition, participants completed questionnaires regarding disability, kinesiophobia, catastrophization and quality of life. ResultsThe group with a higher risk of CS had worst performance in the 6MWT (U = 1248; p < 0.001), STS (t(83) = 3.63; p < 0.001) and TUG (t(83) = −4.46; p < 0.001). Similarly, endurance in the right (U = 1453,5; p = 0,002) and left (U = 1467; p = 0,003) side-bridge tests, and the trunk extensor test (U = 1546; p = 0,003) was worse. Disability (U = 1272; p < 0.001), physical capacity kinesiophobia (t(83) = -2.21; p = 0.03) work kinesiophobia (U = 1452; p < 0.001), and pain catastrophization (t(77.57) = -5.03; p < 0.001), were also higher in the group with a higher risk of CS. Quality of life indicators were worse in the higher risk group for all domains of the EQ-5D-3L: Mobility (X2(1) = 12.92; p < 0.001), self-care (X2(1) = 16,3; p = 0,012), usual activities (X2(2) = 14.14; p = 0.001), pain (X2(2) = 27.79; p < 0.001), anxiety and depression (X2(2) = 15.05; p = 0.001). ConclusionPatients with low back pain and higher risks of CS appear to show lower performance in physical capacity tests, higher rates of disability, kinesiophobia, pain catastrophization, and lower quality of life compared to those with lower risks of CS.

Mutual Relationship Between Upper Extremity Function and Core Muscle Endurance in Patients with Multiple Sclerosis

Objective: This study aimed to determine the relationship between upper extremity function and core muscle endurance in patients with multiple sclerosis (PwMS). Methods: Twenty-two PwMS and 20 healthy controls (HC) were included in this retrospective cross-sectional study. The upper extremity function was assessed by the Nine Hole Peg Test (NHPT). In addition, the core muscle endurance was assessed by the side bridge test, trunk flexor endurance test, trunk extensor test, and prone bridge test. Results: Upper extremity function and core muscle endurance (except extensor endurance) in PwMS were lower compared to HC (p&amp;lt;0.05). In addition, the results of correlation analyses in PwMS showed that both sides’ upper extremity functions were related to EDSS, and trunk flexor endurance (p&amp;lt;0.05). Moreover, the right-upper extremity function was related to the right side bridge endurance test performance while the left-upper extremity function was related to left side bridge endurance test performance and disease duration (p&amp;lt;0.05). Conclusion: These results demonstrated the mutual relationship between upper extremity function and core muscle endurance in PwMS. Therefore, the core stabilization training may improve both the core muscle endurance and upper extremity function in PwMS.

Association between core stability and physical function, functional performance in patients with systemic sclerosis.

To investigate the association of core stability with physical function and functional performance in patients with systemic sclerosis (SSc). Forty patients who met the American College of Rheumatology / European League Against Rheumatism 2013 classification criteria for SSc were included in the cross-sectional study. For evaluation of core stability, trunk muscle endurance and trunk muscle strength were assessed. Trunk extensor and trunk flexor endurance tests were used for assessment of trunk muscle endurance. Trunk muscle strength was measured with a hand-held dynamometer and modified sit-up test. To measure physical function the Health Assessment Questionnaire Disability Index (HAQ-DI) and to measure functional performance 6-minute walking test (6MWT) and sit-to-stand test (STS) were used. Patients with SSc had lower mean trunk extensor and flexor endurance test times (49.87±30.81 and 32.17±15.42seconds, respectively), modified sit-up test repetition (17.42±7.81) and trunk extensor and flexor muscle strength (7.48±2.29kg and 6.20±1.68kg, respectively) when compared to the reference values in healthy individuals. All measurements were used to evaluate core stability associated with HAQ-DI score, 6DMWT walking distance and STS test duration (all P<.05). Patients with SSc have markedly reduced core stability and this negatively affects the physical function and functional performance. Therefore, this study highlights the importance of trunk muscle in patients with SSc. We suggest that not only upper-lower extremity muscles, but also trunk muscle strength and endurance should be measured and core stability exercises can be added to the training programs to maintain and/or improve physical functions and functional performance in SSc patients.

Cervicothoracic spinal alignment and neck flexor muscle endurance in young and older adult females with and without neck and shoulder pain (Katakori in Japanese).

