Neck Movement Research Articles

Assessment and Training of Perceptual-Motor Function: Performance of College Wrestlers Associated with History of Concussion.

Concussion may affect sport performance capabilities related to the visual perception of environmental events, rapid decision-making, and the generation of effective movement responses. Immersive virtual reality (VR) offers a means to quantify, and potentially enhance, the speed, accuracy, and consistency of responses generated by integrated neural processes. A cohort of 24 NCAA Division I male wrestlers completed VR assessments before and after a 3-week VR training program designed to improve their perceptual-motor performance. Prior to training, the intra-individual variability (IIV) among 40 successive task trials for perceptual latency (i.e., time elapsed between visual stimulus presentation and the initiation of movement response) demonstrated strong discrimination between 10 wrestlers who self-reported a history of concussion from 14 wrestlers who denied ever having sustained a concussion (Area Under Curve ≥ 0.750 for neck, arm, and step movements). Natural log transformation improved the distribution normality of the IIV values for both perceptual latency and response time (i.e., time elapsed between visual stimulus presentation and the completion of movement response). The repeated measures ANOVA results demonstrated statistically significant (p < 0.05) pre- and post-training differences between groups for the IIV in perceptual latency and the IIV in response time for neck, arm, and step movements. Five of the six IIV metrics demonstrated a statistically significant magnitude of change for both groups, with large effect sizes. We conclude that a VR assessment can detect impairments in perceptual-motor performance among college wrestlers with a history of concussion. Although significant post-training group differences were evident, VR training can yield significant performance improvements in both groups.

Effectiveness of Myofascial Release Technique Versus Cupping Therapy on Pain and Range of Motion in College Going Students with Trapezitis

Background: Trapezitis is one of the common inflammatory conditions seen among college going students dueto prolonged poor posture stressful neck movement. Students with Trapezitis usually complaints of pain anddifficulty in activities of daily living. Myofascial release technique can be defined as a soft tissue mobilizationtechnique that reduce trapezius spasm and ultimately pain is reduced. Cupping is ancient medical technique it is general utilise a glass cup to create suction over a painful area.Need of study: There are few literatures or research work available on this. No comparison is done on abovetechniques. So, this study was done to compare both the techniques.Objective: To compare the Myofascial Release Technique and Cupping therapy on pain intensity and neck disabilityindex in Trapezitis among college going students.Methodology: A total of 50 students with Trapezitis meeting the inclusion and exclusion criteria were allocated into two groups of 25 each. Group A (MFR) and Group B (Cupping) to receive 6 sessions of MFR and cupping therapy Pre and Post intervention scores of Visual analogue Scale (VAS), Cervical ROM (CROM) and Neck disability index (NDI) were measured.Results: Data was analysed by SPSS21, t-test were applied. Statistically significant improvements were observed in both groups but more pronounced in Group B. VAS (t = 6.3257) P&lt;0.0001. NDI (t = 9.0547) P&lt;0.0001Conclusion: The results suggested that cupping therapy showed better results than myofascial release in relieving Trapezitis in college going students.

The effects of workplace intervention programs to manage work-related musculoskeletal pain among poultry slaughterhouse workers: A randomized controlled trial

