Neck Range Of Motion Research Articles

Transdermal iontophoresis versus high power pain threshold ultrasound in Mechanical Neck Pain: a randomized controlled trial

BackgroundThe investigation aimed to assess the impacts of magnesium sulphate (MgSO4) iontophoresis and high-power pain-threshold ultrasound (HPPT-US) on pain, range of motion (ROM), and functional activity in physical therapy students suffering from mechanical cervical pain.MethodsTypically, 75 males aged 19 to 30 years suffering from mechanical neck pain were enrolled in this investigation. Participants were divided at random into three groups. Group A received iontophoresis plus conventional physical therapy program, Group B received HPPTUS along with conventional therapy, and Group C received conventional therapy only. The outcomes were pain evaluated by visual analog scale (VAS) and Digital Electronic Pressure Algometer, cervical range of motion measured by Myrin gravity reference goniometer, and Arabic Neck disability index (ANDI) evaluate neck function.ResultsThe differences within and between groups were detected utilizing a mixed-design multivariate analysis of variance (MANOVA). The within- and between-group analysis of all outcome measures revealed that there were statistically significant differences at post-intervention between high-power ultrasound and conventional group at all variables and also between iontophoresis and conventional group, but there was no statistically significant variation between high-power ultrasound and iontophoresis.ConclusionMgSO4 iontophoresis and HPPT-US are effective in decreasing pain, improving neck function, and improving neck ROM in subjects with mechanical neck pain who have active myofascial trigger points (MTrPs) on the upper fibers of the trapezius with no superiority of one over the other.Trail registrationThe study was registered in the Clinical Trials Registry (registration no: NCT05474898) 26/7/2022.

Effect of thoracic manipulation on neck pain in the mobility group: A randomized controlled trial.

Thoracic spine manipulation (TSM) increases the thoracic spine's range of motion (ROM), effectively reducing pain intensity and disability in patients with mechanical neck pain. We aimed to determine the effect of TSM on neck pain intensity and functional impairment in patients classified under the "mobility" category in Childs' classification. In this randomized controlled trial, patients with mechanical neck pain who met the inclusion criteria were randomly assigned to either the TSM (n = 21) or sham manipulation (n = 20) group. The primary outcomes were pain during neck rotation and subjective improvement assessed using the Numerical Pain Rating Scale (NPRS) and Global Rating of Change (GROC), respectively. The secondary outcomes were NPRS at rest, disability (assessed using the Neck Disability Index [NDI]), and ROM of the cervical and thoracic spine rotation. Outcome measurements were performed at baseline, immediately after treatment, 1 week after treatment, and at the 4-week follow-up. Linear mixed models were used to analyze the NPRS, NDI, and ROM. The GROC was analyzed using a chi-square test for the percentage recording ≥+4; the means of each group were compared using an unpaired t-test. The NPRS with neck rotation, neck and thoracic ROM, and NDI showed significant interactions between the groups. The NPRS with neck rotation was significantly lower in the TSM group than in the sham group at all time points after the treatment (p < 0.001). There was no difference between the groups in the proportion showing moderate (≥+4) improvement according to the GROC; however, there was a significant difference in the mean values (p = 0.013). Incorporating TSM into treatment protocols may improve clinical outcomes in patients with neck pain, potentially leading to better pain management and functional recovery. Therefore, physiotherapists should consider TSM as a viable and effective intervention to improve patient outcomes in neck pain rehabilitation.

