| 1. |
- Berglund, K. M., et al.
(author)
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Prevalence of pain and dysfunction in the cervical and thoracic spine in persons with and without lateral elbow pain
- 2008
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 13:4, s. 295-299
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Journal article (peer-reviewed)abstract
- The purpose of this study was to Survey the prevalence of pain in the cervical and thoracic spine (C2-T7) in persons with and Without lateral elbow pain. Thirty-one subjects with lateral elbow pain and 31 healthy controls participated in the study. The assessment comprised a pain drawing, provocation tests of the cervical and thoracic spine, a neurodynamic test of the radial nerve, and active cervical range of motion. Seventy percent of the subjects with lateral elbow pain indicated pain in the cervical or thoracic spine, as compared to 16% in the control group (p< ;0.001). The frequency of pain responses to the provocation tests of the cervical and thoracic spine was significantly higher (p< ;0.05) in the lateral elbow pain (LEP) group, as was the frequency of pain responses to the neurodynamic test of the radial nerve (p< ;0.001). Cervical flexion and extension range of motion was significantly lower (p< ;0.01) in the LEP group. The results indicate a relation between lateral elbow pain and pain in the vertebral spine (C2-T7). The cervical and thoracic spine should be included in the assessment of patients with lateral elbow pain.
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| 2. |
- Bjerkefors, Anna, et al.
(author)
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Deep and superficial abdominal muscle activation during trunk stabilization exercises with and without instruction to hollow.
- 2010
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 15:5, s. 502-7
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Journal article (peer-reviewed)abstract
- The deepest muscle of the human ventro-lateral abdominal wall, the Transversus Abdominis (TrA), has been ascribed a specific role in spine stabilization, which has motivated special core stability exercises and hollowing instruction to specifically involve this muscle. The purpose here was to evaluate the levels of activation of the TrA and the superficial Rectus Abdominis (RA) muscles during five common stabilization exercises performed in supine, bridging and four-point kneeling positions, with and without instruction to hollow, i.e. to continuously pull the lower part of the abdomen towards the spine. Nine habitually active women participated and muscle activity was recorded bilaterally from TrA and RA with intramuscular fine-wire electrodes introduced under the guidance of ultrasound. Results showed that subjects were able to selectively increase the activation of the TrA, isolated from the RA, with the specific instruction to hollow and that side differences in the amplitude of TrA activity, related to the asymmetry of the exercises, remained even after the instruction to hollow. The exercises investigated caused levels of TrA activation from 4 to 43% of that during maximal effort and can thus be used clinically to grade the load on the TrA when designing programs aiming at training that muscle.
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| 3. |
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| 4. |
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| 5. |
- Clark, Nicholas C., et al.
(author)
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Proprioception in Musculoskeletal Rehabilitation : Part 2: Clinical Assessment and Intervention
- 2015
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 20:3, s. 378-387
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Journal article (peer-reviewed)abstract
- IntroductionProprioception can be impaired in gradual-onset musculoskeletal pain disorders and following trauma. Understanding of the role of proprioception in sensorimotor dysfunction and methods for assessment and interventions is of vital importance in musculoskeletal rehabilitation. In Part 1 of this two-part Masterclass we presented a theory-based overview of the role of proprioception in sensorimotor control, causes and findings of altered proprioception in musculoskeletal conditions, and general principles of assessment and interventions.PurposeThe aim of this second part is to present specific methods for clinical assessment and interventions to improve proprioception in the spine and extremities.ImplicationsClinical assessment of proprioception can be performed using goniometers, inclinometers, laser-pointers, and pressure sensors. Manual therapy, taping, and bracing can immediately enhance proprioception and should be used to prepare for exercise interventions. Various types of exercise (active joint repositioning, force sense, co-ordination, muscle performance, balance/unstable surface, plyometric, and vibration training) should be employed for long-term enhancement of proprioception.
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| 6. |
- Dal Maso, Fabien, et al.