Background: The prevalence rate of work-related musculoskeletal pain (WMSP) among poultry slaughterhouse workers (PSW) has been reported in the shoulder, arm, and hand due to the involvement of repetitive and forceful upper limb movements. An intervention program is needed to reduce upper limb pain and improve upper limb functions among PSW. Objectives: This study aimed to investigate the effectiveness of workplace intervention programs on musculoskeletal pain, upper limb functions, and work ability among PSW. Materials and methods: A total of 48 participants (21 males and 27 females) who met the inclusion criteria were recruited into the study. The participants were allocated into two groups: The workplace intervention group (WIG, N=24; 10 males; 14 females) and the control group (CG, N=24; 11 males; 13 females). The WIG performed the exercise training with elastic resistance bands (ERB) and stretching exercises for eight weeks, and the CG did not perform any activity. The Visual Analogue Scale (VAS), shoulder reach flexibility test, active range of motion (AROM), the disability of the Arm, Shoulder, and Hand (KKU-DASH), and Thai Work Ability Index (Thai WAI) were used as outcome evaluations. The two-way analyses of variance (ANOVAs) with repeated measures (group x time) were used for statistical analyses, and the statistical significance was set at p&lt;0.05. Results: Approximately 79.1% (N=19) of the participants in WIG reported significantly decreased pain intensity of upper limb 3.06 (0.83 to -5.4) in the right side (p&lt;0.01) and 1.96 (1.6 to -5.6) in the left side (p&lt;0.001) after the 8-week intervention. Meanwhile, shoulder flexibility in WIG significantly increased (p&lt;0.001) to around 3.55 cm. (0.67 to 8.20) on the right side and 5.61 cm. (2.0 to 10.67) on the left side. For AROM in WIG, neck flexion, lateral neck flexion, neck rotation, and left shoulder flexion significantly increased (p&lt;0.05), as well as KKU-DASH and Thai WAI scores (p&lt;0.001). There was no significant difference within-group in all variables in CG. Conclusion: The workplace intervention program significantly reduced upper limb pain and increased neck movement and shoulder flexion among PSW. The training programs also improved work ability and reduced disability with upper extremity musculoskeletal conditions among PSW.

Examination of a practical method to quantitatively evaluate the rolling over movement in a clinical setting.

[Purpose] We investigated the utility of wearable inertial and magnetic sensing modules for analyzing neck and trunk movements during the rolling over movement. [Participants and Methods] The participants were instructed to roll over from the supine to the side-lying position with three sensor units attached to their forehead, xiphoid process of the sternum, and abdomen. Experiments were conducted on two prescribed patterns: one emphasizing hip joint flexion and adduction, and the other focusing on scapular protraction and horizontal shoulder joint adduction in two healthy participants (one male and one female). The flexion and rotation angles of the neck and trunk were calculated using conventional spreadsheet software with data obtained from the sensors. The obtained values were compared for agreement with those derived from a three-dimensional (3D) motion analysis device. [Results] The cross-correlation coefficient for the flexion and rotation angles of the neck and trunk between the two measurement methods was approximately 0.85, and the root mean square (RMS) angle difference was approximately 5.0°. [Conclusion] Wearable inertial and magnetic sensors can be used to quantitatively evaluate neck and trunk movements during the rolling over movement.

The motor apparatus of head movements in the Oleander hawkmoth (Daphnis nerii, Lepidoptera).

Head movements of insects play a vital role in diverse locomotory behaviors including flying and walking. Because insect eyes move minimally within their sockets, their head movements are essential to reduce visual blur and maintain a stable gaze. As in most vertebrates, gaze stabilization behavior in insects requires the integration of both visual and mechanosensory feedback by the neck motor neurons. Although visual feedback is derived from the optic flow over the retina of their compound eyes, mechanosensory feedback is derived from their organs of balance, similar to the vestibular system in vertebrates. In Diptera, vestibular feedback is derived from the halteres-modified hindwings that evolved into mechanosensory organs-and is integrated with visual feedback to actuate compensatory head movements. However, non-Dipteran insects, including Lepidoptera, lack halteres. In these insects, vestibular feedback is obtained from the antennal Johnston's organs but it is not well-understood how it integrates with visual feedback during head movements. Indeed, although head movements are well-studied in flies, the underlying motor apparatus in non-Dipteran taxa has received relatively less attention. As a first step toward understanding compensatory head movements in the Oleander hawkmoth Daphnis nerii, we image the anatomy and architecture of their neck joint sclerites and muscles using X-ray microtomography, and the associated motor neurons using fluorescent dye fills and confocal microscopy. Based on these morphological data, we propose testable hypotheses about the putative function of specific neck muscles during head movements, which can shed light on their role in neck movements and gaze stabilization.

