Spinal Mobility Research Articles

Therapeutic effect of modified cervical Jiaji acupuncture on mixed type cervical spondylosis.

To observe the clinical efficacy of modified cervical Jiaji acupuncture in the treatment of mixed cervical spondylosis (MCS). In this retrospective study, 120 patients with MCS who were treated in Yongchuan Hospital, Affiliated with Chongqing Medical University, from May 2020 to May 2023, were selected as the study subjects. According to the treatment methods, 52 patients who were treated with ordinary seat traction, tendon manipulation and ironing from January 2020 to December 2021 were grouped as the traditional treatment group. From January 2022 to December 2023, 68 patients who were treated with acupuncture at cervical Jiaji points formed the acupuncture group. Cervical Jiaji points (EX-B2) are located on both sides of the spinous process from the first to the seventh cervical vertebra, 0.5 inch lateral to the posterior median line, with 7 points on one side, and a total of 14 points. The patients were in a prone position and the points were treated using direct needling with filiform needle and reinforcing-reducing manipulation. Both groups were treated for 2 weeks. The pain, pain intensity, pain improvement quality, blood flow improvement, cervical spine mobility, cervical spine function and clinical efficacy of the two groups before and after treatment were compared. After treatment, the pain rating index (PRI) score, present pain intensity (PPI) score and visual analogue scale (VAS) score of the two groups all decreased, with those in the acupuncture group decreasing more substantially than that in the traditional treatment group (all P < 0.05). The mean blood flow velocity (Vm) in the right vertebral artery, left vertebral artery and basilar artery in the acupuncture group were significantly higher than in the traditional treatment group (all P < 0.05). The right-handed, left-handed, posterior, anteflexion, left-flexion and right-flexion activities of the acupuncture group were better than in the traditional treatment group (all P < 0.05), and the neck disability index (NDI) score and clinical assessment scale for cervical spondylosis (CASCS) scores of in the acupuncture group were better than the traditional treatment group (all P < 0.05). After therapy, the total effective rate of the acupuncture group was 86.67%, which was significantly higher than 71.67% in the traditional treatment group (P < 0.05). Modified cervical Jiaji acupuncture is effective in treating MCS. It can improve the clinical symptoms, cervical spine function and cervical spine mobility, and reduce the intensity of pain.

Exploring the Impact of Spinal Mobilization in Adolescent Idiopathic Scoliosis

Background: Adolescent idiopathic scoliosis (AIS) is a prevalent musculoskeletal condition in adolescents, characterized by a complex etiology and significant impact on health. The condition is typically managed through various physical therapies, but the effectiveness of combining different therapeutic approaches, particularly the integration of spinal mobilization with conventional exercises, is not well established. Objective: This study aimed to evaluate the effectiveness of combining Schroth exercises with spinal mobilization in improving Cobb's angle in patients with AIS, compared to Schroth exercises alone. Methods: A randomized controlled trial was conducted at Mubarak Hospital, Sargodha, involving 12 patients aged 10-20 years with diagnosed AIS. Participants were divided into two groups: a Control Group (n=6) receiving Schroth exercises and an Experimental Group (n=6) receiving Schroth exercises plus spinal mobilization. The treatment duration was four weeks. Pre- and post-intervention Cobb's angles were measured using radiographs. Data analysis was performed using SPSS version 25. Results: Both groups demonstrated a significant reduction in Cobb's angle post-intervention. The Control Group showed a decrease from a mean ± SD of 20 ± 3.46 degrees to 17.5 ± 3.61 degrees (P &lt; 0.001). The Experimental Group exhibited a more pronounced reduction, from 20.3 ± 2.80 degrees to 15.5 ± 3.08 degrees (P &lt; 0.001). Conclusion: The study concluded that the integration of spinal mobilization with Schroth exercises is more effective in reducing Cobb's angle in patients with AIS compared to Schroth exercises alone. This combination therapy may represent a more potent approach for the management of AIS.

