Lateral Rotation Research Articles

Comparing the Movement System Impairment Method and Routine Physical Therapy for Knee Pain: A Randomized Clinical Trial

This study explores the effectiveness of the Movement System Impairment (MSI) model compared to traditional physiotherapy for treating knee pain. Fifty patients with unilateral knee pain participated, with their femur, tibia, and knee alignment assessed in nine functional positions. Evaluations included the Tegner Activity Scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), muscle power, extensibility, and pain levels. Patients were randomly assigned to either the MSI treatment group, which focused on identifying and correcting faulty movements, or a routine physiotherapy group that received general strengthening and stretching exercises. Results indicated that both treatment approaches improved muscle power in hip abductors and lateral rotators, as well as scores on the Tegner Activity Scale and the KOOS. Notably, the MSI group demonstrated greater improvements in the muscle power of the hip lateral rotators and knee extensors and a significant reduction in knee pain during walking compared to the routine group (p = 0.005). In conclusion, both treatments enhanced pain, function, and muscle strength, while the MSI model significantly reduced knee pain in walking and improved hip and knee muscle power compared to routine physiotherapy.

The biomechanical effects of treating double-segment lumbar degenerative diseases with unilateral fixation through interlaminar fenestration interbody fusion surgery: a three-dimensional finite element study

BackgroundTransforaminal lumbar interbody fusion (TLIF) surgery has become increasingly popular in the surgical treatment of lumbar degenerative diseases. The optimal structure for stable double-segment fixation remains unclear.ObjectiveTo compare the biomechanical changes of unilateral fixation versus bilateral fixation in patients with lumbar degeneration undergoing double-segment TLIF surgery, and to explore the stability and feasibility of unilateral double-segment fixation.MethodsA three-dimensional finite element model of L3-5 was established based on CT data from a recruited young male volunteer, and the model was validated to have reasonable predictive capability. Surgical procedures were simulated by adjusting bony structures to create models of unilateral and bilateral fixation for double-segment TLIF. Under a pure moment of 10 Nm, range of motion (ROM), extension, lateral bending, axial rotation movements, as well as stresses on interbody fusion devices, internal fixation, and endplates were recorded and compared.ResultsUnilateral fixation was fixed on the left side, with both groups performing flexion, extension, left lateral flexion, right lateral flexion, left rotation, and right rotation movements. All reconstructed conditions showed decreased motion from L3 to L5. Unilateral fixation had greater lumbar spine range of motion (ROM) in all directions compared to bilateral fixation. The greatest difference between the two occurred during right lateral flexion at the L3-4 segment, measuring 1.78°. During right lateral flexion at the L4-5 segment, the largest difference was 2.29°. Regarding stress on the fusion devices, unilateral fixation models exhibited higher stresses than bilateral fixation models, but no significant differences in stability were found. Terminal plate stress in unilateral posterior fixation was higher during flexion than in the bilateral model, showing a similar trend in stress changes. No significant difference was seen in internal fixation stress between the two groups during two-segment fusion, with the posterior internal fixation stress in unilateral fixation being 1.7 times higher during flexion and 1.9 times higher during left bending compared to bilateral fixation.ConclusionUnilateral fixation in two-segment transforaminal lumbar interbody fusion (TLIF) surgery can increase stability compared to bilateral fixation, with no significant differences observed between the two models. Unilateral two-segment fixation allows for greater lumbar spine mobility than bilateral fixation, albeit with a slight increase in stress on the posterior fixation and fusion devices under the unilateral fixation mode. This provides some biomechanical evidence for selecting surgical approaches for elderly patients who cannot tolerate long surgeries, suggesting that two-segment unilateral fixation may be advisable.Clinical trial numberNot applicable.

Physiotherapeutic strategy for cervicalgia resulting from excessive use of Smartphones in students of an Angolan university