[Purpose] The characteristics of neck and shoulder pain (NSP) in different age populations have not been sufficiently examined. Therefore, the purpose of this study was to compare and verify the cervicothoracic spinal alignment and neck flexor muscle endurance of young and older adult females with and without NSP. [Participants and Methods] We assessed 72 female participants (39 young participants, 33 elderly participants, 43 NSP, 29 non-NSP) aged 18–82 years who were recruited for this study. Cervicothoracic spinal alignment measurements were obtained with forward head alignment (FHA) along with the upper thoracic angle. The neck flexor endurance test was performed. [Results] There were no significant age-by-group interactions for any of the assessment variables. However, the upper thoracic angle and neck flexor muscle endurance showed significant effects in the groups. Age also had significant effects on FHA and upper thoracic angle. [Conclusion] These results suggested that the neck flexor muscle endurance was more appropriate as an evaluation tool for older adult females with NSP. It was also suggested that the cervical flexor muscle endurance and upper thoracic angle were more appropriate as evaluation tools for young adult females with NSP.

SAĞLIKLI OLGULARDA GÖVDE KAS ENDURANSI, SOLUNUM FONKSİYONLARI VE SOLUNUM KAS KUVVETİ İLİŞKİSİ

Purpose: Trunk muscles are acrive in the forceful expiration, and trunk this study aimed to examine the relationship between pulmonary function, respiratory muscle strength, and trunk muscle endurance. Methods: The study was conducted with 60 volunteer and healthy individuals whose ages varied between 20 and 36 years. Pulmonary function and maximum inspiratory and expiratory pressure (MIP and MEP) were measured using a desktop spirometer. Trunk muscle endurance of the subjects was evaluated using the prone bridge, side bridge, flexor endurance, and Sorensen tests. Results: A positive significant relationship was observed between the percentage of forced vital capacity (%FVC) and prone bridge (r=0.395, p=0.002), flexor endurance (r=0.256, p=0.049), and Sorensen (r=0.255, p=0.049) tests. Likewise, a positivesignificant correlation was found between the percentage of forced expiratory volume in 1 second (%FEV1) and prone bridge (r=0.408, p=0.001), flexor endurance (r=0.358, p=0.005), and side bridge (r=0.277, p=0.032) tests. The results revealed a positive relationship between MIP and prone bridge (r=0.376, p=0.003) and side bridge tests (r=0.470, p&amp;lt;0.001). Likewise, there was a positive correlation between MEP and prone bridge test (r=0.401, p=0.004) and side bridge test (r=0.365 p=0.002). Conclusion: Pulmonary function and respiratory muscle strength are associated with the endurance of the trunk muscles, which ensure core stability. Trunk muscle endurance exercises may have a positive influence on respiratory function.

Correlation Of Lumbopelvic-hip Complex Stability To Pain In NCAA Division III Golfers

Lumbopelvic-hip complex (LPHC) stability is known to be a major contributor in injury prevention of ballistic movement. However, the literature primarily focuses on the kinematics of the hips and trunk relative to swinging sports, specifically in professional golfers. Data is sparse regarding isometric strength (ISO) and muscular endurance (ME) of the LPHC relative to pain in male and female collegiate golfers. PURPOSE: Therefore, the purpose of this study was to determine the relationship of LPHC isometric strength and muscular endurance to upper extremity, lower extremity, and back pain in NCAA Division III golfers. METHODS: Thirty-two NCAA Division III golfers (19.8 ± 1.3 yrs.; 70.0 ± 11.1 kg.; 173.4 ± 11.1 cm) volunteered to participate. Thirteen were female, and nineteen were male. A health history questionnaire was used to establish current pain or stiffness within each athlete. Bilateral internal and external rotation ISO, as well as adduction and abduction ISO, was measured using a handheld dynamometer. Two trials were conducted for each variable, and the mean was used for statistical analysis. Additionally, ME of the anterior and posterior trunk was measured using the trunk flexor endurance and trunk extensor endurance tests of the standardized Mcgill’s Torso Muscular Endurance Test Battery. A Pearson product-moment correlation was run to determine relationships between ISO and ME to current pain. RESULTS: A statistically significant, negative correlation was found between lead hip internal rotation ISO, relative to the golf stance, and current pain (r = -.369, n = 32, p = .038). Of the 14 reported cases of pain, 11 instances were localized to the back and hips. No other statistically significant correlations were established between current pain and ME or ISO of bilateral external rotation, abduction, adduction, and internal rotation of the back hip. CONCLUSION: Deficient internal rotation isometric strength of the lead hip could be considered a risk factor for hip and back pain in collegiate golfers.