(author)
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Distance between rotator cuff footprints and the acromion, coracoacromial ligament, and coracoid process during dynamic arm elevations : Preliminary observations : Technical and measurement report
- 2016
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 25, s. 94-99
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Journal article (peer-reviewed)abstract
- Background The objective of this study was to provide preliminary measures of the distance between the supraspinatus, infraspinatus, and subscapularis footprints and the acromion, coracoacromial ligament, and coracoid process, during dynamic arm elevations through the entire range-of-motion.
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| 7. |
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| 8. |
- Ertzgaard, Per, et al.
(author)
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A new way of assessing arm function in activity using kinematic Exposure Variation Analysis and portable inertial sensors - A validity study
- 2016
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 21, s. 241-249
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Journal article (peer-reviewed)abstract
- Portable motion systems based on inertial motion sensors are promising methods, with the advantage compared to optoelectronic cameras of not being confined to a laboratory setting. A challenge is to develop relevant outcome measures for clinical use. The aim of this study was to characterize elbow and shoulder motion during functional tasks, using portable motion sensors and a modified Exposure Variation Analysis (EVA) and evaluate system accuracy with optoelectronic cameras. Ten healthy volunteers and one participant with sequel after stroke performed standardised functional arm tasks. Motion was registered simultaneously with a custom developed motion sensor system, including gyroscopes and accelerometers, and an optoelectronic camera system. The EVA was applied on elbow and shoulder joints, and angular and angular velocity EVA plots was calculated. The EVA showed characteristic patterns for each arm task in the healthy controls and a distinct difference between the affected and unaffected arm in the participant with sequel after stroke. The accuracy of the portable system was high with a systematic error ranging between -1.2 degrees and 2.0 degrees. The error was direction specific due to a drift component along the gravity vector. Portable motion sensor systems have high potential as clinical tools for evaluation of arm function. EVA effectively illustrates joint angle and joint angle velocity patterns that may capture deficiencies in arm function and movement quality. Next step will be to manage system drift by including magnetometers, to further develop clinically relevant outcome variables and apply this for relevant patient groups.
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| 9. |
- Fyhr, Charlotte, 1989-, et al.
(author)
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The effects of shoulder injury on kinaesthesia : A systematic review and meta-analysis
- 2015
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In: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 20:1, s. 28-37
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Research review (peer-reviewed)abstract
- The aim of this systematic review was to synthesize the evidence for changes for proprioceptive variables consisting of movement and position sense in participants with glenohumeral musculoskeletal disorders. Five databases were searched until 13th August 2013. Methodological quality was assessed and meta-analyses were performed for active and passive joint reposition sense (AJPS and PJPS) and movement sense, determined with threshold to detection of passive motion (TTDPM). The search yielded 17 studies, four of which were classified as having high methodological quality, seven as moderate and six as low quality. For participants with post-traumatic glenohumeral instability, pooled findings indicate moderate evidence for higher TTDPM for involved shoulders compared to control groups and the contralateral uninvolved side, indicating decreased movement sense. For AJPS and PJPS there was moderate to limited evidence for significant increased errors for involved compared to uninvovled shoulders, but not when compared to the control groups. Limited evidence was found for decreased AJPS acuity for patients with chronic rotator cuff pain and for patients with unspecified shoulder pain compared to healthy controls. Movement sense is most likely to be impaired after shoulder injury involving post-traumatic instability when compared to the contralateral shoulder and to controls, while deficits for AJPS and PJPS are more likely to be evident compared to the contralateral shoulder in participants with glenohumeral musculoskeletal disorders. (C) 2014 Elsevier Ltd. All rights reserved.
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| 10. |
- Gutke, Annelie, et al.