Efficacy of Myofascial Release With Transcutaneous Electrical Nerve Stimulation Conductive Glove for Neck Myofascial Syndrome: A Randomized Clinical Trial Study

ObjectiveThe purpose of this study was to assess the efficacy of a myofascial release (MR) protocol applied with a transcutaneous electrical nerve stimulation (TENS) conductive glove. MethodsEighty individuals with neck myofascial syndrome were randomly divided into 4 groups: (1) MR protocol with a TENS conductive glove (MR+TENS), (2) MR protocol without TENS (MR), (3) conventional TENS protocol (TENS), and (4) placebo TENS (control). All participants attended 6 sessions over a period of 3 weeks. The following measures were evaluated at baseline, at the third week, and at the 1-month follow-up: Pain with the visual analog scale (VAS pain), upper trapezius pressure pain threshold (PPT) with pressure algometry, cervical range of motion (ROM) with goniometry, and disability with the neck disability index (NDI). A 2-way ANOVA with repeated measurements was applied. ResultsSignificant changes between the 3 intervention groups and the control group were noted in the VAS and the NDI scores (P < .05) with the MR+TENS group exhibiting the biggest difference. Additionally, MR significantly increased PPT compared to TENS, and even further when applied with the conductive glove (P < .05). Regarding lateral flexion ROM, MR was equally effective either alone or in combination with the glove compared to TENS (P < .05). In contrast, TENS did not appear to affect neck PPT and ROM (P > .05). Finally, no difference between the groups was detected in cervical rotation ROM (P > .05). ConclusionThe MR protocol appears to be more effective in dealing with pain, disability, and lateral flexion ROM than conventional TENS. A TENS conductive glove significantly improves the effects of MR, possibly due to the combined mechanical and electrical stimulation of the muscle.

Concussion Reduction in Division I and II Athletes: Effects of Simple Cervical Spine Exercise Regimen.

Primary preventative medicine lacks a consensus on effective concussion prevention strategies for collegiate athletes. Cervical strength has been identified as a potential factor in concussion risk reduction. This study evaluates the impact of a commercially available, portable cervical muscle stretching and strengthening device, NeckX®, on cervical strength, range of motion (ROM), and concussion incidence in collegiate athletes participating in high-concussion-risk sports. A single-arm prospective cohort study was conducted with 162 collegiate athletes from various sports. Participants underwent a 12-week neck exercise protocol using the NeckX® device. Clinical data, including neck strength and ROM, were collected at weeks 0, 6, and 12. Concussion incidence was self-reported by participants and cross-referenced with records from the athletic department. Data were analyzed for significant neck strength and ROM changes throughout the 12-week study. A two-way analysis of variance multiple comparisons with the Tukey-Kramer significant difference test was utilized, using the Holm-Sidak method, with an alpha of 0.05. All athletic teams experienced a significant increase in cervical strength during the 12-week intervention (α = 0.05, p < 0.05). Increases in cervical flexion and extension force were most consistent between teams. Cervical ROM increased significantly in male and female soccer players (α = 0.05, p < 0.05). The overall incidence of head and neck injuries, including concussions, was reduced to 6.60% during the study period, the lowest recorded value in the university's athletic department history. The use of the NeckX® device for 12 weeks was effective in enhancing pericervical muscle strength and ROM while reducing concussion incidence in collegiate athletes participating in high-concussion-risk sports. Interestingly, the positive outcomes were consistent for both males and females, indicating the universal advantages of neck training among collegiate athletes. These findings support existing research on the benefits of cervical strengthening exercises for reducing concussions in collegiate athletes and highlight the convenience and affordability of using this device.

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 cranial base release and swallowing exercises in rehabilitation of post-operative total thyroidectomy patient. A case report

Thyroidectomy is a widely practiced surgical intervention with low mortality and morbidity rates; however, it can result in long-term complications impacting health and social well-being. Early physical rehabilitation programs have been shown to effectively address issues such as swallowing difficulties and motor function impairment in the neck and shoulders, thereby improving the overall quality of life for patients. This study aimed to assess the impact of cranial base release (CBR) in conjunction with swallowing exercises on the post-surgery recovery of patients undergoing total thyroidectomy. A 29-year-old male patient presented with swelling on the left side of the neck, along with pain during neck movements, speech difficulties, and swallowing issues. The patient's neck range of motion, swallowing impairment score, and neck pain and disability scale were measured both before and after treatment. The patient underwent a six-week rehabilitation program consisting of CBR, swallowing exercises, and conventional physiotherapy sessions twice daily. The combined approach of CBR and swallowing exercises resulted in significant improvements in neck range of motion, swallowing impairment score, and neck pain and disability scale for patients following total thyroidectomy. This study highlights the beneficial effects of integrating CBR with swallowing exercises in the rehabilitation of post-operative total thyroidectomy patient, offering promising outcomes for their recovery.