Comparative study of observed actions, motor imagery and control therapeutic exercise on the conditioned pain modulation in the cervical spine: a randomized controlled trial

Aim: The aim of this study was to compare the effects of cervical exercise, motor imagery (MI) and action observation (AO) of cervical exercise actions on conditioned pain modulation and pressure pain thresholds. The second objective was to assess the effects of these interventions on cervical motor activity (ranges of motion and muscle endurance), attention, and the ability to generate motor images.Study design: Single-blinded randomized controlled trial.Materials and methods: Fifty-four healthy subjects were randomly assigned to each group. Response conditioned pain modulation, pressure pain threshold, were the main variables. The secondary outcome measures included, cervical range of motion, Neck flexor endurance test, mental movement representation associated and psychosocial variables.Results: All groups showed significant differences in time factor for all evaluated variables (p < .01) except pressure pain threshold over the tibial region. The post hoc analysis revealed significant within-group differences in the AE and AO groups in conditioned pain modulation (p < .05), with medium effect size in time [AE (d –0.61); AO (d –0.74)].Conclusion: The results showed that within-group changes in conditioned pain modulation, cervical muscle endurance, and attention where founded only in the AE and AO groups. Variations in pain thresholds at pressure in the trapezium area were also obtained in the three groups. Changes in the ranges of flexion-extension and rotation movement were presented exclusively in the exercise group, and in the capacity to generate motor images only in the AO group. However, there was no difference in the pressure pain threshold over the tibial region.

The lateral neck flexor endurance test: Normative values in the young adult population

BackgroundUnilateral muscular deficits have been identified in individuals with neck pain, although no unilateral clinical tests have been described in the literature. Assessment of lateral neck flexor endurance may allow identification of abnormal unilateral muscle function. The lateral neck flexor (LNF) endurance test, where an individual holds their head parallel to the ground while side-lying, may be a clinical option. We sought to (1) determine inter-rater reliability of the LNF endurance test and (2) establish normative LNF values in healthy individuals. MethodsInter-rater reliability was assessed for four raters, working in pairs to assess a pilot sample of 20 individuals. Normative data was subsequently collected for 60 healthy adults, age 20–40. All participants completed the International Physical Activity Questionnaire to assess physical activity and the LNF endurance test was assessed once per side. ResultsThe LNF endurance test demonstrated excellent inter-rater reliability: ICC(2,1) = 0.972 [0.941–0.987]. Left and right median LNF hold times were 122.0, 133.94 s for males and 97.42, 93.73 s for females, respectively. Individual median hold time ratios were 72.1% for males and 68.7% for females. There were no meaningful correlations between reported physical activity and LNF endurance. ConclusionThe LNF endurance test is a reliable measure. Males generally displayed greater LNF endurance than females, although variability within groups was high. Based on the observed values in this healthy population, 120 s for males and 90 s for females with a 70% side:side ratio appear to be useful normative benchmarks although further research is required including clinical populations.

Efficacy of Graded Activity with and without Daily-Monitored-Walking on Pain and Back Endurance among Patients with Concomitant Low-Back Pain and Type-2 Diabetes: A Randomized Trial.

There is evidence supporting the efficacy of Graded Activity (GA) in managing clinical attributes of patients with Low-Back Pain (LBP) in the general population. However, it is unknown whether GA alone is efficacious in managing these clinical attributes in patients with concomitant LBP and Type-2 Diabetes (T2D) or additional daily-monitored walking will be required. A single-blind controlled trial involving 58 patients (mean age: 48.3±9.4 years, 64.7% females) with concomitant LBP and T2D who received treatment twice weekly for twelve weeks was conducted. Participants were randomized into GA or GA with daily-monitored-walking (GAMW) groups. Pain Intensity (PI), Static Back Extensors Endurance (SBEE), Static Abdominal Muscular Endurance (SAME) and Glycaemic Control (GC) were assessed using Visual Analogue Scale, Biering-Sorensen test, flexor endurance test, and in2itTM device respectively at baseline, 4th, 8th and 12th week. Data were analysed using repeated measures ANOVA and Unpaired t-tests at α = 0.05. There were significant differences in PI, SAME and SBEE among participants in each of GA and GAMW groups respectively (p<0.05). Within-group difference on GC was significant for GAMW (6.3±0.9%, 5.7±0.7%) but not GA (6.3±0.9%, 6.3±0.9%). There was significant difference (p<0.05) between GA and GAMW group participants for SBEE (7.2±0.1 sec, 7.3±0.1 sec) at week 8 of the study and GC (-0.5±0.2%, -0.6±0.5%) at the end of the study. No differences were found between GA and GAMW groups for PI and SAME. Graded activity with daily-monitored-walking produced positive effects on GC and yielded a better improvement on SAME and SBEE.

