Neck Movement Research Articles

Effects of Vibration Therapy on Muscle Strength, Shoulder Range of Motion, and Muscle Biomechanical Properties in Patients with Breast Cancer Undergoing Radiotherapy: A Randomized Controlled Trial

Abstract Objective To investigate the effects of vibration therapy to home-based exercises on shoulder muscle strength, range of motion (ROM), pain-related disability, and muscles viscoelastic properties of shoulder and neck in patients with breast cancer undergoing radiotherapy. Design In this randomized controlled superiority trial was conducted with 38 participants who underwent breast cancer surgery. All patients were randomized into two groups: control group (CG) and vibration group (VG). Both groups performed home-based exercises for 5 days a week for 6 weeks. VG recived additional vibration therapy for 2 days a week for 6 weeks. Shoulder ROM, muscle strength, pain, disability, grip stength, and viscoelastic properties of the pectoralis major, upper trapezius, and sternocleidomastoid were compared pre- and post-intervention. Results VG demonstrated better improvement in shoulder ROM, muscle strength and pain-related disability (p < 0.05), except for internal rotation ROM. Only tone of pectoralis major was significantly higher in VG according to group x time interaction (p < 0.05), no differences were detected in terms of muscle viscoelastic properties in the CG patients (p > 0.05). Conclusion Vibration therapy provided superior improvements in muscle strength, ROM, and pain-related disability compared to home-based exercises alone in patients with breast cancer undergoing radiotherapy in the early postoperative phase.

Numerical modeling and analysis of neck injury induced by parachute opening shock.

Neck injuries from parachute opening shock (POS) are a concern in skydiving and military operations. This study employs finite element modeling to simulate POS scenarios and assess cervical spine injury risks. Validated against various conditions, including whiplash, the model replicates head/neck kinematics and soft tissue responses. POS simulations capture body/head motions during parachute deployment, indicating minimal risk of severe neck injuries (Abbreviated Injury Score/AIS ≥ 2) and low risk of soft tissue tears. Vertebral stress analysis during a rougher jump highlights high stress at C5/C6 lamina, indicating fracture risk. Comparative analysis with rear impact scenarios reveals distinct strain patterns, with rear impacts showing higher ligament strain, consistent with higher soft tissue damage risk. Though POS simulations exhibit lower strain values, they emphasize similar neck deformation patterns. The model's capability to accurately simulate head and neck movements during parachute openings provides critical validation for its use in assessing injury risks. The study's findings underline the importance of considering specific loading conditions in injury assessments and contribute to refining safety standards for skydiving and military operations. By highlighting the differences in injury mechanisms between POS and rear impacts, this research offers valuable insights into tailored injury mitigation strategies. The results not only enhance our understanding of neck injury mechanisms but also inform the development of protective gear and safety protocols, ultimately aiding in injury prevention for skydivers and military personnel.

Musculoskeletal Ultrasound Assessment of the Clinical Efficacy of the Combination of Acupressure and "Three Methods of Neck Movement (TCM)" Therapy in the Treatment of Cervical Spondylosis: A Study Protocol for a Randomized Controlled Trial.

Neck-type cervical spondylopathy (NTCS), a common degenerative disorder affecting the spine, poses challenges for patients and society. Research has demonstrated the effectiveness of traditional tuina techniques in treating NTCS, although some limitations still exist. Our study aimed to evaluate the effectiveness of combining regular massage techniques with three methods of neck movement (TCM) therapy for managing NTCS, utilizing musculoskeletal ultrasound measurements. In this study, 70 eligible patients with non-traumatic cervical spondylosis will be randomly assigned in a 1:1 ratio to either the experimental group, which will receive Tuina combined with a three-method neck movement treatment, or the control group, which will receive standard Tui Na manipulation. All participants will receive treatment for four weeks. Assessments will be conducted using musculoskeletal ultrasound, the McGill Pain Scale, and the Neck Disability Index (NDI) at three-time points: before treatment, at the end of treatment, and after 12 and 16weeks of treatment. This paper investigates the utility of musculoskeletal ultrasound as a tool for evaluating the therapeutic efficacy of an integrated Traditional Chinese Medicine (TCM) strategy in alleviating pain and enhancing functional outcomes for patients with NTCS.The objective is to present a clinically viable and long-term treatment option. Chinese Clinical Trial Registry, ChiCTR2300072648. Registered on June 20, 2023.

