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Sample records for average neck flexion

  1. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions

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    Sejdić Ervin

    2009-10-01

    Full Text Available Abstract Background A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. Methodology To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing chin tuck swallows. Three yellow markers geometrically arranged on a pair of dark visors were used as tracking cues. Results The algorithm was applied to data collected from 178 healthy participants during neutral and chin tuck position swallows. Our analyses revealed no major influences of body mass index and age on neck flexion angles during swallowing, while gender influenced the average neck angle only during wet swallows in the neutral position. Chin tuck angles seem to be independent of anthropometry and gender in healthy adults, but deserve further study in pathological populations. Conclusion The proposed neck flexion angle extraction algorithm may be useful in future studies where strict participant compliance to swallowing task protocol can be assured.

  2. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions

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    Sejdić Ervin; Hung Delbert; Steele Catriona M; Chau Tom

    2009-01-01

    Abstract Background A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. Methodology To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing c...

  3. Femoral neck radiography: effect of flexion on visualization

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    Garry, S.C. [Univ. of Alberta, Dept. of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada); Jhangri, G.S. [Univ. of Alberta, Dept. Public Health Sciences, Edmonton, Alberta (Canada); Lambert, R.G.W. [Univ. of Alberta, Dept.of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada)]. E-mail: rglamber@cha.ab.ca

    2005-06-15

    To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15{sup o} and flexion in 10{sup o} increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0{sup o} and 20{sup o} flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation ({rho} < 0.05). Visualization of the femoral neck in the extended position progressively deteriorated from 15{sup o} internal rotation to 30{sup o} external rotation ({rho} <0.01). However, when 20{sup o} flexion was applied to bones in external rotation, visualization significantly improved at 15{sup o} ({rho} <0.05) and 30{sup o} ({rho} <0.01). Flexion of the externally rotated femur can bring the femoral neck into horizontal alignment, and a relatively small amount (20{sup o}) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

  4. Changes in saccadic reaction time while maintaining neck flexion in men and women.

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    Fujiwara, K; Kunita, K; Toyama, H

    2000-03-01

    We investigated changes in saccadic reaction time in relation to the degree of increase in activity of neck extensor muscles when neck flexion occurred, and assessed the reliability of the measurements. Saccadic reaction time was measured firstly, during neck flexion angles set at 5 degrees increments from 0 degrees (resting position) to 25 degrees, with the chin either resting on a stand or not, and secondly, during shoulder girdle elevator muscles providing a relative muscle force of 30%, with the neck flexion angle maintained at 0 degrees by having the subjects rest their chins on a stand. Saccadic reaction time was evaluated by the latency to the beginning of eye movement toward the lateral target, which was moved at random intervals in 20 degrees amplitude jumps. Muscle activity in the trapezius muscle was evaluated using the mean amplitude of electromyogram recordings. Very high coefficients of reliability in muscle activity and saccadic reaction time were observed between the two sets of tests at 1-h intervals and also among the three trials with a 1-min rest. When their necks were flexed and the subjects rested their chins on a stand, muscle activity increased slightly in accordance with the enlargement of this angle, with no significant change in saccadic reaction time. With the chin not resting on the stand, muscle activity increased gradually, while the saccadic reaction time decreased to that obtained at an average neck flexion angle of 20 degrees. However, the angle where the shortest reaction time was obtained showed considerable individual variation (5-25 degrees ). Activity in the trapezius muscle at a 20 degrees neck flexion angle, with the chin not resting on the stand, was far less than that for 30% maximal voluntary contraction in shoulder girdle elevator muscles. Nevertheless, the saccadic reaction times were roughly equivalent under the two different sets of conditions. No sex differences were observed in terms of saccadic reaction time under

  5. Effects of neck pain on reaching overhead and reading: a case–control study of long and short neck flexion

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    Constand, Marissa K; MacDermid, Joy C

    2013-01-01

    Background Reaching overhead and reading are tasks that many individuals encounter daily. The level of difficulty of these tasks increases if an individual has neck pain. This study determined the neck movement patterns during these two tasks by comparing neck flexion of individuals with and without neck pain. Methods This case control study used the portable video technology, Dartfish ProSuite 5.5 Video Software, to analyse neck flexion movement patterns. Healthy individuals and individuals ...

  6. Kinematic analysis of the lower cervical spine in the protracted and retracted neck flexion positions

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    Park, So Hyun

    2015-01-01

    [Purpose] The aim of this study was to analyze lower cervical spine kinematics in protracted and retracted neck flexion positions in healthy people. [Subjects and Methods] The craniovertebral angle (CVA) and intervertebral body angles of the lower cervical spine of 10 healthy individuals were analyzed using fluoroscopy in a neutral sitting with the head in the neutral (N), protracted (Pro), and retracted (Ret) positions and with the neck in full flexion with the head in the neutral (N-fx), pr...

  7. Changes in saccadic reaction time while maintaining neck flexion in the elderly.

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    Kunita, Kenji; Fujiwara, Katsuo

    2006-05-01

    We investigated changes in saccadic reaction time during maintenance of neck flexion in elderly individuals. Subjects comprised 49 volunteers, including 19 young adults and 30 elderly adults. Elderly subjects were separated into 2 groups (trained group: n=18; untrained group: n=12) based on responses to a questionnaire concerning activities of daily living. Saccadic reaction time was measured at angles of neck flexion of 0 degrees (resting position), 10 degrees and 20 degrees , with the chin either resting on a stand (chin-on) or not (chin-off). Reaction time was determined as the latency to the beginning of eye movement toward the lateral target, which was moved at random intervals in jumps of 20 degrees amplitude. In the chin-on posture, the angle of neck flexion had no significant effect on reaction time in any group. In the chin-off posture, the flexion angle significantly affected reaction time in both young and elderly trained groups. Significant shortenings of the reaction time were obtained at 10 degrees and 20 degrees neck flexion in the young group, and at 20 degrees neck flexion in the elderly trained group. No significant shortening of reaction time was noted in the elderly untrained group. These findings suggest that neural function associated with shortening of saccadic reaction time due to neck extensor activity decreases with age, and the decrements become more marked with inactivity in daily life.

  8. Effect of neck flexion restriction on sternocleidomastoid and abdominal muscle activity during curl-up exercises.

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    Lee, Dong-Kyu; Moon, Dong-Chul; Hong, Ki-Hoon

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effect of neck flexion restriction on sternocleidomastoid (SCM), rectus abdominis (RA), and external oblique (EO) muscle activity during a traditional curl-up exercise and a curl-up with neck flexion restriction. [Subjects] In total, 13 healthy male subjects volunteered for this study. [Methods] All subjects performed a traditional curl-up exercise and a curl-up exercise in which neck flexion was restricted by the subject's hand. Surface electromyography (EMG) signals were recorded from the SCM, RA, and EO during the curl-up. [Results] There was significantly lower EMG activity of the SCM during the curl-up exercise with neck flexion restriction compared to the traditional curl-up exercise. Conversely, the activity of the RA and EO muscles was significantly higher in the curl-up exercise with neck flexion restriction than in the traditional curl-up exercise. [Conclusion] Neck flexion restriction is recommended to prevent excessive activation of superficial cervical flexors during the curl-up exercise.

  9. Extension and flexion in the upper cervical spine in neck pain patients.

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    Ernst, Markus J; Crawford, Rebecca J; Schelldorfer, Sarah; Rausch-Osthoff, Anne-Kathrin; Barbero, Marco; Kool, Jan; Bauer, Christoph M

    2015-08-01

    Neck pain is a common problem in the general population with high risk of ongoing complaints or relapses. Range of motion (ROM) assessment is scientifically established in the clinical process of diagnosis, prognosis and outcome evaluation in neck pain. Anatomically, the cervical spine (CS) has been considered in two regions, the upper and lower CS. Disorders like cervicogenic headache have been clinically associated with dysfunctions of the upper CS (UCS), yet ROM tests and measurements are typically conducted on the whole CS. A cross-sectional study assessing 19 subjects with non-specific neck pain was undertaken to examine UCS extension-flexion ROM in relation to self-reported disability and pain (via the Neck Disability Index (NDI)). Two measurement devices (goniometer and electromagnetic tracking) were employed and compared. Correlations between ROM and the NDI were stronger for the UCS compared to the CS, with the strongest correlation between UCS flexion and the NDI-headache (r = -0.62). Correlations between UCS and CS ROM were fair to moderate, with the strongest correlation between UCS flexion and CS extension ROM (r = -0.49). UCS flexion restriction is related to headache frequency and intensity. Consistency and agreement between both measurement systems and for all tests was high. The results demonstrate that separate UCS ROM assessments for extension and flexion are useful in patients with neck pain.

  10. How does the neck flexion affect the cervical MRI features of Hirayama disease?

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    Hou, Chao; Han, Hongbin; Yang, Xiaohong; Xu, Xiaojuan; Gao, Hui; Fan, Dongsheng; Fu, Yu; Sun, Yu; Liu, Bo

    2012-10-01

    Although flexion cervical MRI has been recommended for the diagnosis of Hirayama disease (HD), no study focused on the MR features at different neck flexion angles. Moreover, no uniform flexion angle has been confirmed in clinical practice. The purpose of this study is to quantitatively investigate the MRI typical signs of HD patients in different neck flexion degree and gives a suggestion to the MR scanning. Cervical MRI in neutral and different flexion positions (cervical flexion angle 20°, 25°, 30°, 35°, and 40°) were performed in 45 HD patients. Three MRI features including anterior shifting of the posterior wall of the cervical dural canal (ASD), widening of cervical epidural space, and epidural flow voids (EFV) at each flexed position were summarized. To evaluate ASD quantitatively, the widest cervical epidural space with the maximum sagittal diameters (d) and cervical canal sagittal diameter (D) at the same level were measured. The d/D values at different angles were calculated and compared. ASD was demonstrated in 34 out of 45 cases (75.6%) at 20° and in all cases (100%) at other 4 angles (χ (2) = 25.728, P flexion angles have effects on ASD, widening of cervical epidural space and EFV. 25° is recommended as the least effective diagnostic flexion angle for MRI diagnosis of HD, and 35° may be the best one.

  11. Cervical spine segmental vertebral motion in healthy volunteers feigning restriction of neck flexion and extension.

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    Puglisi, Filadelfio; Strimpakos, Nikolaos; Papathanasiou, Matthildi; Kapreli, Eleni; Bonelli, Aurelio; Sgambetterra, Sergio; Ferrari, Robert

    2007-09-01

    The purpose of this study was to obtain comparative data concerning the percentage contribution of segmental cervical vertebral motion to the cervical range of motion (ROM) in healthy volunteers under two conditions: (1) normal, voluntary neck flexion and extension and (2) feigned restriction of neck flexion and extension. Each healthy subject's angular motion over forward cervical flexion and extension was measured first by X-ray analysis during normal, voluntary motion. Then the subjects were asked to pretend that they had a 50% restricted neck range due to pain or stiffness and thus to move in both flexion and extension only as far as about 50% of their normal range. A total of 26 healthy subjects (ten males and sixteen females, age 28.7+/-7.7 years) participated. The total angular motion from C2 to C7 was normal in the unrestricted condition and was significantly reduced in the feigned restriction condition (prange. A greater percentage contribution was made by C2-C3 and C3-C4 than under normal conditions (Prange (pcervical segments and less contribution to the angular rotation by the lowest cervical segment. Feigners of restricted neck range thus produce a pattern different from nonfeigning subjects.

  12. Flexion-relaxation ratio in computer workers with and without chronic neck pain.

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    Pinheiro, Carina Ferreira; dos Santos, Marina Foresti; Chaves, Thais Cristina

    2016-02-01

    This study evaluated the flexion-relaxation phenomenon (FRP) and flexion-relaxation ratios (FR-ratios) using surface electromyography (sEMG) of the cervical extensor muscles of computer workers with and without chronic neck pain, as well as of healthy subjects who were not computer users. This study comprised 60 subjects 20-45years of age, of which 20 were computer workers with chronic neck pain (CPG), 20 were computer workers without neck pain (NPG), and 20 were control individuals who do not use computers for work and use them less than 4h/day for other purposes (CG). FRP and FR-ratios were analyzed using sEMG of the cervical extensors. Analysis of FR-ratios showed smaller values in the semispinalis capitis muscles of the two groups of workers compared to the control group. The reference FR-ratio (flexion relaxation ratio [FRR], defined as the maximum activity in 1s of the re-extension/full flexion sEMG activity) was significantly higher in the computer workers with neck pain compared to the CG (CPG: 3.10, 95% confidence interval [CI95%] 2.50-3.70; NPG: 2.33, CI95% 1.93-2.74; CG: 1.99, CI95% 1.81-2.17; p<0.001). The FR-ratios and FRR of sEMG in this study suggested that computer use could increase recruitment of the semispinalis capitis during neck extension (concentric and eccentric phases), which could explain our results. These results also suggest that the FR-ratios of the semispinalis may be a potential functional predictive neuromuscular marker of asymptomatic neck musculoskeletal disorders since even asymptomatic computer workers showed altered values. On the other hand, the FRR values of the semispinalis capitis demonstrated a good discriminative ability to detect neck pain, and such results suggested that each FR-ratio could have a different application.

  13. Cervical flexion-relaxation response to neck muscle fatigue in males and females.

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    Nimbarte, Ashish D; Zreiqat, Majed M; Chowdhury, Suman Kanti

    2014-12-01

    In this study the effect of muscle fatigue on the cervical spine flexion-relaxation response was studied. Twenty healthy participants (10 males and 10 females) were recruited for data collection. The Sorenson protocol was utilized to induce neck muscle fatigue. Surface electromyography and optical motion capture systems were used to measure neck muscle activation and head-neck posture, respectively. A post-fatigue reduction in the Flexion-Relaxation Ratio (FRR) and higher FRR for females compared to males were observed. A post-fatigue decrease was also observed in the onset and offset angles resulting in an expansion of the myoelectric silence period. Gender had no effect on the onset and offset angles of the silence period. Post-fatigue shift in the onset and offset angles and the expansion of the silence period indicate an increased contribution by the passive viscoelastic tissues in stabilizing the cervical spine under fatigued condition.

  14. Effects of neck flexion on contingent negative variation and anticipatory postural control during arm movement while standing.

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    Fujiwara, Katsuo; Tomita, Hidehito; Maeda, Kaoru; Kunita, Kenji

    2009-02-01

    We investigated the effects of neck flexion on contingent negative variation (CNV) and anticipatory postural control using an arm flexion task in standing. CNV was adopted to evaluate the state of activation of brain areas related to anticipatory postural control. Subjects were required to flex the arms in response to a sound stimulus preceded by a warning sound stimulus. Two different intervals (2.0 and 3.5s) between these two stimuli were used in neck position in quiet standing (neck resting) and neck position at 80% angle of maximal neck flexion. The mean amplitude of CNV 100-ms before the response stimulus, recorded from a Cz electrode, was calculated. Onset timing of activation of the postural muscles (lumbar paraspinal, biceps femoris and gastrocnemius) with respect to the anterior deltoid was analyzed. Reaction time at the anterior deltoid was significantly shorter in the 2.0s period than in the 3.5s period, and in the neck flexion than in the neck resting in both periods. In the 2.0s, but not in the 3.5s period, neck flexion resulted in an increased CNV amplitude and an increased duration of preceding activation of the postural muscles, and the correlation between these increases was significant.

  15. Effects of neck flexion on discriminative and cognitive processing in anticipatory postural control during bilateral arm movement.

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    Fujiwara, Katsuo; Yaguchi, Chie; Kunita, Kenji; Mammadova, Aida

    2012-06-19

    We investigated the effect of neck flexion on discriminative and cognitive processing in postural control during bilateral arm movement while standing, using event-related potential (ERP) and electromyogram. Fourteen healthy subjects flexed their arms to the target stimuli with a 20% probability in neck resting and flexion positions. Amplitude and latency of N2 and P3, anterior deltoid (AD) reaction time, onset time of postural muscles with respect to AD activation, and peak amplitude and latency of all muscles were measured. With neck flexion, N2 and P3 amplitudes increased, N2 and P3 latencies and AD reaction time shortened, and onset times of all postural muscles became earlier. No significant differences in peak amplitude and latency of each muscle were found between neck positions. Significant positive correlations were found in changes with neck flexion between P3 latency and AD reaction time, and between N2 latency and onset time of erector spinae. These suggest that with neck flexion, attention allocation to discriminative and cognitive processing increased, and the processing speed increased with shortening of reaction time in focal muscles. In addition, the onset time of postural muscles became earlier without changing the activation pattern, which was associated with the hastened discriminative processing.

  16. Kinematic analysis of the lower cervical spine in the protracted and retracted neck flexion positions.

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    Park, So Hyun

    2015-01-01

    [Purpose] The aim of this study was to analyze lower cervical spine kinematics in protracted and retracted neck flexion positions in healthy people. [Subjects and Methods] The craniovertebral angle (CVA) and intervertebral body angles of the lower cervical spine of 10 healthy individuals were analyzed using fluoroscopy in a neutral sitting with the head in the neutral (N), protracted (Pro), and retracted (Ret) positions and with the neck in full flexion with the head in the neutral (N-fx), protracted (Pro-fx), and retracted (Ret-fx) positions. [Results] There were significant differences in the CVA and intervertebral body angle at the C3-4 level, and the Ret position showed the highest values followed by the N and Pro positions. Regarding the intervertebral body angle at the C4-5 level, the Pro position showed a higher value than the N and Ret positions. At the C6-7 level, the Pro position showed the lowest value compared with the N and Ret positions. In the CVA, the Ret-fx position showed a higher value than the N-fx and Ret-fx positions. [Conclusion] The results suggest that in the neutral sitting position, protraction is an ineffective posture due to overstress of the C6-7 segment, which is placed in a hyperflexed position at this level. Instead, retraction is the recommend posture for the patient with C6-7 degeneration, which makes for a more flexed position in the upper cervical spine and a less flexed position in the lower cervical spine.