EFFECT OF CORE STABILIZATION TRAINING APPLIED TO 10-13 AGE SWIMMERS ON THE SWIMMING TIME AND SOME MOTORIC CHARACTERISTICS

Purpose: The aim of this study is the effect of core stabilization training (CST) at male swimmers in 10-13 ages on 50 m backstroke swimming time (ST), Biering Sorenson (BS) test, Flexor (FE) and Lateral Endurance test (LE) and Stork (SD) balance test parameters. Methods: 14 volunteer male swimmers who swim at the Yesilvadi Galatasaray Sports School were randomized to Experiment1 (D1) (n = 7) (age 11.57 ± 1.272 years, height 1.53 ± 0.04 m and weight 39.62). ± 3.55 kg) and Experiment2 (D2) (n = 7) (age 11.43 ± 1.272 years, height 1.53 ± 0.04 m and weight 41.43 ± 4.11 kg) after first measurements via the random method and 7 volunteered males were divided into the control group (F) (n = 7) (age 12 ± 1,155 years, height 1.53 ± 0.04 m and weight 41.43 ± 4.11 kg) and included in the study. CSA was applied to the D1 group athletes before swimming training 3 days a week (plank, side plank, reverse arm, reverse leg, reverse crunch, supine bridge, “V” sitting). The D2 group had only club swimming training and the K group had no training. The data were analyzed by Paired-Samples T Test and ANOVA test in SPSS 22.0 package program and the significance level was determined as p> 0.05. Results: Statistically significant difference detected in D1 group 50 m (ST) (p=0,012), BS (p=0,001), LE-right (p=0,04) and LE-left (p=0,022), FE values (p=0,004). Significant difference detected in D2 group 50 m ST (p=0,015) and BS test (p=0,000) result (p 0.05). As the result of final measurement results, significant difference detected at LE-right measurement between D1 group and D2 group, and LE-right and LE-left measurements among K group (p<0.05). Conclusions: As a result, it can be said that 8-week core and swimming trainings provide improvement in swimming point and endurance parameters and performance improvement can be achieved by applying to swimmers in 10-12 ages. Article visualizations:

Relationship between core stability and static balance in non-elite collegiate athletes

Background and Aim: Core stability has become very popular in fitness training and injury prevention programs that incorporate spinal musculature training including core strengthening and stability. Core dysfunction could be related to lower extremity functional performance including balance. The aim of present study was to evaluate the relationship between core stability and static balance. It will provide a rationale to focus on core stability training to enhance lower-limb performance, improvement of balance, and reduction of injuries. Materials and Methods: Based on inclusion and exclusion criteria, thirty nonelite collegiate athletes (male and female) were recruited for the study. Their core stability was analyzed using extensor endurance test (EET), flexor endurance test, and side-bridge test (SBT), whereas the static stability was evaluated using stork stand balance test. Results: Static balance was significantly correlated with EET and right and left SBT of core stability. Conclusion: The study concludes that there is a significant relationship between core stability and static balance in nonelite collegiate athletes in sagittal plane.

Intra and Inter-Rater Reliability for Deep Neck Flexor and Neck Extensor Muscle Endurance Tests in Subjects with and without Subclinical Neck Pain

Abstract Purpose Deep neck flexor (DNF) and neck extensor (NE) muscle endurance tests are a part of standard assessment procedure in routine physical therapy practice and these tests needs to be reliable. Materials and Methods Intra-rater (between-day) and inter-rater (within-day) reliability was assessed for 2 neck muscle endurance tests in 26 subclinical neck pain and 31 normal subjects by 2 blinded assessors. The tests conducted included 1) DNF endurance test performed in supine and 2) NE muscle endurance test performed in prone position. Results and discussion The Intra-rater and inter-rater reliability was determined by means of Intra Class Correlation (ICC), with 95% confidence intervals. The intra rater reliability testing showed good agreement for both DNF (ICC=0.76 and 0.78) and NE muscle endurance (ICC=0.75 and 0.76) tests. Meanwhile, the inter-rater reliability showed moderate to good agreement for both DNF (ICC – 0.58 and 0.61) and NE muscle endurance tests (ICC – 0.57 and 0.74) in subjects with subclinical neck pain. Subclinical neck pain subjects had a significantly lower endurance holding times compared to normal (p&lt;0.001). Conclusion The intra and inter rater reliability ranged from moderate to good agreement. Neck flexor and extensor muscle endurance can be measured reliably in a clinical setup in subjects with subclinical neck pain.