Endoscopic transnasal and transoral resection of the odontoid process and C1 combined with occipitocervical fusion for osteoradionecrosis of the upper cervical spine: a case report and literature review

BackgroundOsteoradionecrosis (ORN) of the upper cervical spine is a rare but severe complication of head and neck cancer radiotherapy. To raise awareness of this condition, we describe a patient with a history of nasopharyngeal carcinoma who developed ORN of the upper cervical spine and review the published literature reporting surgical management.Case presentationA 59-year-old female patient with persistent neck pain for one month and limited range of neck motion who had undergone radiotherapy for nasopharyngeal carcinoma with a total dose of 69.96 Gy 15 years ago presented to our hospital. The patient underwent endoscopic transnasal and transoral resection of the odontoid process and C1 anterior arch, combined with occipitocervical fusion. To better understand surgical management of ORN of the upper cervical spine, the literature published in the PubMed, Ovid MEDLINE, and Embase databases was reviewed. Our patient experienced alleviation of cervical pain and did not exhibit any postoperative complications. Since 2005, 11 cases of surgical management of ORN of the upper cervical spine (including the present case) have been published. Basilar invagination and/or atlantoaxial subluxation were observed in 4 /11 cases. Endoscopic procedures were performed in 4/11 cases, and occipitocervical fusion was performed in 8 /11 cases.ConclusionEndoscopic transnasal and transoral resection of the odontoid process and C1 anterior arch is a safe and effective treatment option for ORN of the upper cervical spine. Occipitocervical fusion is useful in patients with basilar invagination and atlantoaxial subluxation.

Evaluating functional ability in older adults’ object retrieval behavior from kitchen furniture using OpenPose and REBA

The purpose of this study is to evaluate, through analysis, the ability of older persons to retrieve items from kitchen cabinets. To achieve this goal, data were collected from 128 valid questionnaires and supplemented with field research and user interviews. The study revealed that the elderly’s behavior in retrieving items from kitchen spaces is characterized by both high frequency and difficulty. For this experiment, a total of 42 participants, comprising 21 males and 21 females from the self-care elderly population in the Yangtze River Delta region, were recruited. Two different experimental settings were arranged: one with kitchen utensils arranged in a straight line and another with a purpose-made chest of drawers with varying heights. Video recordings using the Logitech C930C were utilized to capture the gestures and behaviors of the elderly while retrieving objects from the kitchen cupboards (cabinets). By employing a combination of the OpenPose model and the Rapid Entire Body Assessment (REBA) method, which involves calculating human posture angles, REBA scores, and determining the risk level of Work-Related Musculoskeletal Disorders (WMSDs), a risk assessment framework for manual operations associated with WMSDs was developed. Using the angle data acquired from the user operation experiment as parameters, a gradient model of the elderly user’s operational capability was established. The findings indicated a significant impact of neck, trunk, and knee movements on the subjects (P < 0.001). The participants were able to distinguish between different levels of exertion, categorizing movements as ‘easy’, ‘moderate,’ or ‘strenuous.’ These results form the basis for a comfort gradient model for leaning over and retrieving items. Given the prevalent conditions of bone and joint degeneration and osteoporosis among the elderly population, it is evident that they face challenges when accessing items in the kitchen. Therefore, investigating the elderly’s execution abilities during the retrieval process becomes crucial. Understanding how different cabinet heights impact the joint angles of the elderly can be instrumental in optimizing cabinet designs for elderly users, thereby reducing their physical exertion in the kitchen and enhancing their comfort levels. This research holds significant value in improving the quality of life for the elderly population at home and fostering the advancement of elderly-friendly design principles.