(author)
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The inter-rater reliability of a standardised classification system for pregnancy-related lumbopelvic pain
- 2010
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In: MANUAL THERAPY. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 15:1, s. 13-18
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Journal article (peer-reviewed)abstract
- Pregnancy-related lumbopelvic pain has varying clinical presentations and effects among subgroups. Different lumbopelvic pain subgroups require different specific management approaches which require the differentiation between lumbar and pelvic girdle pain (PGP). Thirty-one consecutive pregnant women with non-specific lumbopelvic pain were evaluated by two examiners and classified into lumbar pain, PGP, or combined pelvic girdle and lumbar pain. A standard history about different positions/activities of daily life such as bending, sitting, standing, walking, and lying, was followed by a standardised mechanical assessment of the lumbar spine (Mechanical Diagnosis and Therapy), including tests of repeated end-range movements to standing and lying, pelvic pain provocation tests (distraction test, posterior pelvic pain provocation test, Gaenslens test, compression test, and sacral thrust) a hip-rotation range-of-motion test, the active straight-leg-raising test, and a neurological examination. Agreement for the three syndromes (lumbar pain, PGP, or combined pelvic girdle and lumbar pain) was 87% (27/31), with a kappa coefficient of 0.79 (95% CI 0.60-0.98). It was possible to perform the classification procedure throughout pregnancy. There was substantial agreement between the two examiners for the classification of non-specific lUrnbopelvic pain into lumbar pain and PGP in pregnant women.
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| 11. |
- Holmgren, Ulrika, et al.
(author)
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Inter-examiner reliability of four static palpation tests used for assessing pelvic dysfunction
- 2008
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In: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 13:1, s. 50-56
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Journal article (peer-reviewed)abstract
- In muscle energy technique (MET), palpation is an important tool aimed at detecting asymmetry and selecting interventions. The aim of this study was to test the inter-examiner reliability of static palpation of the transverse processes of L5 (L5), sacral sulci (SS), inferior lateral angles of the sacrum (ILA), and the medial malleoli (MM) in a clinical setting. Twenty-five participants, aged 18–78 years, with low back pain and/or sacroiliac pain with or without radiating pain to the knee, were independently examined by two experienced physiotherapists. For L5, SS, ILA, the proportion of observed agreement was 40–44% and the κ coefficient 0.11 (SE=0.12) to 0.17 (SE=0.10). For MM, the observed agreement was 52% and the κ coefficient 0.28 (SE=0.15). Differences in palpation technique seem to be the most likely source of the low inter-examiner reliability in this study. For clinical practise, continued use of these tests as methods for detecting asymmetry and selecting interventions is of doubtful utility.
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| 12. |
- Johansson, Ann-Christin, et al.
(author)
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The Star Excursion Balance Test : Criterion and divergent validity on patients with femoral acetabular impingement
- 2016
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 26, s. 104-109
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Journal article (peer-reviewed)abstract
- Background A valid functional test, evaluating dynamic balance control, might be valuable clinic tool for evaluation of treatment outcome on patients with femoral acetabular impingement (FAI). Objectives The aim of this study was to evaluate criterion and divergent validity of the Star Excursion Balance Test (SEBT) on patients with bilateral FAI- changes, with unilateral clinical symptoms. Method In this cross sectional correlational and comparative study fifteen patients with bilateral FAI with unilateral symptoms and 15 controls participated. Criterion validity was determined by analysing agreement between SEBT and The Copenhagen Hip and Groin Outcome Score (HAGOS), The Hip Sports Activity Scale (HSAS), pain and leg strength on FAI patients. Divergent validity was determined by comparing SEBT on FAI patients with controls and by comparing SEBT on patient's symptomatic and asymptomatic hips. Results/findings SEBT posterolateral and posteromedial direction had high criterion validity in relation to HAGOS subscale pain intensity and symptoms (rs = 0.75, p = 0.001, respectively rs = 0.70, p = 0.004). Criterion validity was low in relation to HAGOS subscales sports, recreation, participation in physical activity and quality of life. SEBT in the posterolateral and posteromedial direction had good divergent validity (p = 0.006, respectively p = 0.001) and in the posterolateral direction SEBT could differentiate between patient's symptomatic and asymptomatic hip (p = 0.005). Conclusions SEBT in posterolateral and posteromedial direction has good criterion validity in relation to pain and other symptoms. In the posterolateral and posteromedial direction SEBT also had divergent validity. Clinically it is recommended to combine SEBT in the posterolateral and posteromedial direction with other measurements on patients with FAI.