Introduction: Neck pain is considered one of the most uncomfortable musculoskeletal problems and has a major impact on the quality of life of individuals, being the fourth leading cause of disability in adults. With technology constantly advancing, giving rise to devices with numerous functions such as smartphones, it contributes greatly to daily activities, especially for students. However, a large part of students overuse their smartphones and spend hours connected in flexed postures, overloading the cervical region. And physiotherapy offers a variety of effective techniques for this dysfunction. Objective: To analyze the effectiveness of the physiotherapeutic strategy in students with neck pain resulting from excessive smartphone use. Methods: A quasi-experimental study with a longitudinal strategy was carried out with a sample of 14 students of both genders who presented neck pain. The intensity of pain, the range of motion of the cervical region were evaluated, and the spurling test was performed. After the evaluation, a pain relief and range of motion increase program was performed in 6 sections. Results: There was a slight improvement in pain intensity with the visual analogue scale (p=0.11), there was an improvement in the range of motion, both in cervical flexion (p=0.002), cervical extension (p=0.002), right and left lateral cervical tilt (p=0.04) and cervical rotation (p=0.03) and there was an improvement in the spurling test (p=0.002). Conclusion: The physiotherapeutic strategy was effective and provided greater functional independence in students with neck pain due to excessive smartphone use

A Computer Modeling-Based Target Zone for Transposition Osteotomy of the Acetabulum in Patients with Hip Dysplasia.

This study aimed to determine the acetabular position to optimize hip biomechanics after transposition osteotomy of the acetabulum (TOA), a specific form of periacetabular osteotomy, in patients with hip dysplasia. We created patient-specific finite-element models of 46 patients with hip dysplasia to simulate 12 virtual TOA scenarios: lateral rotation to achieve a lateral center-edge angle (LCEA) of 30°, 35°, and 40° combined with anterior rotation of 0°, 5°, 10°, and 15°. Joint contact pressure (CP) on the acetabular cartilage during a single-leg stance and simulated hip range of motion without osseous impingement were calculated. The optimal acetabular position was defined as satisfying both normal joint CP and the required range of motion for activities of daily living. Multivariable logistic regression analysis was used to identify preoperative morphological predictors of osseous impingement after virtual TOA with adequate acetabular correction. The prevalence of hips in the optimal position was highest (65.2%) at an LCEA of 30°, regardless of the amount of anterior rotation. While the acetabular position minimizing peak CP varied among patients, approximately 80% exhibited normalized peak CP at an LCEA of 30° and 35° with 15° of anterior rotation, which were the 2 most favorable configurations among the 12 simulated scenarios. In this context, the preoperative head-neck offset ratio (HNOR) at the 1:30 clock position (p = 0.018) was an independent predictor of postoperative osseous impingement within the required range of motion. Specifically, an HNOR of <0.14 at the 1:30 clock position predicted limitation of required range of motion after virtual TOA (sensitivity, 57%; specificity, 81%; and area under the receiver operating characteristic curve, 0.70). Acetabular reorientation to an LCEA of between 30° and 35° with an additional 15° of anterior rotation may serve as a biomechanics-based target zone for surgeons performing TOA in most patients with hip dysplasia. However, patients with a reduced HNOR at the 1:30 clock position may experience limited range of motion in activities of daily living postoperatively. This study provides a biomechanics-based target for refining acetabular reorientation strategies during TOA while considering morphological factors that may limit the required range of motion.

Finite element analysis shows minimal stability difference between individualized mini-hemilaminectomy-corpectomy and partial lateral corpectomy in a dog model.

Use finite element analysis to evaluate the biomechanical effects of spinal decompression procedures in healthy Beagle dogs, comparing individualized mini-hemilaminectomy-corpectomy (iMHC), mini-hemilaminectomy, partial lateral corpectomy (PLC), and hemilaminectomy. A finite element model of the L1-L2 functional spinal unit was generated using CT data. For each decompression model, loads were applied in 0.2-Nm steps (maximum, 2.0 Nm) in 6 directions: flexion, extension, right and left lateral bending, and right and left axial rotation. The L1 spinous process tip displacement angle was quantified numerically. Among the 4 techniques, mini-hemilaminectomy exhibited the smallest displacement angles across all directions. Hemilaminectomy exhibited the largest displacement angles in extension, flexion, right rotation, and left rotation across all techniques. Left and right lateral bending displacement angles were marginally larger for iMHC than for hemilaminectomy at 0.4 Nm; however, at 2.0 Nm, displacement angles were similar. Mini-hemilaminectomy minimizes functional spinal unit instability to the greatest extent. Hemilaminectomy is more unstable than iMHC and PLC in flexion, extension, and rotation. Mini-hemilaminectomy-corpectomy and PLC are more unstable than hemilaminectomy in lateral bending, with iMHC being slightly more unstable than PLC or nearly equal. Mini-hemilaminectomy minimizes instability to the greatest extent in cases of ventrolateral spinal compression. In cases of ventral spinal compression, iMHC may be preferable to PLC for providing equivalent stability without impeding spinal cord visualization, but both techniques can cause instability depending on loading direction, so careful attention to postoperative instability is necessary when excessive vertebral body resection is involved.