More neck pain, less spinal mobility, altered sitting posture: Sagittal spinal alignment and mobility in women with chronic neck pain

BackgroundIncreasing evidence suggests that people with chronic neck pain (CNP) may display altered biomechanics beyond the cervical spine. However, whether spinal alignment and mobility are associated with neck pain is not clarified. ObjectivesTo investigate whether there is a significant association between neck pain intensity and sagittal spinal alignment and mobility in people with CNP, and to examine whether sagittal spinal alignment and mobility differ according to pain intensity. DesignA cross-sectional study. MethodForty-four women with CNP were included. The neck pain intensity at rest and during neck movements was assessed with the visual analogue scale (VAS). A skin-surface measurement device was used to assess sagittal alignment and mobility while sitting and standing. Linear regression analysis was used to assess associations. Participants were divided into two groups according to the pain intensity as group with mild pain (VAS≤4.4 cm) and group with moderate to severe pain (VAS>4.4 cm) and compared using the analysis of covariance. ResultsGreater resting pain was associated with a more forward trunk during sitting (Beta = 0.433, p < 0.05). Greater pain during neck movements was associated with increased lumbar lordosis during sitting (Beta = −0.376, p < 0.05). Classified by pain intensity at rest, trunk mobility while sitting was lower and forward trunk inclination and sacral kyphosis while sitting were higher in those with moderate/severe pain (η2p = 0.093–0.119, p < 0.05). By pain intensity during neck movements, women with moderate/severe pain exhibited lower sacral mobility while sitting (η2p = 0.129, p < 0.05). ConclusionsAddressing the entire spine in the assessment and management of CNP may help reduce pain.

The Relationship Between the Triple Airway Maneuver Insertion Technique and The Success Rate of Laryngeal Mask Airway Installation in Elective Surgery

Background: The Laryngeal Mask Airway (LMA) is a widely utilized supraglottic airway device by anesthesiologists in selective procedures, particularly in cases where intubation is not feasible or when managing a difficult airway. Complicating factors such as a short neck and large tongue can hinder LMA insertion, necessitating the use of the Triple Airway Maneuver (TAM). This technique involves a combination of head elevation, anterior mandible lift, and mouth opening to facilitate airway clearance. Purpose: This study was to evaluate the relationship between the TAM technique and the success rate of LMA insertion during elective surgeries at Dr. Soedirman Kebumen General Hospital. Methods: A cross-sectional, analytic study was conducted in June 2024, involving 52 respondents selected via purposive sampling. Data were collected using observation sheets. Findings: The findings revealed that the majority of respondents were aged 17-25 years (38.5%) and had a body mass index of 18.5-25.0 (73.1%). Non-smokers constituted 73.1% of the sample, while 46.2% had occupations involving repetitive neck movements. The TAM group achieved 45 successful LMA insertions, with 44 succeeding on the first attempt and 1 on the second, compared to 7 successful insertions in the non-TAM group. However, Kendall’s tau c test (p=0.056) indicated no statistically significant relationship between TAM and LMA insertion success rates, and the correlation coefficient (0.385) suggested a weak relationship. Conclusions: the TAM technique does not significantly influence the success rate of LMA insertion

Comparing repeated end range movements and Kinesio taping effects on head and neck movement pattern and discomfort in smartphone users

IntroductionUsing smartphones has increased exponentially, especially after the COVID-19 pandemic. However, there is a relationship between neck flexion angle during working with a smartphone and neck musculoskeletal disorders. Therefore, this study compares the effect of Kinesio taping and Repeated End Range Movements (RERM) on head and neck flexion angles changes during texting and discomfort after texting with a smartphone. MethodTwenty-four smartphone users participated in this cross-over study. All of 24 subjects were experimented with the control, RERM and taping conditions. They filled Numeric Rating Scale questionnaire before and after 30 min of texting. In addition, their head and neck flexion angles were measured during the task by photogrammetry. ResultsIn the RERM group, individuals felt significantly less discomfort than the control group after the task (P = 0.032). Although the slope of average head and neck flexion angles linear regression lines of all the three groups was positive before the break time, it became negative in the taping and control groups after the break time. In addition, the linear regression of average head and neck flexion angles of the RERM group was significantly different (P < 0.001). ConclusionRERM can effectively maintain normal head and neck movement pattern during and reduce neck discomfort after texting on smartphone.