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| 13. |
- Landén Ludvigsson, Maria, et al.
(author)
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Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders : A case-control ultrasound speckle tracking analysis
- 2016
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 21, s. 177-182
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Journal article (peer-reviewed)abstract
- Background: Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood.Objectives: This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction. Design and Methods: A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep).Results: The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01).Conclusion: This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius.
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| 14. |
- Laslett, Mark, et al.
(author)
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Diagnosis of Sacroiliac Joint Pain : Validity of individual provocation tests and composites of tests
- 2005
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 10:3, s. 207-218
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Journal article (peer-reviewed)abstract
- Previous research indicates that physical examination cannot diagnose sacroiliac joint (SIJ) pathology. Earlier studies have not reported sensitivities and specificities of composites of provocation tests known to have acceptable inter-examiner reliability. This study examined the diagnostic power of pain provocation SIJ tests singly and in various combinations, in relation to an accepted criterion standard. In a blinded criterion-related validity design, 48 patients were examined by physiotherapists using pain provocation SIJ tests and received an injection of local anaesthetic into the SIJ. The tests were evaluated singly and in various combinations (composites) for diagnostic power. All patients with a positive response to diagnostic injection reported pain with at least one SIJ test. Sensitivity and specificity for three or more of six positive SIJ tests were 94% and 78%, respectively. Receiver operator characteristic curves and areas under the curve were constructed for various composites. The greatest area under the curve for any two of the best four tests was 0.842. In conclusion, composites of provocation SIJ tests are of value in clinical diagnosis of symptomatic SIJ. Three or more out of six tests or any two of four selected tests have the best predictive power in relation to results of intra-articular anaesthetic block injections. When all six provocation tests do not provoke familiar pain, the SIJ can be ruled out as a source of current LBP. © 2005 Elsevier Ltd. All rights reserved.
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| 15. |
- Linder, Martin, et al.
(author)
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Laterality judgments in people with low back pain-a cross-sectional observational and test-retest reliability study
- 2016
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 21, s. 128-133
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Journal article (peer-reviewed)abstract
- BackgroundDisruption of cortical representation, or body schema, has been indicated as a factor in the persistence and recurrence of LBP. This has been observed through impaired laterality judgment ability and it has been suggested that this ability is affected in a spatial rather than anatomical manner.ObjectivesWe compared laterality judgment performance of foot and trunk movements between people with LBP with or without leg pain and healthy controls, and investigated associations between test performance and pain. We also assessed the test-retest reliability of the Recognise OnlineTM software when used in a clinical and a home setting.DesignCross-sectional observational and test-retest study.MethodsThirty individuals with LBP and 30 healthy controls performed judgment tests of foot and trunk laterality once supervised in a clinic and twice at home.ResultsNo statistically significant group differences were found. LBP intensity was negatively related to trunk laterality accuracy (p=0.019). Intraclass correlation values ranged from 0.51-0.91. Reaction time improved significantly between test occasions while accuracy did not.ConclusionsLaterality judgments were not impaired in subjects with LBP compared to controls. Further research may clarify the relationship between pain mechanisms in LBP and laterality judgment ability. Reliability values were mostly acceptable, with wide and low confidence intervals, suggesting test retest reliability for Recognise OnlineTM could be questioned in this trial. A significant learning effect was observed which should be considered in clinical and research application of the test.
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| 16. |
- Lorås, H., et al.