Effectiveness of eye-cervical re-education versus motor imagery therapy on chronic neck pain: A randomized controlled trial

The aim of this study was to investigate the effect of adding eye cervical re-education exercises (ECRE) versus motor imagery therapy (MIT) to conventional physical therapy (CPT) on pain, functional disability, and cervical range of motion (ROM) in subjects with chronic neck pain (CNP). The study employed a randomized controlled trial design with 60 patients with CNP. Participants were selected from the outpatient clinics of the Faculty of Physical Therapy at Cairo University and were randomly assigned to three groups: conventional physical therapy only (CPT) (Group I, N = 20), eye-cervical re-education exercises plus CPT (Group II, N = 20), and motor imagery therapy plus CPT (Group III, N = 20). All participants received 3 sessions per week for 4 weeks. Visual Analogue Scale (VAS), Neck Range of Motion (ROM) and Neck Disability Index (NDI) were measured at baseline and after 4 weeks of intervention. In terms of pain intensity, neck disability index, neck flexion and extension, right and left lateral flexion, and right and left rotation ROM outcome measures, the results revealed statistically significant differences between groups (p &lt; 0.05). Group II showed statistically significant improvement compared to both Group I and Group III in all measured outcomes (p &lt; 0.05). Additionally, Group III showed statistically significant improvement compared to Group I in all measured outcomes (p &lt; 0.05). Adding eye-cervical re-education exercises or motor imagery therapy to conventional physical therapy resulted in notable improvements. Eye-cervical re-education exercises, in particular, showed greater benefits in reducing pain, enhancing cervical ROM, and decreasing disability compared to conventional physical therapy alone in patients with chronic neck pain.

An Exploratory Analysis of Physical Examination Subtypes in Pediatric Athletes With Concussion.

Pediatric athletes with concussion present with a variety of impairments on clinical assessment and require individualized treatment. The Buffalo Concussion Physical Examination is a brief, pertinent clinical assessment for individuals with concussion. The purpose of this study was to identify physical examination subtypes in pediatric athletes with concussion within 2 weeks of injury that are relevant to diagnosis and treatment. Secondary analysis of a published cohort study and clinician consensus. Three university-affiliated sports medicine centers. Two hundred seventy children (14.9 ± 1.9 years). Orthostatic intolerance, horizontal and vertical saccades, smooth pursuits, vestibulo-ocular reflex, near-point convergence, complex tandem gait, neck range of motion, neck tenderness, and neck spasm. Correlations between independent variables were calculated, and network graphs were made. k -means and hierarchical clustering were used to identify clusters of impairments. Optimal number of clusters was assessed. Results were reviewed by experienced clinicians and consensus was reached on proposed subtypes. Physical examination clusters overlapped with each other, and no optimal number of clusters was identified. Clinician consensus suggested 3 possible subtypes: (1) visio-vestibular (horizontal and vertical saccades, smooth pursuits, and vestibulo-ocular reflex), (2) cervicogenic (neck range of motion and spasm), and (3) autonomic/balance (orthostatic intolerance and complex tandem gait). Although we identified 3 physical examination subtypes, it seemed that physical examination findings alone are not enough to define subtypes that are both statistically supported and clinically relevant, likely because they do not include symptoms, assessment of mood or cognitive problems, or graded exertion testing.