Craniovertebral Junction Tuberculosis, a Rare Presentation With Hypoglossal and Facial Nerve Palsy

Case: A 47-year-old man presented with neck pain, restricted neck movements, along with involvement of facial and hypoglossal nerve. On the basis of clinico-radiological correlation, the patient was diagnosed with craniovertebral junction tuberculosis and was started on antitubercular therapy (ATT). Failing the conservative trial, the patient was operated and occipitocervical fusion was done with bone grafting. After 12 months of ATT intake, he showed complete recovery of the facial and hypoglossal nerve, with complete resolution of instability pain. Conclusion: Craniovertebral junction tuberculosis is uncommon, and its manifestation with cranial nerves involvement is even more rare. Meticulous clinico-radiological assessment should be done to diagnose and plan the treatment. Early recognition and prompt initiation of ATT, along with timely surgical intervention, when necessary, are crucial for optimal management and outcomes.

Pressure Visualization and Quantification Photonic Skin Based on Flexible Optical Fiber Combiner

AbstractThe integration of pressure quantification and visualization enhances pressure perception, accuracy, and efficiency. Current solutions require improvements in quantization accuracy, structural simplicity, and integration. We proposed a novel photonic skin comprising a 3 × 1 flexible optical fiber combiner, integrating red, green, and blue light emitting diode (LED) chips through three flexible optical fibers. Under pressure, changes in the optical fibers' transmission loss alter the output light intensity ratio, thus inducing a color shift at the combiner's output. This visible change can be precisely quantified using a color sensor chip. Performance metrics include sensing range up to 33N, sensitivity between 0.04 and 0.24 dB N−1, detection limit below 0.08 N, response time of 500 ms, recovery time of 400 ms, and durability exceeding 2000 cycles. A compact flexible circuit board manages light source driving, data acquisition, and wireless communication, forming a wearable photonic skin system. This system enables visual recognition and quantitative measurement of pressure across diverse scenarios, including different tactile modes, multi‐position pressure, finger bending, and neck movement. For oral occlusion force detection, the spatial separation of the sensing and visualization areas enables the system to simultaneously provide accurate measurements and intuitive visual assessment.

Prevalence of thoracic outlet syndrome among patients visiting physical therapy outpatient department of public sector Tertiary Care Hospitals, Peshawar

The indications and symptoms in the upper extremity brought on by compression of the brachial plexus, subclavian vein, and/or subclavian artery at the thoracic outlet were originally referred to as thoracic outlet syndrome (TOS). The symptoms of neurogenic thoracic outlet syndrome (NTOS) are caused by compression of the brachial plexus roots as they travel through the thoracic outlet. The most typical symptom of thoracic outlet syndrome is neurogenic thoracic outlet syndrome (NTOS). The brachial plexus is compressed and irritated, which causes its symptoms.A cross-sectional study was conducted from March 2023 to June 2023 among patients visiting Physical therapy outpatient department of public sector tertiary care hospitals Peshawar. The DASH questionnaire was distributed to all patients according to inclusion criteria from different hospitals to collect data on the prevalence of thoracic outlet syndrome.The study found that the prevalence of thoracic outlet syndrome was higher in female. The prevalence was higher among female housewives (77.77%) compared to male (63%). Risk factors associated with this pain included improper posture in same position while working, long work durations, repetitive tasks, and restricted neck movements.

Fluorosis Masquerading as Compressive Myelopathy

A 60-year-old woman from Cuddalore presented with restricted neck movements, progressive difficulty in walking, and lower limb weakness, leading to bed confinement. Clinical examination revealed spastic paraparesis, brisk reflexes, and sensory deficits below the hips. Laboratory investigations indicated renal insufficiency and elevated urine fluoride levels. Imaging demonstrated calcifications of sacroiliac, sacrospinous ligaments, interosseous membrane, and posterior longitudinal ligament, with osteosclerosis and osteoporosis. Differential diagnoses included Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis. However, the unique pattern of ligament calcification and elevated fluoride levels supported a diagnosis of fluorosis. This case underscores the importance of considering fluorosis in patients from endemic areas with spastic paraparesis and characteristic radiological findings. Posterior decompression via laminectomy was performed, emphasizing the need for awareness of fluorosis as a potential cause of cervical compressive myelopathy.