Dynamic response analysis of monopile-supported offshore wind turbine on sandy ground under seismic and environmental loads

Monopiles are the most widely adopted foundation type for Offshore Wind Turbines (OWTs) in shallow waters. With the expansion of the construction of OWT, the number of OWT farms in seismic regions increases globally including the coastal areas of Japan and China. It is necessary to evaluate the impact of earthquakes including the vibration and soil liquefaction on the OWTs supported by the monopile foundation, while the effects of liquefaction on offshore structures, especially for OWTs with monopiles, have not been sufficiently studied. This study investigates the seismic response of the monopile-supported OWTs with the use of an advanced soil model. A three-dimensional numerical model is built, and dynamic analyses are carried out using the OpenSees framework. The pressure-dependent multi-yield (PDMY03) constitutive model is used to simulate the dynamic soil behavior. The applicability of the large-diameter pile modeling method for proper soil-pile interaction modeling in this numerical analysis is first validated through centrifuge tests on monopiles subjected to lateral loading. The dynamic analyses are then carried out to demonstrate the seismic response of the entire OWT system. The numerical results indicate that the contribution of higher modes of vibration is becoming of increased importance for large wind turbines and soil-structure interaction plays a significant role in the dynamic response. Moreover, the monopile-supported OWT in dense sand deposits experiences substantial lateral displacement and rotation under the combined action of wind and earthquake loads when liquefaction occurs.

Age- and Gender-Related Femoral Bowing Analysis in the Korean Population and Features for Clinical Applications.

Background and Objectives: The anterolateral bowing of the femur shows differences between races and has recently caused many clinical problems. Asians tend to have increased femoral bowing, but there is a lack of large-scale studies. We aim to identify the patterns of femoral bowing in the Korean population through comprehensive analysis and address its clinical implications. Materials and Methods: We analyzed 550 femoral radiographs from Korean patients using three different views: anteroposterior, lateral, and 15-degree internal rotation. Initial univariate analysis examined age and gender differences, followed by multivariate analysis incorporating height and weight to understand their combined effects on femoral bowing. Results: The study included 229 (41.6%) males and 321 (58.4%) females, with a mean age of 62.53 years (SD = 21.93). Initial analysis showed greater femoral bowing in females than males by 2.72° (p < 0.001) in anteroposterior views. However, multivariate analysis revealed age to be the primary significant factor affecting femoral bowing across all viewing angles (p < 0.001), while gender effects became non-significant when controlling for other variables. The AP angle regression model explained 26% of the total variance, with each year increase in age associated with a 0.12-degree increase in bowing angle. Conclusions: This study demonstrated that age is the primary factor influencing femoral bowing in the Korean population, with apparent gender differences potentially attributable to age distribution differences between groups. Anteroposterior radiographic imaging proved most suitable for assessing bowing angles. These findings provide important insights for surgical planning and implant selection, particularly in addressing potential mismatch issues in Asian populations.

A new field-test for assessing the medial and lateral hamstring strength at long-muscle length

This research investigates the influence of tibial rotations with knee flexion (KF) on the electromyographic (EMG) activities of hamstring muscles (HM) groups and the strength ratio between the medial and lateral rotation of the tibia. A cross-sectional design was employed to assess muscle activity, isometric strength and reliability. The research was conducted in a controlled laboratory environment. Thirty-six amateur male athletes were recruited as volunteers. The measures included peak muscle activity of the semitendinosus and biceps femoris long head, the knee flexors’ isometric strength ratio and reliability. The isometric strength ratios of medial (MR) to lateral (LR) tibial rotations were 0.94 ± 0.17 at 90°, and 0.93 ± 0.10 at both 60° and 30° of KF angulation. Tibial position significantly influenced knee flexion strength as well as HM activity, irrespective of KF angulation. Specifically, biceps femoris activity increased by 33.6% in LR compared to MR, while semitendinosus activity increased by 22.6% in MR compared to LR. The Knee-Rotation test (KR-test) can be a valuable tool for evaluating both HM groups (ICC >0.87), and identifying the primary target for strengthening purposes during the injury prevention process. It provides insights for effective rehabilitation and training interventions.