Effects of dry needling on pain, range of motion and function in patients with upper cross syndrome

Background: In upper cross syndrome, upper trapezius, levator scapulae, sub occipital, sternocleidomastoid, pectoralis major and minor become tight. Whereas, the phasic muscle including lower and middle trapezius, deep neck flexor and serratus anterior muscle weaken. Objectives: To determine the effects of dry needling on pain, range of motion and function in upper cross syndrome. Methods: This randomized clinical trial was conducted at Sheikh Zaid Hospital Rahim yar khan. Ethical approval REC/RCRS/20/1049 was obtained from Riphah International University Lahore. Group A was treated with dry needling along with conventional therapy and group B was treated with conventional therapy and 34 subjects were allocated in both groups. The duration of study was of 2 weeks with 1 session per week. The pre and post intervention scores were taken for Visual analogue scale, Neck disability index and neck range of motion. The data was analyzed using SPSS 25. Results: There was no significant difference (p&lt;0.05) between groups based on demographic data at baseline. The BMI in group A was 24.38(1.14) and in group B 23.19(2.59). The mean difference of VAS in group A was 2.89(1.68) with CI [1.98, 3.76] (p&lt;0.05) and in group B was 2.87(1.03) with CI [2.33,3.42] (p&lt;0.05). The mean difference for NDI in group A was 21.25(10.85) with CI [15.46, 27.03] (p&lt;0.05) and in Group B was 14.68(8.42) with CI [10.20,19.17] (p&lt;0.05). In VAS and NDI between group analysis did not show significant result (p&gt;0.05). Conclusion: Dry needling along with conventional therapy only improves range of motion but in term of pain and functionality, dry needling and conventional therapy are equally effective. Clinical Trial Number: NCT04674904

Efficacy of capacitive-resistive therapy on the treatment of myofascial pain – A randomized control trial

BackgroundMyofascial pain syndrome is a painful musculoskeletal condition with muscle spasm, referred pain, stiffness, restricted range of motion. Capacitive-resistive diathermy heats deep tissues by transferring energy through radiofrequency waves. Although this modality is used to treat various musculoskeletal disorders, there is no specific data on myofascial trigger points. Thus, we aimed to evaluate the effectiveness of capacitive-resistive diathermy on the myofascial trigger points. MethodsThirty-six volunteers with active myofascial trigger points were included. Patients were randomly and equally allocated into two groups. Group-1 is the capacitive-resistive diathermy treatment group; Group-2 is the placebo capacitive-resistive diathermy (PG). Visual analog scale (VAS), pain pressure threshold (PPT), neck disability index (NDI), neck range of motion (nROM), Short form-36 (SF-36) were used as outcomes before and after the intervention. ResultsIn both groups, VAS, PPT, NDI score significantly improved within the groups (p < 0.05). The CRG showed a statistically significant improvement in nROM for flexion, extension, and rotation (p < 0.05). However, ROM increase in CRG is not superior to PG (p > 0.05). ConclusionsThere was no significant difference between the two groups. We thought positive results in the PG might attributed to doing exercise. As a result, capacitive-resistive diathermy is not superior to exercise, but can be used as an adjuvant modality in myofascial trigger points treatment.

Ab. No. 55 Using Inertial Measurement Units (IMU) for Measuring Neck Range of Motion (ROM) in Persons With Neck Pain: a Validity and Reliability Study

Introduction: Neck pain is one of the top five leading causes of disability in people around the globe. Range of Motion (ROM) is a fundamental clinical measure used to examine movement of joints in the body. A Universal goniometer is used to manually measure the ROM, this may be prone to measurement errors. Inertial Measurement Units (IMU) sensors detect the linear acceleration and angular velocity. They could be utilized to evaluate joint ROM, as they are relatively inexpensive and can be calibrated to convenience. The study aims to validate the device using an Optical motion capture system (OMCS) (Phase 1) and To measure the test-retest reliability of the device in the clinical setup in people with neck pain (Phase 2) Methods: Phase 1: Validation of the IMU was done against OMCS in Bioengineering department for Neck flexion, extension, lateral flexion and rotation (both left and right) on two consecutive days for 34 individuals. Phase 2: Forty patients with neck pain were recruited from Outpatient Physiotherapy unit, CMC Vellore. Data was recorded by the IMU system and stored on a computer. Patients were reassessed again to test the reliability on another day. The same clinician administered the assessments for all patients. Result: Phase 1 - The correlation coefficient was found to be excellent between the IMU and OMCS for all movements of the neck. Neck angle error - 2.19 to 4.20. Phase 2 - Intra-rater reliability of the device was assessed and it was found to be moderate to good among people with neck pain. The ICC ranged from 0.62 to 0.83 for the different neck ROM. Conclusion: The use of IMU for measuring neck ROM is a valid and reliable tool. It can be a useful clinical tool for consistent measurement and accurate documentation in the future.

