Background: Walking sticks are used widely by people with arthritis, principally to reduce pain and improve stability and balance. However, they are frequently used incorrectly and can be dangerous if not properly maintained.Methods: Fifty randomly selected patients attending a rheumatology department were surveyed to determine whether their stick was appropriate to their needs and whether they were using it correctly.Results: Of the 50 patients, 38% used their stick incorrectly, usually in the wrong hand. Forty-four per cent of sticks were of the wrong length and 54% were in imperfect condition, the main defect being a worn ferrule. Among the minority (18 patients) who had received instruction and training, 72% used their stick correctly, while only 50% of those who had not been trained used their stick in the correct hand where applicable to their condition.Conclusions: These findings highlight the importance of educating patients on how to obtain greatest benefit from their walking stick and of the necessity to check it regularly for defects to ensure safe usage. (Source: Musculoskeletal Care)
Hypermobility and the hypermobility syndrome.
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Hypermobility and the hypermobility syndrome.
Man Ther. 2007 Nov;12(4):298-309
Authors: Simmonds JV, Keer RJ
Hypermobile joints by definition display a range of movement that is considered excessive, taking into consideration the age, gender and ethnic background of the individual. Joint hypermobility, when associated with symptoms is termed the joint hypermobility syndrome or hypermobility syndrome (JHS). JHS is an under recognised and poorly managed multi-systemic, hereditary connective tissue disorder, often resulting in a great deal of pain and suffering. The condition is more prevalent in females, with symptoms frequently commencing in childhood and continuing on into adult life. This paper provides an overview of JHS and suggested clinical guidelines for both the identification and management of the condition, based on research evidence and clinical experience. The Brighton Criteria and a simple 5-point questionnaire developed by Hakim and Grahame, are both valid tools that can be used clinically and for research to identify the condition. Management of JHS frequently includes; education and lifestyle advice, behaviour modification, manual therapy, taping and bracing, electrotherapy, exercise prescription, functional rehabilitation and collaborative working with a range of medical, health and fitness professionals. Progress is often slow and hampered by physical and emotional setbacks. However with a carefully considered management strategy, amelioration of symptoms and independent functional fitness can be achieved.
PMID: 17643337 [PubMed - indexed for MEDLINE]
(Source: Manual Therapy)
Advice for the management of low back pain: a systematic review of randomised controlled trials.
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Advice for the management of low back pain: a systematic review of randomised controlled trials.
Man Ther. 2007 Nov;12(4):310-27
Authors: Liddle SD, Gracey JH, Baxter GD
To synthesise the evidence relating to the effectiveness of advice, the relevance of its content and frequency, and to compare the advice being offered to acute, subacute and chronic low back pain (LBP) patients. A systematic review of Randomised Controlled Trials (RCTs) using advice, either alone or with another intervention. The QUOROM guidelines and the Cochrane Collaboration Back Review Group Guidelines for Systematic Reviews were followed throughout: methodological assessment identified RCTs of ‘high’ or ‘medium’ methodological quality, based on their inclusion of at least 50% of the specified internal validity criteria. Outcome measures were analysed based on five recommended core outcome domains; pain, work disability, back-specific function, generic health status and satisfaction with care. Relevant RCTs (n=56) were scored for methodological quality; 39 RCTs involving 7347 patients qualified for inclusion, based upon their methodological quality. Advice as an adjunct to exercise was most effective for improving pain, back-specific function and work disability in chronic LBP but, for acute LBP, was no more effective for improving these outcomes than simple advice to stay active. Advice as part of a back school was most effective for improving back-specific function in subacute LBP; these trials generally demonstrated long-term positive results. Advice as an adjunct to exercise was the most common form of treatment for acute and chronic LBP; advice as part of a back school was most commonly used for subacute LBP. Fifteen percent of acute LBP trials had a positive outcome, compared to 86% and 74% of subacute and chronic LBP trials respectively. A wide variety of outcome measures were used, making valid comparisons between treatment outcomes difficult. The advice provided to patients with LBP within RCTs varied considerably depending on symptom duration. The findings of this review have important implications for clinical practice, and for the design of further clinical trials in this area. Advice to stay active is sufficient for acute LBP; however, it appears that RCTs do not commonly reflect these recommendations. No conclusions could be drawn as to the content and frequency of advice that is most effective for subacute LBP, due to the limited number and poor quality of RCTs in this area: this review provides preliminary support for advice as part of a back school approach. Given that the effectiveness of treatment for subacute symptoms will directly influence the development of chronicity, these results would suggest that education and awareness of the causes and consequences of back pain may be a valuable treatment component for this patient subgroup. For chronic LBP there is strong evidence to support the use of advice to remain active in addition to specific advice relating to the most appropriate exercise, and/or functional activities to promote active self-management. More investigation is needed into the role of follow-up advice for chronic LBP patients.