  17. A Comparison of the Deep Cervical Flexor Muscle Thicknesses in Subjects with and without Neck Pain during Craniocervical Flexion Exercises.

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    Jun, Ilsub; Kim, Kyoung

    2013-11-01

    [Purpose] The purpose of the present study was to examine the amount of change in the thicknesses of the deep cervical flexor (DCF) and sternocleidomastoid (SCM) muscles in subjects with neck pain and subjects without neck pain during craniocervical flexion exercise (CCFE). [Subjects] The total number of subjects was 40, comprising 20 in the no-pain group (males 11, females 9) and 20 in the pain group (males 8, females 12). [Methods] Muscle images were obtained using ultrasound, and the thicknesses of the individual muscles were measured using the NIH ImageJ software. [Results] During CCFE, as pressure increased, the no-pain group recruited the DCF more than the pain group, while the pain group recruited the SCM more. [Conclusion] Selective DCF contraction exercises are considered very useful in the treatment of patients with neck pain.

  18. Kinematic data on primate head and neck posture: implications for the evolution of basicranial flexion and an evaluation of registration planes used in paleoanthropology.

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    Strait, D S; Ross, C F

    1999-02-01

    Kinematic data on primate head and neck posture were collected by filming 29 primate species during locomotion. These were used to test whether head and neck posture are significant influences on basicranial flexion and whether the Frankfurt plane can legitimately be employed in paleoanthropological studies. Three kinematic measurements were recorded as angles relative to the gravity vector, the inclination of the orbital plane, the inclination of the neck, and the inclination of the Frankfurt plane. A fourth kinematic measurement was calculated as the angle between the neck and the orbital plane (the head-neck angle [HNA]). The functional relationships of basicranial flexion were examined by calculating the correlations and partial correlations between HNA and craniometric measurements representing basicranial flexion, orbital kyphosis, and relative brain size (Ross and Ravosa [1993] Am. J. Phys. Anthropol. 91:305-324). Significant partial correlations were observed between relative brain size and basicranial flexion and between HNA and orbital kyphosis. This indicates that brain size, rather than head and neck posture, is the primary influence on flexion, while the degree of orbital kyphosis may act to reorient the visual field in response to variation in head and neck posture. Regarding registration planes, the Frankfurt plane was found to be horizontal in humans but inclined in all nonhuman primates. In contrast, nearly all primates (including humans) oriented their orbits such that they faced anteriorly and slightly inferiorly. These results suggest that for certain functional craniometric studies, the orbital plane may be a more suitable registration plane than Frankfurt "Horizontal."

  19. Characteristics of the Motor Units during Sternocleidomastoid Isometric Flexion among Patients with Mechanical Neck Disorder and Asymptomatic Individuals

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    Yang, Chia-Chi; Su, Fong-Chin; Yang, Po-Ching; Lin, Hwai-Ting

    2016-01-01

    Mechanical neck disorder is a widespread and non-neurological musculoskeletal condition resulting from modern lifestyles. Presently, the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles and the characteristics of the short-term synchronization of the motor unit in patients with neck pain are ambiguous. This study therefore aims to clarify the fundamental electrophysiological properties of the motor units of the sternocleidomastoid muscles in patients with mechanical neck disorder and in asymptomatic individuals. We further investigated whether alterations in the degree of motor unit short-term synchronization occur. The surface electrophysiological signals of the bilateral sternal heads of the sternocleidomastoid muscles of twelve patients with mechanical neck disorder and asymptomatic individuals were detected at 25% of the maximum voluntary contraction during cervical isometric flexion and then decomposed into individual motor unit action potential trains. We found that the patients with mechanical neck disorder showed significantly higher initial and mean firing rates of the sternocleidomastoid muscles and displayed substantially lower motor unit short-term synchronization values compared with the asymptomatic subjects. Consequently, these convincing findings support the assertion that patients with mechanical neck disorder display altered neuromuscular control strategies, such as the reinforcement of motor unit recruitment firing rates in the sternocleidomastoid muscles. The motor units of these patients also revealed neural recruitment strategies with relatively poor efficiency when executing the required motor tasks. PMID:27941995

  20. Radioanatomy of upper airways in flexion and retroflexion of the neck

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    Penning, L.

    1988-02-01

    Ten flexion-retroflexion radiographs of the cervical spine (in lateral projection) were utilized to study anatomical configuration and topography of the upper airpassages in these two positions. Measurements of AP diameters revealed narrowing in flexion and widening in retroflexion, being maximal at the region of the epiglottis, and minimal at the regions of larynx and trachea. The distance from the pharyngeal attachment of the skull-base, to the upper chest aperture proved to be markedly greater in retroflexion than in flexion. As the pharynx virtually does not change its length during these movements, it is drawn up (with respect to the upper chest aperture) in retroflexion, and pushed down in flexion, over a mean distance of 42 mm. The up and down movement of the upper part of the trachea is slightly less: 38 mm.

  1. Ranges of Cervical Intervertebral Disc Deformation during an In-Vivo Dynamic Flexion-Extension of the Neck.

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    Yu, Yan; Mao, Haiqing; Li, Jing-Sheng; Tsai, Tsung-Yuan; Cheng, Liming; Wood, Kirkham B; Li, Guoan; Cha, Thomas D

    2017-03-23

    While abnormal loading is widely believed to cause cervical spine disc diseases, in-vivo cervical disc deformation during dynamic neck motion has not been well delineated. This study investigated the range of cervical disc deformation during an in-vivo functional flexion-extension of the neck. Ten asymptomatic human subjects were tested using a combined dual fluoroscopic imaging system and MRI based 3D modeling technique. Overall disc deformation was determined using the changes of the space geometry between upper and lower endplates of each intervertebral segment (C3/4, C4/5, C5/6 and C6/7). Five points (anterior, center, posterior, left and right) of each disc were analyzed to examine the disc deformation distributions. The data indicated that between the functional maximum flexion and extension of the neck, the anterior points of the discs experienced large changes of distraction/compression deformation and shear deformation. The higher level discs experienced higher ranges of disc deformation. No significant difference was found in deformation ranges at posterior points of all discs. The data indicated that the range of disc deformation is disc level dependent and the anterior region experienced larger changes of deformation than the center and posterior regions, except for the C6/7 disc. The data obtained from this study could serve as baseline knowledge for the understanding of the cervical spine disc biomechanics and for investigation of the biomechanical etiology of disc diseases. These data could also provide insights for development of motion preservation surgeries for cervical spine.

  2. Influence of Cervical Muscle Fatigue on Musculo-Tendinous Stiffness of the Head-Neck Segment during Cervical Flexion.

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    Raphaël Portero

    Full Text Available The aim of this study is to determine if the fatigue of cervical muscles has a significant influence on the head-neck segment musculo-tendinous stiffness.Ten men (aged 21.2 ± 1.9 years performed four quick-release trials of flexion at 30 and 50% MVC before and after the induction of muscular fatigue on cervical flexors. Electromyographic activity was recorded on the sternocleidomastoids (SCM and spinal erectors (SE, bilaterally. Musculo-tendinous stiffness was calculated through the quick-release method adapted to the head-neck segment.We noticed a significant linear increase of the head-neck segment musculo-tendinous stiffness with the increase of exertion level both before (P < 0.0001 and after the fatigue procedure (P < 0.0001. However, this linear relationship was not different before and after the fatigue procedure. EMG analysis revealed a significant increase of the root mean square for the right SCM (P = 0.0002, the left SCM (P < 0.0001, the right SE (P < 0.0001, and the left SE (P < 0.0001 and a significant decrease of the median power frequency only for the right (P = 0.0006 and the left (P = 0.0003 SCM with muscular fatigue.We did not find significant changes in the head-neck segment musculo-tendinous stiffness with fatigue of cervical muscles. We found a significant increase in EMG activity in the SCM and the SE after the induction of fatigue of the SCM. Our findings suggest that with fatigue of cervical flexors, neck muscle activity is modulated in order to maintain the musculo-tendinous stiffness at a steady state.

  3. Effects of Cervical Flexion on the Flexion-relaxation Ratio during Smartphone Use.

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    Shin, HyeonHui; Kim, KyeongMi

    2014-12-01

    [Purpose] The purpose of this study was to measure the cervical flexion-relaxation ratio (FRR) and intensity of neck pain and identify the differences according to postures adopted while using smartphones. [Subjects] Fifteen healthy adults with no neck pain, spinal trauma, or history cervical surgery participated in this study. [Methods] The activity of the cervical erector spinae muscle was recorded while performing a standardized cervical flexion-extension movement in three phases (flexion, sustained full flexion, extension). And neck pain intensity was recorded using a visual analog scale (VAS) with values between 0 and 10. Postures held while using a smartphone are distinguished between desk postures and lap postures. The FRR was calculated by dividing the maximal muscle activation during the extension phase by average activation during the complete flexion phase. [Results] No significant differences were found in the FRR between desk posture, lap posture, and baseline, though the intensity of the neck pain increased in the lap posture. [Conclusion] The FRR could be a significant criterion of neuromuscular impairment in chronic neck pain or lumbar pain patients, but it is impossible to distinguish neck pain that is caused by performing task for a short time. Prolonged lap posture might cause neck pain, so the use of smartphones for a long time in this posture should be avoided.

  4. The influence of age, gender, lifestyle factors and sub-clinical neck pain on the cervical flexion-rotation test and cervical range of motion.

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    Smith, Kenric; Hall, Toby; Robinson, Kim

    2008-12-01

    The flexion-rotation test (FRT) is commonly used when assessing cervicogenic headache. Additionally, active range of motion (AROM) is frequently used to evaluate impairment in neck pain. No studies have investigated the interaction of the FRT and AROM with age, gender, pain and lifestyle factors. The purpose of this study was to determine the influence of these factors on the FRT and cervical AROM. A group of 66 participants (aged 20-78) were studied, 28 experienced sub-clinical neck pain (recurrent neck pain or discomfort which has not received treatment from a healthcare professional) while 38 did not. Age, gender, lifestyle factors and sub-clinical neck pain were assessed using a questionnaire. Measurement of AROM was performed by two examiners blind to the results of the questionnaire. Multiple linear regression analysis found that 59% of the variance in the FRT was explained by the presence of sub-clinical pain and cervical lateral flexion measures. Secondly, 58-72% of the variance in active cervical ROM measures was influenced by factors including the FRT, gender and movements of the neck in other planes. This study found that lifestyle factors do not influence the cervical FRT and AROM.

  5. Peak torque and average power at flexion/extension of the shoulder and knee when using a mouth guard in adults with mild midline discrepancy.

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    Lee, Sang-Yeol; Hong, Min-Ho; Choi, Seung-Jun

    2014-07-01

    [Purpose] This study was conducted to investigate the changes in torque and power during flexion and extension of the shoulder and the knee joints caused by midline correction using mouth guards made from different materials in adults with mild midline discrepancy. [Subjects] The subjects of this study were males (n=12) in their 20s who showed a 3-5 mm difference between the midlines of the upper and lower teeth but had normal masticatory function. [Methods] The torque and average power of the lower limb and upper limb were measured during flexion and extension according to various types of mouth guard. [Results] There were significant differences in relative torque and average power between three conditions (no mouth guard, soft-type mouth guard, and hard-type mouth guard) at shoulder flexion and extension. There were no significant differences in relative torque and average power between the three conditions at knee flexion and extension. [Conclusions] These results suggest that use of a mouth guard is a method by which people with a mild midline discrepancy can improve the stability of the entire body.

  6. The relationship between superficial muscle activity during the cranio-cervical flexion test and clinical features in patients with chronic neck pain.

    Science.gov (United States)

    O'Leary, Shaun; Falla, Deborah; Jull, Gwendolen

    2011-10-01

    Changes in motor behavior are a known feature of chronic mechanical neck pain disorders. This study examined the strength of the association between reported levels of pain and disability from 84 individuals (63 women, 21 men) with chronic mechanical neck pain and levels of electromyographic activity recorded from superficial cervical flexor (sternocleidomastoid; SCM and anterior scalene; AS) muscles during progressive stages of the cranio-cervical flexion muscle test. A significant positive association was observed between superficial muscle activity and pain intensity (P 0.5) or perceived disability (P > 0.21). The strongest relationship between pain intensity and superficial muscle activity occurred at the final increment of the cranio-cervical flexion test (inner-range test position) for both the SCM and AS muscles (R(2) = 0.16). Although a positive and significant relationship between pain intensity and superficial muscle activity was shown, the relationship was only modest (16% explained variance), indicating that multiple factors contribute to the altered motor function observed in individuals with chronic mechanical neck pain.

  7. Intratester and intertester reliability of the Cybex electronic digital inclinometer (EDI-320) for measurement of active neck flexion and extension in healthy subjects.

    Science.gov (United States)

    Tousignant, M; Boucher, N; Bourbonnais, J; Gravelle, T; Quesnel, M; Brosseau, L

    2001-11-01

    This study examined the intratester and intertester reliability of the electronic digital goniometer EDI-320 for the measurement of active neck flexion and extension in healthy subjects. In the context of evidence-based practice, the EDI-320 instrument has the potential to improve patient assessment, provide a clearer picture of patient progress, and confirm the effectiveness of physiotherapy interventions. However, the psychometric properties of the EDI-320 have not yet been documented for cervical spine range of motion. Forty-four individuals with no known history of cervical disorder within the three months prior to the testing, voluntarily consented to participate in this study. Repeated measurements with the EDI-320 were taken by two trained testers (TH1 and TH2) and data were recorded by two separate observers. Subjects performed a standardized warm-up. Testers were required to repeat palpation of bony landmarks prior to each trial. Measurements were taken at the end-range of active cervical flexion and extension for each subject. Both testers measured each subject twice. The intraclass correlation coefficients (ICC) were derived from one-way ANOVA for intratester reliability and a two-way ANOVA for intertester reliability. Paired t -tests were then applied to verify for systematic error. Moderate intratester reliability was found for both testers for flexion (TH1: ICC=0.77; 95% CI: 0.62-0.87; TH2: ICC=0.77; 95% CI: 0.58-0.87). As for extension, high intratester reliability was found for TH1 (ICC=0.79; 95% CI: 0.65-0.88) and moderate for TH2: (ICC=0.83; 95% CI: 0.63-0.92). Intertester reliability results showed a moderate reliability for both flexion and extension (ICC=0.66; 95% CI: 0.24-0.84) on the first trial. On the second trial, reliability was moderate for flexion (ICC=0.73; 95% CI: 0.53-0.85) and high for extension (ICC=0.80; 95% CI: 0.64-0.89). The t -test analysis revealed the inclusion of systematic error by Tester 2 for intratester reliability

  8. The Effect of Dry Needling on Range of Motion of Neck Lateral Flexion in Subjects With Active Trigger Point in Upper Trapezius Muscle

    Directory of Open Access Journals (Sweden)

    Ziaeifar

    2014-12-01

    Full Text Available Background Myofascial trigger point is one of the most common causes of musculoskeletal disorders. Myofascial trigger point in upper trapezius has been reported as a symptom in patients with neck and upper thoracic pain. Objectives The purpose of this study was to investigate the effect of dry needling compared with ischemic pressure on trigger point in upper trapezius muscle. Materials and Methods 28 subjects with myofascial trigger point in upper trapezius participated in this study. The subjects were randomly assigned to two groups: dry needling (n = 13 and ischemic pressure (n = 15. The neck lateral flexion range of motion was measured before and after treatment in both groups using a standard goniometer. Paired t-test was used to determine any significant difference in range of motion after treatment sessions compared with pre-treatment score in control and experimental group. Analysis of Covariance (ANCOVA was calculated to determine the significance of differences between the control and experimental groups in post-test scores, with pre-treatment scores used as covariates in the analysis. Results Statistical analysis (paired t-test revealed significant increase in neck lateral flexion range of motion in contra-lateral side after treatment sessions in control and experimental group compared with pre-treatment score (P < 0.05. However, only dry needling was effective in increase of range of motion in Ipsi-lateral side (P = 0.001. In the ANCOVA, controlling for pre-test scores, no significant difference was found between the two groups in the after treatment sessions (P = 0.06 and (P = 0.15. Conclusions The application of DN produces an improvement in ILF and CLF can be prescribed for subjects with MTP in UT muscles.