Management outcomes of cervical radiculopathy with conservative treatment, anterior cervical discectomy fusion (ACDF), and anterior cervical disc replacement (ACDR)—Retrospective single center matched cohort study

Abstract Background: Degenerative cervical radiculopathy results from nerve root compression in the cervical neural foramina, often due to a herniated disc, osteophyte, or facetal/ligamentum flavum hypertrophy. Typically, 80% of patients show improvement within the initial 12 weeks through nonoperative measures, with surgical intervention considered for non-responders. This study aimed to compare clinical and radiological outcomes in cervical radiculopathy patients undergoing prolonged conservative care, anterior cervical discectomy and fusion (ACDF), or anterior cervical disc replacement (ACDR) after a 1‐year follow‐up. Materials and Methods: Our study was a retrospective single‐center study involving 780 cervical radiculopathy patients from January 2012 to December 2021. About 80.12% found relief with conservative management within 12 weeks. Remaining 155 patients were offered surgery, with 73 opting for continued conservative care, and 82 undergoing surgery (55 with ACDF and 27 with ACDR). Evaluation was done using visual analogue scale (VAS), Neck Disability Index (NDI), and radiographic parameters. Results: The mean follow‐up was 11.58 ± 6.7 months. ACDR group: Mean age 43.38 ± 8.56, VAS 7.81 ± 1.04 preoperatively, improved significantly to 2.07 ± 1.34 (P &lt; 0.05) at 1‐year follow‐up. ACDF group: Mean age 44.85 ± 10.65, VAS 8.22 ± 1.21 preoperatively, improved significantly to 2.09 ± 1.01 (P &lt; 0.05) at 1‐year follow‐up. Conservative group: Mean age 45.04 ± 11.19, VAS 7.77 ± 1.86 preoperatively, improved significantly to 2.08 ± 1.40 (P &lt; 0.05) at 1‐year follow‐up. Radiographic parameters significantly improved in all groups at 1‐year follow‐up (P &lt; 0.05). Range of motion (ROM) changes varied across groups. Miyazaki’s grading and Kim’s score showed comparable results. Conclusion: Comparable clinical and radiological outcomes were observed among conservative, ACDF, and ACDR approaches. ACDR approach demonstrated a better NDI score outcome. Neck ROM was better maintained or improved in the ACDR approach, decreased in ACDF, and remained almost similar in the conservative group.

Higher femoral head–to–femoral neck ratio are associated with limited range of motion of hip joints in hereditary multiple exostosis patients

Hip involvement is one of the most common skeletal manifestations of hereditary multiple exostoses (HME) in 30-90% of the patients. The anatomical changes in the proximal femur in patients with HME, may lead to deformities and related functional deficits. Its effect on the range of motion (ROM) of the hip joint is not well described. The aim of this study was to evaluate the role of hip deformity of HME disease in the ROM of the hip joint. It was hypothesized that certain morphological parameters affect the ROM of the hip joint. Conclusively, 44 patients including 27 men and 17 women (88 hips) were evaluated. Hips are divided in Group 1 (no ROM limitation group) and Group 2 (ROM limitation group). The head-neck ratio (HNR), center edge angle (CE), Sharp’s acetabular angle (SAA), alpha angle (AA), neck shaft angle (NSA) and ROM parameters were measured. The correlations between radiological parameters (SAA, CE, NSA, AA and HNR), and the ROM data (F, E, Abd, Add, IR and ER) were statistically evaluated. All evaluated parameters (SAA, CE, NSA, AA) except the HNR do not show significant differences between study group 1 (no ROM limitation group) and group 2 (ROM limitation group). The means of the HNR in group 1 were significantly higher than those in group 2 (HNR: 1.23 vs. 0.92, p&lt;0.001). In group 2 HNR showed a strong positive correlation with Abd (PC 0.72, p&lt;0.001), E (PC 0.7, p&lt;0.001), ER (PC 0.67, p&lt;0.001), IR (PC 0.67, p&lt;0.001) and F (PC 0.66, p&lt;0.001). HME patients with hip involvement have better ROM of the hip joint, if they have the higher HNR. Additionally, a positive correlation between HNR and ROM capacity was determined.