(author)
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Frame-difference analysis of video-recorded laser-beam projections
- 2015
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In: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 20:6, s. 879-883
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Journal article (peer-reviewed)abstract
- Laser beams have been applied in many human motion research contexts to project movements in specific motor tasks. Currently, there are no objective analysis methods for laser projection recordings. The principal aim of this study was to investigate the feasibility of quantifying motion by applying frame differencing and image analysis methods to video streams of laser beam projections. The laser projection was controlled by a mechanical device that produced pseudo random rotations. The 2D motion recorded by the video was compared with recordings obtained with an electromagnetic system where a sensor was fixed to the same device as the laser. High correlations in the time and frequency domains were found between the methods. We conclude that the proposed method can accurately quantify complex motion patterns from laser beam projections. (C) 2015 Elsevier Ltd. All rights reserved.
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| 17. |
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| 18. |
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| 19. |
- Nijs, Jo, et al.
(author)
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Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories.
- 2015
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In: Manual therapy. - : Elsevier BV. - 1532-2769 .- 1356-689X. ; 20:1, s. 216-220
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Journal article (peer-reviewed)abstract
- Even though nociceptive pathology has often long subsided, the brain of patients with chronic musculoskeletal pain has typically acquired a protective (movement-related) pain memory. Exercise therapy for patients with chronic musculoskeletal pain is often hampered by such pain memories. Here the authors explain how musculoskeletal therapists can alter pain memories in patients with chronic musculoskeletal pain, by integrating pain neuroscience education with exercise interventions. The latter includes applying graded exposure invivo principles during exercise therapy, for targeting the brain circuitries orchestrated by the amygdala (the memory of fear centre in the brain). Before initiating exercise therapy, a preparatory phase of intensive pain neuroscience education is required. Next, exercise therapy can address movement-related pain memories by applying the 'exposure without danger' principle. By addressing patients' perceptions about exercises, therapists should try to decrease the anticipated danger (threat level) of the exercises by challenging the nature of, and reasoning behind their fears, assuring the safety of the exercises, and increasing confidence in a successful accomplishment of the exercise. This way, exercise therapy accounts for the current understanding of pain neuroscience, including the mechanisms of central sensitization.
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| 20. |
- Peolsson, Anneli, et al.
(author)
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A tissue velocity ultrasound imaging investigation of the dorsal neck muscles during resisted isometric extension
- 2010
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In: MANUAL THERAPY. - : Elsevier Science B.V., Amsterdam. - 1356-689X .- 1532-2769. ; 15:6, s. 567-573
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Journal article (peer-reviewed)abstract
- Persons with neck pain exhibit altered patterns of muscle patterning, but limited investigations have been carried out on these alterations or muscle patterning in healthy volunteers. This study investigated the tissue motion of the dorsal neck muscles at the C4 segmental level in 15 healthy subjects during manually resisted head extension. Doppler-based tissue velocity ultrasound imaging (TVI) was used to detect regional tissue deformation, providing indirect evidence of inter-muscular movement patterning. The deep muscles, multifidus and semispinalis, had different muscular movement patterning than the superficial muscles, especially the trapezius muscle. The semispinalis cervicis (SSCerv) was the first deformed upon exercise initiation, followed by multifidus and semispinalis capitis (SSCap). The semispinalis muscles, notably capitis, exhibited a high rate of deformation during the exercise. The trapezius muscle exhibited the least and lowest deformation rate. In conclusion, TVI provided detailed information on regional tissue activity and muscle movement patterning among the dorsal neck muscles. In future studies, data from patients with neck disorders will have to be matched to data from healthy volunteers in a variety of situations and activities.
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| 21. |
- Peolsson, A., et al.