The effect of stretching exercises on the mobility of the spine in the sagittal plane in people using digital devices – preliminary observations

Introduction. Digital devices and a sedentary lifestyle pose significant health risks in today’s society, further exacerbated by the regular adoption of incorrect posture. Prolonged adoption of an incorrect posture can result in pain and impaired spinal mobility. Aim of the study. The study aims to evaluate the impact of stretching exercises on improving cervical, thoracic and lumbar spine mobility in the sagittal plane. Furthermore, it sought to examine the potential correlation between the occurrence of pain and the duration of digital equipment usage. Study materials and methodology. The study was conducted on a sample group of 22 individuals aged 18 to 21 (20.11 ± 1.56) years. Linear measurements, including the Schober and Otto-Wurm tests, were used to examine spinal mobility in the sagittal plane. The subjects were given a 10-day programme comprising six stretching exercises to perform autonomously daily. After ten days, line measurements were retaken. Results. Significant statistical values were observed for spinal ranges of motion in the sagittal plane; no statistically significant value was obtained for the incidence of pain and the duration of use of digital devices. Conclusions. The subjects demonstrated improvement in cervical, thoracic, and lumbar spine mobility in the sagittal plane following the implementation of stretching exercises. Additionally, a decrease in spinal pain was observed.

Comparison of the efficacy of Transcutaneous Electrical Nerve Stimulation and Short Wave Diathermy on Patients with Chronic Nonspecific Low Back Pain

Background: Transcutaneous electrical nerve stimulation (TENS) is widely used as a therapeutic adjunct in the management of low back pain. It is a relatively safe, non-invasive, and easy-to-use modality, making it an attractive treatment option. For more than four decades, TENS has been applied in the treatment of acute and chronic pain syndromes. Short wave diathermy (SWD) is a modality that produces deep heating by converting electromagnetic energy to thermal energy. Short wave diathermy (SWD) is also a popular therapy for low back pain. Methods: This randomized controlled clinical trial was conducted to evaluate the comparative efficacy between TENS and SWD on chronic nonspecific low back pain patients. 120 patients with chronic low back pain were treated according to inclusion &amp; exclusion criteria. Patients were equally distributed in three groups. Group-A patients (n=40) were treated with NSAID+ADL, Group-B patients (n=40) were treated with NSAID+ADL+TENS, and Group-C patients (n=40) were treated with NSAID+ADL+SWD. Written informed consent was obtained from all patients. Data were calculated and analyzed by computer-based software SPSS (Statistical Package for Social Science) Windows 16.0 version. Main outcome measure (s) Age, Sex, Occupational status, Socioeconomic status, Subjective pain intensity score, Visual Analogue Scale, Tenderness index, Disability due to pain, Spinal mobility index, and Oswestry disability Index. Results: The mean duration of pain was found to be 23.90±2.57 months in group A, 21.0+1.50 months in group B and 22.1±1.89 months in group C. The visual analog score was improved individually in group-A, group B and Group C after treatment, which was statistically significant (P&lt;0.05). Oswestry disability questionnaire score was also improved individually in group-A, group B and Group C after treatment, which was statistically significant (P&lt;0.05). In the case of comparison between group-B and Group C, this was not statistically significant (P&gt;0.05). In this current study, it was observed that the entire variable individually improved in Group-A, Group B, and Group C. So, all three treatment groups benefited from drugs and therapy. But, these were not statistically significant (P&gt;0.05) between Group B and Group C. Conclusion: Beneficial effects of TENS and SWD were seen in the study population, but no firm conclusion could be drawn. TAJ 2023; 36: No-2: 135-143

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.