  9. Neck Flexion Induces Larger Deformation of the Brain Than Extension at a Rotational Acceleration, Closed Head Trauma

    Directory of Open Access Journals (Sweden)

    Hans-Arne Hansson

    2014-01-01

    Full Text Available A closed head trauma induces incompletely characterized temporary movement and deformation of the brain, contributing to the primary traumatic brain injury. We used the pressure patterns recorded with light-operated miniature sensors in anaesthetized adult rabbits exposed to a sagittal plane rotational acceleration of the head, lasting 1 ms, as a measure of brain deformation. Two exposure levels were used and scaled to correspond to force levels reported to cause mild and moderate diffuse injury in an adult man, respectively. Flexion induced transient, strong, extended, and predominantly negative pressures while extension generated a short positive pressure peak followed by a minor negative peak. Low level flexion caused as strong, extended negative pressures as did high level extension. Time differences were demonstrated between the deformation of the cerebrum, brainstem, and cerebellum. Available X-ray and MRI techniques do not have as high time resolution as pressure recordings in demonstrating complex, sequential compression and stretching of the brain during a trauma. The exposure to flexion caused more protracted and extensive deformation of the brain than extension, in agreement with a published histopathological report. The severity and extent of the brain deformation generated at a head trauma thus related to the direction at equal force.

  10. Head flexion angle while using a smartphone.

    Science.gov (United States)

    Lee, Sojeong; Kang, Hwayeong; Shin, Gwanseob

    2015-01-01

    Repetitive or prolonged head flexion posture while using a smartphone is known as one of risk factors for pain symptoms in the neck. To quantitatively assess the amount and range of head flexion of smartphone users, head forward flexion angle was measured from 18 participants when they were conducing three common smartphone tasks (text messaging, web browsing, video watching) while sitting and standing in a laboratory setting. It was found that participants maintained head flexion of 33-45° (50th percentile angle) from vertical when using the smartphone. The head flexion angle was significantly larger (p neck pain of heavy smartphone users. Practitioner Summary: In this laboratory study, the severity of head flexion of smartphone users was quantitatively evaluated when conducting text messaging, web browsing and video watching while sitting and standing. Study results indicate that text messaging while sitting caused the largest head flexion than that of other task conditions.

  11. The ratio of change in muscle thickness between superficial and deep cervical flexor muscles during the craniocervical flexion test and a suggestion regarding clinical treatment of patients with musculoskeletal neck pain.

    Science.gov (United States)

    Goo, Miran; Kim, Seong-Gil; Jun, Deokhoon

    2015-08-01

    [Purpose] The purpose of this study was to identify the imbalance of muscle recruitment in cervical flexor muscles during the craniocervical flexion test by using ultrasonography and to propose the optimal level of pressure in clinical craniocervical flexion exercise for people with neck pain. [Subjects and Methods] A total of 18 students (9 males and 9 females) with neck pain at D University in Gyeongsangbuk-do, South Korea, participated in this study. The change in muscle thickness in superficial and deep cervical flexor muscles during the craniocervical flexion test was measured using ultrasonography. The ratio of muscle thickness changes between superficial and deep muscles during the test were obtained to interpret the imbalance of muscle recruitment in cervical flexor muscles. [Results] The muscle thickness ratio of the sternocleidomastoid muscle/deep cervical flexor muscles according to the incremental pressure showed significant differences between 22 mmHg and 24 mmHg, between 24 mmHg and 28 mmHg, between 24 mmHg and 30 mmHg, and between 26 mmHg and 28 mmHg. [Conclusion] Ultrasonography can be applied for examination of cervical flexor muscles in clinical environment, and practical suggestion for intervention exercise of craniocervical flexors can be expected on the pressure level between 24 mmHg and 26 mmHg enabling the smallest activation of the sternocleidomastoid muscle.

  12. Correlation between Trunk Posture and Neck Reposition Sense among Subjects with Forward Head Neck Postures

    OpenAIRE

    Han Suk Lee; Hyung Kuk Chung; Sun Wook Park

    2015-01-01

    Objective. To assess the correlation of abnormal trunk postures and reposition sense of subjects with forward head neck posture (FHP). Methods. In all, postures of 41 subjects were evaluated and the FHP and trunk posture including shoulder, scapular level, pelvic side, and anterior tilting degrees were analyzed. We used the head repositioning accuracy (HRA) test to evaluate neck position senses of neck flexion, neck extension, neck right and left side flexion, and neck right and left rotation...

  13. Scapular Winging as a Symptom of Cervical Flexion Myelopathy

    OpenAIRE

    Yaguchi, Hiroaki; Takahashi, Ikuko; Tashiro, Jun; Tsuji, Sachiko; Yabe, Ichiro; Sasaki, Hidenao

    2007-01-01

    A 23-year-old man complained of weakness of the right arm that he first noted six years prior to his visit. Neurological examination revealed atrophy and weakness of the triceps and serratus anterior muscle on the right side, which resulted in scapular winging on that side. MRI with neck flexion revealed compression of the cervical cord enabling a diagnosis of flexion myelopathy. Proximal muscle weakness and atrophy in flexion myelopathies including Hirayama disease are extremely rare. Here, ...

  14. Impact responses of the cervical spine: A computational study of the effects of muscle activity, torso constraint, and pre-flexion.

    Science.gov (United States)

    Nightingale, Roger W; Sganga, Jake; Cutcliffe, Hattie; Bass, Cameron R 'Dale'

    2016-02-29

    Cervical spine injuries continue to be a costly societal problem. Future advancements in injury prevention depend on improved physical and computational models, which are predicated on a better understanding of the neck response during dynamic loading. Previous studies have shown that the tolerance of the neck is dependent on its initial position and its buckling behavior. This study uses a computational model to examine three important factors hypothesized to influence the loads experienced by vertebrae in the neck under compressive impact: muscle activation, torso constraints, and pre-flexion angle of the cervical spine. Since cadaver testing is not practical for large scale parametric analyses, these factors were studied using a previously validated computational model. On average, simulations with active muscles had 32% larger compressive forces and 25% larger shear forces-well in excess of what was expected from the muscle forces alone. In the short period of time required for neck injury, constraints on torso motion increased the average neck compression by less than 250N. The pre-flexion hypothesis was tested by examining pre-flexion angles from neutral (0°) to 64°. Increases in pre-flexion resulted in the largest increases in peak loads and the expression of higher-order buckling modes. Peak force and buckling modality were both very sensitive to pre-flexion angle. These results validate the relevance of prior cadaver models for neck injury and help explain the wide variety of cervical spine fractures that can result from ostensibly similar compressive loadings. They also give insight into the mechanistic differences between burst fractures and lower cervical spine dislocations.

  15. Improving Pre-Operative Flexion in Primary TKA: A Surgical Technique Emphasizing Knee Flexion with 5-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Edward McPherson

    2014-06-01

    Full Text Available This study prospectively reviews a consecutive series of 228 primary total knee arthroplasty (TKA procedures utilizing a technique to optimize knee flexion. The main features include: (1the use of a “patellar friendly” femoral component and reduced thickness patellar components, (2 patient individualized adjustment of the femoral component rotation set strictly to the anterior-posterior femoral axis, (3a rigorous flexion compartment debridement to remove non-essential posterior femoral bone with a Z-osteotome, and (4incorporation of a rapid recovery protocol with features to promote knee flexion. Results were categorized into three groups: low pre-op flexion (90 degrees and below, regular pre-op flexion (91-125 degrees, and high pre-op flexion (126 degrees and above. Average flexion in the low flexion group improved by 20 degrees at 6 weeks, 28 degrees at 3 months, 31 degrees at 1 year, and 30 degrees at 5 years. In the regular flexion group, average flexion improved by 2 degrees at 6 weeks, 10 degrees at 3 months, 12 degrees at 1 year, and 13 degrees at 5 years. Finally, in the high flexion group, average flexion decreased by 7 degrees at 6 weeks, regained preoperative levels at 3 months, and increased by 3 degrees at 1 year and 4 degrees at 5 years. In summary, a technique that emphasizes patellofemoral kinematics can consistently improve flexion in TKA in short and long-term follow-up.

  16. Comparison of upper cervical flexion and cervical flexion angle of computer workers with upper trapezius and levator scapular pain.

    Science.gov (United States)

    Yoo, Won-Gyu

    2014-02-01

    [Purpose] In this study, we compared upper cervical flexion and cervical flexion angle of computer workers with upper trapezius and levator scapular pain. [Subject] Eight male computer workers with upper trapezius muscle pain and eight others with levator scapular muscle pain participated. [Methods] Each subject was assessed in terms of upper cervical flexion angle and total cervical flexion angles using a cervical range of motion instrument after one hour of computer work. [Results] The upper cervical flexion angle of the group with levator scapular pain was significantly lower than that of the group with upper trapezius pain after computer work. The total cervical flexion angle of the group with upper trapezius pain was significantly lower than that of the group with levator scapular pain after computer work. [Conclusion] For selective and effective intervention for neck pain, therapists should evaluate upper and lower cervical motion individually.

  17. Flexion in Abell 2744

    CERN Document Server

    Bird, Justin P

    2016-01-01

    We present the first flexion-focused gravitational lensing analysis of the first of the strong-lensing "cosmic telescope" galaxy clusters, observed as part of the Hubble Frontier Fields initiative. Using HST observations of Abell 2744 (z = 0.308), we apply a modified Analytic Image Model (AIM) technique to measure source galaxy flexion and shear values at a final number density of 82 arcmin$^{-2}$. By using flexion data alone we are able to identify the primary mass structure aligned along the heart of the cluster in addition to a major substructure peak offset 1.43' from the cluster core. We generate two types of nonparametric reconstructions: a flexion aperture mass map, which identifies the central potential and substructure peak with mass signal-to-noise of 3.5$\\sigma$ and 2.3$\\sigma$ respectively; and a convergence map derived directly from the smoothed flexion field. For the primary peak we find a mass of $1.93\\times10^{14}\\,h^{-1}\\,M_{\\odot}$ within a 45" (145h$^{-1}$ kpc) aperture, and for the western...

  18. Flexion/extension cervical spine views in blunt cervical

    Directory of Open Access Journals (Sweden)

    Nasir Sadaf

    2012-06-01

    Full Text Available 【Abstract】Objective: To examine the contribution of flexion and extension radiographs in the evaluation of ligamentous injury in awake adults with acute blunt cervical spine trauma, who show loss of cervical lordosis and neck pain. Methods: All patients who presented to our emer-gency department following blunt trauma were enrolled in this study, except those with schiwora, neurological defi-cits or fracture demonstrated on cross-table cervical spine X-rays, and those who were either obtunded or presented after cervical spine surgery. Adequacy of flexion and exten-sion views was checked by the neurosurgery and radiology team members. All these patients underwent cross-table cervical spine view followed by flexion/extension views based on the loss of lordosis on cross-table imaging and the presence of neck pain. Results: A total of 200 cases were reviewed, of whom 90 (45% underwent repeat X-rays because of either inadequate exposure or limited motion. None of the patients with loss of lordosis on cross-table view had positive flexion and extension views of cervical spine for instability. Conclusions: Our results show that in patients who underwent acute radiographic evaluation of blunt cervical spine trauma, flexion and extension views of the cervical spine are unlikely to yield positive results in the presence of axial neck pain and/or loss of cervical lordosis. We can also hypothesize that performing flexion and extension views will be more useful once the acute neck pain has settled. Key words: X-rays; Cervical vertebrae; Lordosis

  19. Flexion/extension cervical spine views in blunt cervical trauma

    Institute of Scientific and Technical Information of China (English)

    Sadaf Nasir; Manzar Hussain; Roomi Mahmud

    2012-01-01

    Objective: To examine the contribution of flexion and extension radiographs in the evaluation of ligamentous injury in awake adults with acute blunt cervical spine trauma,who show loss of cervical lordosis and neck pain.Methods: All patients who presented to our emergency department following blunt trauma were enrolled in this study,except those with schiwora,neurological deficits or fracture demonstrated on cross-table cervical spine X-rays,and those who were either obtunded or presented after cervical spine surgery.Adequacy of flexion and extension views was checked by the neurosurgery and radiology team members.All these patients underwent cross-table cervical spine view followed by flexion/extension views based on the loss of lordosis on cross-table imaging and the presence of neck pain.Results: A total of 200 cases were reviewed,of whom 90 (45%) underwent repeat X-rays because of either inadequate exposure or limited motion.None of the patients with loss of lordosis on cross-table view had positive flexion and extension views of cervical spine for instability.Conclusions: Our results show that in patients who underwent acute radiographic evaluation of blunt cervical spine trauma,flexion and extension views of the cervical spine are unlikely to yield positive results in the presence of axial neck pain and/or loss of cervical lordosis.We can also hypothesize that performing flexion and extension views will be more useful once the acute neck pain has settled.

  20. Changes in the activity of the muscles surrounding the neck according to the angles of movement of the neck in adults in their 20s

    OpenAIRE

    Lee , Tae-Ho; Lee, Joon-Hyuk; Lee, Yun-seob; Kim, Myoung-Kwon; Kim, Seong-Gil

    2015-01-01

    [Purpose] The aim of this study was to examine changes in the muscle activity around the neck according to the neck movement angle during neck flexion and extension. [Subjects and Methods] Activities of the sternocleidomastoid muscle (SCM), splenius capitis and splenius cervicis muscles, upper trapezius muscle, and middle trapezius muscle during flexion and extension were assessed in 24 college students. [Results] SCM muscle activation significantly increased at every angle during flexion and...

  1. Starting position of movement and perception of angle of trunk flexion while standing with eyes closed.

    Science.gov (United States)

    Fujiwara, K; Miyaguchi, A; Toyama, H; Kunita, K; Asai, H

    1999-08-01

    The present study attempted to investigate the effect of position on the perception of angle of trunk flexion while standing. For this purpose, the range effect was factored out by setting the constant target angle at 10 degrees, with varied starting positions of trunk flexion. We found that subjects underestimated angle of trunk flexion when the starting position was close to a quiet standing posture, overestimated when close to maximum trunk flexion, and correctly perceived it when at the middle position. Less perceptual distortion was observed at the positions close to maximum trunk flexion in the present study than in our previous one, in which various target angles of trunk flexion were reproduced from a quiet standing posture. The reduced distortion in the present study was believed to have resulted from factoring out the range effect. The flexion angle of the hip joint changed in tandem with that of the trunk, while very little movement was observed in the ankle, knee, and neck joints. Judging from the changing pattern of hip-joint angle, the muscle activity of the erector spinae and biceps femoris increased gradually to 90 degrees trunk flexion. In contrast, the actual increment of muscle activity reached zero or a minimum value at the middle angles as the angle of trunk flexion increased. It was assumed that the abrupt change in kinesthetic information associated with muscle activity exerted a great influence on the perception of trunk flexion.

  2. Correlation between Trunk Posture and Neck Reposition Sense among Subjects with Forward Head Neck Postures

    Directory of Open Access Journals (Sweden)

    Han Suk Lee

    2015-01-01

    Full Text Available Objective. To assess the correlation of abnormal trunk postures and reposition sense of subjects with forward head neck posture (FHP. Methods. In all, postures of 41 subjects were evaluated and the FHP and trunk posture including shoulder, scapular level, pelvic side, and anterior tilting degrees were analyzed. We used the head repositioning accuracy (HRA test to evaluate neck position senses of neck flexion, neck extension, neck right and left side flexion, and neck right and left rotation and calculated the root mean square error in trials for each subject. Spearman’s rank correlation coefficients and regression analysis were used to assess the degree of correlation between the trunk posture and HRA value, and a significance level of α = 0.05 was considered. Results. There were significant correlations between the HRA value of right side neck flexion and pelvic side tilt angle (p<0.05. If pelvic side tilting angle increases by 1 degree, right side neck flexion increased by 0.76 degrees (p=0.026. However, there were no significant correlations between other neck motions and trunk postures. Conclusion. Verifying pelvic postures should be prioritized when movement is limited due to the vitiation of the proprioceptive sense of neck caused by FHP.

  3. Flexion/extension cervical spine views in blunt cervical

    OpenAIRE

    Nasir Sadaf; Hussain Manzar; Mahmud Roomi

    2012-01-01

    【Abstract】Objective: To examine the contribution of flexion and extension radiographs in the evaluation of ligamentous injury in awake adults with acute blunt cervical spine trauma, who show loss of cervical lordosis and neck pain. Methods: All patients who presented to our emer-gency department following blunt trauma were enrolled in this study, except those with schiwora, neurological defi-cits or fracture demonstrated on cross-table cervical spine X-rays, and tho...

  4. Neck Muscle Fatigue Resulting from Prolonged Wear of Weighted Helmets

    Science.gov (United States)

    2008-06-01

    documented neck injury rates of 50% or higher ranging from minor neck strain to cervical vertebral fracture3,11-14,17. Lighter helmets were developed...greater neck fatigue and susceptibility to neck injury. There may be an increase in cervical loads during aircraft ejections (catapult, windblast...and compromised effectiveness for long missions. The neck load limits ( flexion , extension, and rotation) under operational conditions are

  5. In-vivo spinal cord deformation in flexion

    Science.gov (United States)

    Yuan, Qing; Dougherty, Lawrence; Margulies, Susan S.

    1997-05-01

    Traumatic mechanical loading of the head-neck complex results cervical spinal cord injury when the distortion of the cord is sufficient to produce functional or structural failure of the cord's neural and/or vascular components. Characterizing cervical spinal cord deformation during physiological loading conditions is an important step to defining a comprehensive injury threshold associated with acute spinal cord injury. In this study, in vivo quasi- static deformation of the cervical spinal cord during flexion of the neck in human volunteers was measured using magnetic resonance (MR) imaging of motion with spatial modulation of magnetization (SPAMM). A custom-designed device was built to guide the motion of the neck and enhance more reproducibility. the SPAMM pulse sequence labeled the tissue with a series of parallel tagging lines. A single- shot gradient-recalled-echo sequence was used to acquire the mid-sagittal image of the cervical spine. A comparison of the tagged line pattern in each MR reference and deformed image pair revealed the distortion of the spinal cord. The results showed the cervical spinal cord elongates during head flexion. The elongation experienced by the spinal cord varies linearly with head flexion, with the posterior surface of the cord stretching more than the anterior surface. The maximal elongation of the cord is about 12 percent of its original length.