The Effect of Corrective Exercise on Pain Referred to The Jaw Joint (TMJ) in Elderly Women With Upper Crossed Syndrome

Background: Upper crossed syndrome is a muscular imbalance disorder associated with various referred pains, especially jaw discomfort. Complications like temporomandibular joint (TMJ) osteoarthritis may link to forward head posture and mechanical head pains resulting from this syndrome.&#x0D; Objectives: The objective of this study was to compare the impact of corrective exercise on pain of TMJ in elderly women with upper cross syndrome.&#x0D; Methods: A total of 30 elderly women with upper crossed syndrome were enrolled at the Kahrizak Elderly Care Center and randomly assigned to either a corrective exercise group or a control group. The experiment group underwent an eight-week training program. Pain levels and neck range of motion were assessed using a pain ruler and goniometer, respectively. In order to measure neck extension, the mean difference and effect size were determined using paired t-test and Cohen’s d, respectively. Referred pain ratings were analyzed using Mann-Whitney U and Wilcoxon signed-rank tests, with effect size calculations, to further understand the intervention’s effect on pain perception.&#x0D; Results: Both groups demonstrated significant changes in referred pain perceptions (P = 0.0441) post-intervention. However, regarding neck extension, neither the control nor the experiment group exhibited statistically significant alterations in neck extension (P = 0.4309)&#x0D; Conclusions: These findings indicate that corrective exercises have a positive effect on alleviating referred pain in the jaw joint caused by muscle imbalance. Given the merits of corrective exercises as a non-pharmacological intervention, they are recommended as an effective approach for improving referred pain in the jaw.

Comparative Effects of Percussion Theragun Versus Physical Activity in Non-Specific Neck Pain in Young Adults – A Randomized Clinical Tr

Background: The percussion theragun uses fast oscillatory back and forth movements to produce vibrations of different frequencies. Handheld percussive massage treatment has acquired fame as of late, for both remedial use and in sports practice. Physical activity is any movement that uses energy that improves strength, flexibility. With both the possible treatment options, the study raises the question of which of the two produces better results in subjects with Non-specific neck pain in terms of reduction of pain and increase in range. The objective of this study was to assess and compare the therapeutic effects of the percussion theragun with physical activity for the treatment of non-specific neck pain. Method and Measures: The study was conducted on 36 subjects with non-specific neck pain who were given 3 consecutive sessions (in a span of 3 days) of intervention. Through randomized method subjects were divided into the percussion theragun group (group A) and conventional physical activity group (group B). Outcome measures such as VAS (visual analogue scale) and Neck range of motion were assessed Results: The nonspecific neck pain participants in Group A and Group B showed significant improvement in extension, right lateral flexion, left lateral flexion neck ROM and reduction in VAS after exposed to the respective intervention. However, the Group A showed a significant improvement in VAS and ROM when compared with Group B. Conclusion: The current study provided the evidence to prove that the protocols used in this study show significant reduction in pain and range of motion in subjects with non-specific neck pain in both the groups. The percussion theragun group showed significantly greater improvement than the physical activity group.