Pedicle drilling force control of a robotic surgical system via spine-soft tissue coupling model and parameters optimization

Bone drilling is a crucial operation in spinal fusion surgery that requires precise control of the applied force to ensure surgical safety. This manuscript aims to enhance the force servo performance of the orthopedic robot during automatic bone drilling operations. Firstly, an analytical model is introduced to describe the spinal mobility of the spine-soft tissue coupling structure. Then, the model is calibrated using force data obtained from stress relaxation tests. Next, optimal force controller parameters are determined through drilling force control simulations based on the identified model. The dynamic performance and robustness of the closed-loop control system are analyzed to ensure safe drilling procedures. Finally, bone drilling experiments are conducted in a force control mode to verify the effectiveness of the proposed method. The step drilling force response's steady-state error is less than 0.15 N, the relative control error is less than 3 %, and there is no noticeable force overshoot. The amplitude of the sinusoidal force response decays to −3 dB when the target force frequency is up to 3.49 rad/s, indicating a wide control bandwidth. These results demonstrate that the proposed method can rapidly and safely provide an adequate force servo to carry out automatic bone drilling.

Effects of Progressive Physiotherapy Along with or Without Active Bed Rest at Hospital for the Management of Chronic Low Back Pain (LBP) Patients in Bangladesh

Background: Low Back Pain (LBP) is a significant health condition globally suffered by the middle and older aged population due to its impact on work disability, absenteeism and costs. Physiotherapy with active rest and therapeutic intervention, including mobilization, manipulation, exercise therapy and electrotherapy, is the choice of treatment as conservative management, whereas surgery is required in case of advanced neurological involvement. Specific level-induced spinal mobilization has a greater impact on correcting the faulty biomechanics of the spinal column if considered active rest at an early stage, whereas generalized spinal physiotherapy without rest is also effective for managing mechanical spinal pain. Objective: To determine the effects of physiotherapy with or without active rest for chronic low back pain. Method: Experimental research design with simple random sampling was used in this study to find out the effects of Progressive Physiotherapy along with or without active rest at the hospital for the management of patients with chronic Low Back Pain (LBP) in Bangladesh of 20-55 years of aged peoples with pre and posttest basis. Results: The study showed that physiotherapy with or without active rest effectively reduces pain and back disability for low back pain patients, whereas physiotherapy with active rest is more effective than physiotherapy without active rest for back pain patients. Comparison of within-group and between-group results showed that the P&lt;0.05. The comorbidities were about 40% diabetic, 33% spinal deformity and 6.67% spinal and other surgical conditions which influence LBP. The experimental group reduced 64% pain and the control group reduced 24% pain. Conclusion and Recommendations: Physiotherapy with active rest is more effective than physiotherapy without active rest for LBP patients, whereas both treatment groups are significantly effective individually. RCT study can proceed for further evaluation.

The Impact of HVLA Manipulations and Therapeutic Massage in Increasing the Mobility of the Lateral Flexion of the Neck

The purpose of this study was to establish if high-velocity, low-amplitude manipulation (HVLA) combined with therapeutic massage can improve cervical spine mobility, particularly neck lateral flexion, on the left and right sides, given that lateral neck flexion is 90 degrees. The sample of 75 participants was comprised of 35 men (46.6%) and 40 women (53.3%), all of whom were between the ages of 20 and 60 and were divided into four groups based on their average ages: 20 to 30 years, 31 to 40 years, 41 to 50 years, and 51 to 60 years. These groups were further subdivided into two groups by gender, male and female. Patients' lateral flexion was measured with a goniometer, which displays the angle of lateral flexion before and after treatment. C1-C7 vertebral level and shoulder joint level HVLA procedures were conducted. The therapeutic massage concentrated on the trapezius, sternocleidomastoid, platysma, splenius, and semispinalis muscles using relaxing techniques. Each patient's left and right elbow lateral flexion was measured with a goniometer following HVLA manipulations and therapeutic massage to see whether or not there was a significant increase. After combining the findings and measurements, we were able to determine that these combined methods increase the cervical spine joint mobility of the 75 participants by a mean of 12.36 degrees.