Comparison of MRI cross-sectional area and functions of core muscles among asymptomatic individuals with and without lumbar intervertebral disc degeneration

BackgroundPrevious studies suggested that patients with symptomatic intervertebral disc degeneration (IDD) of lumbar spine have reduced cross-sectional area (CSA) and functions of core muscles. However, reduced CSA and functions of core muscles have been observed not only in patients with symptomatic IDD but also in patients with other subgroups of low back pain (LBP). Thus, it is uncertain whether reduced CSA and functions of core muscles lead to IDD and LBP, or pain leads to reduced CSA and functions of core muscles in patients with symptomatic IDD. Therefore, this study aimed to compare the CSA and functions of core muscles between asymptomatic participants with and without IDD in magnetic resonance imaging (MRI).MethodsTwenty asymptomatic participants (12 men and 8 women) participated in this study. Ten participants had asymptomatic IDD at L4–5. The others were healthy controls (without IDD at all levels of lumbar spine). The CSA of core muscles was measured using MRI. Maximal isometric trunk flexor strength and side bridge strength were measured by a Smart KEMA strength sensor. Trunk flexor endurance test, side bridge endurance test and plank endurance test were used to measure core endurance. Double legs loading test was used to measure core stability. Mann-Whitney U test was used to compare the differences between two groups.ResultsThere were no significant differences in core muscle functions between the two groups (p > 0.05). Moreover, there was no significant difference in CSA between the two groups (p > 0.05).ConclusionsThere was no significant difference in CSA and core muscle functions between asymptomatic participants with and without IDD. These findings indicate that a degenerative or bulging disc in asymptomatic individuals has little effect on CSA and functions of core muscles, especially in young age. Therefore, the general core endurance test or strength test could not differentiate asymptomatic people with and without IDD of lumbar spine.Trial registration numberClinical Research information Service. KCT0004061. Registered 13 June 2019. retrospectively registered.

Effect of Deep Cervical Flexor Training on Craniovertebral Angle and Muscle Endurance among Students with Forwarding Head Posture

With the ease of use and a wide variety of choices of smartphones, it significantly affects the ways of life in terms of socializing, applications, gathering, and sharing information. Little do people know that it can also affect posture. This is where an introduction of exercise that targets the muscles involved in the impaired posture comes to maintain a proper posture. This study aimed to evaluate the effect of deep cervical flexor training on the craniovertebral angle and muscle endurance of students with forwarding head posture. The study is an experimental type of research that was utilized on thirty (30) junior high school students who had undergone fishbowl technique selection and were assigned to two (2) groups namely control and experimental group. Craniovertebral angle and deep neck flexor endurance test were used to determine the pre-and post-test of both groups. There is a significant difference in the paired t-test result of the pre-and post-test outcome of deep cervical flexor training of the experimental group in terms of CVA. In contrast to DNFET, there is no significant difference in the paired t-test result of the pre-and post-test intervention of deep cervical flexor training of the experimental group. Deep cervical flexor training is useful to increase CVA.

Comparison of climbing-specific strength and endurance between lead and boulder climbers.

Albeit differences in climbing-specific strength of the forearms have been demonstrated between lead and boulder climbers, little is known about the potential differences in force and power output of the upper body pulling-apparatus between disciplines. The aim of this study was to compare the climbing-specific upper-body strength and finger flexor endurance between lead and boulder climbers, as well as to examine the relative utilization of force when testing on a ledge hold compared to a jug hold. Sixteen boulder climbers (red-point climbing grade 17.9 ± 3.3) and fifteen lead climbers (red-point climbing grade 20.5 ± 3.5) performing on an advanced level volunteered for the study. Peak force, average force and rate of force development (RFD) were measured during an isometric pull-up, average velocity in dynamic pull-up, and finger flexor endurance in an intermittent test to fatigue. The isometric pull-up was performed on a ledge hold (high finger strength requirements) and on a jug hold (very low finger strength requirements). Boulder climbers demonstrated a higher maximal and explosive strength in all strength and power measurements (26.2–52.9%, ES = 0.90–1.12, p = 0.006–0.023), whereas the finger flexor endurance test showed no significant difference between the groups (p = 0.088). Both groups were able to utilize 57–69% of peak force, average force and RFD in the ledge condition compared to the jug condition, but the relative utilization was not different between the groups (p = 0.290–0.996). In conclusion, boulder climbers were stronger and more explosive compared to lead climbers, whereas no differences in finger flexor endurance were observed. Performing climbing-specific tests on a smaller hold appears to limit the force and power output equally between the two groups.