Penetrating Injury Neck Sparing Major Vital Structures: A Case Report

Introduction: Penetrating neck injury accounts for only a small incidence of all trauma case. The neck is a compact structure with vascular, neural and aerodigestive tract compacted closely.Trauma to the aerodigestive tract, neural structures, vascular structures can present with increased mortality and morbidity Case Presentation: The authors here report a peculiar case of 24 years old male presenting with Penetrating neck injury by a wooden foreign body. The patient was managed surgically without any related complications. The Foreign Body was found to be missing all the vital structures in the neck after thorough confirmation by imaging modalities and later intra-operative findings. Discussion: Due to the close vicinity of these structures, injury to vital structures is a very real and potentially life threatening complication. Associated vascular, Aerodigestive and neural injuries results in an increase in fatality rate up to 50% in some cases and may be associated with an increased risk of medianitis. Furthermore, wooden foreign body carries an increased risk of infectious, difficulty of detection in different imaging modalities. Foreign body neck is known for secondary displacement during neck movements, hence confirming that an early treatment is strongly recommended. Conclusion: Due to high risk of injury to vital structures and mortality prompt detection and management of penetrating injury neck should a high priority

Imaging Single-Cell Ca2+ Dynamics of Brainstem Neurons and Glia in Freely Behaving Mice.

In vivo brain imaging, using a combination of genetically encoded Ca2+ indicators and gradient refractive index (GRIN) lens, is a transformative technology that has become an increasingly potent research tool over the last decade. It allows direct visualisation of the dynamic cellular activity of deep brain neurons and glia in conscious animals and avoids the effect of anaesthesia on the network. This technique provides a step change in brain imaging where fibre photometry combines the whole ensemble of cellular activity, and multiphoton microscopy is limited to imaging superficial brain structures either under anaesthesia or in head-restrained conditions. We have refined the intravital imaging technique to image deep brain nuclei in the ventral medulla oblongata, one of the most difficult brain structures to image due to the movement of brainstem structures outside the cranial cavity during free behaviour (head and neck movement), whose targeting requires GRIN lens insertion through the cerebellum-a key structure for balance and movement. Our protocol refines the implantation method of GRIN lenses, giving the best possible approach to image deep extracranial brainstem structures in awake rodents with improved cell rejection/acceptance criteria during analysis. We have recently reported this method for imaging the activity of retrotrapezoid nucleus and raphe neurons to outline their chemosensitive characteristics. This revised method paves the way to image challenging brainstem structures to investigate their role in complex behaviours such as breathing, circulation, sleep, digestion, and swallowing, and could be extended to image and study the role of cerebellum in balance, movement, motor learning, and beyond. Key features • We developed a protocol that allows imaging from brainstem neurons and glia in freely behaving rodents. • Our refined method of GRIN lenses implantation and cell sorting approach gives the highest number of cells with the least postoperative complications. • The revised deep brainstem imaging method paves way to understand complex behaviours such as cardiorespiratory regulation, sleep, swallowing, and digestion. • Our protocol can be implemented to image cerebellar structures to understand their role in key functions such as balance, movement, motor learning, and more.

Танцевальное искусство в художественном проектировании титров иранского кино

Iranian dance is distinguished by a number of specific features, one of which is the graceful movements of the hands, wrists, and legs, combined with lively facial expressions and body positions. The refined, intricate, and flirtatious gestures and symbols of Persian courtiers, solo, improvisational dances, and the spiritual dance of Sufis reflect the richness of Persian culture. After the 1979 revolution, in accordance with the new revolutionary realities, dance in Iran came under restrictions. However, dance art as a pillar of Persian culture remains an important social phenomenon for the nation, transforming and flowing into other types of art. Using the titles of Iranian films created after the 1979 revolution as examples, this paper traces the designers’ appeal to the dance heritage of Iran and reveals the similarity of the design of film credits with the basic elements of choreography, in particular, ballet, theater, and folk dance. The title is considered as a product of complex design (sound design, kinetic typography, animated graphics), whose fundamental elements (composition, color, visual forms of communication) are similar to the basis of choreographic / ballet art (dance movements, costumes, background). When designing film credits, Iranian designers use references to dance movements (circular, spiral, improvisational), movements of hands, legs (arabesque, petit allegro, folk dances of Khorasani, Bakhtiari, Keshmeh kermanji), fingers, hips, neck, and shoulders (urban dance of jakheli). It is revealed that such borrowings simplify for Iranian designers the task of preparing the viewer for the perception of a movie