Reduced sleep quality is highly prevalent and associated with physical function and cardiorespiratory fitness in patients with axial spondyloarthritis: a cross-sectional study

Objectives To assess sleep quality, and its associations with physical function, cardiorespiratory fitness, and spinal mobility, in axial spondyloarthritis (axSpA) patients. Method Baseline data from the Exercise for Spondyloarthritis trial were used. Assessments included [Pittsburgh Sleep Quality Index (PSQI), 0–21, 21 = worst], performance-based physical function [Ankylosing Spondylitis Performance Index (ASPI), seconds, higher = worse], patient-reported physical function [Bath Ankylosing Spondylitis Functional Index (BASFI), 0–10, 10 = worst], cardiorespiratory fitness [peak oxygen uptake ( V O2 peak), mL/kg/min, lower = worse], and spinal mobility [Bath Ankylosing Spondylitis Metrology Index (BASMI), 0–10, 10 = worst]. Associations were examined in separate models using multiple linear regression. Results Ninety-nine patients with axSpA were included, 53% female, mean age 46 years, and 72% with high disease activity (ASDAS-C-reactive protein ≥ 2.1), of whom 84 (85%) had reduced sleep quality. Sleep disturbance was most frequently reported (65%), followed by poor subjective sleep quality (53%), daytime dysfunction (41%), and increased sleep latency (41%). Positive associations were observed between PSQI and ASPI [β = 0.10, 95% confidence interval (CI) 0.01, 0.19] and PSQI and BASFI (β = 0.85, 95% CI 0.51, 1.20), and there was an inverse association between PSQI and V O2peak (β = −0.14, 95% CI −0.27, −0.01), adjusted for age and sex. There was no association between PSQI and BASMI. Conclusion Reduced sleep quality was common in axSpA patients with moderate to high disease activity. Better sleep quality was associated with better physical function and higher cardiorespiratory fitness. There was no association between sleep quality and spinal mobility. Trial registration ClinicalTrials.gov NCT02356874

Gait analysis, trunk movements, and electromyographic patterns after minimally invasive spine surgery for lumbar instability: An observational prospective study

ObjectiveThe aim of the present study was to investigate trunk kinematics and spine muscle activation during walking after minimally invasive surgery in patients with L4-L5 degenerative spondylolisthesis suffering from lumbar instability (LI). MethodsEleven patients suffering from LI and 13 healthy controls (HC) were enrolled. Trunk kinematics and spine muscle activation patterns during walking were collected. Maximal trunk ranges of motion were also recorded from standing position. Assessments were performed pre-operatively (T0), 1 month (T1) and 3 months (T2) after MIS. ResultsWe found significant improvement in spine muscle activation during walking at T2 compared to T0, mainly involving right/left symmetry at the operated level (L4-L5) and up-down synchronization from L3 to S1. Significant improvements in trunk rotation nearing to the HC group during walking were also found at T2 after surgery, though no changes were observed in the maximal range of motion of the trunk during standing. Furthermore, trunk rotation improvement correlated with a lower grade of residual disability. ConclusionsOur findings indicate that trunk rotation improves after surgery, and impaired aspects of spine muscle activation can be improved with surgery. These biomechanical parameters could represent novel tools for monitoring the effect of surgery in LI and preventing impaired spine mobility and muscle activation.

Male spondyloarthritis patients and those with longer disease duration have less severe disc degeneration: propensity score-matched comparison.

Using whole spine sagittal T2 MRI, we aimed to compare the severity and prevalence of disc degeneration (DD) in axial SpA patients vs the general population and to determine any association between spinal inflammation, structural changes, mobility and DD among SpA patients. Two prospectively collected cohorts of SpA patients (n = 411) and the general population (n = 2007) were recruited. Eventually, 967 participants from the populational cohort and 304 participants from the SpA cohort were analysed. Two hundred and nineteen matched pairs were generated by propensity score matching. Imaging parameters, including Pfirrmann grading, disc herniation, high-intensity zone, Schmorl's node, Modic change and anterior marrow change were studied and compared from C2/3 to L5/S1. DD was defined as Pfirrmann grade 4 or 5. Demographic factors, including age, sex and BMI, were collected. Multivariable linear regression was used to determine the association between spinal inflammation [Spondyloarthritis Research Consortium of Canada (SPARCC) spine MRI index], structural changes [modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS)] and mobility (BASMI) with lumbar Pfirrmann score. SpA patients had lower prevalence of DD (P < 0.001). The disease stage-stratified regression model showed that SPARCC spinal MRI index was associated with higher lumbar Pfirrmann scores in early disease (β = 0.196, P = 0.044), whereas mSASSS was associated with lower lumbar Pfirrmann scores in later disease (β = -0.138, P = 0.038). Males had higher mSASSS (P < 0.001) and lower odds of whole spine DD (odds ratio = 0.622, P = 0.028). SpA patients had lower DD severity than the general population. Males had higher mSASSSs, and increased mSASSS at later disease was associated with less severe DD.