The Relationship between Core Muscle Stability and Balance in Yoga

Core muscle stability includes the strength and endurance of the flexor and extensor muscles present at deep inside of the trunk region of our body which is considered as an important factor for sports performance. Purpose of the study was to assess the correlation between balance and core muscle stability of the yoga practicing women in college level. Sixteen (16) inter college level yoga women were agreed to take part in the study as subject. Dynamic balance was measured by Modified Bass Test, Static balance was measured by Standing Stork Test and Core muscle stability was measured by four different tests – Side Bridge Test Left (SBTL), Side Bridge Test Right (SBTR), Back Extensor Test (BET) and Flexor Endurance Test (FET).The entire tests considered in this study were standard tests. Mean and standard deviation were computed as descriptive statistics and coefficient of correlation (r) was computed by Pearson Product Moment method. Only 0.05 level has been considered to judge the significance of the study. All statistical calculations were done by using standard statistical software (Excel-2007). Results revealed that dynamic balance has positive correlation with SBT Left (r=0.300), SBT right (r=0.255), BET(r=0.287) and FET (r=0.408). Static balance has also positive correlation with SBT Left (r=0.559), SBT Right (=0.154), BET (r=0.095) and FET (r=0.007). All the computed values of coefficient of correlation (r) in this study found statistically insignificant except SBTL with static balance which is statistically significant. Conclusion: It can be concluded that core muscle stability have a little impact on dynamic and static balance among college level women who practice yoga regularly.

Is there a relation between rotator cuff injury and core stability?

Strong core stabilization not only minimizes the load on the vertebral column, but also improves strength and endurance of peripheral joints, and enables the energy transfer to distal segments. Despite the current interest surrounding core stability, none of the studies investigated the effect of core stability on the formation of rotator cuff tear or healing after repair. To determine the relationship between core stability and upper extremity functional performance in patients who underwent rotator cuff repair surgery and to compare those with healthy subjects of similar age. Patients who underwent rotator cuff repair (RC repair group, n= 58 patient) and healthy subjects of the similar age group (control group, n= 114) were included in the study. The mean age was 55.03 ± 9.84 years in the RC repair group and 52.71 ± 6.31 years in the control group. The RC repair group took standardized rehabilitation. The rehabilitation program did not include core strength and stability exercise. Core endurance was assessed with Flexor Endurance, Prone Bridge and Supine bridge test. Disabilities of the Arm, Shoulder and Hand (DASH), Short Form-36 (SF-36) and the Close Kinetic Chain Upper Extremity Stability (CKCUES) test were used to evaluate the upper extremity functional performance. The core endurance (prone and supine bridge test) of the control group was statistically significantly better than the RC repair group (p⩽ 0.005). The DASH-T, SF-36 and CKCUES scores of the control group were also statistically significantly better. The neuromuscular system should be considered as a whole, and addition of the core stabilization exercises to an effective rehabilitation program after RC repair surgery may be beneficial.

A Therapeutic Exercise Program Improves Pain and Physical Dimension of Health-Related Quality of Life in Young Adults: A Randomized Controlled Trial.