Spontaneous vertebral artery stenosis, dissection and cerebellar infarction in a gentleman while playing bowling.

Background: An increased incidence of vertebral artery dissection has recently become a recognized cause of acute stroke for about 1/5 of strokes in young patients. Case Presentation: A male in his 30s presented to the emergency department with sudden onset of severe vertigo, vomiting, and dizziness while he was playing bowling. The symptoms started when he suddenly twisted his neck while throwing the ball towards pins. Initial diagnosis of central vertigo led to performing plain CT head and CT head angiogram, which demonstrated non-occlusive extradural left vertebral artery dissection. Following CT scans, an MRI head, and MRA head and neck were performed which confirmed the CT diagnosis and also showed left posterior inferior cerebellar artery territory infarcts with micro haemorrhages. The patient was started on dual antiplatelet medications which was continued for 6 months with a follow up MRI/MRA scan of head and neck. Conclusion: This appears to be a unique case where sudden twisting of the neck possibly resulted in vertebral artery dissection and cerebellar infarction. Hence, it is vital to be aware of sports related presentation resulting in sudden neck movements and tear in vertebral artery causing dissection.

Rare Indication of Atlantoaxial Fusion-failed Conservative Management of Primary Atlantoaxial Osteoarthritis

Introduction: Osteoarthritis of the atlantoaxial joint is a significant cause of occipitocervical pain, which is often missed and has an increasing prevalence with age. The patients typically present with occipitocervical pain and restricted and painful neck rotations. Despite the primary reliance on conservative management for this pathology, surgical intervention becomes crucial for those not responding to standard conservative treatment. The presented case series highlights the rarity of the requirement of surgical intervention in the management of Atlantoaxial osteoarthritis (AAOA) and the clinical outcomes of surgical management in AAOA. Case Report: This paper presents a case series of four patients who were managed surgically with atlantoaxial fusion, from a database of 108 patients with AAOA. The case series includes three males and one female with a mean age of presentation being 67.5 years. All four patients presented with occipitocervical pain, and painful neck movements and were diagnosed with AAOA on the anteroposterior open mouth view radiographs showing changes of osteoarthritis such as bone erosions, sclerosis, osteophytes. The patients were managed conservatively with non-steroidal anti-inflammatory drugs, intra-articular steroid injections, and cervical collar immobilization. Those not responding to conservative management and with incapacitating pain were managed surgically with atlantoaxial fusion procedures. Conclusion: In a group of patients with a painful and debilitating degenerative AAOA only a small proportion of cases require surgical intervention. In this cohort, only 3.70 % of patients required surgery, highlighting the rarity of surgical intervention required in the management of AAOA. Nevertheless, when conducted, atlantoaxial fusion has proved to be efficacious with a low rate of serious complications and the patient self-rated outcome in terms of post-operative visual analog scale score and neck disability index scores indicating a high degree of satisfaction with the procedures. Keywords: Atlantoaxial, osteoarthritis, fusion, transarticular screws.

Nasotracheal intubation in pediatrics: a narrative review.