Thoracic Spine Mobility and Posture: Correlation and Predictive Values in Physically Independent Older Adults.

The posture undergoes changes during aging and may serve as a marker for the evaluation of the thoracic spine. This study aimed to correlate the variables for the evaluation of thoracic spine mobility and propose predictive equation models from the measurements of the thoracic Schober test and the digital inclinometer in older adults. The mobility of thoracic flexion and extension by levels (T1, T8 and T12) of 41 older adult subjects (66 ± 7years) was quantified with a digital inclinometer (degrees) and Schober's test (cm). There was a moderate positive correlation between the digital inclinometer and the Schober test at T1 (r = .69), T12 (r = .60), and total flexion levels T1 to T12 (r = .74). Simple linear regression equations showed that thoracic Schober predicts thoracic mobility measures for these same levels. Moderate to strong correlations were observed between the inclinometer and the Schober Test measurements. The development of predictive equation models based on the thoracic Schober test could potentially enhance the ability to predict spinal mobility in physically independent older adults.

Predictive underestimation of difficult direct laryngoscopy in a patient with rheumatoid arthritis-associated immobilized craniocervical junction

BackgroundThe upper cervical spine is a major focus of damage by rheumatoid arthritis (RA). Specific screening for mobility of the upper cervical spine, which is essential for direct laryngoscopy, is lacking. Herein, we present a case of RA with Cormack-Lehane grade IV, which was not predicted by preoperative examination.Case presentationA 66-year-old woman with RA was scheduled for a right total knee arthroplasty and right elbow synovectomy. She had a long history of RA without symptoms related to the cervical spine or spinal cord. Although physical examination suggested moderate risk of difficult intubation with preserved cervical retroflexion, her Cormack-Lehane classification was grade IV under muscle relaxation. Bony integration of the occiput to axis was considered to be the main cause of difficult direct laryngoscopy, and restricted neck rotation was found postoperatively.ConclusionsRA patients may have limited upper cervical spine motion despite normal cervical retroflexion.

Inhibition of Neurogenic Inflammatory Pathways Associated with the Reduction in Discogenic Back Pain.

Retrospective cohort study. This study aimed to determine whether the initiation of anti-calcitonin gene-related peptide (CGRP inhibitor) medication therapy for migraines was also associated with improvements in back/neck pain, mobility, and function in a patient population with comorbid degenerative spinal disease and migraine. CGRP upregulates pro-inflammatory cytokines such as tumor necrosis factor-α, interleukin-6, brain-derived neurotrophic factor, and nerve growth factor in spinal spondylotic disease, which results in disc degeneration and sensitization of nociceptive neurons. Although CGRP inhibitors can quell neurogenic inflammation in migraines, their off-site efficacy as a therapeutic target for discogenic back/neck pain conditions remains unknown. All adult patients diagnosed with spinal spondylosis and migraine treated with CGRP inhibitors at a single academic institution between 2017 and 2020 were retrospectively identified. Patient demographic and medical data, follow-up duration, migraine severity and frequency, spinal pain, functional status, and mobility before and after the administration of CGRP inhibitors were collected. Paired univariate analysis was conducted to determine significant changes in spinal pain, headache severity, and headache frequency before and after the administration of CGRP inhibitors. The correlation between changes in the spinal pain score and functional or mobility improvement was assessed with Spearman's rho. In total, 56 patients were included. The mean follow-up time after the administration of CGRP inhibitors was 123 days for spinal pain visits and 129 days for migraine visits. Back/neck pain decreased significantly (p <0.001) from 6.30 to 4.36 after starting CGRP inhibitor therapy for migraine control. As recorded in the spine follow-up notes, 25% of patients experienced a functional improvement in the activities of daily living, and 17.5% experienced mobility improvement while taking CGRP inhibitors. Change in back/ neck pain moderately correlated (ρ=-0.430) with functional improvement but was not correlated with mobility improvement (ρ=-0.052). Patients taking CGRP inhibitors for chronic migraines with comorbid degenerative spinal conditions experienced significant off-target reduction of back/neck pain.