(author)
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Altered mechanical deformation of the trapezius and multifidus muscles registered with ultrasonography in women with chronic whiplash-associated disorders
- 2016
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 25, s. e58-
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Journal article (peer-reviewed)abstract
- Background: The deformation and deformation rate of the dorsal neck muscle layers in individuals with chronic whiplash associated disorders (WAD) is rarely evaluated, and the mechanical behaviour during dynamic neck extension remains to be investigated.Purpose: To compare the deformation and deformation rate of dorsal neck muscles (trapezius, splenius capitis, semispinalis capitis and cervicis, and multifidus) in women with chronic WAD compared with healthy controls during a dynamic resisted neck extension.Methods: Nine women with chronic grade 2 and 3 WAD (mean age 38 years, standard deviation [SD] 11.3) and nine age- and gender-matched healthy controls (mean age 38 years, SD 11.6) participated in this cross-sectional, controlled study. Ultrasonography movies and post-process speckle tracking were used to investigate real-time mechanical dorsal neck muscle behaviour at the C4 segmental level during a low-loaded dynamic standardized neck extension. Deformation (longitudinal shortening and elongation) and deformation rate (speed of deformation) were calculated during the entire exercise sequence.Results: There were significant differences between the WAD and control groups in total deformation for the trapezius (p < 0.04) and multifidus (p < 0.03). The WAD group showed more shortening in the deformation pattern during the concentric contraction phase in the trapezius muscle, and during both the concentric and eccentric phase in the multifidus muscle compared to healthy controls. There were no other significant differences between groups either in deformation or deformation rate.Conclusion: There were altered mechanical deformations of the trapezius and multifidus muscles, with preliminary evidence for overuse in individuals with WAD compared to healthy controls. The findings must be interpreted with caution due to the small sample size.Implications: An ultrasound investigation made it possible to non-invasively capture multi-layered muscles in real time, adding new information of value for clinical practice of patients with WAD, which may impact future rehabilitation.
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| 22. |
- Peolsson, Anneli, et al.
(author)
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Does posture of the cervical spine influence dorsal neck muscle activity when lifting?
- 2014
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In: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 19:1, s. 32-36
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Journal article (peer-reviewed)abstract
- Previous studies have shown that postural orientations of the neck, such as flexed or forward head postures, are associated with heightened activity of the dorsal neck muscles. While these studies describe the impact of variations in neck posture alone, there is scant literature regarding the effect of neck posture on muscle activity when combined with upper limb activities such as lifting. The purpose of this study was to evaluate the effect of three different neck postures on the activity of the different layers of the dorsal neck muscles during a lifting task. Ultrasound measurements of dorsal neck muscle deformation were compared over two time points (rest, during lift) during a lifting task performed in three different neck postural conditions (neutral, flexed and forward head posture) in 21 healthy subjects. Data were analysed by post-process speckle tracking analysis. Results demonstrated significantly greater muscle deformation induced by flexed and forward head postures, compared to the neutral posture, for all dorsal neck muscles at rest (p < 0.05). Significant condition by time interactions associated with the lift was observed for four out of the five dorsal muscles (p < 0.02). These findings demonstrate that posture of the cervical spine influenced the level of muscle deformation not only at rest, but also when lifting. The findings of the study suggest that neck posture should be considered during the evaluation or design of lifting activities as it may contribute to excessive demands on dorsal neck muscles with potential detrimental consequences. (C) 2013 Elsevier Ltd. All rights reserved.
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| 23. |
- Peolsson, Anneli, et al.
(author)
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Ultrasound imaging with speckle tracking of cervical muscle deformation and deformation rate : isometric contraction of patients after anterior cervical decompression and fusion for cervical disc disease and controls
- 2012
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 17:6, s. 519-525
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Journal article (peer-reviewed)abstract
- There is currently a lack of information regarding neck muscle activity during specific exercises. The purpose of the present study was to investigate deformation and deformation rate in different layers of dorsal and ventral neck muscles during isometric neck muscle contraction in individuals after anterior cervical decompression and fusion and in healthy controls. This study included 10 individuals (mean age 60 years; SD 7.1) with a verified, long-standing neck disorder and 10 healthy, age- and sex-matched controls. Ultrasonography and post-process speckle tracking analysis was used to investigate the degree and the rate of neck muscles motions at the C4 segmental level during sub-maximal, isometric resistance of the head in a seated position. None of the analyses performed showed significant differences between groups (p > 0.05). In the dorsal muscles, both groups exhibited a higher deformation rate in the multifidus than in the trapezius, splenius, and semispinalis capitis (p ≤ 0.01). In the neck disorder group, the multifidus also showed a higher deformation rate compared to the semispinalis cervicis (p = 0.02). In the ventral muscles of patients with neck disorders, the longus colli had a higher deformation rate than the sternocleidomastoid (p = 0.02). Among the healthy controls, the multifidus showed a higher degree of deformation (p = 0.02) than the trapezius. In conclusion, our results showed no significant differences between the two groups in mechanical neck muscle activation. Larger studies with different exercises, preferably with a standardized measure of resistance, are needed to investigate whether patients and controls show differences in deformation and deformation rates in neck muscles.