Effect of Chronic Smart Phone Usage on the Pain &amp; Range of Motion of Neck among Healthcare Professional Students

Effect of Chronic Smart Phone Usage on the Pain &amp; Range of Motion of Neck among Healthcare Professional Students

Implant Design and Cervical Spinal Biomechanics and Neurorehabilitation: A Finite Element Investigation.

The cervical spine, pivotal for mobility and overall body function, can be affected by cervical spondylosis, a major contributor to neural disorders. Prevalent in both general and military populations, especially among pilots, cervical spondylosis induces pain and limits spinal capabilities. Anterior Cervical Discectomy and Fusion (ACDF) surgery, proposed by Cloward in the 1950s, is a promising solution for restoring natural cervical curvature. The study objective was to investigate the impacts of ACDF implant design on postsurgical cervical biomechanics and neurorehabilitation outcomes by utilizing a biofield head-neck finite element (FE) platform that can facilitate scenario-specific perturbations of neck muscle activations. This study addresses the critical need to enhance computational models, specifically FE modeling, for ACDF implant design. We utilized a validated head-neck FE model to investigate spine-implant biomechanical interactions. An S-shaped dynamic cage incorporating titanium (Ti) and polyetheretherketone (PEEK) materials was modeled at the C4/C5 level. The loading conditions were carefully designed to mimic helmet-to-helmet impact in American football, providing a realistic and challenging scenario. The analysis included intervertebral joint motion, disk pressure, and implant von Mises stress. The PEEK implant demonstrated an increased motion in flexion and lateral bending at the contiguous spinal (C4/C5) level. In flexion, the Ti implant showed a modest 5% difference under 0% activation conditions, while PEEK exhibited a more substantial 14% difference. In bending, PEEK showed a 24% difference under 0% activation conditions, contrasting with Ti's 17%. The inclusion of the head resulted in an average increase of 18% in neck angle and 14% in C4/C5 angle. Disk pressure was influenced by implant material, muscle activation level, and the presence of the head. Polyetheretherketone exhibited lower stress values at all intervertebral disc levels, with a significant effect at the C6/C7 levels. Muscle activation level significantly influenced disk stress at all levels, with higher activation yielding higher stress. Titanium implant consistently showed higher disk stress values than PEEK, with an orders-of-magnitude difference in von Mises stress. Excluding the head significantly affected disk and implant stress, emphasizing its importance in accurate implant performance simulation. This study emphasized the use of a biofidelic head-neck model to assess ACDF implant designs. Our results indicated that including neck muscles and head structures improves biomechanical outcome measures. Furthermore, unlike Ti implants, our findings showed that PEEK implants maintain neck motion at the affected level and reduce disk stresses. Practitioners can use this information to enhance postsurgery outcomes and reduce the likelihood of secondary surgeries. Therefore, this study makes an important contribution to computational biomechanics and implant design domains by advancing computational modeling and theoretical knowledge on ACDF-spine interaction dynamics.

Aesthetics and Choreography of Bharatanatyam

The word “Aesthetic” in the context of Indian Aesthetics means “Science and philosophy of Fine Art” Bharathe muni wrote the theoretical treatise Natyasastra on Indian performing Arts including theatre, dance acting, and Music. Natyasastra is said to explain Indian aesthetics. Natyasastra is the scientific explanation of classical Indian dances. In this context, Bharatanatyam is also grounded in the principles of the Natyashastra. This research highlights how aesthetic aspects permeate Bharathanatya choreography, which involves designing the dance according to the rhythm of the ragas, along with abhinaya, bhava, and rasa. The choreography of Bharatanatyam is based on body parts and body shape( body proposition) by various elements, including positions (sthāna), hand gestures (mudra), neck movements, eye movements, head movements, karanas, mandalas, and charis. In Bharatanatyam, the body and the shape of the body (including the organs) are the basic source. Beauty is associated with interpretation. Deciphering the symbols means interpretation. The purpose of this study is to explore how aesthetic aspects play an important role in the creation of Bharatanatyam choreography, as Bharatanatyam is an art of both design and creativity this study uses the descriptive research method, observational research method, and qualitative research method. It is descriptive in the sense that it explains the aesthetics of Bharatanatyam choreography and observational since it observes the aesthetic aspects of Bharatanatyam choreography which is method-based. Moreover, the study examines the aesthetic expressions of the performers, who also serve as observers of the art form... When Bharatanatyam is designed with aesthetic aspects in mind, it becomes a powerful and valuable dance form. Systematically, organizing and expressing choreography with these aesthetic elements leads to seamless creativity, effective communication with the audience, relevance for future generations, and the preservation of socio-cultural values.