Case series study and finite element analysis of a new cervicothoracic fixation device

ObjectiveTo introduce a specialized device designed for the fixation of the cervical-thoracic spine and describe its surgical installation, finite element analysis, and clinical outcomes.MethodsA finite element model of the C6-T1 segment was developed and validated, and simulations of subtotal resection of anterior cervical vertebrae, artificial vertebrae placement, and titanium plate fixation were performed. The model was subjected to a 75 N load to simulate the weight of the head and a 1 N·m force to simulate flexion, lateral bending, and axial rotation. The analysis focused on range of motion, total stress, stress in the artificial vertebrae, and stress in the device. The clinical outcomes were evaluated in a retrospective case series of 140 patients with cervical spine fractures.ResultsUnder the same loading conditions, the maximum stresses on specialized anatomical and biomechanical devices for the fixation of the cervicothoracic segment of the spine during neutral, forwards flexion, backwards extension, left lateral bending, right lateral bending, left rotation, right rotation and other working conditions were 25.097 MPa, 149.480 MPa, 64.150 MPa, 67.804 MPa, 72.754 MPa, and 117.98 MPa, respectively. And, the maximum ROMs were 2.230 mm, 5.585 mm, 4.682 mm, 3.184 mm, 3.061 mm, 4.451 mm, and 4.645 mm. Compared with those in the preoperative period, the patients’ CL, OPCL, UCL, LCL, UROM, LROM, VAS score, NDI score, JOA score, intervertebral space height at the injured segment, cervical anterior kyphosis angle, Cobb angle, vertebral displacement, ASIA grade, fracture classification, and vertebral displacement improved (P < 0.05). Sixty-two patients had dysphagia, and 3 patients experienced leakage of cerebrospinal fluid.ConclusionThe design of the new cervicothoracic internal fixation device conforms to the anatomical structure of the cervicothoracic spine, which can provide immediate stability, better screw placement and adequate bone grafting, and reduce the risk of complications. Despite some disadvantages, it is a good device for segmental fixation of the cervical and thoracic spine.

Prolotherapy in the Treatment of Sports-Related Tendinopathies: A Systematic Review of Randomized Controlled Trials.

As sports have increased in popularity, the incidence of tendinopathy has also grown dramatically. Nonoperative techniques and treatments used to address these pathologies continue to evolve and improve. One such treatment, prolotherapy (PrT), has become increasingly popular and may provide patients with an alternative nonoperative treatment option. To review high-quality randomized controlled trials (RCTs) that analyzed PrT treatments for the most common tendinopathies. Specifically, this review aims to provide meaningful data regarding methods and outcomes for each condition treated and guide professionals who are considering PrT as a treatment option. Systematic review; Level of evidence, 2. All RCTs published in English between January 1, 1980, and July 30, 2021, and reported in Embase, Medline, and Web of Science databases were reviewed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. After the initial search, a total of 3264 articles were identified. Studies analyzing sports medicine injuries and musculoskeletal pathologies using an RCT design were included, while case-reports, case-studies, reviews, and observational studies were excluded. Two independent researchers reviewed the search results, and conflicts were resolved by discussion of inclusion and exclusion criteria among all authors. The articles' quality was evaluated using the Cochrane tool for assessing the risk of bias. Statistical analysis and graphical representations were performed using SPSS Version 28.00. A total of 20 articles, including 1136 patients, met the inclusion criteria and were included in the study. Overall, in 85% of the studies, PrT was found to be effective in the treatment of tendinopathy. Specifically, PrT was superior to or as effective as the control in 83% (10/12) of the studies analyzing lateral epicondylitis (LE) and rotator cuff (RC) tendinopathies and in 88% (7/8) of the studies on plantar fasciitis (PF), Osgood-Schlatter disease (OSD), and Achilles tendinosis (AT). LE, RC, and PF tendinopathies were the most studied conditions (17/20 studies), while AT and OSD were the least studied (3/20 studies). Of the studies, 95% (19/20) used dextrose solutions, with only 1 using solutions of 2.5% phenol, 25% glycerin, and 25% dextrose in sterile water. Our systematic review suggests that PrT appears to be a promising alternative treatment for common tendinopathies. Most studies used a hypertonic dextrose solution. Even though further, larger randomized controlled trials comparing PrT with other orthobiologics would be beneficial, based on this review, sports medicine physiciansmay safely pursue PrT as an additional component of conservative treatment.