PMID: 17395522 [PubMed - indexed for MEDLINE]
(Source: Manual Therapy)
Manual fixation versus locking during upper cervical segmental mobilization. part 2: an in vitro three-dimensional arthrokinematic analysis of manual axial rotation and lateral bending mobilization of the atlanto-axial joint.
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Manual fixation versus locking during upper cervical segmental mobilization. Part 2: an in vitro three-dimensional arthrokinematic analysis of manual axial rotation and lateral bending mobilization of the atlanto-axial joint.
Man Ther. 2007 Nov;12(4):353-62
Authors: Cattrysse E, Baeyens JP, Clarys JP, Van Roy P
BACKGROUND: Three-dimensional kinematic aspects of coupled motion during manual cervical mobilization have not previously been studied. Using an in vitro 3D-motion analysis method, the kinematic effects of two different segmental techniques for axial rotation and lateral bending mobilization of the upper cervical spine were investigated as a second part of the study (in part one, kinematic effects of flexion-extension mobilization have been investigated). METHODS: Axial rotation and lateral bending mobilization of the atlanto-occipital and atlanto-axial segments were analysed in vitro using an electromagnetic tracking device. Local reference frames were defined based on bony reference points that were registered using a 3D-digitizing stylus. Five embalmed and one fresh specimen were analysed. Segmental motion was registered simultaneously in the atlanto-occipital and the atlanto-axial joints during manual mobilization through the full range of axial rotation and lateral bending mobility. The 3D-kinematic aspects during regional mobilization were compared with those during segmental mobilization with manual fixation and during segmental mobilization using a locking technique. RESULTS: During both segmental axial rotation techniques of the atlanto-axial joint, a significant reduction of the coupled lateral bending and flexion-extension motion was observed. The locking technique also induced an increase in the main axial rotation component. During lateral bending mobilization of the atlanto-axial joint, the manual fixation technique reduced the effect on the coupled flexion-extension component significantly. INTERPRETATIONS: These results suggest that for manual segmental axial rotation and lateral bending mobilization of the upper cervical spine segmental manual fixation or locking may be preferred in different situations depending on the desired effects. This study brings additional information to the data provided by part 1 of this study on the 3D-arthrokinematic effects of flexion-extension mobilization.
PMID: 17189711 [PubMed - indexed for MEDLINE]
(Source: Manual Therapy)
Manual fixation versus locking during upper cervical segmental mobilization. part 1: an in vitro three-dimensional arthrokinematic analysis of manual flexion-extension mobilization of the atlanto-occipital joint.
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Manual fixation versus locking during upper cervical segmental mobilization. Part 1: an in vitro three-dimensional arthrokinematic analysis of manual flexion-extension mobilization of the atlanto-occipital joint.
Man Ther. 2007 Nov;12(4):342-52
Authors: Cattrysse E, Baeyens JP, Clarys JP, Van Roy P
BACKGROUND: Segmental manual spinal mobilization techniques are used to restrict the effects of interventions to one spinal segment. It is, however, not known whether it is possible to generate such a localization of effects. Segmental motion in the cervical spine was previously studied by applying pure moments of force on cadaver specimens. So far, no studies have been performed on the segmental three-dimensional (3D)-kinematic aspects of cervical manual flexion-extension mobilization. METHODS: 3D-aspects of manual flexion-extension motion in the atlanto-occipital and atlanto-axial segments were analysed in vitro using an electromagnetic tracking device. Segmental bony reference points were registered using a 3D-digitizing stylus to define bone-embedded coordinate frames. Six spinal specimens–five embalmed and one fresh–were analysed in this study. Segmental motions were analysed in the atlanto-occipital and the atlanto-axial joints during manual mobilization through the full range of flexion-extension mobility. The 3D-kinematic analysis of two different segmental mobilization techniques–manual fixation of C1 versus locking of the inferior cervical spine–is presented. RESULTS: A significant reduction (P<0.05) of the associated axial rotation and lateral bending motions was observed during the manual fixation technique without influencing the main motion component of flexion-extension. The locking technique did not significantly influence the movements on the mobilized atlanto-occipital segment, but reduced all movement components in the atlanto-axial joint. INTERPRETATIONS: The results suggest that, for manual segmental flexion-extension mobilization of the upper cervical spine, manual fixation or locking might be chosen in different situations according to the desired effects.
PMID: 17074528 [PubMed - indexed for MEDLINE]
(Source: Manual Therapy)
Acute neck pain: cervical spine range of motion and position sense prior to and after joint mobilization.