Impact of adolescent idiopathic scoliosis on in-school adolescents and intervention

Adolescent idiopathic scoliosis (AIS) is one of the most common types of scoliosis, which affects patients balance function and spinal mobility, leads to spinal deformity,and also has some degree of negative effect on pulmonary function, which, to varying degrees, seriously affects adolescents physical and mental health and quality of life, increases patients familys financial burden, and may also result in the depletion of social resources. Therefore, early identification and intervention of AIS is an urgent issue. There is still some controversy about whether to screen for AIS, and each region should make decisions based on their own situation. The popularisation of the disease should be put on the agenda as soon as possible. This paper summarises the impact of AIS on adolescents learning and social interaction. In addition, specific interventions after the emergence of AIS, such as conservative treatment, surgical treatment, and traditional Chinese medicine, are generally described, and their advantages and disadvantages are analysed. This paper is intended to provide more theoretical basis for an further understanding of scoliosis.

Diffuse idiopathic skeletal hyperostosis, beyond the musculoskeletal system

It has been suggested that diffuse idiopathic skeletal hyperostosis (DISH), a skeletal disease characterized by the ligamentous ossification of the anterolateral spine, is a radiological entity with no clinical implications; however, many patients suffer from chronic back pain, decreased spinal mobility, and postural abnormalities. Additionally, the pathological new bone formation at the cervical and thoracic levels may mainly produce dysphagia and breathing disturbances. Over the last 20 years, a close association between DISH, obesity, diabetes mellitus (DM), and metabolic syndrome (MS) has emerged. However, a causal relationship has not yet been established. It has been suggested that the longer life expectancy and the growing incidence of MS in Western populations, associated with the tendency of DISH to manifest in later life, may increase the DISH prevalence rates in the following decades. Future investigations should focus on the early DISH phase to clarify pathogenetic mechanisms and identify targeted therapies.

Impact of disease outcomes on the Assessment of SpondyloArthritis International Society Health Index (ASAS HI): a Bayesian network analysis of the DESIR cohort

ObjectiveThe objective of this study is to build a structural model visualising and quantifying the interrelationships of different disease outcomes with the Assessment of SpondyloArthritis International Society Health Index (ASAS...

Comparison of Spine Posture, Mobility and Body Image Perception in Healthy and Primary Dysmenorrhea Women

The aim of this research was to compare spinal posture, mobility and body image perception between healthy women and women with primary dysmenorrhoea. A total of 120 women, 57 healthy and 63 with Primary dysmenorrhoea, were included in the study. The mean age of the participants was 22 years in the group with primary dysmenorrhoea and 21 years in the healthy group; BMI results were 23.05 and 21.45, respectively. Participants' pain severity, attitudes towards menstruation and menstrual symptoms, physical activity levels and body image perceptions were assessed with the corresponding questionnaires. Participants' spinal posture and mobility were assessed with Spinal Mouse device. In our study, pain score of women with Primary dysmenorrhoea was higher than healthy women (p&amp;lt;0.001). Sacrum-hip angle (p=0.005), inclination angle (p=0.014) and mobility of these regions ((p=0.006), (p=0.001)) were lower in the Primary dysmenorrhoea group compared with the healthy group. Menstrual symptoms were more severe in women with Primary dysmenorrhoea (p&amp;lt;0.001) and their attitudes towards menstruation were more negative (p=0.013, p=0.003, p=0.034, p=0.023, p&amp;lt;0.001, p&amp;lt;0.001). Physical activity levels (p=0.294) and body image perceptions of Primary dysmenorrhoea and healthy women were similar (p=0.225). As a result we found that the spinal posture and mobility of women with Primary dysmenorrhoea differed negatively from healthy women and that they approached menstruation cognitively worse. These results may be important for women with Primary dysmenorrhoea to be aware of their own bodies. We think that women with Primary dysmenorrhoea should be educated about this issue.