Dynamics of an oblate spheroidal particle in a square duct filled with viscoelastic fluids

Herein, we used the fictitious domain method to numerically investigate the lateral migration and rotation of an oblate spheroidal particle in a square duct filled with Oldroyd-B fluids. We adopted Reynolds numbers ranging from 25 to 100 and Weissenberg numbers from 0.01 to 0.50. At low to moderate Weissenberg numbers (Wi ≤ 0.50), viscous forces remain dominant in particle motion. Additionally, we considered the effects of initial lateral position, orientation, and blocking ratio on particle dynamics. The results indicate that for flow in square channels with finite fluid inertia, as Wi increases, the elastic effects gradually strengthen, causing the equilibrium position of the particles to shift from near the centerline of the channel toward the diagonal. Notably, under significant fluid elasticity conditions, additional equilibrium positions emerge in the corners of the channel. When released with their x0–y0 plane (containing the two longest axes of the oblate spheroid) parallel to the x–y plane (duct cross section) of the flow field, particles exhibited three distinct motion modes: tumbling, rolling, and kayaking. Tumbling was influenced by fluid inertia and corner attraction, which exhibited transitions to rolling or kayaking. The study also emphasized that the initial orientation of the particles impacted their sustained tumbling under low inertial flows. In addition, the blockage ratio (the ratio of the equivalent diameter of the particle to the duct height) mainly affected the equilibrium positions, and particles with a blockage ratio β ≤ 0.125 were readily attracted to the corners.

Muscle energy technique versus Maitland’s mobilization on shoulder pain and disability after neck dissection surgeries

Background. A substantial number of patients who undergo various neck dissection procedures experience shoulder dysfunction and pain, which can significantly complicate or disrupt daily routines, social engagements, and overall Quality of Life (QOL). Muscle Energy Techniques (MET) and mobilization have been demonstrated to effectively reduce shoulder pain and disability. Objective. The objective of this study was to examine the therapeutic benefits of MET and mobilization in improving shoulder pain and disability following neck dissection surgeries and compare these two techniques’ efficacies. Design. The present study employed a randomized, single-blind, controlled trial Methods. Thirty patients between the ages of 25 and 70 (13 men and 17 women) with shoulder dysfunction following six months’ post-neck dissection surgeries were enrolled in the study. Patients were equally randomized into two groups of 15per each: Group A received the Muscle Energy Technique (MET), and Group B underwent Maitland’s Mobilization. Both groups participated in identical conventional physiotherapy regimens. Both interventions were administered at a frequency of three sessions per week over four weeks. Visual Analogue Scale (VAS) for pain assessment, Shoulder Pain, and Disability Index (SPADI), in addition to shoulder range of motion (flexion, abduction, and lateral rotation), were measured before and after four weeks of intervention. Results. Following four weeks of intervention, both groups exhibited significant improvements in VAS, SPADI, and shoulder flexion, abduction, and lateral rotation, with p values ≤ 0.001. A comparison between the groups showed a statistically significant difference in all measured outcomes, favoring Group A, with p-values &lt; 0.001. Conclusion. The Muscle Energy Technique (MET) and Maitland’s Mobilization were effective therapeutic strategies for alleviating shoulder pain and disability following neck dissection surgeries. However, the results showed that MET outperformed Maitland’s Mobilization strategies.

Greater squat stance width alters three-dimensional hip moment demands

Barbell squat exercise may be performed with different stance widths, which will influence lower limb kinematics and joint reaction forces. Consequently, three-dimensional hip moments may vary with stance width, influencing muscle loading, and the muscles trained when performing squat exercise. To examine how squat stance width affects hip moments, males (n = 11) and females (n = 13) performed barbell squats at narrow, medium, and wide stance widths. Motion capture and force platform data were used to calculate three-dimensional hip net joint moments (NJM) as indicators of the muscular moments required. Hip extensor NJM was greater for wide than medium (P < 0.001) and narrow (P < 0.001) stance squats. Hip adductor NJM was not different between squat stance widths (P = 0.414). Hip lateral rotator NJM was greater in medium versus narrow squats (P < 0.001), and in wide versus medium (P < 0.001) and narrow (P < 0.001) squats. Taken together, the rotational demands at the hip increase as stance width increases, due to higher hip extensor and lateral rotator NJM. In contrast hip adductor NJM is invariant. These data provide insight into the three-dimensional requirements that muscles must meet at the hip when squat exercise is performed at different stance widths.

