| 31. |
- Röijezon, Ulrik, et al.
(författare)
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Proprioception in Musculoskeletal Rehabilitation : Part 1: Basic Science and Principles of Assessment and Clinical Interventions
- 2015
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Ingår i: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 20:3, s. 368-377
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionImpaired proprioception has been reported as a feature in a number of musculoskeletal disorders of various body parts, from the cervical spine to the ankle. Proprioception deficits can occur as a result of traumatic damage, e.g., to ligaments and muscles, but can also occur in association with painful disorders of a gradual-onset nature. Muscle fatigue can also adversely affect proprioception and this has implications for both symptomatic and asymptomatic individuals. Due to the importance of proprioception for sensorimotor control, specific methods for assessment and training of proprioception have been developed for both the spine and the extremities.PurposeThe aim of this first part of a two part series on proprioception in musculoskeletal rehabilitation is to present a theory based overview of the role of proprioception in sensorimotor control, assessment, causes and findings of altered proprioception in musculoskeletal disorders and general principles of interventions targeting proprioception.ImplicationsAn understanding of the basic science of proprioception, consequences of disturbances and theories behind assessment and interventions is vital for the clinical management of musculoskeletal disorders. Part one of this series supplies a theoretical base for part two which is more practically and clinically orientated, covering specific examples of methods for clinical assessment and interventions to improve proprioception in the spine and the extremities.
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| 32. |
- Röijezon, Ulrik, et al.
(författare)
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The slow and fast components of postural sway in chronic neck pain
- 2011
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Ingår i: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 16:3, s. 273-278
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the slow and fast components of postural control in quiet stance in subjects with chronic neck pain, associations between postural sway and self-rated characteristics and to study the impact of anthropometrics on postural sway.Design: A single-blinded cross-sectional study including two separate data collections.Subjects: Sample 1: Persons with chronic non-specific neck pain (NS, n=24), whiplash associated disorders (WAD, n=21). Healthy subjects were controls (CON, n=21). Sample 2: Women only, 98 NS and 32 CON subjects.Methods: Subject performed a quiet stance test with eyes closed on a force platform while the center of pressure (CoP) trajectory was measured. Sample 1 was tested on a firm surface for 30 seconds, while sample 2 was tested on both firm and foam surfaces for 190 seconds. The CoP signal was decomposed into the slow and fast components and the magnitude of these signals were calculated. Anthropometrics were included as covariate in the analysis of group differences if correlated with postural sway variables. Group differences in the sway variables were evaluated, as well as association between postural sway and self-ratings of symptoms, functioning and kinesiophobia.Results: Increased magnitude of the slow sway component was found for both neck pain groups. Increasing age was associated with increased magnitude of the fast component. Surface conditions had no effect on group difference. For WAD, associations were found between the magnitude of the slow component and self-rated characteristics related to physical functioning, sensory alterations and psychosocial functioning. For NS, concurrent low back pain was associated with increased postural sway.Conclusion: Postural control can be altered in chronic neck pain. This effect was present only for the slow sway component, which implies aberration in sensory feedback or processing of sensory information. Associations between postural sway and self-rated characteristics in WAD support the clinical validity of postural control assessment in this group. Increased postural sway found in NS with concurrent low back pain suggests an important role of generalised spinal pain on postural control alterations.
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| 33. |
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| 34. |
- Samsson, Karin, 1978, et al.
(författare)
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Physiotherapy triage assessment of patients referred for orthopaedic consultation - Long-term follow-up of health-related quality of life, pain-related disability and sick leave
- 2015
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Ingår i: Manual Therapy. - : Elsevier BV. - 1356-689X. ; 20:1, s. 38-45
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The literature indicates that physiotherapy triage assessment can be efficient for patients referred for orthopaedic consultation, however long-term follow up of patient reported outcome measures are not available. Aim: To report a long-term evaluation of patient-reported health-related quality of life, pain-related disability, and sick leave after a physiotherapy triage assessment of patients referred for orthopaedic consultation compared with standard practice. Methods: Patients referred for orthopaedic consultation (n = 208) were randomised to physiotherapy triage assessment or standard practice. The randomised cohort was analysed on an intention-to-treat (ITT) basis. The patient reported outcome measures EuroQol VAS (self-reported health-state), EuroQol 5D-3L (EQ-5D) and Pain Disability Index (PDI) were assessed at baseline and after 3, 6 and 12 months. EQ VAS was analysed using a repeated measure ANOVA. PDI and EQ-5D were analysed using a marginal logistic regression model. Sick leave was analysed for the 12 months following consultation using a Mann-Whitney U-test. Results: The patients rated a significantly better health-state at 3 after physiotherapy triage assessment [mean difference -5.7 (95% CI -11.1; -0.2); p = 0.04]. There were no other statistically significant differences in perceived health-related quality of life or pain related disability between the groups at any of the follow-ups, or sick leave. Conclusion: This study reports that the long-term follow up of the patient related outcome measures health-related quality of life, pain-related disability and sick leave after physiotherapy triage assessment did not differ from standard practice, indicating the possible benefits of implementation of this model of care. (C) 2014 Elsevier Ltd. All rights reserved.