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| 24. |
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| 25. |
- Peterson, Gunnel, et al.
(author)
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Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls : A case-control ultrasound study
- 2015
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In: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 20:2, s. 319-327
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Journal article (peer-reviewed)abstract
- Previous studies have shown altered neck muscle function in individuals with chronic whiplash associated disorder (WAD). However, we lack real-time investigations with non-invasive methods that can distinguish between the different ventral neck muscle layers. This study investigated deformations and deformation rates in the sternocleidomastoid (SCM), longus capitis (Lcap), and longus colli (Lco) muscles with real-time ultrasonography. Twenty-six individuals with WAD were compared with 26 controls, matched for age and sex. Ultrasound imaging of the SCM, Lcap, and Lco were recorded during 10 repetitive arm elevations. The first and tenth arm elevations were post-process analyzed with speckle tracking. There were few significant differences in the deformations or deformation rates in the SCM, Lcap, and Lco between the WAD and control group. In controls, deformations and deformation rates showed linear positive relationships between SCM/Lcap, SCM/Lco, and Lcap/Lco which increased from the first arm elevation (R-2 = 0.14-0.70); to the tenth arm elevation (R-2 = 0.51-0.71). The WAD group showed similar or weaker linear relationship (R-2 < 0.19) during the tenth compared to the first (R-2 < 0.44) arm elevation except for deformations in Lcap/Lco (R-2 = 0.13-0.57). This result indicated that deformations and deformation rates in one muscle were correlated by similar deformations and deformation rates in other neck muscles in the control group, but this interplay between muscles was not found in the WAD group. (C) 2014 Elsevier Ltd. All rights reserved.
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| 26. |
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| 27. |
- Rudolfsson, Thomas, et al.
(author)
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Range of motion in the upper and lower cervical spine in people with chronic neck pain
- 2012
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In: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 17:1, s. 53-59
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Journal article (peer-reviewed)abstract
- Reduced cervical range of motion (ROM) is a common finding in people with neck pain. With few exceptions, only the angle between head and thorax has been measured. Our aim was to use an extended model to compare active cervical flexion and extension, separate for upper and lower cervical levels, between people with chronic non-traumatic neck pain and controls. We also investigated associations between ROM measures, symptoms and self-rated functioning. In this cross-sectional study, 102 subjects with neck pain and 33 healthy controls participated. An electromagnetic tracker system was used to measure the kinematics to construct a three-segment model including the thorax, cervical spine and head. Neutral flexion/extension were defined at subjects’ self-selected seated posture. We found that in the neck pain group, extension in the upper cervical levels and predominately flexion for the lower levels were reduced. The ratio between ROM for the upper and lower levels was altered in the neck pain group so that the lower levels contributed to a lesser extent to the total sagittal ROM compared to controls. These findings could not be explained by a greater forward head posture but must have other origins. For the neck pain group, ROM measures were weakly associated to pain and self-rated functioning. Altogether, this implies that using a three-segment model for assessment of ROM can be a valuable improvement for characterisation of patients and treatment evaluation.
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| 28. |
- Röijezon, Ulrik, et al.
(author)
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Proprioception in Musculoskeletal Rehabilitation : Part 1: Basic Science and Principles of Assessment and Clinical Interventions
- 2015
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 20:3, s. 368-377
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Journal article (peer-reviewed)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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| 29. |
- Röijezon, Ulrik, et al.