Nasotracheal intubation (NTI) plays an important role in pediatric airway management, offering advantages in specific situations, such as oral and maxillofacial surgery and situations requiring stable tube positioning. However, compared to adults, NTI in children presents unique challenges owing to anatomical differences and limited space. This limited space, in combination with a large tongue and short mandible, along with large tonsils and adenoids, can complicate intubation. Owing to the short tracheal length in pediatric patients, it is crucial to place the tube at the correct depth to prevent it from being displaced due to neck movements, and causing injury to the glottis. The equipment used for NTI includes different tube types, direct laryngoscopy vs. video laryngoscopy, and fiberoptic bronchoscopy. Considering pediatric anatomy, the advantages of video laryngoscopy have been questioned. Studies comparing different techniques have provided insights into their efficacy. Determining the appropriate size and depth of nasotracheal tubes for pediatric patients remains a challenge. Various formulas based on age, weight, and height have been explored, including the recommendation of depth-mark-based NTI. This review provides a comprehensive overview of NTI in pediatric patients, including the relevant anatomy, equipment, clinical judgment, and possible complications.

Effects of Foam Roller, Massage Gun, and FDM Technique on Neck Movement and Pain in Adults with Neck Pain

Effects of Foam Roller, Massage Gun, and FDM Technique on Neck Movement and Pain in Adults with Neck Pain

Prevalence of Cervicogenic Headache and Its Association with Upper Crossed Syndrome in Dentists

Cervicogenic headaches refer to a type of headache that originates from the cervical spine can be exacerbated by certain neck movements. Recognizing the link between cervicogenic headaches and Upper Cross Syndrome allows for targeted diagnostic assessments. Objective: To examine the relationship between cervicogenic headaches and USC in dental professionals and deeper understanding of the impact of occupational factors on the occurrence and severity of these headaches. Methods: This cross-sectional study was conducted on 180 participants selected through purposive sampling technique. Inclusion Criteria was both genders between 20 and 50 years age dentist · Having sitting duration of 3 hour or more than 3 hours. Exclusion Criteria was any malignancy related to soft tissues and joints. Study ran from 1 March 2022 to 30 September 2022. Results: The cervical flexion rotation test was positive in 40.7% i.e. 44 participants and is negative in 59.3% i.e. 64 participants. The pectoralis major contracture test was positive in 45.4% i.e. 45 participants and is negative in 54.6% i.e. 59 participants and there is a relation between cervicogenic headache and upper crossed syndrome and in dentists. Conclusions: The findings of this research highlight a substantial prevalence of cervicogenic headache among dentists 45.4% and emphasize a significant association between cervicogenic headache and the presence of upper crossed syndrome. These results provide valuable insights for dental professionals, clinicians, and policymakers to implement appropriate interventions and ergonomic strategies to mitigate the burden of cervicogenic headache in dental practice.

The Effects of Smartphones on Child Health

Over the last ten years, technology has advanced significantly, and more people throughout the world have access to smartphones. Because of the increased use of technology, including cellphones, children are leading more sedentary lifestyles. Long-term smartphone usage has sparked further questions about possible changes in spinal posture, continual neck flexion, restrictions on neck motions, and declines in pulmonary function. According to data from the Pew Research Center, the proportion of smartphone users in emerging and developing nations increased quickly from 21% in 2013 to 37% in 2015. By 2020, the numbers are projected to be 6.4 billion smartphone subscribers, or around 70% of the world's population. In the US, 84% of teenagers aged 13 to 19 and 79% of children aged 9 to 12 possess cellphones, and by the time they are 12 years old, they use their smartphones on average for five hours each day [1]. Mobile phones have reportedly become a need for young people and children, according to Pakistani research on cell phone habits among teens in southern Punjab [2]. Due to the rise in smartphone use among kids and teenagers, their musculoskeletal systems are significantly impacted. Obesity, poor posture, and thoracic limitation brought on by muscular imbalances are linked to the decline in fundamental physical fitness. The aforementioned issues often lead to a decline in pulmonary function. Musculoskeletal problems are likely to worsen with time, particularly if users see their cellphones with their heads flexed. Excessive smartphone usage may also affect the cervical angle scan, especially if users don't keep their posture neutral, which might put more strain on the cervical spine. Constant forward neck flexion when using a smartphone causes the lower cervical spine to bend excessively, which is linked to decreased lung function and respiratory muscle power. In terms of psychology, excessive smartphone usage weakens social bonds and increases loneliness, sadness, and social anxiety, leading to mental immaturity, emotional instability, inattentiveness, and lack of self-control in kids. Increased sleep issues are also linked to increased mobile phone use. Despite certain benefits, the increased use of cell phones has raised a lot of concerns over their negative impacts on academic performance, health, and character development. Several health issues are also related to increased smartphone usage in children. To maintain posture, cranio-cervical and improved respiratory function, instruction on optimal smartphone using posture as well as information on the implications of prolonged smartphone usage are required.