  6. Evaluation of head and neck postures

    NARCIS (Netherlands)

    Delleman, N.J.

    2000-01-01

    This paper describes the literature and two experiments on the evaluation of head and neck postures. It is concluded that health and safety professiona1s and ergonomists during posture evaluation should consider neck flexion/extension (head vs. trunk), besides the traditionally used inclination of t

  7. Developmental biomechanics of neck musculature.

    Science.gov (United States)

    Lavallee, Amy V; Ching, Randal P; Nuckley, David J

    2013-02-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A factorial study was performed on 91 human subjects measuring head-and-neck anthropometry and neck strength and endurance in three bending directions (flexion, extension, and lateral) as a function of age (6-23 years). Using a custom device, neck maximum voluntary contraction (MVC) force was measured in triplicate. Next, neck muscle endurance (sustained effort) was measured as the subjects' ability to maintain 70% of peak force over 30s. Linear regression of peak force and endurance as a function of age revealed each direction to significantly (pNeck muscle strength, similar between young males and females, becomes disparate in adolescence and adulthood with males exhibiting greater strength. Bending direction differences were also found with extension strength being the greatest regardless of age and sex. Furthermore, neck circumference appears predictive of neck strength and endurance in children. Together, these relationships may facilitate improved design of injury prevention interventions.

  8. Improved knee flexion following high-flexion total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Lionberger David R

    2012-06-01

    Full Text Available Abstract Background The application of new techniques and materials in total knee arthroplasty (TKA continue to be a primary focus in orthopedic surgery. The primary aim of the present study is to evaluate post TKA total range of motion (ROM among a group of patients who received a gender specific high-flexion design modification implant compared to a control group of patients who received non-gender specific implants. Methods and results The control group was comprised of 39 TKAs that were recruited pre-operatively and received the non-gender specific implant while the study group consisted of 39 TKAs who received gender specific implants. The study group yielded an improvement in mean post-operative ROM of 21° at 12 months, whereas the mean improvement in ROM among the control group was 11°. Thus, the study group had a 10° increased ROM improvement (91% over the control group (p = 0.00060. In addition, 100% of the subjects with gender specific high-flexion implants achieved greater or equal ROM post-operatively compared to 82% for the control cohort. Lastly, women who exhibited greater pre-operative ROM and lower body mass index (BMI were found to benefit the most with the gender specific prosthesis. Conclusion Our study demonstrates that among subjects with a normal BMI, the gender specific high-flexion knee implant is associated with increased ROM as compared to the non-gender specific non-high-flexion implant designs.

  9. Neck muscle function in violinists/violists with and without neck pain.

    Science.gov (United States)

    Steinmetz, Anke; Claus, Andrew; Hodges, Paul W; Jull, Gwendolen A

    2016-04-01

    Neck pain is associated with changes in neuromuscular control of cervical muscles. Violin and viola playing requires good function of the flexor muscles to stabilize the instrument. This study investigated the flexor muscle behaviour in violin/viola players with and without neck pain using the craniocervical flexion test (CCFT). In total, 12 violin/viola players with neck pain, 21 violin/viola players without neck pain in the preceding 12 weeks and 21 pain-free non-musicians were included. Activity of the sternocleidomastoid muscles (SCM) was measured with surface electromyography (EMG) during the CCFT. Violin/viola players with neck pain displayed greater normalised SCM EMG amplitudes during CCFT than the pain-free musicians and non-musicians (P neck pain in violinists/violists is associated with altered behaviour of the superficial neck flexor muscles consistent with neck pain, despite the specific use of the deep and superficial neck flexors during violin playing.

  10. Deep flexion-oriented bisurface-type knee joint and its tibial rotation that attributes its high performance of flexion.

    Science.gov (United States)

    Ueo, Toyoji; Kihara, Yuuichi; Ikeda, Noboru; Kawai, Jun; Nakamura, Kenji; Hirokawa, Shunji

    2011-04-01

    In 1989, we developed an artificial knee prosthesis that could accommodate the oriental lifestyle where people would sit more often on the floor than on a chair. The knee had a bisurface feature with an auxiliary joint of a ball and socket at the center of the posterior part aiming at an improved flexional function. The auxiliary joint functions not only to facilitate a rollback movement but also to add a rotational movement. It was investigated whether this knee prosthesis could show an internal rotation of the tibia during flexion such as the physiologic movement of the knee. The internal rotation of the tibia was evaluated for the patients who could sit on legs in the oriental style after total knee arthroplasty. The average flexion angle of patients who achieved this style of sitting was 144.1°, and the average internal rotation was estimated as 14.3° by a pattern matching method using a computer-assisted design system.

  11. Changes in the activity of the muscles surrounding the neck according to the angles of movement of the neck in adults in their 20s.

    Science.gov (United States)

    Lee, Tae-Ho; Lee, Joon-Hyuk; Lee, Yun-Seob; Kim, Myoung-Kwon; Kim, Seong-Gil

    2015-03-01

    [Purpose] The aim of this study was to examine changes in the muscle activity around the neck according to the neck movement angle during neck flexion and extension. [Subjects and Methods] Activities of the sternocleidomastoid muscle (SCM), splenius capitis and splenius cervicis muscles, upper trapezius muscle, and middle trapezius muscle during flexion and extension were assessed in 24 college students. [Results] SCM muscle activation significantly increased at every angle during flexion and extension. The activities of the splenius capitis and splenius cervicis muscles increased significantly during flexion. The activity of the upper trapezius muscle also increased significantly. [Conclusion] The results highlight the need for individuals not to adopt a neck flexion posture for extended periods.

  12. Hirayama′s disease: The importance of flexion magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    S Jakhere

    2011-01-01

    Full Text Available Hirayama′s disease is a form of juvenile muscular atrophy affecting young individulas in their second to third decade. The underlying pathogenetic mechanism is believed to be an imbalanced growth between the individuals′ vertebral column and the spinal canal contents, which causes abutment of the anterior spinal cord against the vertebral column and detachment of the posterior dura, leading to microcirculatory disturbances and ischemic changes in the cord. This mechanism is exiquisitely demonstrated on magnetic resonance imaging (MRI, but requires additional imaging, with the neck in the flexed position. Neurphysiological imaging studies have provided supporting evidence by demonstrating changes in the N13 potential, with neck flexion. Nonetheless, few studies have also reported contradictory findings with MRI and somatosensory evoked potentials, in Hirayamas Disease. This condition is underdiagnosed because most clinicians are not familiar with this disorder and do not request a flexion MRI. Early recognition of this entity and differentiation from other causes of focal cord atrophy is important, because limitation of neck flexion by using a simple neck collar can prevent its further progression. We report the classical MRI findings in a young patient with Hirayama′s disease with neutral and flexion MRI.

  13. Limitation of activities of daily living accompanying reduced neck mobility after laminoplasty preserving or reattaching the semispinalis cervicis into axis.

    Science.gov (United States)

    Takeuchi, Kazunari; Yokoyama, Toru; Ono, Atsushi; Numasawa, Takuya; Wada, Kanichiro; Itabashi, Taito; Toh, Satoshi

    2008-03-01

    Although difficulties with neck mobility often interfere with patients' activities of daily living (ADL) after cervical laminoplasty, there was no detailed study on the relation between the limitations of ADL accompanying postoperative reduced neck mobility and the cervical posterior approach. The aim of this study was to compare retrospectively the frequency of limitations of ADL accompanying neck mobility after laminoplasty preserving the semispinalis cervicis inserted into the C2 spinous process with that after laminoplasty reattaching the muscle to C2. Forty-nine patients after C4-C7 laminoplasty with C3 laminectomy preserving the semispinalis cervicis inserted into C2 (Group A) and 24 patients after C3-C7 laminoplasty reattaching the muscle (Group B) were evaluated. The frequency of postoperative limitations of ADL accompanying each of three neck movements of extension, flexion and rotation were investigated. The postoperative O-C7 angles at extension and flexion was measured on lateral extension and flexion radiographs of the cervical spine, respectively. The postoperative cervical range of motion in rotation was measured in the cranial view using a digital camera. Frequency of limitations of ADL accompanying extension was lower (P = 0.037) in Group A (2%) than in Group B (17%). Frequency of limitations of ADL accompanying flexion was similar in Group A (8%) and Group B (4%). Frequency of limitations of ADL accompanying rotation was lower (P = 0.031) in Group A (12%) than in Group B (33%). Average O-C7 angle at extension was significantly larger (P = 0.002) in Group A (147 degrees ) than in Group B (136 degrees ). Average O-C7 angle at flexion was similar in Group A (93 degrees ) and Group B (91 degrees ). Average range of motion in rotation was significantly larger (P = 0.004) in Group A (110 degrees ) than in Group B (91 degrees ). This retrospective study suggested that the frequency of limitations of ADL accompanying neck extension or rotation was lower

  14. Performance in the cranio-cervical flexion test is altered in elderly subjects.

    Science.gov (United States)

    Uthaikhup, Sureeporn; Jull, Gwendolen

    2009-10-01

    The cranio-cervical flexion test (CCFT) tests the coordination of the deep and superficial cervical flexor muscles during a cranio-cervical flexion task. The test has revealed impairments in muscle function in younger/middle aged patients with various neck pain disorders. Neck pain and headache are common in elders but it is unknown if age alone affects performance in the CCFT. This study compared performance in the CCFT between healthy asymptomatic elderly and younger subjects. Electromyographic (EMG) amplitude in the sternocleidomastoid (SCM), angle of cranio-cervical flexion and ability to target the pressure levels of each test stage were examined in 44 elderly and 39 young participants. The results indicated that the elderly group had higher measures of normalized EMG signal amplitude in the SCM during the test (pcervical flexion range of motion for the five successive stages of the test (particularly at 26, 28 and 30 mm Hg stages) compared to young subjects. Clinicians must be aware of this occurrence when assessing performance in the CCFT in elders with neck pain.

  15. 多方法评价仰卧位屈颈牵引治疗神经根型颈椎病的随机对照研究%Randomized Controlled study on Multi-method Evaluation of the Clinical Value of Supine Cervical Vertebra Traction with Neck Flexion in the Treatment of Cervical Spondylotic Radiculopathy

    Institute of Scientific and Technical Information of China (English)

    王一; 蔚浩; 周睿

    2016-01-01

    Objective To probe into the clinical value of supine cervical vertebra traction with neck flexion in treating cervical spondylotic radiculopathy.Methods From August 2011 to December 2013,71 patients were divided randomly into a treatment group of 36 cases and a control group of 35 cases.They were treated respectively with supine cervical vertebra traction with neck flexion,and cervical vertebra traction on a sitting position.Both groups had acupuncture,moxibustion,massage and medium frequency electrotherapy.The period of observation was 15 days.We evaluated the results by surveying physiological curvature of the cervical spine on lateral radiograph,and visual analogue scale (VAS),neck disability index (NDI),criteria of diagnosis and therapeutic effect of syndromes in traditional Chinese medicine syndrome and clinical assessment scale for cervical spondylosis (CASCS) were also used.Results Physiological curvature of cervical spine was much improved in both groups after treatment (P < 0.05).The distance of cervical vertebra arc between vertebral anterior edge sequences in treatment group before treating was (4.07±3.63) mm and it was (9.03±4.31) mm after treatment.For the control group,those two numbers were respectively (4.13±3.02) and (8.87±3.97)mm.There was no significant difference in the distance of cervical vertebra arc and its increase between vertebral anterior edge between the two groups after treatment.There was significant difference in the efficiency rate between the two groups (P < 0.05) (treatment group 100.00%,control group 97.14%).When cured rate and cured-markedly effective rate were added,the treatment group (80.56%) was much better than the control group (51.43%) (P < 0.01).As to VAS score,NDI and CASCS scores,both groups got much better after treatment (P < 0.01).For VAS,the treatment group decreased from 8.43±0.75 before treatment to 1.40±0.61 after treatment,while the control group from 8.35±0.78 before treatment to 2.55±0

  16. Load and speed effects on the cervical flexion relaxation phenomenon

    Directory of Open Access Journals (Sweden)

    Descarreaux Martin

    2010-03-01

    Full Text Available Abstract Background The flexion relaxation phenomenon (FRP represents a well-studied neuromuscular response that occurs in the lumbar and cervical spine. However, the cervical spine FRP has not been investigated extensively, and the speed of movement and loading effects remains to be characterized. The objectives of the present study were to evaluate the influence of load and speed on cervical FRP electromyographic (EMG and kinematic parameters and to assess the measurement of cervical FRP kinematic and EMG parameter repeatability. Methods Eighteen healthy adults (6 women and 12 men, aged 20 to 39 years, participated in this study. They undertook 2 sessions in which they had to perform a standardized cervical flexion/extension movement in 3 phases: complete cervical flexion; the static period in complete cervical flexion; and extension with return to the initial position. Two different rhythm conditions and 3 different loading conditions were applied to assess load and speed effects. Kinematic and EMG data were collected, and dependent variables included angles corresponding to the onset and cessation of myoelectric silence as well as the root mean square (RMS values of EMG signals. Repeatability was examined in the first session and between the 2 sessions. Results Statistical analyses revealed a significant load effect (P Conclusions The load increase evoked augmented FRP onset and cessation angles as well as heightened muscle activation. Such increments may reflect the need to enhance spinal stability under loading conditions. The kinematic and EMG parameters showed promising repeatability. Further studies are needed to assess kinematic and EMG differences between healthy subjects and patients with neck pain.

  17. CT perfusion measurements of head and neck carcinoma from single section with largest tumor dimensions or average of multiple sections: Agreement between the two methods and effect on intra- and inter-observer agreement

    Energy Technology Data Exchange (ETDEWEB)

    Tawfik, Ahmed M., E-mail: ahm_m_tawfik@hotmail.com [Institut für Diagnostische und Interventionelle Radiologie, Klinikum der J.W.v. Goethe Universität Frankfurt am Main, Theodor-Stern-Kai 7 Frankfurt am Main 60590 (Germany); Diagnostic Radiology Department, Mansoura Faculty of Medicine, 62 Elgomhorya Street, Mansoura 35512 (Egypt); Nour-Eldin, Nour-Eldin A.; Naguib, Nagy N. [Institut für Diagnostische und Interventionelle Radiologie, Klinikum der J.W.v. Goethe Universität Frankfurt am Main, Theodor-Stern-Kai 7 Frankfurt am Main 60590 (Germany); Razek, Ahmed Abdel [Diagnostic Radiology Department, Mansoura Faculty of Medicine, 62 Elgomhorya Street, Mansoura 35512 (Egypt); Denewer, Adel T. [Surgical Oncology Department, Mansoura Oncology Centre, Mansoura Faculty of medicine (Egypt); Bisdas, Sotirios [Department of Neuroradiology, Eberhard Karls University, Tübingen (Germany); Vogl, Thomas J. [Institut für Diagnostische und Interventionelle Radiologie, Klinikum der J.W.v. Goethe Universität Frankfurt am Main, Theodor-Stern-Kai 7 Frankfurt am Main 60590 (Germany)

    2012-10-15

    Purpose: To evaluate the agreement between quantitative CT perfusion measurements of head and neck squamous cell carcinoma (SCC) obtained from single section with maximal tumor dimension and from average values of multiple sections, and to compare intra- and inter-observer agreement of the two methods. Methods: Perfusion was measured for 28 SCC cases using a region of interest (ROI) inserted in the single dynamic CT section showing maximal tumor dimension, then using average values of multiple ROIs inserted in all tumor-containing sections. Agreement between values of blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) calculated by the two methods was assessed. Intra-observer agreement was assessed by comparing repeated calculations done by the same radiologist using both methods after 2 months blinding period. Perfusion measurements were done by another radiologist independently to assess inter-observer agreement of both methods. Results: No significant differences were observed between the means of the 4 perfusion parameters calculated by both methods, all p values >0.05 The 95% limits of agreement between the two methods were (−33.9 to 43) ml/min/100 g for BF, (−2.5 to 2.8) ml/100 g for BV, (−4.9 to 3.9) s for MTT and (−17.5 to 18.6) ml/min/100 g for PS. Narrower limits of agreement were obtained using average of multiple sections than with single section denoting improved intra- and inter-observer agreement. Conclusion: Agreement between both methods is acceptable. Taking the average of multiple sections slightly improves intra- and inter-observer agreement.

  18. Changes in head and neck position affect elbow joint position sense.

    Science.gov (United States)

    Knox, Joanna J; Hodges, Paul W

    2005-08-01

    Changes in the position of the head and neck have been shown to introduce a systematic deviation in the end-point error of an upper limb pointing task. Although previous authors have attributed this to alteration of perceived target location, no studies have explored the effect of changes in head and neck position on the perception of limb position. This study investigated whether changes in head and neck position affect a specific component of movement performance, that is, the accuracy of joint position sense (JPS) at the elbow. Elbow JPS was tested with the neck in four positions: neutral, flexion, rotation and combined flexion/rotation. A target angle was presented passively with the neck in neutral, after a rest period; this angle was reproduced actively with the head and neck in one of the test positions. The potential effects of distraction from head movement were controlled for by performing a movement control in which the head and neck were in neutral for the presentation and reproduction of the target angle, but moved into flexion during the rest period. The absolute and variable joint position errors (JPE) were greater when the target angle was reproduced with the neck in the flexion, rotation, and combined flexion/rotation than when the head and neck were in neutral. This study suggests that the reduced accuracy previously seen in pointing tasks with changes in head position may be partly because of errors in the interpretation of arm position.