(author)
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The slow and fast components of postural sway in chronic neck pain
- 2011
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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 16:3, s. 273-278
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Journal article (peer-reviewed)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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| 30. |
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| 31. |
- Sjölander, P, et al.
(author)
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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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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 13:2, s. 122-131
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Journal article (peer-reviewed)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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| 32. |
- Treleaven, Julia, et al.
(author)
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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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In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 22, s. 122-130
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Journal article (peer-reviewed)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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| 33. |
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| 34. |
- Wibault, Johanna, et al.
(author)
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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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In: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 18:5, s. 403-409
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Journal article (peer-reviewed)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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| 35. |
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| 36. |
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| 37. |
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| 38. |
- Johansson, Kajsa, et al.
(author)
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Intra- and interexaminer reliability of four manual shoulder maneuvers used to identify subacromial pain
- 2009
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In: MANUAL THERAPY. - : Elsevier BV. - 1356-689X. ; 14:2, s. 231-239
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Journal article (peer-reviewed)abstract
- Shoulder pain is a diagnostic challenge and the physical clinical examination of the shoulder is crucial. It is important that the diagnostic tests used are valid as well as reliable. The objective of the study was to assess intra- and interexaminer reliability for four Manual Shoulder maneuvers; the Neer impingement sign, the Hawkins-Kennedy impingement test, the Patte maneuver, the Jobe supraspinatus test. These maneuvers are frequently used in clinical practice to examine patients with shoulder complaints in which subacromial pain is highly suspected. Thirty-three participants with shoulder pain were included consecutively. Within a week from inclusion, the four maneuvers were performed by a physiotherapist. The procedure was standardized in order to increase reproducibility. After a week, the maneuvers were performed again by the same physical therapist (test-retest) and by another physical therapist (test for interexaminer reliability). All four maneuvers have an almost perfect agreement (Kappa coefficients 0.91-1.00), if performed with suggested standardizations. Neer impingement sign, Hawkins-Kennedy impingement test, Patte maneuver as well as Jobe supraspinatus test, are highly reproducible and therefore reliable to use in clinical practice to identify patients with subacromial pain with an impingement phenomenon, but the maneuvers are limited as structural discriminators.
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| 39. |
- Malmström, Eva-Maj, et al.
(author)
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Influence of prolonged unilateral cervical muscle contraction on head repositioning - Decreased overshoot after a 5-min static muscle contraction task.
- 2010
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In: Manual Therapy. - : Elsevier BV. - 1356-689X. ; 15, s. 229-234
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Journal article (peer-reviewed)abstract
- The ability to reproduce a specified head-on-trunk position can be an indirect test of cervical proprioception. This ability is affected in subjects with neck pain, but it is unclear whether and how much pain or continuous muscle contraction factors contribute to this effect. We studied the influence of a static unilateral neck muscle contraction task (5 min of lateral flexion at 30% of maximal voluntary contraction) on head repositioning ability in 20 subjects (10 women, 10 men; mean age 37 years) with healthy necks. Head repositioning ability was tested in the horizontal plane with 30 degrees target and neutral head position tests; head position was recorded by Zebris((R)), an ultrasound-based motion analyser. Head repositioning ability was analysed for accuracy (mean of signed differences between introduced and reproduced positions) and precision (standard deviation of the differences). Accuracy of head repositioning ability increased significantly after the muscle contraction task, as the normal overshoot was reduced. An average overshoot of 7.1 degrees decreased to 4.6 degrees after the muscle contraction task for the 30 degrees target and from 2.2 degrees to 1.4 degrees for neutral head position. The increased accuracy was most pronounced for movements directed towards the activated side. Hence, prolonged unilateral neck muscle contraction may increase the sensitivity of cervical proprioceptors.
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| 40. |
- Samsson, Karin, 1978, et al.
(author)
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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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In: Manual Therapy. - : Elsevier BV. - 1356-689X. ; 20:1, s. 38-45
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Journal article (peer-reviewed)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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