The Relationship Between Using Smartphones andText Neck Syndrome in Online Learning Among University Students in Jordan: A Survey Study

Background. The use of online learning methods has expanded considerably in many countries since the declaration of COVID-19 as a global pandemic by the World Health Organization. Smartphones are widely used for voice and text messaging, checking emails, and distance learning. The aim of this study was to investigate the relationship between using smartphones and text neck syndrome. Material and methods. A cross-sectional study was conducted among university students in Jordan between February and March 2023. All undergraduate students were invited to participate. A self-administered online (Google forms) questionnaire was distributed by posting the link to the questionnaire on students’ groups through social media websites such as Facebook, Twitter, and WhatsApp. Results. A total of 171 students responded to the survey. The participants included 103 (60%) females and 68 (40%) males. Approximately 79% of the participants were less than 22 years old. Almost half of the participants reported pain at neck (54%) and shoulder (51%), while about 61% of participants suffered from upper back pain. Conclusions. 1. Smartphones are widely becoming essential in educational technology, and more concern should be expended to increase the awareness about optimal and healthy usage of smartphones by restricting usage duration in order to reduce neck and shoulder pain and associated poor functioning in daily living activities. 2. Poor patterns of smartphone use increase the likelihood of neck pain. 3. Neck movement limitations are not associated with age or gender. 4. Students who did not report limitation in neck movement were less likely to have difficulty with reading.

Oral Motor Exercise in Improving the Movements Of The Jaw, Lip, Tongue in Case of Oral Phase Dysphagia on a Cerebral Palsy Patient

The dysphagia case in children with cerebral palsy is a disorder that must be treated immediately because it will have a serious impact on the child's health and speech fluency. The Oral motor exercise method is one of the therapies to improve jaw, neck, and tongue movements in patients with cerebral palsy. The purpose of this study was to investigate the oral motor exercise on a dysphagia patient of 3-years old with cerebral palsy disorder at Syamsudin SH Hospital, Sukabumi, from January to March 2019. This type of research is a descriptive quantitative method with single subject experiment. A research subject was a patient with cerebral palsy, a 3- years old – boy who has dysphagia. The patient cannot speak and only cries and says 'AAAA' if he wanted something and the patient was choking and coughing when eating or drinking. To deal with this problem, 20 sessions of therapy and 1 evaluation were carried out. The results showed that by comparing the results of the initial test and the final test, there was an increase in the ability to move the organs of the lips, tongue, jaw, and chewing movements of the patient. In the initial test, the patient got 2 points and the final test result. the patient got 4 points which indicated 50% success scale. From the therapeutic success scale obtained, it was concluded that the therapy was quite successful.

Intelligent Head-bot, towards the Development of an AI Based Cognitive Platform

A cognitive humanoid head is an AI enabled head-bot platform that resembles human's cognitive abilities, such as perception, thinking, learning, and decision-making. The platform is able to interact with human through natural language processing and recognize individuals, thus allowing seamless communication between two parties. No such cognitive platform has been introduced in Bangladesh, thus creating an open field to contribute to the field of Machine Intelligence. This study aims to develop an AI based humanoid head (head-bot) capable of imitating a range of expressions, recognizing individuals, and interacts with visitors through general conversation. The head-bot skeleton is developed using a number of hexagonal blocks of PVC sheet to mimic a human-head-like structure where LCD, camera, microphones, and speaker are mounted. Two separate Machine Learning models are designed for face detection and recognitions, and voice enabled chat-bot implementation. The head-bot platform incorporates 2-DoF neck movements for various head gestures and face tracking. The Artificial Neural Network models are tested with accuracy of 95.05%, and 99.0%, for face detection and recognitions, and speech recognitions and response generation, respectively. According to the overall results and system performances, it seems that the proposed system has a number of good potentials for real life applications such as entertainment, guidance, conversations, interactive receptionists, personal companion, medical assistance, and so on.