Influence of the surrounding environment on the response of seated midsize male volunteers subjected to lateral sled accelerations

Predicting vehicle occupants’ posture during evasive manoeuvres is crucial for assessing their safety in the event of a collision. Volunteer experiments have been performed in the past under lateral accelerations, both within a vehicle cabin and on a seat mounted on a sled. However, discrepancies in the volunteer responses between both setups have been identified. This study hypothesizes that the response of the volunteers differs as a consequence of the proximity to the frame in the vehicle cabin, in comparison to the absence of such a structure on the sled.The present study conducted a novel sled experiment, on which five volunteers with anthropometry comparable to the 50th percentile male were subjected to 0.3 g lateral accelerations, with three different surrounding environments. In twelve pulses, an additional lateral structure was placed to the right or left side of the seated volunteers. The volunteers were asked to either brace or relax their muscles.The results show significant differences between the configurations with and without the structure placed on the right side. This effect was observed for both the lateral excursion of the upper body and the corresponding rotation when the volunteers were relaxed (p < 0.01). The average maximum lateral head rotation decreased from 27° to 14° with the structure on the right. No significant difference in head rotation was found for the braced muscle configuration.This study supports the hypothesis that the proximity to a surrounding environment influences human responses during dynamic loading. Nevertheless, there was no significant difference in maximum muscle activation between the configurations, but a faster reaction of the sternocleidomastoid muscle with the presence of the structure.

Effects of passive shoulder-support exoskeleton entity and support force on user range of motion under external loads

This study investigates the effects of a passive shoulder-support exoskeleton entity and support force on the range of motion (ROM) of the shoulder and trunk. Twenty-six healthy participants underwent ROM assessments across three exoskeleton setting conditions (without the exoskeleton; wearing the exoskeleton but the support force deactivated; wearing the exoskeleton with the support force activated) and three external load conditions (0 kg, 3 kg, and 6 kg). Results show that while the exoskeleton entity constrained the shoulder ROM (vertical abduction/adduction, flexion/extension, and horizontal abduction/adduction) and trunk ROM (lateral flexion and rotation), the support force partially alleviated this constraint. External loads primarily restricted the mobility of the shoulder but not the trunk. Interaction effects revealed the complex interplay between external loads and exoskeleton settings on ROM and perceived difficulty, particularly in shoulder vertical abduction/adduction. This study underscores the necessity of considering exoskeleton entity, support force, and external loads in optimizing user joint mobility.The industrial exoskeleton represents a promising solution for enhancing workplace safety and productivity by mitigating work-related musculoskeletal disorders. This study assessed the impact of the exoskeleton's entity and support force on joint mobility across different load scenarios. Joint mobility is critical to perform industrial tasks that require high flexibility and agility.

Assessment of the Gordon lateral rotation index in postoperative rotational evaluation of supracondylar humerus fractures: a study on validity, reliability, and applicability.

Assessment of the Gordon lateral rotation index in postoperative rotational evaluation of supracondylar humerus fractures: a study on validity, reliability, and applicability.

Comparing the effects of neck stabilization exercises versus dynamic exercises among patients having nonspecific neck pain with forward head posture: a randomized clinical trial

BackgroundNonspecific neck pain (NSNP) is a well-established global burden affecting. It is also a common problem in Pakistan. The burden of neck pain is also increasing day by day due to poor work ergonomics, and increased use of computers and mobiles after the pandemic. An individual’s poor posture is often associated with forward head posture (FHP). Limited evidence is available about the effects of neck stabilization (NSE) and dynamic exercises (NDE) for nonspecific neck pain particularly in patients with FHP. This aimed to compare the effects of NSE versus NDE among patients having NSNP with FHP in reducing pain, disability, forward head posture and improving neck range of motion.MethodsIt is a single-blinded randomized clinical trial with 60 patients aged 18–40 years, with moderate intensity NSNP for > 3 weeks and < 6 months along with FHP with a moderate disability on neck disability index (NDI) randomly assigned to the treatment groups. Group 1 was doing NSE and group 2 was doing NDE. Transcutaneous Electical Nerve Stimulation, cold packs, and stretching exercises were given to both groups. A total of 9 sessions (3 sessions/ week) were given to participants. NDI questionnaire, Visual analogue scale (VAS), goniometry, and plumb line measurement tool were used as baseline and assessment at the end of 3rd week. The data was analyzed on SPSS version 21. Descriptive analysis was performed. Independent t-test was used for between group comparison and paired t-test used for within group comparison. A p-value less than 0.05 was considered statistically significant.ResultsAfter treatment within-group analysis of both NSE and NDE showed significant (p < 0.001) improvement in pain on VAS, all ROMs of the neck including flexion, extension, left and right lateral flexion and left rotation, plumb line and NDI score with very large effect size. However, between-group analysis showed non-significant differences (p > 0.05) for post-treatment mean VAS, neck ROM, NDI and plumb line measurement.ConclusionBetween NSE and NDE, no one is more beneficial than another. Both are equally effective in alleviating pain, increasing ROM, decreasing functional disability, and improving forward head posture in patients with NSNP.Trial RegistrationRegistered trial at ClinicalTrials.gov Identifier: NCT05298631, 28/03/2022, prospectively registered.