  19. Neck Pain

    Science.gov (United States)

    ... antidepressants for pain relief. Therapy Physical therapy. A physical therapist can teach you correct posture, alignment and neck- ... therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially ...

  20. Analytic PSF Correction for Gravitational Flexion Studies

    CERN Document Server

    Levinson, Rebecca Sobel

    2013-01-01

    Given a galaxy image, one cannot simply measure its flexion. An image's spin one and three shape properties, typically associated with F- and G-flexion, are actually complicated functions of the galaxy's intrinsic shape and the telescope's PSF, in addition to the lensing properties. The same is true for shear. In this work we create a completely analytic mapping from apparent measured galaxy flexions to gravitational flexions by (1) creating simple models for a lensed galaxy and for a PSF whose distortions are dominated by atmospheric smearing and optical aberrations, (2) convolving the two models, and (3) comparing the pre- and post-convolved flexion-like shape variations of the final image. For completeness, we do the same for shear. As expected, telescope astigmatism, coma, and trefoil can corrupt measurements of shear, F- flexion, and G-flexion, especially for small galaxies. We additionally find that PSF size dilutes the flexion signal more rapidly than the shear signal. Moreover, mixing between shears, ...

  1. Neck and shoulder muscle strength in patients with tension-type headache

    DEFF Research Database (Denmark)

    Madsen, Bjarne K; Søgaard, Karen; Andersen, Lars L.

    2016-01-01

    in TTH patients and healthy controls by examining maximal voluntary isometric contraction (MVC) during shoulder abduction, neck flexion and extension as well as the extension/flexion strength ratio of the neck. METHODS: Sixty TTH patients and 30 sex- and age-matched healthy controls were included....... Patients were included if they had TTH ≥8 days per month. The MVC neck extensor and flexor muscles were tested with the participant seated upright. MVC shoulder abduction was tested with the individual lying supine. RESULTS: Compared to controls TTH patients had significantly weaker muscle strength in neck...

  2. Torso flexion modulates stiffness and reflex response.

    Science.gov (United States)

    Granata, K P; Rogers, E

    2007-08-01

    Neuromuscular factors that contribute to spinal stability include trunk stiffness from passive and active tissues as well as active feedback from reflex response in the paraspinal muscles. Trunk flexion postures are a recognized risk factor for occupational low-back pain and may influence these stabilizing control factors. Sixteen healthy adult subjects participated in an experiment to record trunk stiffness and paraspinal muscle reflex gain during voluntary isometric trunk extension exertions. The protocol was designed to achieve trunk flexion without concomitant influences of external gravitational moment, i.e., decouple the effects of trunk flexion posture from trunk moment. Systems identification analyses identified reflex gain by quantifying the relation between applied force disturbances and time-dependent EMG response in the lumbar paraspinal muscles. Trunk stiffness was characterized from a second order model describing the dynamic relation between the force disturbances versus the kinematic response of the torso. Trunk stiffness increased significantly with flexion angle and exertion level. This was attributed to passive tissue contributions to stiffness. Reflex gain declined significantly with trunk flexion angle but increased with exertion level. These trends were attributed to correlated changes in baseline EMG recruitment in the lumbar paraspinal muscles. Female subjects demonstrated greater reflex gain than males and the decline in reflex gain with flexion angle was greater in females than in males. Results reveal that torso flexion influences neuromuscular factors that control spinal stability and suggest that posture may contribute to the risk of instability injury.

  3. Immediate effects of active cranio-cervical flexion exercise versus passive mobilisation of the upper cervical spine on pain and performance on the cranio-cervical flexion test.

    Science.gov (United States)

    Lluch, Enrique; Schomacher, Jochen; Gizzi, Leonardo; Petzke, Frank; Seegar, Dagmar; Falla, Deborah

    2014-02-01

    This study compared the immediate effects of an assisted plus active cranio-cervical flexion exercise (exercise group) versus a passive mobilisation plus assisted cranio-cervical flexion (mobilisation group) on performance of the cranio-cervical flexion test (CCFT), cervical range of motion (ROM) and pain in patients with chronic neck pain. Eighteen volunteers with chronic idiopathic neck pain participated in the study and were randomised to one of the two intervention groups. Current level of pain, cervical ROM and pain perceived during movement, pressure pain threshold (PPT) and surface electromyography (EMG) during performance of the CCFT were measured before and immediately after the intervention. A significant reduction in resting pain and PPT measured over cervical sites was observed immediately following both interventions, although a greater change was observed for the exercise group. No change in cervical ROM was observed after either intervention. Reduced sternocleidomastoid and anterior scalene EMG amplitude were observed during stages of the CCFT but only for the participants in the active exercise group. Although both active and passive interventions offered pain relief, only the exercise group improved on a task of motor function highlighting the importance of specific active treatment for improved motor control of the cervical spine.

  4. Neck pain

    OpenAIRE

    2002-01-01

    Non-specific neck pain has a postural or mechanical basis, and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but becomes chronic in about 10% of people.Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident.

  5. Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone - A preliminary randomized controlled trial

    DEFF Research Database (Denmark)

    Brage, K; Ris Hansen, Inge; Falla, D

    2015-01-01

    -shoulder exercises, balance and aerobic training) (INV), or pain education alone (CTRL). Effect on neck pain, function and Global Perceived Effect (GPE) were measured. Surface electromyography (EMG) was recorded from neck flexor and extensor muscles during performance of the Cranio-Cervical Flexion Test (CCFT...

  6. Neck lump

    Science.gov (United States)

    ... the neck lump treated. When to Contact a Medical Professional Call your health care provider if you have an abnormal neck swelling or ... to Expect at Your Office Visit The health care provider will take your medical history and do a physical exam. You may ...

  7. MR imaging and radiography of patients with cervical hyperextension-flexion injuries after car accidents

    Energy Technology Data Exchange (ETDEWEB)

    Borchgrevink, G.E. [The Emergency Clinic, Trondheim Univ. Hospital (Norway); Smevik, O. [MR-Centre Medical Section, Trondheim Univ. Hospital (Norway); Nordby, A. [Dept. of Radiology, Trondheim Univ. Hospital (Norway); Rinck, P.A. [MR-Centre Medical Section, Trondheim Univ. Hospital (Norway); Stiles, T.C. [Dept. of Psychiatry and Behavioural Medicine, Trondheim Univ. (Norway); Lereim, I. [The Emergency Clinic, Trondheim Univ. Hospital (Norway)

    1995-07-01

    Fifty-two patients underwent MR imaging and conventional radiography of the neck within 4 days after a hyperextension-flexion injury. The patients also had follow-up investigations during the first 2 years. The images did not reveal any serious lesions in any of them. Based on the main MR and radiographical findings the patients were divided into 4 groups; no findings, posture abnormalities, spondylosis and disc pathology (from MR images) or reduced intervertebral space (from the radiographs). The outcomes of the different groups were compared with reference to neck stiffness, neck pain and headache during a 2-year follow-up period. The patient groups did not correspond completely when diagnosed from MR imaging and radiography. However, patients with pre-existing spondylosis had more symptoms when examined by both modalities. Based on the radiographs, the group with posture abnormalities had significant fewer symptoms than the other groups. (orig.).

  8. State Averages

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of a variety of averages for each state or territory as well as the national average, including each quality measure, staffing, fine amount and number of...

  9. Airway Management of Post-burn Neck Contracture with Microstomia: Age Old Technique Revisited

    Directory of Open Access Journals (Sweden)

    Chetna Jadeja;

    2012-12-01

    Full Text Available This case report describes airway management of a patient of post burn neck contracture with fixed flexion deformity and restricted mouth opening. Attempt to intubate the patient with fiberoptic bronchoscope failed so the neck contracture was released under tumescent anaesthesia. The patient was then intubated with the help of stylet.

  10. Noninvasive analysis of human neck muscle function

    Science.gov (United States)

    Conley, M. S.; Meyer, R. A.; Bloomberg, J. J.; Feeback, D. L.; Dudley, G. A.

    1995-01-01

    STUDY DESIGN. Muscle use evoked by exercise was determined by quantifying shifts in signal relaxation times of T2-weighted magnetic resonance images. Images were collected at rest and after exercise at each of two intensities (moderate and intense) for each of four head movements: 1) extension, 2) flexion, 3) rotation, and 4) lateral flexion. OBJECTIVE. This study examined the intensity and pattern of neck muscle use evoked by various movements of the head. The results will help elucidate the pathophysiology, and thus methods for treating disorders of the cervical musculoskeletal system. SUMMARY OF BACKGROUND DATA. Exercise-induced contrast shifts in T2 has been shown to indicate muscle use during the activity. The noninvasive nature of magnetic resonance imaging appears to make it an ideal approach for studying the function of the complex neuromuscular system of the neck. METHODS. The extent of T2 increase was examined to gauge how intensely nine different neck muscles or muscle pairs were used in seven subjects. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation was assessed to infer the pattern of use among and within individual neck muscles or muscle pairs. RESULTS. Signal relaxation increased with exercise intensity for each head movement. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation also increased with exercise load. Neck muscles or muscle pairs extensively used to perform each head movement were: extension--semispinalis capitis and cervicis and splenius capitis; flexion--sternocleidomastoid and longus capitis and colli; rotation--splenius capitis, levator scapulae, scalenus, semispinalis capitis ipsilateral to the rotation, and sternocleidomastoid contralateral; and lateral flexion--sternocleidomastoid CONCLUSION. The results of this study, in part, agree with the purported functions of neck muscles derived from anatomic location. This also was true for the few

  11. Novel technique for evaluation of knee function continuously through the range of flexion.

    Science.gov (United States)

    Bell, Kevin M; Arilla, Fabio V; Rahnemai-Azar, Ata A; Fu, Freddie H; Musahl, Volker; Debski, Richard E

    2015-10-15

    Previous research has utilized robots to examine joint kinematics and in situ forces in response to loads applied at discrete flexion angles (static method). Recently, studies have applied loads continuously throughout flexion (continuous flexion method). However, the joint kinematics resulting from each of these methods have not been directly compared. Therefore, the objective of this study was to utilize a robotic testing system to compare kinematics and in situ forces of porcine knees in response to 89 N of anterior tibial load and 4 Nm of internal tibial torque between the static method (loads applied at 30°, 45°, 60°, and 75° of flexion) and the continuous flexion method (measured continuously from 30-75° of flexion) for both the anterior cruciate ligament (ACL) intact and ACL deficient (ACLD) knees. When anterior tibial load was applied the average differences in anterior tibial translation between the two methods for the intact state was 0.5±0.0 mm and for the ACLD state was 0.3±0.2 mm. The difference in the in situ forces in the ACL was 1.6±0.9 N. When internal tibial torque was applied the average differences in the resultant internal tibial rotation for the intact state was 0.9±0.4° and for the ACLD state was 1.0±0.5°. The difference in the in situ forces in the ACL was 3.3±2.0 N. Both methods are equally efficient in detecting significant differences (pknee states. The continuous flexion method was also shown to be more efficient than the static method and provides continuous data on knee function throughout the range of motion.

  12. Relationship between active cervical range of motion and flexion-relaxation ratio in asymptomatic computer workers.

    Science.gov (United States)

    Yoo, Won-Gyu; Park, Se-Yeon; Lee, Mi-Ra

    2011-01-01

    A high prevalence and incidence of neck and shoulder pain is present in the working population, especially sedentary workers. Recent findings have indicated that the flexion-relaxation (FR) ratio in the cervical erector spinae (CES) muscles might be a significant criteria of neuromuscular impairment and function. Additionally, the active cervical range of motion (ROM) is frequently used for discriminating between individuals with pain and those who are asymptomatic. The purpose of the present study was to examine the relationship between the active cervical ROM and the FR ratio in a sample of regular visual display terminal (VDT) workers. In total, 20 asymptomatic male VDT workers were recruited. Active cervical ROM was measured by a cervical ROM (CROM) instrument. Surface electromyography (EMG) was used to collect myoelectrical signals from the CES muscles, and the FR ratio was calculated for statistical analysis. Pearson correlation coefficients were used to quantify the linear relationship between the active cervical ROM and the FR ratio. The values obtained for the FR ratio in the right CES muscles correlated significantly with the active cervical ROM measured in flexion (r=0.73, pcervical FR ratio had a positive correlation with cervical movements, and that changes of the activation patterns in CES demonstrated as cervical FR ratio are associated with reduction of the cervical range of motion including flexion and lateral flexion. In addition, muscular dysfunction of the CES could occur in regular computer workers prior to occurrence of pain; this means that the FR ratio could be used to evaluate the potential risk of neck discomfort in computer workers.

  13. Effects of neck exercise on high-school students' neck-shoulder posture.

    Science.gov (United States)

    Lee, Myoung-Hyo; Park, Su-Jin; Kim, Jin-Sang

    2013-05-01

    [Purpose] This study examined the effects of deep flexor muscle-strengthening exercise on the neck-shoulder posture, and the strength and endurance of the deep flexor muscles of high-school students. [Subjects] The subjects were 30 seventeen-year-old female high-school students who complained about bad posture and chronic neck-shoulder pain. They were randomly divided into an experimental group of 15 subjects, who performed a deep flexor muscle-strengthening exercise and a control group of 15 subjects, who performed a basic stretching exercise. [Methods] The experimental group of 15 subjects performed a deep flexor muscle-strengthening exercise consisting of low-load training of the cranio-cervical flexor muscle, and the control group of 15 subjects performed a basic stretching exercise consisting of seven motions. [Results] The experimental group showed statistically significant changes in head tilt angle, neck flexion angle, forward shoulder angle, and the result of the cranio-cervical flexion test after the training. In contrast, the control group showed no statistically significant changes in these measures following the training. When the results of the groups were compared, statistically significant differences were found for all items between the experimental group and the control group. [Conclusion] Strengthening cranio-cervical flexor muscles is important for the adjustment of neck posture, and maintaining their stability is required to improve neck-shoulder posture.

  14. Influence of head flexion on intraocular pressure, cardiovascular, and respiratory responses in patients undergoing cataract surgery after endotracheal intubation

    Directory of Open Access Journals (Sweden)

    MR Safavi

    2007-11-01

    Full Text Available Background: In cataract surgery, the periorbital area is prepared anddraped after induction of general anesthesia and endotracheal intubation (ETI.For this purpose, the patient’s head and neck is usually flexed 30 to 45degrees. Neck flexion causes displacement of the endotracheal tube tip towardthe carina. Stimulation of the tracheal mucosa may cause bucking, increasedintraocular pressure (IOP, laryngospasm and/or bronchospasm, during lightanesthesia. Laryngeal constriction and all components of the tracheal responsemay affect end-tidal carbon dioxide pressure (PETCO2 and peripheral arterialhemoglobin oxygen saturation (SpaO2. Thus, in the current study, weinvestigated the influence of head and neck flexion on heart rate (HR, systolicand diastolic blood pressure (SAP and DAP, SpaO2, PETCO2, and IOP in patientsundergoing cataract surgery with endotracheal intubation during generalanesthesia.Patients and Methods: The present prospective study comprised patientsaged from 40 to 80 year with 106 American Society of Anesthesia (ASA physicalstatus I and II. Anesthesia was induced with thiopental sodium, lidocaine andfentanyl. Atracurium 0.5 mg/kg was administered to facilitate trachealintubation. HR, SAP, DAP, SpaO2, PETCO2, and IOP were measured at 1, 2, and 5minutes after head flexion.Results: Mean SAP, DAP, IOP, and HR was increased after ETI and headflexion compared with baseline values. PETCO2 and SpaO2 were decreased after ETIand at 1, 2 minutes after head flexion compared with baseline values.Conclusion: In patients undergoing cataract surgery during generalanesthesia, endotracheal tube movement caused changes in head and neck positionresulting in significant effects on heart rate, systolic and diastolic bloodpressures, laryngeal reflexes, SpaO2, PETCO2, and intraocular pressure.

  15. Flexion and extension structural properties and strengths for male cervical spine segments.

    Science.gov (United States)

    Nightingale, Roger W; Carol Chancey, V; Ottaviano, Danielle; Luck, Jason F; Tran, Laura; Prange, Michael; Myers, Barry S

    2007-01-01

    New vehicle safety standards are designed to limit the amount of neck tension and extension seen by out-of-position motor vehicle occupants during airbag deployments. The criteria used to assess airbag injury risk are currently based on volunteer data and animal studies due to a lack of bending tolerance data for the adult cervical spine. This study provides quantitative data on the flexion-extension bending properties and strength on the male cervical spine, and tests the hypothesis that the male is stronger than the female in pure bending. An additional objective is to determine if there are significant differences in stiffness and strength between the male upper and lower cervical spine. Pure-moment flexibility and failure testing was conducted on 41 male spinal segments (O-C2, C4-C5, C6-C7) in a pure-moment test frame and the results were compared with a previous study of females. Failures were conducted at approximately 90 N-m/s. In extension, the male upper cervical spine (O-C2) fails at a moment of 49.5 (s.d. 17.6)N-m and at an angle of 42.4 degrees (s.d. 8.0 degrees). In flexion, the mean moment at failure is 39.0 (s.d. 6.3 degrees) N-m and an angle of 58.7 degrees (s.d. 5.1 degrees). The difference in strength between flexion and extension is not statistically significant. The difference in the angles is statistically significant. The upper cervical spine was significantly stronger than the lower cervical spine in both flexion and extension. The male upper cervical spine was significantly stiffer than the female and significantly stronger than the female in flexion. Odontoid fractures were the most common injury produced in extension, suggesting a tensile mechanism due to tensile loads in the odontoid ligamentous complex.