Acute suppurative thyroiditis in a 10-year-old child

BACKGROUND: Acute suppurative thyroiditis in children is a rare and potentially life-threatening thyroid disease that requires rapid diagnostics and treatment.&#x0D; CLINICAL CASE DESCRIPTION: A clinical case of a 10-year-old girl with a thyroid abscess is described. She had fever, painful neck swelling, sore throat, tachycardia, restricted neck movement, and dysphagia for 6–7 days. The treatment consisted of antibiotic therapy, incision and drainage of the abscess using local ozone therapy. It was found that causative agents were Staphylococcus aureus and Escherichia coli. The girl had a follow-up examination in 9 months after the discharge — there were no signs of thyroid pathology.&#x0D; CONCLUSION: Although acute suppurative thyroiditis is extremely rare in children, it occurs sometimes. Since this condition may be associated with a piriform sinus fistula, the child must be examined for it because of the risk of recurrence.

Cranial Migration of a VP Shunt—A Routine Procedure with a Rare Complication!

AbstractVentriculoperitoneal shunt is one of the commonest neurosurgical procedures associated with a high-rate complication. Moreover, the variety of complications are nonetheless astonishing. Shunt malfunction is considered the most common complication of this procedure, but a cranial migration of shunt leading to malfunction is extremely rare. We present a case of a 6-month-old male child who was initially managed with a right-sided medium-pressure ventriculoperitoneal shunt for aqueductal stenosis with hydrocephalus at the age of 3 months and presented to us with features of shunt malfunction owing to a cranial migration of the shunt assembly. Cranial migration of a ventriculoperitoneal shunt is an extremely rare complication. Its possible mechanism includes a large subgaleal space for the chamber, larger size burr hole, inadequate anchorage of the shunt assembly, and excessive neck movements of the child in the postoperative procedure.

Comparison of Treatment Outcome of the Effectiveness of Isometric Exercises as Compared to General Exercises with Cervical Spine Mobilization in The Management of Chronic Non Specific Neck Pain

The purpose of this study was to evaluate the “effectiveness of isometric exercises as compared to general exercises along with cervical spinal mobilization to reduce pain, disability and to increase range of motion in chronic non-specific neck pain”For this randomized controlled experiment total 32 patients (16 in each group) with chronic non-specific neck pain were recruited from physiotherapy Ward Mayo Hospital Lahore, Department of Physiotherapy King Edward Medical University Lahore between October, 2019 and March, 2020. Simple randomization method was used to assign participants into isometric exercise group and general exercise with cervical spine mobilization group. The isometric exercise group performed exercises for neck muscle groups with a rubber band and general exercises with cervical mobilization group performed active range of movement exercises for all neck movements. Patients in both groups received 4 supervised treatment sessions per week for 6 weeks. Visual Analogue Scale (VAS), Neck disability index Questionnaire and goniometer were used to assess pain, disability and neck range of movements at baseline and after 6 weeks.Both interventions showed statistically significant improvements in pain, function and range of movement p = 0.001for isometric exercise group, p = 0.05 for general exercises group and p= &lt;0.001 for range of movement. However, mean improvements in post intervention VAS score and Neck disability index Questionnaire score was better in isometric exercises group as compared to general exercise group. In conclusion, both interventions are effective in the treatment of chronic non- specific neck pain however; isometric exercises are clinically more effective than general exercises with cervical spine mobilization.