Measurement properties of a computer adaptive device, the Senscoordination 3D Cervical Trainer, to assess cervical range of motion in people with neck pain

IntroductionClinicians commonly assess cervical range of motion (ROM) in patients with neck pain. Recently, a new instrument has been developed, the Senscoordination 3D Cervical Trainer (SCT), designed to measure neck ROM in addition to joint position error, static and dynamic balance performance, and performance on a ‘neuro muscular control test’. This study aims to assess the interrater reliability, concurrent validity, and responsiveness of the SCT using the CROM device as a comparator. MethodsOne hundred patients with non-specific neck pain were included and their active cervical ROM was measured in a random order by two raters in succession using both devices simultaneously at baseline and after personalised physiotherapy management, at 12 week follow up. Convergent validity and responsiveness were quantified by a Pearson correlation coefficient. The intraclass correlation coefficient (ICC) was used to calculate the test–retest reliability of the SCT. The smallest detectable change (SDC) was calculated per movement direction and for the total range of motion. ResultsThe correlation between the measures obtained with the CROM device and the SCT was high (0.97 or 0.98 depending on direction of movement). Interrater reliability was high for all directions (ICC ranging from 0.81 to 0.97). The SDC ranged from 6.9 for left cervical rotation to 12.2 for right cervical rotation. At the follow up, correlation between the change score on the CROM device and the SCT was high (0.86–0.94 depending on the direction of movement). ConclusionThe SCT is a valid, reliable and responsive instrument for measuring cervical ROM.

Physiotherapeutic Interventions for Upper Cross Syndrome: A Systematic Review and Meta-Analysis.

Upper cross syndrome is a postural dysfunction that can cause a variety of upper-body musculoskeletal problems. Early detection and physiotherapy can help to prevent further complications. However, no systematic review has evaluated the effect of various physiotherapy intervention strategies to treat this syndrome. Therefore, this study aims to conduct a detailed methodological literature search of the most effective treatment strategies available for the correction of upper cross syndrome. Prospective human subject studies published in the English language that report the assessment and rehabilitation of upper cross syndrome were included. Clinical trials (randomized and non-randomized) were included when compared to a comparator, control group, and no treatment. The search was limited to human subjects and English-language articles. Outcome measures included craniovertebral angle, kyphotic angle, rounded shoulder, neck or shoulder pain, neck range of motion, electromyographic activity of neck or scapular muscles, and functional limitations. To evaluate the methodological quality of randomized controlled trials, the Cochrane collaboration tool was employed. For non-randomized studies, the Risk of Bias in Non-randomized Studies of Intervention was used. The Grading of Recommendations, Assessment, Development, and Evaluation system was used to rate the effectiveness of the evidence. A random-effect meta-analysis was performed for quantitative analysis to report significant differences based on calculated mean differences, with matching 95% confidence intervals (CIs) whenever possible. Out of the 34 potentially relevant articles, 18 were included. The postural variables including craniovertebral angle, kyphotic angle, and rounded shoulder showed a significant improvement with the physiotherapy group compared to the no-treatment group (standardized mean difference = -1.78; 95% CI = -2.68 to -0.87; p = 0.0001). Secondary outcomes such as pain and functional limitation showed a significant difference when advanced manual therapy techniques were used compared to conventional therapy (standardized mean difference = -0.71; 95% CI = -1.04 to -0.39; p< 0.0001; and standardized mean difference = -0.57; 95% CI = -1.00 to -0.14; p = 0.009, respectively). Exercise therapy was found to be beneficial in correcting postural alignment and movement patterns, while manual therapy was found to be similarly effective in pain reduction and functional improvement.