  16. Comparison of Upper Cervical Flexion and Cervical Flexion Angle of Computer Workers with Upper Trapezius and Levator Scapular Pain

    OpenAIRE

    Yoo, Won-gyu

    2014-01-01

    [Purpose] In this study, we compared upper cervical flexion and cervical flexion angle of computer workers with upper trapezius and levator scapular pain. [Subject] Eight male computer workers with upper trapezius muscle pain and eight others with levator scapular muscle pain participated. [Methods] Each subject was assessed in terms of upper cervical flexion angle and total cervical flexion angles using a cervical range of motion instrument after one hour of computer work. [Results] The uppe...

  17. Improving lensing cluster mass estimate with flexion

    CERN Document Server

    Cardone, Vincenzo F; Er, Xinzhong; Maoli, Roberto; Scaramella, Roberto

    2016-01-01

    Gravitational lensing has long been considered as a valuable tool to determine the total mass of galaxy clusters. The shear profile as inferred from the statistics of ellipticity of background galaxies allows to probe the cluster intermediate and outer regions thus determining the virial mass estimate. However, the mass sheet degeneracy and the need for a large number of background galaxies motivate the search for alternative tracers which can break the degeneracy among model parameters and hence improve the accuracy of the mass estimate. Lensing flexion, i.e. the third derivative of the lensing potential, has been suggested as a good answer to the above quest since it probes the details of the mass profile. We investigate here whether this is indeed the case considering jointly using weak lensing, magnification and flexion. We use a Fisher matrix analysis to forecast the relative improvement in the mass accuracy for different assumptions on the shear and flexion signal - to - noise (S/N) ratio also varying t...

  18. In Vivo Healthy Knee Kinematics during Dynamic Full Flexion

    Directory of Open Access Journals (Sweden)

    Satoshi Hamai

    2013-01-01

    Full Text Available Healthy knee kinematics during dynamic full flexion were evaluated using 3D-to-2D model registration techniques. Continuous knee motions were recorded during full flexion in a lunge from 85° to 150°. Medial and lateral tibiofemoral contacts and femoral internal-external and varus-valgus rotations were analyzed as a function of knee flexion angle. The medial tibiofemoral contact translated anteroposteriorly, but remained on the center of the medial compartment. On the other hand, the lateral tibiofemoral contact translated posteriorly to the edge of the tibial surface at 150° flexion. The femur exhibited external and valgus rotation relative to the tibia over the entire activity and reached 30° external and 5° valgus rotations at 150° flexion. Kinematics’ data during dynamic full flexion may provide important insight as to the designing of high-flexion total knee prostheses.

  19. Exercise training as treatment of neck pain among fighter pilots

    DEFF Research Database (Denmark)

    Murray, Mike; Lange, Britt; Andersen, Christoffer Højnicke

    ) seldom, trained but stopped, 6) no participation at all. Maximal Voluntary Isometric Contraction (MVC) and Rate of Force Development (RFD) for cervical flexion and extension were measured by strain-gauge transducers. Results Prevalence of neck pain was significantly reduced in ET from baseline (mean ± SD...... 58% participated more that once a week (scale 1+2). Compliance according to the questionnaire correlated with registrations in the training diary (r = -0.745, P = MVC measures for cervical flexion and extension at baseline in ET were 183.6 N ± 47.1 and 286.5 N ± 48.0, and in REF 160.7 N...

  20. Cervical range of movement in relation to neck dimension.

    Science.gov (United States)

    Reynolds, Jeremy; Marsh, D; Koller, Heiko; Zenenr, Juliane; Bannister, G

    2009-06-01

    The authors investigated the effect of neck dimension upon cervical range of motion. Data relating to 100 healthy subjects, aged between 20 and 40 years, were recorded with respect to age, gender and range of motion in three planes. Additionally, two widely used methods of measuring neck motion, chin-sternal distance and uniplanar goniometer, were assessed against a validated measurement tool, the 'CROM goniometer'. Using multiple linear regression analysis it was determined that sagittal flexion (P = 0.002) and lateral rotation (P cervical range of motion as outcome variable or as a measure at posttreatment follow-up, neck circumference was shown to be one of the factors influencing total neck motion, particularly sagittal flexion and lateral tilt. Comparison of cervical range of motion assessed with a validated measurement tool, the CROM goniometer, with results of both frequently applied clinician's instruments, the uniplanar goniometer and measurement of chin-sternal distance, showed low reliability with the latter techniques, and motion values measured with these techniques should be interpreted with caution if using them for comparison of cervical range of motion of alike groups. We demonstrated that neck dimension should be incorporated into cervical functional outcome assessment and one should be wary about recorded values for neck motion from non-validated measurement tools.

  1. Prediction of three dimensional maximum isometric neck strength.

    Science.gov (United States)

    Fice, Jason B; Siegmund, Gunter P; Blouin, Jean-Sébastien

    2014-09-01

    We measured maximum isometric neck strength under combinations of flexion/extension, lateral bending and axial rotation to determine whether neck strength in three dimensions (3D) can be predicted from principal axes strength. This would allow biomechanical modelers to validate their neck models across many directions using only principal axis strength data. Maximum isometric neck moments were measured in 9 male volunteers (29±9 years) for 17 directions. The 3D moments were normalized by the principal axis moments, and compared to unity for all directions tested. Finally, each subject's maximum principal axis moments were used to predict their resultant moment in the off-axis directions. Maximum moments were 30±6 N m in flexion, 32±9 N m in lateral bending, 51±11 N m in extension, and 13±5 N m in axial rotation. The normalized 3D moments were not significantly different from unity (95% confidence interval contained one), except for three directions that combined ipsilateral axial rotation and lateral bending; in these directions the normalized moments exceeded one. Predicted resultant moments compared well to the actual measured values (r2=0.88). Despite exceeding unity, the normalized moments were consistent across subjects to allow prediction of maximum 3D neck strength using principal axes neck strength.

  2. Evaluation criteria for AIS 1 neck injuries in frontal impacts--a parameter study combining field data and Madymo modeling.

    Science.gov (United States)

    Jakobsson, Lotta; Lundgren, Kristina; Norin, Hans; Svensson, Mats

    2004-12-01

    Two situations with an expected higher AIS 1 neck injury rate in frontal impact were compared to a reference situation using a Madymo human body model in three different sitting postures and four different crash pulses. The two situations were reduced occupant weight and occupant with initial forward arm resistance, respectively. Occupant neck motion phases were identified and corresponding possible evaluation criteria were evaluated within the phases. Typical neck kinematics was seen for the two different situations. Occupants of lower weight had a more extended neck in the initial protraction phase and also a generally more pronounced upper neck link angle. Occupants with initial arm resistance had generally greater lower neck link angle at the time when the upper neck link angle was straight. No evaluation criteria reflected the anticipated AIS 1 neck injury rate consistently. In the initial protraction phase, NICmin correlated to expected injury outcome in almost half of the cases. In the protraction-flexion shift phase, Nkm, Nij, upper neck shear force and neck tension force reflected anticipated severity outcome to some extent. In the flexion phase, upper and lower neck extension correlated to anticipated AIS 1 neck injury rate only to a minor extent. The different sitting postures were more influential than the different crash pulses, emphasizing the importance of not only considering the spectra of impact severity but also differences in sitting postures in safety system development and evaluation.

  3. Neck Injuries and Disorders

    Science.gov (United States)

    ... or upper arms. Muscle strain or tension often causes neck pain. The problem is usually overuse, such as from ... or accidents, including car accidents, are another common cause of neck pain. Whiplash, a soft tissue injury to the neck, ...

  4. Effect of the cervical flexion angle during smart phone use on muscle fatigue of the cervical erector spinae and upper trapezius

    OpenAIRE

    Lee, Sangyong; Lee, Daehee; Park, Jungseo

    2015-01-01

    [Purpose] The purpose of this study was to examine the influence of the cervical flexion angle when using a smart phone on muscle fatigue of the cervical erector spinae (CES) and upper trapezius (UT). [Subjects] This study recruited 12 healthy adults. [Methods] Each subject sat on a chair, with his/her back against the wall and held a smart phone with both hands. Fatigue of the neck and shoulder muscles at different cervical flexion angles (0°, 30°, and 50°) was measured by electromyography. ...

  5. Weak lensing goes bananas: What flexion really measures

    CERN Document Server

    Schneider, Peter

    2007-01-01

    In weak gravitational lensing, the image distortion caused by shear measures the projected tidal gravitational field of the deflecting mass distribution. To lowest order, the shear is proportional to the mean image ellipticity. If the image sizes are not small compared to the scale over which the shear varies, higher-order distortions occur, called flexion. For ordinary weak lensing, the observable quantity is not the shear, but the reduced shear, owing to the mass-sheet degeneracy. Likewise, the flexion itself is unobservable. Rather, higher-order image distortions measure the reduced flexion, i.e., derivatives of the reduced shear. We derive the corresponding lens equation in terms of the reduced flexion and calculate the resulting relation between brightness moments of source and image. Assuming an isotropic distribution of source orientations, estimates for the reduced shear and flexion are obtained; these are then tested with simulations. In particular, the presence of flexion affects the determination o...

  6. INFLUENCE OF FLEXION POSITION OF THE KNEE ON LIMB ALIGNMENT

    Institute of Scientific and Technical Information of China (English)

    蒋雷生

    2003-01-01

    Objective To verify the influence of flexion position of the knee on limb alignment,the change of the standing femorotibial angle(FTA)with knee flexion was radiologically investigated. MethodsRadiographs were taken on each left knee of 47 volunteers with seldom complaints in a one-leg standing position,The standing femorotibial angles(FTA)in full knee extension were compared with the corresponding ones in different angles of knee flexion,and the relationship between the FTA and the flexion angle was investigated. Results Standing FTAs in knee flexion were always smaller than the corresponding ones in full knee extension.With the increment of the flexion angle,the FTA decreased.Positive correlation was found between the difference(△FTA)of the standing FTA in full extension and in flexion and the flexion angle of the knee.Conclusion In the preoperative planning of knee surgeries such as high tibial osteotomy and arthroplasty,the influence of flexion contracture on limb alignment should be taken into consideration to avoid overcorrection or undercorrection.

  7. Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243

    Directory of Open Access Journals (Sweden)

    Markus A. Wimmer

    2015-01-01

    Full Text Available Walking is only one of many daily activities performed by patients following total knee replacement (TKR. The purpose of this study was to examine the hypotheses (a that subject activity characteristics are correlated with knee flexion range of motion (ROM and (b that there is a significant difference between the subject’s flexion/extension excursion throughout the day and the ISO specified input for knee wear testing. In order to characterize activity, the number of walking and stair stepping cycles, the time spent with dynamic and stationary activities, the number of activity sequences, and the knee flexion/extension excursion of 32 TKR subjects were collected during daily activity. Flexion/extension profiles were compared with the ISO 14243 simulator input profile using a level crossing classification algorithm. Subjects took an average of 3102 (range: 343–5857 walking cycles including 65 (range: 0–319 stair stepping cycles. Active and passive ROMs were positively correlated with stair walking time, stair step counts, and stair walking sequences. Simulated knee motion according to ISO showed significantly fewer level crossings at the flexion angles 20–40° and beyond 50° than those measured with the monitor. This suggests that implant wear testing protocols should contain more cycles and a variety of activities requiring higher knee flexion angles with incorporated resting/transition periods to account for the many activity sequences.

  8. Lhermitte's Sign Developing after IMRT for Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Dong C. Lim

    2010-01-01

    Full Text Available Background. Lhermitte's sign (LS is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS.

  9. Decoding subtle forearm flexions using fractal features of surface electromyogram from single and multiple sensors

    Directory of Open Access Journals (Sweden)

    Kumar Dinesh

    2010-10-01

    Full Text Available Abstract Background Identifying finger and wrist flexion based actions using a single channel surface electromyogram (sEMG can lead to a number of applications such as sEMG based controllers for near elbow amputees, human computer interface (HCI devices for elderly and for defence personnel. These are currently infeasible because classification of sEMG is unreliable when the level of muscle contraction is low and there are multiple active muscles. The presence of noise and cross-talk from closely located and simultaneously active muscles is exaggerated when muscles are weakly active such as during sustained wrist and finger flexion. This paper reports the use of fractal properties of sEMG to reliably identify individual wrist and finger flexion, overcoming the earlier shortcomings. Methods SEMG signal was recorded when the participant maintained pre-specified wrist and finger flexion movements for a period of time. Various established sEMG signal parameters such as root mean square (RMS, Mean absolute value (MAV, Variance (VAR and Waveform length (WL and the proposed fractal features: fractal dimension (FD and maximum fractal length (MFL were computed. Multi-variant analysis of variance (MANOVA was conducted to determine the p value, indicative of the significance of the relationships between each of these parameters with the wrist and finger flexions. Classification accuracy was also computed using the trained artificial neural network (ANN classifier to decode the desired subtle movements. Results The results indicate that the p value for the proposed feature set consisting of FD and MFL of single channel sEMG was 0.0001 while that of various combinations of the five established features ranged between 0.009 - 0.0172. From the accuracy of classification by the ANN, the average accuracy in identifying the wrist and finger flexions using the proposed feature set of single channel sEMG was 90%, while the average accuracy when using a combination

  10. Influence of flexion angle of files on the decentralization of oval canals during instrumentation.

    Science.gov (United States)

    Oliveira, Maria Antonieta Veloso Carvalho de; Alves, Letícia Duarte; Pereira, Analice Giovani; Raposo, Luís Henrique Araújo; Biffi, João Carlos Gabrielli

    2015-01-01

    The aim of this study was to evaluate the influence of the flexion angle of files on the decentralization of root canals during instrumentation. Fifteen lower incisors were instrumented with Protaper Universal files and radiographed in two directions (mesiodistal and buccolingual) before and after instrumentation with a #15 K-file in position for evaluating the flexion angle of files. The specimens were also scanned before and after instrumentation using micro-computed tomography to obtain the canal area and the distance from the center position of the file to the canal walls. Sections located 1.0 mm (end of the canal), 3.0 mm (apical third), 9.0 mm (middle third), and 15.0 mm (cervical third) from the apex were verified. After instrumentation, the flexion angles of files decreased by an average of 0.76º in the buccolingual direction and 1.92º in the mesiodistal direction (p cervical to the end of the root canal (p flexion angles of files influence the final shape of the root canal, resulting in file decentralization along the pathway of the canal.

  11. Gravitational demand on the neck musculature during tablet computer use.

    Science.gov (United States)

    Vasavada, Anita N; Nevins, Derek D; Monda, Steven M; Hughes, Ellis; Lin, David C

    2015-01-01

    Tablet computer use requires substantial head and neck flexion, which is a risk factor for neck pain. The goal of this study was to evaluate the biomechanics of the head-neck system during seated tablet computer use under a variety of conditions. A physiologically relevant variable, gravitational demand (the ratio of gravitational moment due to the weight of the head to maximal muscle moment capacity), was estimated using a musculoskeletal model incorporating subject-specific size and intervertebral postures from radiographs. Gravitational demand in postures adopted during tablet computer use was 3-5 times that of the neutral posture, with the lowest demand when the tablet was in a high propped position. Moreover, the estimated gravitational demand could be correlated to head and neck postural measures (0.48 neck musculature during tablet computer use and are important for developing ergonomics guidelines. Practitioner Summary: Flexed head and neck postures occur during tablet computer use and are implicated in neck pain. The mechanical demand on the neck muscles was estimated to increase 3-5 times during seated tablet computer use versus seated neutral posture, with the lowest demand in a high propped tablet position but few differences in other conditions.

  12. A Review of Direct Neck Measurement in Occupational Settings

    Directory of Open Access Journals (Sweden)

    Helenice J. C. Gil Coury

    2010-12-01

    Full Text Available No guidelines are available to orient researchers on the availability and applications of equipment and sensors for recording precise neck movements in occupational settings. In this study reports on direct measurements of neck movements in the workplace were reviewed. Using relevant keywords two independent reviewers searched for eligible studies in the following databases: Cinahal, Cochrane, Embase, Lilacs, PubMed, MEDLINE, PEDro, Scopus and Web of Science. After applying the inclusion criteria, 13 articles on direct neck measurements in occupational settings were retrieved from among 33,666 initial titles. These studies were then methodologically evaluated according to their design characteristics, exposure and outcome assessment, and statistical analysis. The results showed that in most of the studies the three axes of neck movement (flexion-extension, lateral flexion and rotation were not simultaneously recorded. Deficiencies in available equipment explain this flaw, demonstrating that sensors and systems need to be improved so that a true understanding of real occupational exposure can be achieved. Further studies are also needed to assess neck movement in those who perform heavy-duty work, such as nurses and electricians, since no report about such jobs was identified.