The aim of this study was to evaluate the effects of an exercise therapy program on pain and physical dimension of health-related quality of life for young adults with musculoskeletal pain. This is a randomized controlled single-blind trial. Fifty-seven subjects (58% women) were randomly assigned to experimental [n = 28, 21.4 (2.9) yrs] and control [n = 29, 21.0 (4.2) yrs] groups. The experimental group participated in a 9-wk stabilization exercise therapy program, 60 mins/wk, whereas the control group did not exercise, with a preintervention and postintervention assessment. Primary outcome was Physical Component Summary of SF-36. Secondary outcomes were Nordic Musculoskeletal Questionnaire, Visual Analogue Scale, Oswestry Disability Index, Neck Disability Index, and Trunk Flexor Endurance Test. The Shapiro-Wilk, independent t test or Mann-Whitney U test, X, or Fisher's exact test were used for statistical analysis. After intervention, the experimental group improved by 3.2 (4.5) points on the Physical Component Summary (P = 0.01), decreased prevalence of low back pain in the last month (P = 0.02) and cervical disability (P = 0.02), and increased flexor trunk endurance (P = 0.005). This study confirmed that a 9-wk progressive exercise therapy program can improve physical health and reduce the prevalence of cervical disability and low back pain in the last month in young adults with musculoskeletal pain.

Immediate and Short-term Effects of Thoracic Spine Manipulation in Patients With Cervical Radiculopathy: A Randomized Controlled Trial.

Thoracic spine thrust manipulation has been shown to improve patient-rated outcomes for individuals with neck pain. However, there is limited evidence of its effectiveness in patients with cervical radiculopathy. To compare the immediate and short-term effects of thoracic manipulation to those of a sham thoracic manipulation in patients with cervical radiculopathy. In this multicenter randomized controlled trial, participants with cervical radiculopathy were randomized to receive either manipulation (n = 22) or sham manipulation (n = 21) of the thoracic spine. Outcomes were measured at baseline, immediately after treatment, and at a follow-up 48 to 72 hours after manipulation. A repeated-measures analysis of variance was used to analyze neck and upper extremity pain (numeric pain-rating scale), disability (Neck Disability Index), cervical range of motion (ROM), and endurance (deep neck flexor endurance test). The chi-square test was used to analyze changes in neck and upper extremity pain, centralization of symptoms, and beliefs about receiving the active manipulation treatment using a global rating of change scale. Neck and upper extremity pain, cervical ROM, disability, and deep neck flexor endurance all showed significant interactions between group and time (P<.01). Immediately after treatment and at the 48-to-72-hour follow-up, the manipulation group had lower neck pain (P<.01), better cervical ROM (P<.01), lower disability (P<.01), and better deep neck flexor endurance (P = .02) compared to the sham manipulation group. The manipulation group had moderate to large effect-size changes over time. No between-group differences for upper extremity pain were found immediately following the intervention (P = .34) and at 48 to 72 hours after the intervention (P = .18). At 48 to 72 hours after treatment, a greater proportion of participants in the manipulation group reported improvement (global rating of change scale score of 4 or greater) in neck and upper extremity symptoms (P<.01), centralization of symptoms (P<.01), and beliefs about receiving an active manipulation (P = .01) compared to the sham manipulation group. One session of thoracic manipulation resulted in improvements in pain, disability, cervical ROM, and deep neck flexor endurance in patients with cervical radiculopathy. Patients treated with manipulation were more likely to report at least moderate change in their neck and upper extremity symptoms up to 48 to 72 hours following treatment. Therapy, level 2. J Orthop Sports Phys Ther 2019;49(5):299-309. doi:10.2519/jospt.2019.8150.

Exploring the role of cervical spine endurance as a predictor of concussion risk and recovery following sports related concussion

BackgroundConcussions have become a significant public health concern with rising incidence rates. Concussions have been shown to occur concurrently with neck injuries, such as whiplash-associated-disorder, therefore, understanding the role of the neck in concussions is important. ObjectivesTo determine if there is a relationship between cervical muscle endurance and either concussion incidence, or concussion recovery in university athletes. Specifically, the primary aim was to investigate a relationship between pre-season deep neck flexor endurance test (DNFET) time in those who sustained an in-season injury versus those who did not. The secondary aim is to determine correlation in DNFET times and concussion recovery. DesignLongitudinal observational study. MethodsPre-season DNFET was performed on university athletes. In the event of a concussion, cervical endurance and neuromuscular adaptation was re-assessed with the DNFET. Rehabilitative exercises were prescribed, as required, and DNFET was measured at subsequent treatments. ResultsThere was no significant difference between pre-season DNFET times and concussion incidence (p = 0.55). However, there was a moderate correlation between DNFET times and concussion recovery (R = 0.47, p = 0.001) whereby DNFET times improved predictively throughout rehabilitation. ConclusionsWhile no statistically significant relationship was found between DNFET and concussion incidence, a significant clinical relationship was present with recovery. The validity of the DNFET test as a means for assessing risk or measuring recovery requires additional research.