High-Performance Multidirectional Flexible Strain Sensor for Human Motion and Health Monitoring.

Multidirectional strain sensors are pivotal for wearable electronic devices and human-computer interaction. In this investigation, we translocate carbon/graphene (CB/Gr) conductive nanocomposites onto an Ecoflex flexible substrate via a facile technique encompassing reverse molding and spraying, culminating in the fabrication of a 45° strain rosette-shaped multidirectional flexible strain sensor. The sensor distinguishes itself with extraordinary performance characteristics, including high sensitivity (boasting a gauge factor of 35), an extensive strain range from 0 to 100%, exceptional linearity, a rapid response time of merely 200 ms, remarkable stability, and outstanding durability, effortlessly withstanding over 5000 stretch-release cycles. The sensor exhibits its exceptional capability to discern intricate movements, particularly in detecting human hand and neck motions. The sensor's remarkable comprehensive performance and strain direction recognition ability underscore its significant potential for diverse applications, notably in human-computer interaction, human motion monitoring, and health monitoring.

Immediate efficacy of acupuncture combined with active exercise as 10 min rapid therapy for pain and movement disorders in patients suffering from acute stiff neck: protocol for a randomised controlled trial

IntroductionStiff neck is a condition mainly characterised by persistent pain and limited neck movement, which can substantially impact patients’ daily lives during acute episodes. Accordingly, rapid pain relief and restoration...

Deep Learning–Assisted Two-Dimensional Transperineal Ultrasound for Analyzing Bladder Neck Motion in Women With Stress Urinary Incontinence

BACKGROUNDNo universally recognized transperineal ultrasound parameters are available for evaluating stress urinary incontinence. The information captured by commonly used perineal ultrasound parameters is limited and insufficient for a comprehensive assessment of stress urinary incontinence. Although bladder neck motion plays a major role in stress urinary incontinence, objective and visual methods to evaluate its impact on stress urinary incontinence remain lacking. OBJECTIVETo use a deep learning–based system to evaluate bladder neck motion using two-dimensional transperineal ultrasound videos, exploring motion parameters for diagnosing and evaluating stress urinary incontinence. We hypothesized that bladder neck motion parameters are associated with stress urinary incontinence and are useful for stress urinary incontinence diagnosis and evaluation. STUDY DESIGNThis retrospective study including 217 women involved the following parameters: maximum and average speeds of bladder neck descent, β angle, urethral rotation angle, and duration of the Valsalva maneuver. The fitted curves were derived to visualize bladder neck motion trajectories. Comparative analyses were conducted to assess these parameters between stress urinary incontinence and control groups. Logistic regression and receiver operating characteristic curve analyses were employed to evaluate the diagnostic performance of each motion parameter and their combinations for stress urinary incontinence. RESULTSOverall, 173 women were enrolled in this study (82, stress urinary incontinence group; 91, control group). No significant differences were observed in the maximum and average speeds of bladder neck descent and in the speed variance of bladder neck descent. The maximum and average speed of the β and urethral rotation angles were faster in the stress urinary incontinence group than in the control group (151.2 vs 109.0 mm/s, P=0.001; 6.0 vs 3.1 mm/s, P <0.001; 105.5 vs 69.6 mm/s, P <0.001; 10.1 vs 7.9 mm/s, P=0.011, respectively). The speed variance of the β and urethral rotation angles were higher in the stress urinary incontinence group (844.8 vs 336.4, P <0.001; 347.6 vs 131.1, P <0.001, respectively). The combination of the average speed of the β angle, maximum speed of the urethral rotation angle, and duration of the Valsalva maneuver demonstrated a strong diagnostic performance (area under the curve, 0.87). When 0.481*β anglea + 0.013*URAm + 0.483*Dval = 7.405, the diagnostic sensitivity was 70% and specificity was 92%, highlighting the significant role of bladder neck motion in stress urinary incontinence, particularly changes in the speed of the β and urethral rotation angles. CONCLUSIONSA system utilizing deep learning can describe the motion of the bladder neck in women with stress urinary incontinence during the Valsalva maneuver, making it possible to visualize and quantify bladder neck motion on transperineal ultrasound. The speeds of the β and urethral rotation angles and duration of the Valsalva maneuver were relatively reliable diagnostic parameters.