Research on flow field characteristics of curved pipe in bulk grain cyclone conveying based on gas solid coupling

AbstractIn the transportation of grain particles, elbow wear is a pressing concern. A novel approach to mitigate this involves introducing a lateral air supplement rotation mechanism that enables swirling transportation. We assessed the integration of this device at angles of 45°, 55°, and 65° to the central axis of the main pipeline. While the multiphase flow velocity within the main conduit was held constant at 20 m/s, the lateral device's airflow velocities were tested at 20, 30, and 40 m/s. Utilizing the CFD–DEM simulation for grain particle transportation around bends, our findings indicated that an optimal arrangement was with the lateral device at 55° relative to the main pipeline, with an airflow speed of 30 m/s. This setup fostered a forward particle spiral, drastically diminishing wear on the pipe wall. Experimental evaluations corroborated the simulation's outcomes.

Clinical history correlates with lateral atlantoaxial (C1-2) joint edema. A pilot study

BackgroundClinical evaluation in the determination of the etiology of axial spine pain is limited. ObjectiveTo determine if a set of three features of the clinical history are indicative of C1-2 joint edema on MRI. MethodsAll patients from one physician's practice who had axial cervical spine pain from 2021 to 2023 were evaluated. Cases were defined as those with all 3 of the ASL criteria, defined as Age >65, Superior cervical/suboccipital pain, and exacerbation of pain primarily by Lateral cervical spine rotation. Age-matched controls had axial cervical spine pain without meeting the ASL criteria. Edema around the atlantoaxial joint and/or odontoid was evaluated by STIR MR sequences. ResultsThe ASL criteria had a sensitivity of 82 % [95 % CI: 64–100 %], specificity of 79 %, [95 % CI: 63–95 %], positive predictive value of 74 % [95 % CI: 54–94 %], and negative predictive value of 86 % [95 % CI: 72–100 %] in diagnosing C1-2 joint edema. ConclusionA positive ASL criteria is sensitive and specific in the diagnosis of C1-2 joint edema, which may have clinical implications.

A mathematical model of the combination of lateral tilt and rotation of the vertebra

An important section of spinal biomechanics is the analysis of various types of movements in spinal segments, which are difficult to observe, and setting up experiments is quite complex. There are few articles devoted to this topic, and the methodological approaches outlined in these studies are so heterogeneous that they do not allow for a comparative analysis. In this situation, the abstract language of mathematics allows us to objectively answer the questions that arise. Aim of the study was to develop a mathematical model of a spinal segment to calculate the combination of rotation angles and lateral inclination of the vertebra, as well as to identify factors influencing these parameters. Material and methods. The developed mathematical model of the motion segment of the spine was used as the main tool for the study. The initial data for this model were the coordinates of the reference points of the vertebrae, which makes it possible to determine a number of parameters describing their complex structure. Using this model, the parameters of the combination of vertebral movement in the frontal and horizontal planes were calculated. Results and discussion. The developed model of the combination of movements in the spinal segment is adequate to the ideas about the nature of movements in the spinal segments. The coefficient of combination of lateral tilt and rotation of the vertebra for the cervical vertebrae is from 0.5 to 0.7, for the thoracic vertebrae from 0.3 to 0.5, and for the lumbar vertebrae from 0.0 to 0.1. Fluctuations in the value of this coefficient depend on the angle of inclination of the upper articular surfaces of the underlying vertebra. Reducing the size of the articular surfaces leads to a decrease in the magnitude of the angular movements of the vertebra, and their convergence leads to an increase in mobility in the spinal segments. A negative angle of inclination of the articular surfaces causes opposite rotation of the vertebra.