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| 35. |
- Sjölander, P, et al.
(författare)
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Sensorimotor disturbances in chronic neck pain - range of motion, peak velocity, smoothness of movement, and repositioning acuity.
- 2008
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Ingår i: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 13:2, s. 122-131
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this pilot study was to evaluate sensorimotor functions in patients with chronic neck pain with objective and quantitative methods. A group of 16 patients with chronic idiopathic neck pain of insidious onset or whiplash associated disorders (WAD) was compared to an equally sized group of healthy subjects. Kinematics were investigated during voluntary head rotations by measuring range of motion, variability of range of motion (ROM-Variability), peak velocity, and smoothness of movement (jerk index). Repositioning acuity after cervical rotations was evaluated by analysing constant and variable error (VE). In comparison to the healthy subjects, the patients showed significantly larger jerk index, ROM-Variability and VE. No statistically significant differences were found between insidious neck pain and WAD. It is concluded that jerky and irregular cervical movements and poor position sense acuity are characteristic sensorimotor symptoms in chronic neck pain. The observed individuality in sensorimotor disturbances emphasizes the importance of developing specific rehabilitation programs for specific dysfunctions, and of using objective and quantitative methods for evaluation of rehabilitation.
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| 36. |
- Treleaven, Julia, et al.
(författare)
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Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness : A prospective randomized study comparing three exercise programs
- 2016
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Ingår i: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 22, s. 122-130
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dizziness and unsteadiness are common symptoms following a whiplash injury. Objective: To compare the effect of 3 exercise programs on balance, dizziness, proprioception and pain in patients with chronic whiplash complaining of dizziness.Design: A sub-analysis of a randomized study.Methods: One hundred and forty subjects were randomized to either a physiotherapist-guided neck-specific exercise (NSE), physiotherapist-guided neck-specific exercise, with a behavioural approach (NSEB) or prescription of general physical activity (PPA) group. Pre intervention, 3, 6 and 12 months post baseline they completed the University of California Los Angeles Dizziness Questionnaire (UCLA-DQ), Visual Analogue Scales (VAS) for, dizziness at rest and during activity and physical measures (static and dynamic clinical balance tests and head repositioning accuracy (HRA)).Results: There were significant time by group differences with respect to dizziness during activity and UCLA-Q favouring the physiotherapy led neck specific exercise group with a behavioural approach. Within group analysis of changes over time also revealed significant changes in most variables apart from static balance. Conclusion: Between and within group comparisons suggest that physiotherapist led neck exercise groups including a behavioural approach had advantages in improving measures of dizziness compared with the general physical activity group, although many still complained of dizziness and balance impairment. Future studies should consider exercises specifically designed to address balance, dizziness and cervical proprioception in those with persistent whiplash.
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| 37. |
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| 38. |
- Wibault, Johanna, et al.
(författare)
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Using the cervical range of motion (CROM) device to assess head repositioning accuracy in individuals with cervical radiculopathy in comparison to neck- healthy individuals
- 2013
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Ingår i: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 18:5, s. 403-409
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Tidskriftsartikel (refereegranskat)abstract
- This study had two purposes: to compare head repositioning accuracy (HRA) using the cervical range of motion (CROM) device between individuals with cervical radiculopathy caused by disc disease (CDD; n = 71) and neck- healthy individuals (n = 173); and to evaluate the test–retest reliability of the CROM device in individuals with CDD, and criterion validity between the CROM device and a laser in neck-healthy individuals, with quantification of measurement errors. Parameters of reliability and validity were expressed with intra- class- correlation coefficients (ICCs), and measurement errors with standard error of measurement (SEM) and Bland Altman limits of agreement. HRA (Mdn, IQR) differed significantly between individuals with CDD and neck- healthy individuals after rotation right 2.7° (6.0), 1.7° (2.7); and rotation left 2.7° (3.3), 1.3° (2.7) (p < = 0.021); 31% of individuals with CDD were classified as having impairment in HRA. The test–retest reliability of the CROM device in individuals with CDD showed ICCs of 0.79- 0.85, and SEMs of 1.4°- 2°. The criterion validity between the CROM device and the laser in neck-healthy individuals showed ICCs of 0.43- 0.91 and SEMs of 0.8°- 1.3°. The results support the use of the CROM device for quantifying HRA impairment in individuals with CDD in clinical practice; however, criterion validity between the CROM device and a laser in neck-healthy individuals was questionable. HRA impairment in individuals with CDD may be important to consider during rehabilitation and evaluated with the criterion established with the CROM device in neck-healthy individuals.
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| 39. |
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| 40. |
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