The effect of upper trapezius trigger points dry needling on postural control in patients with chronic neck pain

ObjectiveMyofascial neck pain, which strongly affects the upper trapezius muscle, is treated by physiotherapists with dry needling. The purpose of this study was to investigate the effect of upper trapezius trigger points (TrPs) dry needling on postural control and balance in chronic neck pain. DesignRandomized controlled clinical trial. SubjectsThirty individuals with chronic neck pain (more than 3 months), aged 18–40 years, neck disability index (NDI) > 10, and pain intensity (PI) between 3 and 6 who have TrP in the upper trapezius. MethodThirty individuals were randomly assigned into 2 groups, (i) 15 receiving intervention (real dry needling), and (ii) 15 in the sham group (sham dry needling). Outcomes were range of neck movements, neck disability index, pain intensity, and the mean and standard deviation as well as maximum velocity of center of pressure displacement in the anterior-posterior and medio-lateral directions during balance task on the force plate (1 leg stance and closed eyes) before the intervention and after the fifth and fifteenth (follow-up) days. InterventionUpper trapezius dry needling was applied for 3 sessions occurring every other day in a week. ResultNo significant differences were seen between the 2 groups in mean displacement, standard deviation, or maximum velocity in the anterior-posterior and medial-lateral axis and range of motion (ROM) except for left lateral bending; however, a significant difference was observed between the 2 groups in pain intensity and neck disability index. ConclusionDry needling on the upper trapezius TrPs does not change postural control but decreases pain and disability.

Effect of sagittal alignment on spinal cord biomechanics in the stenotic cervical spine during neck flexion and extension.

Spinal cord stress and strain contribute to degenerative cervical myelopathy (DCM), while cervical kyphosis is known to negatively impact surgical outcomes. In DCM, the relationship between spinal cord biomechanics, sagittal alignment, and cord compression is not well understood. Quantifying this relationship can guide surgical strategies. A previously validated three-dimensional finite element model of the human cervical spine with spinal cord was used. Three models of cervical alignment were created: lordosis (C2-C7 Cobb angle: 20°), straight (0°), and kyphosis (- 9°). C5-C6 spinal stenosis was simulated with ventral disk protrusions, reducing spinal canal diameters to 10mm, 8mm, and 6mm. Spinal cord pre-stress and pre-strain due to alignment and compression were quantified. Cervical flexion and extension were simulated with a pure moment load of 2Nm. The Von Mises stress and maximum principal strain of the whole spinal cord were calculated during neck motion and the relationship between spinal cord biomechanics, alignment, and compression was analyzed using linear regression analysis. Spinal cord pre-stress and pre-strain were greatest with kyphosis (7.53kPa, 5.4%). Progressive kyphosis and stenosis were associated with an increase in spinal cord stress (R2 = 0.99) and strain (R2 = 0.99). Cervical kyphosis was associated with greater spinal cord stress and strain during neck flexion-extension and the magnitude of difference increased with increasing stenosis. Cervical kyphosis increases baseline spinal cord stress and strain. Incorporating sagittal alignment with compression to calculate spinal cord biomechanics is necessary to accurately quantify spinal stress and strain during neck flexion and extension.