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Acute neck pain: cervical spine range of motion and position sense prior to and after joint mobilization.
Man Ther. 2007 Nov;12(4):390-4
Authors: McNair PJ, Portero P, Chiquet C, Mawston G, Lavaste F
Despite the relatively high prevalence of cervical spine pain, the efficacy of treatment procedures is limited. In the current study, range of motion and proprioception was assessed prior to and after specific cervical spine mobilisation techniques. A 44-year-old male office worker presented with a history of cervical pain of 1 day duration. He had woken with pain, stiffness and a loss of range of motion. Examination findings indicated pain to be at C5-6 on the left side. Measurement of maximal three-dimensional cervical motion was undertaken using a Zebris system. A position matching task tested the individual’s ability to actively reposition their head and neck. The treatment undertaken involved grade III down-slope mobilisations on the left side at C5-6 and C6-7 in supine lying. This technique was then progressed by placing the subject in an upright sitting position, and sustained natural apophyseal glides were performed at C6. Immediately following the treatment, the patient reported a considerable decrease in pain, less difficulty in movement and reduced stiffness. Motion analyses showed the most marked percentage improvements in range of motion after treatment were in flexion (55%), extension (35%), left rotation (56%), and left lateral flexion (22%). Ipsilateral lateral flexion with axial rotation was also notably improved following treatment. No change in proprioceptive ability was found following the treatment. The findings showed that the application of standardised specific mobilisation techniques led to substantial improvements in the range of motion and the restitution of normal coupled motion.
PMID: 17070722 [PubMed - indexed for MEDLINE]
(Source: Manual Therapy)
The use of surface electromyography as a tool in differentiating temporomandibular disorders from neck disorders.
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The use of surface electromyography as a tool in differentiating temporomandibular disorders from neck disorders.
Man Ther. 2007 Nov;12(4):372-9
Authors: Ferrario VF, Tartaglia GM, Luraghi FE, Sforza C
The aim of this study was to assess the electromyographic characteristics of the masticatory muscles (masseter and temporalis) of patients with either “temporomandibular joint disorder” or “neck pain”. Surface electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 38 patients aged 21-67 years who had either (a) temporomandibular joint disorder (24 patients); (b) “neck pain” (13 patients). Ninety-five control, healthy subjects were also examined. During clenching, standardized total muscle activities (electromyographic potentials over time) were significantly different in the three groups: 75 microV/microVs% in the temporomandibular joint disorder patients, 124 microV/microVs% in the neck pain patients, and 95 microV/microVs% in the control subjects (analysis of variance, P<0.001). The temporomandibular joint disorder patients also had significantly (P<0.001) more asymmetric muscle potentials (78%) than either neck pain patients (87%) or control subjects (92%). A linear discriminant function analysis allowed a significant separation between the two patient groups, with a single patient error of 18.2%. Surface electromyographic analysis during clenching allowed to differentiate between patients with a temporomandibular joint disorder and patients with a neck pain problem.
PMID: 16973402 [PubMed - indexed for MEDLINE]
(Source: Manual Therapy)
Challenging editorial wisdom and raising the “vbi” debate.
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Challenging editorial wisdom and raising the “VBI” debate.
Man Ther. 2007 Oct 29;
Authors: Taylor AJ, Kerry R
PMID: 17977781 [PubMed - as supplied by publisher]
(Source: Manual Therapy)
Facial Reflexology: A Self-Care Manual (Paperback) newly tagged “myofascial pain”
Facial Reflexology: A Self-Care Manual (Paperback)
By Marie-France Muller
41 used and new from $8.85
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First tagged “myofascial pain” by creativedawn
Customer tags: myofascial pain, self-help healing, massage, esthetics, healing, health maintenance, reflexology, facial ageing, skin care, trigger points, pain relief
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Recent Entries
- The Future of Computer-assisted Surgery (CAS) in Sports Medicine.
- Navigated Unicompartmental Knee Replacement.
- In Search of a Gold Standard of Knee Cartilage Defect Topographical Documentation: “Freehand” Arthroscopic Mapping and Introduction of New Concepts.
- Computer-assisted Double Level Osteotomy for Severe Genu Varum.
- Navigated Open Wedge High Tibial Osteotomy.
- Stability Evaluation of Single-Bundle and Double-Bundle Reconstruction During Navigated ACL Reconstruction.
- Computer-assisted Surgery for Anterior Cruciate Ligament Reconstruction.
- History of Computer-assisted Orthopedic Surgery (CAOS) in Sports Medicine.
- Editorial Comments.
- Osteopathic manipulation & its use for low back pain.