  13. Thigh-calf contact force measurements in deep knee flexion.

    NARCIS (Netherlands)

    Zelle, J.G.; Barink, M.; Loeffen, R.; Waal Malefijt, M.C. de; Verdonschot, N.J.J.

    2007-01-01

    BACKGROUND: Knee models often do not contain thigh-calf contact which occurs in deep knee flexion. Thigh-calf contact is expected to reduce muscle forces and thereby affects internal stresses in the knee joint. The purpose of this study was to measure thigh-calf contact forces. Two deep knee flexion

  14. Range of motion in the upper and lower cervical spine in people with chronic neck pain.

    Science.gov (United States)

    Rudolfsson, Thomas; Björklund, Martin; Djupsjöbacka, Mats

    2012-02-01

    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.

  15. Weak lensing goes bananas: what flexion really measures

    Science.gov (United States)

    Schneider, P.; Er, X.

    2008-07-01

    In weak gravitational lensing, the image distortion caused by shear measures the projected tidal gravitational field of the deflecting mass distribution. To lowest order, the shear is proportional to the mean image ellipticity. If the image sizes are not small compared to the scale over which the shear varies, higher-order distortions occur, called flexion. For ordinary weak lensing, the observable quantity is not the shear, but the reduced shear, owing to the mass-sheet degeneracy. Likewise, the flexion itself is unobservable. Instead, higher-order image distortions measure the reduced flexion, i.e., derivatives of the reduced shear. We derive the corresponding lens equation in terms of the reduced flexion and calculate the resulting relation between brightness moments of source and image. Assuming an isotropic distribution of source orientations, estimates for the reduced shear and flexion are obtained and then tested with simulations. In particular, the presence of flexion affects the determination of the reduced shear. The results of these simulations yield the amount of bias of the estimators as a function of the shear and flexion. We point out and quantify a fundamental limitation of the flexion formalism in terms of the product of reduced flexion and source size. If this product increases above the derived threshold, multiple images of the source are formed locally, and the formalism breaks down. Finally, we show how a general (reduced) flexion field can be decomposed into its four components. Two of them are due to a shear field, carrying an E- and B-mode in general. The other two components do not correspond to a shear field, and they can also be split up into corresponding E- and B-modes.

  16. Three-dimensional measurement of femoral neck anteversion and neck shaft angle.

    Science.gov (United States)

    Sangeux, Morgan; Pascoe, Jessica; Graham, H Kerr; Ramanauskas, Fiona; Cain, Tim

    2015-01-01

    We present a three-dimensional measurement technique for femoral neck anteversion and neck shaft angles which do not require alignment of the femoral and scanner axes. Two assessors performed the measurements on 11 patients (22 femurs). Repeatability between assessors was 2.7 degrees for femoral neck anteversion and 4.8 degrees for neck shaft angle. Measurements compared with an alternative single slice method were different by 2 degrees (3 degrees) in average. The method was repeatable and appropriate for clinical practice.

  17. Effect of leg support on muscle cross-correlation of bilateral erector spinae during trunk flexion-extension performance.

    Science.gov (United States)

    Shan, Xinhai; Wei, Yugang; Chen, Zhentao; Fan, Lixia; Shi, Weifei; Yang, Shulong

    2014-01-01

    Investigations corresponding to the affected factors of the cross-correlation of pair muscles are limited though muscle activation patterns of bilateral erector spinae (ES) during trunk flexion-extension performance in standing have been utilized as an indicator in the evaluation of low back pain condition. The purpose of the study is to evaluate the effect of leg support on the cross-correlation of bilateral ES, and to test if the average of bilateral ES could weaken this effect. Twenty male university students volunteered for this study. Each performed the trunk flexion-extension in three leg support conditions randomly with the condition of single left leg support, double leg support and single right leg support, respectively. Each condition included three trials of trunk flexion-extension with the cycle of 5s flexion and 5s extension in standing. Surface electromyography from the right ES muscle as well as from the left one was recorded. The cross-correlation both in pair muscle of right-left ES and in pair muscle of right-average of bilateral ES was calculated in the flexion as well as extension period. A one-way ANOVA with repeated measures was used. The results showed that leg support has some effect on cross-correlation of bilateral ES, which causes the absolute value of phase lag to be significantly larger in flexion period. It is suggested that this effect could be weakened by the average of bilateral ES through significantly increasing the cross-correlation coefficient, and decreasing the absolute value of phase lag.

  18. Effect of the cervical flexion angle during smart phone use on muscle fatigue of the cervical erector spinae and upper trapezius.

    Science.gov (United States)

    Lee, Sangyong; Lee, Daehee; Park, Jungseo

    2015-06-01

    [Purpose] The purpose of this study was to examine the influence of the cervical flexion angle when using a smart phone on muscle fatigue of the cervical erector spinae (CES) and upper trapezius (UT). [Subjects] This study recruited 12 healthy adults. [Methods] Each subject sat on a chair, with his/her back against the wall and held a smart phone with both hands. Fatigue of the neck and shoulder muscles at different cervical flexion angles (0°, 30°, and 50°) was measured by electromyography. The following muscles were assessed: the right upper trapezius (RtUT), left upper trapezius (LtUT), right cervical erector spinae (RtCES), and left cervical erector spinae (LtCES). A cervical range of motion instrument was attached to the subjects' heads to measure the cervical angle during the experiment. [Results] The RtUT and LtUT showed the highest muscle fatigue at a cervical flexion angle of 50° and the lowest fatigue at an angle of 30°. There was no significant difference in the muscle fatigue of the RtCES and LtCES at any of the cervical flexion angles. [Conclusion] UT muscle fatigue depends on the cervical flexion angle when using a smart phone.

  19. Influence of flexion angle of files on the decentralization of oval canals during instrumentation

    Directory of Open Access Journals (Sweden)

    Maria Antonieta Veloso Carvalho de OLIVEIRA

    2015-01-01

    Full Text Available The aim of this study was to evaluate the influence of the flexion angle of files on the decentralization of root canals during instrumentation. Fifteen lower incisors were instrumented with Protaper Universal files and radiographed in two directions (mesiodistal and buccolingual before and after instrumentation with a #15 K-file in position for evaluating the flexion angle of files. The specimens were also scanned before and after instrumentation using micro-computed tomography to obtain the canal area and the distance from the center position of the file to the canal walls. Sections located 1.0 mm (end of the canal, 3.0 mm (apical third, 9.0 mm (middle third, and 15.0 mm (cervical third from the apex were verified. After instrumentation, the flexion angles of files decreased by an average of 0.76º in the buccolingual direction and 1.92º in the mesiodistal direction (p < 0.001; the canal area increased by an average of 0.58, 0.37, 0.23 and 0.13 mm2 from the cervical to the end of the root canal (p < 0.001. Non-instrumented areas were observed on the buccal and lingual walls, and effective action of files was determined on the mesial and distal walls. The sections from the end of the canal showed canal deviation toward the lingual wall, whereas the other sections showed deviation toward the buccal wall. The flexion angles of files influence the final shape of the root canal, resulting in file decentralization along the pathway of the canal.

  20. Reproducibility of cervical range of motion in patients with neck pain

    Directory of Open Access Journals (Sweden)

    de Vet Henrica CW

    2005-12-01

    Full Text Available Abstract Background Reproducibility measurements of the range of motion are an important prerequisite for the interpretation of study results. The aim of the study is to assess the intra-rater and inter-rater reproducibility of the measurement of active Range of Motion (ROM in patients with neck pain using the Cybex Electronic Digital Inclinometer-320 (EDI-320. Methods In an outpatient clinic in a primary care setting 32 patients with at least 2 weeks of pain and/or stiffness in the neck were randomly assessed, in a test- retest design with blinded raters using a standardized measurement protocol. Cervical flexion-extension, lateral flexion and rotation were assessed. Results Reliability expressed by the Intraclass Correlation Coefficient (ICC was 0.93 (lateral flexion or higher for intra-rater reliability and 0.89 (lateral flexion or higher for inter-rater reliability. The 95% limits of agreement for intra-rater agreement, expressing the range of the differences between two ratings were -2.5 ± 11.1° for flexion-extension, -0.1 ± 10.4° for lateral flexion and -5.9 ± 13.5° for rotation. For inter-rater agreement the limits of agreement were 3.3 ± 17.0° for flexion-extension, 0.5 ± 17.0° for lateral flexion and -1.3 ± 24.6° for rotation. Conclusion In general, the intra-rater reproducibility and the inter-rater reproducibility were good. We recommend to compare the reproducibility and clinical applicability of the EDI-320 inclinometer with other cervical ROM measures in symptomatic patients.

  1. Neck x-ray

    Science.gov (United States)

    X-ray - neck; Cervical spine x-ray; Lateral neck x-ray ... There is low radiation exposure. X-rays are monitored so that the lowest amount of radiation is used to produce the image. Pregnant women and ...

  2. Does dragonfly's abdomen flexion help with fast turning maneuvers?

    Science.gov (United States)

    Liu, Geng; Li, Chengyu; Dong, Haibo; Flow Simulation Research Group Team

    2013-11-01

    Dragonflies are able to achieve fast turning maneuvers during take-off flights. Both asymmetric wing flapping and abdomen flexion have been observed during the fast turning. It's widely thought that the asymmetric wing beats are responsible of producing the aerodynamic moment needed for the body rotation. However, the dynamic effect of the abdomen flexion is not clear yet. In this study, an integrated experimental and computational approach is used to study the underlying dynamic effect of dragonfly abdomen flexion. It's found that dragonfly abdomen tended to bend towards the same side as the body reorienting to. Quantitative analysis have shown that during take-off turning maneuver the abdomen flexion can modulate the arm of force by changing the position of the center of mass relative to the thorax. As a result, roll and yaw moments produced by the wing flapping can be enhanced. This work is supported by NSF CBET-1313217. This work is supported by NSF CBET-1313217.

  3. WorldSID Dummy Head-Neck Biofidelity Response.

    Science.gov (United States)

    Been, Bernard; Philippens, Mat; de Lange, Ronald; van Ratingen, Michiel

    2004-11-01

    Accident studies indicate that serious neck injuries are generally infrequent in side crashes. However, given the rapid changes in side impact protection technology, such as side airbags and curtain systems, the nature of head-neck interactions is likely to change. Consequently, the newest generation of anthropomorphic test devices for side impact should provide realistic prediction of the head-neck kinematics and include meaningful measurements related to risk of head and neck injury. The WorldSID dummy has been assessed against a set of five test conditions that have been used to define biofidelity impact response targets. Three of the five test conditions are recommended by ISO TR9790 (ISO 1997), the NBDL 7.2 G, 6.9 m/s lateral sled impact reported by Ewing et al. (1977) and Wismans et al. (1986) , the Patrick and Chou lateral, 6.7 G 5.8 m/s (1976) and Tarriere lateral 12.2 g, 6,1 m/s sled impact (ISO 1997). Due to its expected loading environment, the dummy neck performance has also been evaluated for neck bending in frontal flexion and extension (Mertz and Patrick, 1971). The 5th test condition is the NBDL 45 degrees frontal-oblique sled test (Wismans 1986, Philippens 2004). The latter and two of the ISO TR9790 test conditions form the basis of the draft IHRA requirements for evaluating side impact dummy biomechanical responses. The paper reports on the findings of the assessment of the WorldSID pre-production dummy. The Mertz and Patrick OC moment-head angle corridor is used as supplemental requirement for frontal flexion-extension. The biofidelity requirements contain both kinematic and dynamic response targets. The neck has a good performance for NBDL lateral and Tarriere requirements, and the Mertz OC moment-flexion angle. The performance for the Patrick and Chou, the NBDL oblique test conditions and the Mertz OC moment extension angle are fair to marginal. The repeatability performance of the dummy was found to be good for all lateral and most oblique

  4. Chronic neck pain patients with traumatic or non-traumatic onset

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Juul-Kristensen, Birgit; Boyle, Eleanor

    2017-01-01

    tests of cervical range of motion, gaze stability, eye movement, cranio-cervical flexion, cervical extensors, and pressure pain threshold. The participants completed the following questionnaires: physical and mental component summary of the Short Form Health Survey, EuroQol-5D, Neck Disability Index....... The purpose of this study was to investigate the clinical presentation of chronic neck pain patients with and without traumatic onset by examining cervical mobility, sensorimotor function, cervical muscle performance and pressure pain threshold in addition to the following self-reported characteristics...... in the traumatic group showed worse results on all measures compared with those in the non-traumatic group, significantly on neck muscle function (cervical extension mobility p = 0.005, cranio-cervical flexion test p = 0.007, cervical extensor test p = 0.006) and cervical pressure pain threshold bilateral (p = 0...

  5. High resolution weak lensing mass mapping combining shear and flexion

    Science.gov (United States)

    Lanusse, F.; Starck, J.-L.; Leonard, A.; Pires, S.

    2016-06-01

    Aims: We propose a new mass mapping algorithm, specifically designed to recover small-scale information from a combination of gravitational shear and flexion. Including flexion allows us to supplement the shear on small scales in order to increase the sensitivity to substructures and the overall resolution of the convergence map without relying on strong lensing constraints. Methods: To preserve all available small scale information, we avoid any binning of the irregularly sampled input shear and flexion fields and treat the mass mapping problem as a general ill-posed inverse problem, which is regularised using a robust multi-scale wavelet sparsity prior. The resulting algorithm incorporates redshift, reduced shear, and reduced flexion measurements for individual galaxies and is made highly efficient by the use of fast Fourier estimators. Results: We tested our reconstruction method on a set of realistic weak lensing simulations corresponding to typical HST/ACS cluster observations and demonstrate our ability to recover substructures with the inclusion of flexion, which are otherwise lost if only shear information is used. In particular, we can detect substructures on the 15'' scale well outside of the critical region of the clusters. In addition, flexion also helps to constrain the shape of the central regions of the main dark matter halos. Our mass mapping software, called Glimpse2D, is made freely available at http://www.cosmostat.org/software/glimpse

  6. Relationship between retention of the posterior cruciate ligament and postoperative flexion in total knee arthroplasty.

    Directory of Open Access Journals (Sweden)

    Yokoyama,Yoshiki

    1995-12-01

    Full Text Available This study was conducted to retrospectively analyzed the outcome of 192 total knee arthroplasties in 132 patients with rheumatoid arthritis (118 women, 14 men. The Okayama Mark II prosthesis, which requires the posterior cruciate ligament (PCL to be resected, was used in 83 knees (group I, the Mark II prosthesis, which allows the PCL to be retained, was used in 68 knees (group II, and the new Okayama PCL-R prosthesis, which also allows the PCL to be retained, was used in 41 (group III. According to the Japanese Orthopaedic Association knee scoring system, the clinical outcome of groups I, II and III at 1 year after the operation were 64.9, 71.2 and 72.3 points, respectively, and the average flexion angles in each group at 1 year were 78.4, 92.6 and 101.3 degrees. Postoperative flexion in groups III was significantly greater than in groups I and II. These results suggest that postoperative flexion is greater when the posterior cruciate ligament is retained.

  7. Cervical biomechanics and neck pain of "head-spinning" breakdancers.

    Science.gov (United States)

    Kauther, M D; Piotrowski, M; Hussmann, B; Lendemans, S; Wedemeyer, C; Jaeger, M

    2014-05-01

    The cervical spine of breakdancers is at great risk due to reversed body loading during headspin manoeuvers. This study focused on the cervical biomechanics of breakdancers and a correlation with neck pain. A standardized interview and biomechanical testing of the cervical spine of 25 participants with "headspin" ability ages 16-34 years and an age-matched cohort of 25 participants without any cervical spine problems was conducted. Neck pain history, Neck Disability Index (NDI), cervical range of motion (CROM) and cervical torque were recorded. The "headspin" group reported significantly better subjective fitness, more cervical complaints, higher pain intensity, a longer history of neck pain and a worse NDI compared to the "normal" collective. The "headspin" group showed a 2-2.5 times higher rate of neck pain than the normal population, with increased cervical flexion (pcervical torque in all planes (p<0.001). The CROM showed a negative moderate to strong correlation with NDI, pain intensity and history of neck pain. Sports medicine practitioners should be aware of headspin maneuver accidents that pose the risk of fractures, dislocations and spinal cord injuries of breakdancers.

  8. The effectiveness of thoracic manipulation on patients with chronic mechanical neck pain - a randomized controlled trial.

    Science.gov (United States)

    Lau, Herman Mun Cheung; Wing Chiu, Thomas Tai; Lam, Tai-Hing

    2011-04-01

    The aim of our study was to assess the effectiveness of thoracic manipulation (TM) on patients with chronic neck pain. 120 patients aged between 18 and 55 were randomly allocated into two groups: an experimental group which received TM and a control group without the manipulative procedure. Both groups received infrared radiation therapy (IRR) and a standard set of educational material. TM and IRR were given twice weekly for 8 sessions. Outcome measures included craniovertebral angle (CV angle), neck pain (Numeric Pain Rating Scale; NPRS), neck disability (Northwick Park Neck Disability Questionnaire; NPQ), health-related quality of life status (SF36 Questionnaire) and neck mobility. These outcome measures were assessed immediately after 8 sessions of treatment, 3-months and at a 6-month follow-up. Patients that received TM showed significantly greater improvement in pain intensity (p = 0.043), CV angle (p = 0.049), NPQ (p = 0.018), neck flexion (p = 0.005), and the Physical Component Score (PCS) of the SF36 Questionnaire (p = 0.002) than the control group immediately post-intervention. All these improvements were maintained at the 6-month follow-ups. This study shows that TM was effective in reducing neck pain, improving dysfunction and neck posture and neck range of motion (ROM) for patients with chronic mechanical neck pain up to a half-year post-treatment.