Predicting failure of detection of peritonsillar abscess with ultrasound in pediatric populations

PurposeSome patients require additional imaging following ultrasound (US) to definitively diagnose a peritonsillar abscess (PTA), delaying intervention and disease resolution. We seek to evaluate patient characteristics which may predispose to a secondary imaging requirement to diagnose PTA, in order to better understand ultrasound limitations and predict who will require additional studies. Materials and methodsRetrospective chart review of patients with an US for suspected PTA between July 2017 and July 2020. Patient age, weight, and clinical characteristics, such as pain, trismus, and reduced neck range of motion (ROM) were collected. The need for additional imaging, subsequent surgical intervention, and hospital length of stay (LOS) were also recorded. ResultsOf 411 qualifying patients, 73 underwent additional imaging. Patients who required additional imaging were younger (9.8 vs 11.3 years, p = 0.026) and more likely to have decreased neck ROM (17.8 vs 5.3 %, p = 0.001). Surgical intervention was performed more commonly (27.4 vs 14.8 %, p = 0.015) and hospital LOS was longer (24.0 vs 5.0 h, p < 0.001) in those with secondary imaging. ConclusionsSpecific patient characteristics, such as younger age and decreased neck range of motion, are associated with a higher need for additional imaging. Additionally, the need for additional imaging is associated with a longer hospital LOS and increased likelihood of surgical intervention. Nearly 18 % of patients who underwent US evaluation of PTA required secondary imaging. Although transcervical US remains an excellent tool for diagnosing PTA, this data supports the utility of secondary imaging in certain instances.

Comparison of neck muscle strength, range of motion, and craniovertebral angle among Malaysian young adults using different electronic devices

&lt;b&gt;Aim: &lt;/b&gt;Prolonged use of electronic devices (EDs) and adopting poor posture during ED usage might lead to musculoskeletal disorders among young adults and adolescents. Hence, this study compares neck muscle strength, range of motion (ROM), and craniovertebral angle (CVA) among Malaysian young adults using different EDs.&lt;br /&gt; &lt;b&gt;Methods: &lt;/b&gt;A cross-sectional study using a quantitative study design was applied to compare neck muscle strength, ROM, and CVA between laptop and tablet users of Malaysian young adults. The population of this study covers young adults residing in Selangor, Malaysia. Among them, 30 laptop users and 30 tablet users were selected using the selection criteria and criterion-based sampling method. The data analysis was carried out with SPSS 20.0 at a 5% level of significance.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; There was no significant difference between the laptop and tablet users concerning neck muscle strength and CVA. However, a significant difference was observed only in the neck extension ROM between laptop and tablet users. The mean neck extension ROM is lower in tablet users than in their counterparts. The mean CVA of laptop and tablet users was less than 50 degrees, indicating severe FHP. Most laptop users (73.3%) were categorized into severe FHP than tablet users (53.3%).&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt; The mean neck extension ROM is lower in tablet users than in laptop users. Most laptop users had severe FHP than tablet users. Hence, Malaysian young adults should adhere to the appropriate duration of ED usage, ergonomics while using ED. and postural correction exercises to prevent and reduce musculoskeletal problems.

호흡 패턴 재교육 운동이 전방 머리 자세를 가지는 목 통증 환자에게 미치는 영향

Objective: The purpose of this study was to examine the effects of cervical stabilization exercise(CSE) combined with breathing pattern re-education exercise(BPRE) compared CSE on pain, disability, muscle activity, and range of motion(ROM) in neck pain(NP) patients with forward head posture(FHP). Method: BPRE+CSE(n=15) and Conservative physical therapy(CT)+CSE(n=15) groups were received treatment three times per week for four weeks, respectively. A numeric pain rating scale(NPRS), neck disability index(NDI), ROM, and surface electromyography(SEMG) activities of sternocleidomastoid (SCM) muscle and scalene muscle were measured before and after the treatments for each group. A paired t-test was conducted to test the changes before and after the treatments and an independent t-test was performed to evaluate the difference between groups. Results: In NPRS, NDI, ROM and muscle activity both BPRE+CSE and CT+CSE showed differences (p&lt;.05). BPRE+CSE showed more reduction in NPRS, NDI and muscle activity more increase in ROM(p&lt;.05). Conclusion: These results suggest that the BPRE can pain relief, recovery from neck disability, ROM, and muscle activity for NP patients with a FHP.