Home-based rehabilitation training with human key point detection for chronic low back pain patients: a randomized controlled trial protocol

BackgroundCore stability exercise (CSE) is a globally acknowledged intervention for managing chronic low back pain. However, the sustained adherence of patients with chronic low back pain to CSE can be challenging, mainly due to the absence of supervision and guidance from physical therapists during home-based exercise sessions. Consequently, exercise compliance tends to decline, resulting in suboptimal long-term effectiveness of the intervention. In this trial, our primary aim is to evaluate the potential therapeutic equivalence between home-based rehabilitation training employing key point identification technology and exercise guidance administered in a hospital setting.MethodsIn this trial, we will randomly assign 104 adults with chronic low back pain (CLBP) to either an intervention or control group, with 52 participants in each group. Both interventions will consist of three weekly 0.5-h sessions of core stability exercise (CSE). The intervention group will engage in home rehabilitation training utilizing key identification technology for movement, while the control group will perform supervised exercises in a hospital setting. Outcome assessments will be conducted at 4 weeks and 16 weeks after randomization. The primary outcome measure will be the change in pain intensity based on numeric rating scale (NRS scores) from baseline to 4 weeks. Secondary outcomes will include changes in physical function (measured by the Oswestry Disability Index (ODI)) and lumbar spine mobility as well as activity participation and treatment satisfaction.DiscussionIf home-based rehabilitation method is demonstrated to be non-inferior or even superior to traditional face-to-face exercise guidance, it could significantly advance the adoption of digital medical care and contribute to improving the overall health of the population.Trial registrationNCT05998434. Registered on 16 August 2023.

The Impact of Cervical Degeneration and Sagittal Balance on Retro-Odontoid Soft-Tissue Thickness

ObjectiveTo investigate whether retro-odontoid soft-tissue thickness (ROSTT) is associated with cervical degeneration, cervical spine mobility, and sagittal balance of cervical spine. MethodsThe data of 151 patients who presented at our hospital with cervical spondylosis were reviewed. The ROSTT was measured using T1-weighted sagittal cervical MRI fundings. The assessment of the degree of cervical intervertebral disc degeneration (IVDD) was conducted using sagittal T2-weighted imaging. The T1 slope (T1S), C1–C2 angle, C2−C7 angle, C1−C7 sagittal vertical axis (SVA) and C2−C7 SVA were measured. The range of motion (ROM) was assessed by measuring the flexion-extension radiographs. According to the ROSTT, those measuring less than 3mm were classified as normal group and those measuring larger than 3mm were classified as thickened group. ResultsThe thickened group had larger cervical IVDD grade, age, C2−C7 angle, and T1S compared to the normal group (all P<0.05). Additionally, the C0−2 angle was significantly smaller in the thickened group than in the normal group (P<0.05). ROSTT showed a negative correlation with C0−C2 angle (r=-0.181, P<0.05), but positive correlations with both C2−C7 angle (r=0.255, P<0.05) and T1S (r=0.240, P<0.05). Furthermore, ROSTT was positively correlated with age (r=0277, P<0.05) and cervical IVDD grade (Spearman, r=0.299, p<0.05). ConclusionsCervical sagittal balance and cervical degeneration have a significant impact on ROSTT. Patients with a higher T1S and severe cervical degeneration are more likely to result in greater ROSTT.