  9. 3D motion analysis comparison of left handers' wrist flexion and cutting accuracy according to scissors type.

    Science.gov (United States)

    Park, Joo-Young; Park, Soohee

    2015-03-01

    [Purpose] The purpose of this study was to research the difference in wrist flexion and accuracy of left-handers when using regular scissors made for right-handed persons versus scissors made for left-handers. [Subjects and Methods] Eighteen left-handers participated in the experiment. There were ten males and eight females subjects. The degree of wrist flexion of 18 left-handers was analyzed when using scissors designed for left-handers and when using scissors designed for right-handers. [Results] When left-handers used left-handed scissors, they carried out the task while extending the wrist at 4.67±14.60°, but when they used right-handed scissors, they carried out the task while flexing the wrist at 1.19±12.41°. When left-handers used left-handed scissors, the error rate was 1.39±1.29 times on average, but when they used right-handed scissors, the rate was 0.72±0.67 times on average. [Conclusion] When left-hand dominant persons used left-handed scissors rather than right-handed scissors, the degree of wrist flexion decreased, which created more functionality, and the accuracy of the cutting increased. For improved cutting accuracy and wrist stability and to protect the wrist from extensive flexion, it is necessary for left-handers to use scissors that are made for left-handed people.

  10. 3D motion analysis comparison of left handers’ wrist flexion and cutting accuracy according to scissors type

    Science.gov (United States)

    Park, Joo-Young; Park, Soohee

    2015-01-01

    [Purpose] The purpose of this study was to research the difference in wrist flexion and accuracy of left-handers when using regular scissors made for right-handed persons versus scissors made for left-handers. [Subjects and Methods] Eighteen left-handers participated in the experiment. There were ten males and eight females subjects. The degree of wrist flexion of 18 left-handers was analyzed when using scissors designed for left-handers and when using scissors designed for right-handers. [Results] When left-handers used left-handed scissors, they carried out the task while extending the wrist at 4.67±14.60°, but when they used right-handed scissors, they carried out the task while flexing the wrist at 1.19±12.41°. When left-handers used left-handed scissors, the error rate was 1.39±1.29 times on average, but when they used right-handed scissors, the rate was 0.72±0.67 times on average. [Conclusion] When left-hand dominant persons used left-handed scissors rather than right-handed scissors, the degree of wrist flexion decreased, which created more functionality, and the accuracy of the cutting increased. For improved cutting accuracy and wrist stability and to protect the wrist from extensive flexion, it is necessary for left-handers to use scissors that are made for left-handed people. PMID:25931762

  11. Forward head posture and neck mobility in chronic tension-type headache: a blinded, controlled study.

    Science.gov (United States)

    Fernández-de-las-Peñas, C; Alonso-Blanco, C; Cuadrado, M L; Pareja, J A

    2006-03-01

    Forward head posture (FHP) and neck mobility were objectively assessed in 25 patients with chronic tension-type headache (CTTH) and 25 healthy controls. Side-view pictures were taken in a sitting position to measure the cranio-vertebral angle. A cervical goniometer was employed to measure the range of all cervical motions. Patients with CTTH showed a smaller cranio-vertebral angle (45.3 degrees +/- 7.6 degrees) than controls (54.1 degrees +/- 6.3 degrees), thus presenting a greater FHP (P neck mobility for all cervical movements, except for right lateral flexion (P angle and neck mobility. Within the CTTH group, a negative correlation was found between the cranio-vertebral angle and headache frequency, but neck mobility did not correlate with headache parameters. Further research is needed to define a potential role of FHP and restricted neck mobility in the origin or maintenance of TTH.

  12. Standard versus high-flexion posterior stabilized total knee prostheses.

    Science.gov (United States)

    Li, Ning; Li, Junwei; Li, Peng; Wang, Dan; Liu, Ming; Xia, Lei

    2015-03-01

    This meta-analysis compared clinical outcomes between standard and high-flexion posterior-stabilized total knee prostheses to evaluate which type of total knee prosthesis was superior. Randomized, controlled trials published until October 2013 comparing standard and high-flexion posterior-stabilized total knee prostheses were reviewed. Methodologic quality was assessed with the Physiotherapy Evidence Database scale. After data extraction, the authors compared results with fixed effects or random effects models, depending on the heterogeneity of the included studies. Eight randomized, controlled trials involving 660 patients met the predetermined inclusion criteria. No statistically significant differences between patients undergoing standard and high-flexion posterior-stabilized total knee prostheses were noted in postoperative range of motion (ROM) (weighted mean difference, -1.43; 95% confidence interval [CI], -4.52 to 1.67; P=.37); flexion angle (weighted mean difference, 0.54; 95% CI, -3.75 to 4.84; P=.80); Knee Society Score (weighted mean difference, 0.92; 95% CI, -0.64 to 2.48; P=.25); Hospital for Special Surgery knee score (weighted mean difference, 0.57; 95% CI, -0.42 to 1.55; P=.26); or Knee Society function score (weighted mean difference, 1.00; 95% CI, -1.49 to 3.49; P=.43). No statistical difference was found between the 2 prosthesis types in complications, involving 21 cases in the standard group and 14 cases in the high-flexion group. The current findings confirm that high-flexion posterior-stabilized total knee prostheses are not superior to standard prostheses in terms of ROM, flexion angle, knee scores, or complications with 5 years or less of follow-up.

  13. Study of the head and neck position in microlaryngoscopy using magnetic resonance imaging.

    Science.gov (United States)

    Tong, Busheng; Fang, Rui; Smith, Benjamin L

    2013-01-01

    Several studies have critically analyzed the ideal position for laryngeal exposure during microlaryngoscopy; however, these studies have lacked the ability to evaluate the head and neck position while maintaining a direct view into the airway. Therefore, a newly established two-curve methodology was used to investigate the influence of head and neck position during microlaryngoscopy in MRI images. Fourteen normal adult volunteers were used in this magnetic resonance imaging study. The airway was divided into two curves in the sagittal plane at the center of the airway in three head and neck positions: extension-extension, neutral and flexion-extension position. The airway passage curves, point of inflection and its tangent, the line of laryngoscope, line of hyoid bone and mandible were plotted on each scan. Angles and area formed by these lines were calculated to evaluate the airway morphology changes. The flexion-extension position caused a reduction in the area between the line of laryngoscope and curves, but there was no significant difference between the three positions (p = 0.664). The flexion-extension position also resulted in the lowest angle values for α (angle between the tangent and horizon, p = 0.000), β (between the line of hyoid and horizon, p = 0.002) and δ (between the line of mandible and horizon, p = 0.004). Our study provides a better understanding of the changes in normal airway morphology during microlaryngoscopy in different positions, reinforcing the concept that flexion-extension position is the optimal position for microlaryngoscopy.

  14. The knee in full flexion: an anatomical study.

    Science.gov (United States)

    Pinskerova, V; Samuelson, K M; Stammers, J; Maruthainar, K; Sosna, A; Freeman, M A R

    2009-06-01

    There has been only one limited report dating from 1941 using dissection which has described the tibiofemoral joint between 120 degrees and 160 degrees of flexion despite the relevance of this arc to total knee replacement. We now provide a full description having examined one living and eight cadaver knees using MRI, dissection and previously published cryosections in one knee. In the range of flexion from 120 degrees to 160 degrees the flexion facet centre of the medial femoral condyle moves back 5 mm and rises up on to the posterior horn of the medial meniscus. At 160 degrees the posterior horn is compressed in a synovial recess between the femoral cortex and the tibia. This limits flexion. The lateral femoral condyle also rolls back with the posterior horn of the lateral meniscus moving with the condyle. Both move down over the posterior tibia at 160 degrees of flexion. Neither the events between 120 degrees and 160 degrees nor the anatomy at 160 degrees could result from a continuation of the kinematics up to 120 degrees . Therefore hyperflexion is a separate arc. The anatomical and functional features of this arc suggest that it would be difficult to design an implant for total knee replacement giving physiological movement from 0 degrees to 160 degrees .

  15. Pharyngeal diameter in various head and neck positions during exercise in sport horses

    Science.gov (United States)

    2014-01-01

    Background In equine athletes, dynamic stenotic disorders of the upper airways are often the cause for abnormal respiratory noises and/or poor performance. There are hypotheses, that head and neck flexion may influence the morphology and function of the upper airway and thus could even induce or deteriorate disorders of the upper respiratory tract. Especially the pharynx, without osseous or cartilaginous support is prone to changes in pressure and airflow during exercise. The objective of this study was to develop a method for measuring the pharyngeal diameter in horses during exercise, in order to analyse whether a change of head-neck position may have an impact on the pharyngeal diameter. Results Under the assumption that the width of the epiglottis remains constant in healthy horses, the newly developed method for calculating the pharyngeal diameter in horses during exercise is unsusceptible against changes of the viewing-angle and distance between the endoscope and the structures, which are to be assessed. The quotient of the width of the epiglottis and the perpendicular from a fixed point on the dorsal pharynx to the epiglottis could be used to determine the pharyngeal diameter. The percentage change of this quotient (pharynx-epiglottis-ratio; PE-ratio) in the unrestrained head-neck position against the reference position was significantly larger than that of any other combination of the head-neck positions investigated. A relation between the percentage change in PE-ratio and the degree of head and neck flexion could not be confirmed. Conclusions It could be shown, that the pharyngeal diameter is reduced through the contact position implemented by the rider in comparison to the unrestrained head and neck position. An alteration of the pharyngeal diameter depending on the degree of head and neck flexion (represented by ground and withers angle) could not be confirmed. PMID:24886465

  16. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain.

    Science.gov (United States)

    Kim, Jin Young; Kwag, Kwang Il

    2016-01-01

    [Purpose] The purpose of this study was to investigate clinical effects of deep cervical flexor (DCF) muscles exercise on pain, Neck Disability Index (NDI), and neck and shoulder postures in patients with chronic neck pain. [Subjects and Methods] Twenty-eight patients with chronic neck pain were randomly assigned into either the general strengthening exercise (GSE) group or the DCF activation group as control and experimental groups, respectively. All exercises were performed three times per week over 4 weeks. NDI and numeric rating scale (NRS) score for pain were determined and radiological assessment of neck-shoulder postures (head tilt angle [HTA], neck flexion angle [NFA], and forward shoulder angle [FSA]) was performed before (baseline), 4 weeks after, and 8 weeks after exercise in order to directly compare the exercise effects between the groups. [Results] In the DCF group, the NDI, NRS score, and neck-shoulder postures (analyzed by uisng HTA, NFA, and FSA) were significantly improved. [Conclusion] DCF activation exercise was effective to alleviate pain, recover functions, and correct forward head posture in the patients with neck pain. Hence, it might be recommended in the rehabilitation of patients with chronic neck pain.

  17. Head and Neck

    DEFF Research Database (Denmark)

    Højgaard, Liselotte; Berthelsen, Anne Kiil; Loft, Annika

    2014-01-01

    Positron emission tomography (PET)/computed tomography with FDG of the head and neck region is mainly used for the diagnosis of head and neck cancer, for staging, treatment evaluation, relapse, and planning of surgery and radio therapy. This article is a practical guide of imaging techniques......, including a detailed protocol for FDG PET in head and neck imaging, physiologic findings, and pitfalls in selected case stories....

  18. Knee flexion deformity and patella alta in spastic cerebral palsy.

    Science.gov (United States)

    Lotman, D B

    1976-06-01

    A study on spastic knee flexion deformity has revealed a recurrence rate of 32 per cent following attempted surgical correction on 170 knees (103 patients). This rate appeared to be unrelated to concomitant surgery for correction of hip and ankle deformity. An additional study demonstrated patella alta in 72 per cent of 100 spastic knees (50 patients) and only 2 per cent and 50 knees of a comparable group of 25 non-spastic patients. It is suggested that restoration of a normal patello-femoral relationship may reduce both the functional disability and recurrence rate of spastic knee flexion deformity when this disease is managed surgically.

  19. Spine lateral flexion strength development differences between exercises with pelvic stabilization and without pelvic stabilization

    Science.gov (United States)

    Straton, Alexandru; Gidu, Diana Victoria; Micu, Alexandru

    2015-02-01

    Poor lateral flexor muscle strength can be an important source of lumbar/thoracic back pain in women. The purpose of this study was to evaluate pelvic stabilization (PS) and no pelvic stabilization (NoPS) lateral flexion strength exercise training on the development of isolated right and left lateral flexion strength. Isometric torque of the isolated right and left lateral flexion muscles was measured at two positions (0° and 30° opposed angle range of motion) on 42 healthy women before and after 8 weeks of PS and NoPS lateral flexion strength exercise training. Subjects were assigned in three groups, the first (n=14) trained 3 times/week with PS lateral flexion strength exercise, the second (n=14) trained 3 times/week with NoPS lateral flexion strength exercise and the third (control, n=14) did not train. Post training isometric strength values describing PS and NoPS lateral flexion strength improved in greater extent for the PS lateral flexion strength exercise group and in lesser extent for the NoPS lateral flexion strength exercise group, in both angles (p<0.05) relative to controls. These data indicate that the most effective way of training the spine lateral flexion muscles is PS lateral flexion strength exercises; NoPS lateral flexion strength exercises can be an effective way of training for the spine lateral flexion muscles, if there is no access to PS lateral flexion strength training machines.

  20. [A man with a painful knee with restricted flexion

    NARCIS (Netherlands)

    Valkering, L.J.; Zengerink, M.; Kampen, A. van

    2015-01-01

    A 39-year-old man presented with knee pain and limited knee flexion. MRI showed a mucoid degeneration of the anterior cruciate ligament (celery stalk sign). This rare condition can be treated with arthroscopic debridement with volume reduction of the anterior cruciate ligament. In severe cases, ante

  1. The relationship between the active cervical range of motion and changes in head and neck posture after continuous VDT work.

    Science.gov (United States)

    Yoo, Won-Gyu; An, Duk-Hyun

    2009-04-01

    This study investigated the relationship between the active cervical range of motion (ROM) and changes in the head and neck posture after continuous visual display terminal (VDT) work. Twenty VDT workers were recruited from laboratories. The active cervical ROM of the participants was measured and videotaped to capture the craniocervical and cervicothoracic angles using a single video camera before and after VDT work. Pearson correlation coefficients were used to quantify the linear relationship between active cervical ROM measurements and the changes in the craniocervical and cervicothoracic angles after continuous VDT work. Active neck extension (r=-0.84, p<0.01) was negatively correlated with the mean craniocervical angle, and active neck flexion (r=-0.82, p<0.01) and left lateral flexion (r=-0.67, p<0.01) were negatively correlated with the mean cervicothoracic angle.

  2. Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

    Directory of Open Access Journals (Sweden)

    Alberto Nicodemo

    2014-01-01

    Full Text Available Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

  3. Influence of neck pain on cervical movement in the sagittal plane during smartphone use.

    Science.gov (United States)

    Kim, Man-Sig

    2015-01-01

    [Purpose] Smartphone use reportedly changes posture. However, how neck posture is altered in smartphone users with neck pain is unknown. This study examined changes in the posture of young adults with and without mild neck pain (MNP) when using a smartphone. [Subjects] Thirteen control subjects and 14 subjects with MNP who used smartphones were recruited. [Methods] The upper cervical (UC) and lower cervical (LC) angles in the sagittal plane were measured using an ultrasound-based motion analysis system while the seated subjects used a smartphone for 5 min. [Results] During smartphone use, the MNP group exhibited greater UC and LC flexion angles than the control group. [Conclusion] These findings suggest that young adults with MNP are more careful and more frequently utilize a neutral neck posture than young adults without MNP when using a smartphone while sitting.

  4. Exercise training as treatment of neck pain among military helicopter pilots and crew members

    DEFF Research Database (Denmark)

    Murray, Mike; Lange, Britt; Nørnberg, Bo Riebeling

    ) and Pressure-Pain-Threshold (PPT) in the trapezius m. and upper neck extensors. Secondary outcome: Maximal-Voluntary-Contraction (MVC) for cervical flexion/extension and shoulder-elevation. Results: Neck-pain for ETG was (mean±SD) 1.9±1.7 at baseline and 1.8±2.1 at follow-up, and correspondingly for REF 2.......4±2.0 and 1.7±1.7. Preliminary intention-to-treat analysis, revealed no significant effect on change in pain or PPT between groups. Further analysis, controlling for training frequency, intensity and volume are pending. Baseline MVC for ETG cervical flexion/extension was 184.4±59.8N and 247.2±63.8N...

  5. Morbidity of the neck after head and neck cancer therapy

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    2004-01-01

    Background. Studies on morbidity of the neck after head and neck cancer therapy are scarcely described. Methods. Patients who underwent surgery, including neck dissection, with and without radiation therapy at least 1 year before the study were asked to participate. We assessed neck pain, loss of se

  6. Kinematic Measures during a Clinical Diagnostic Technique for Human Neck Disorder: Inter- and Intraexaminer Comparisons

    Directory of Open Access Journals (Sweden)

    Joseph Vorro

    2013-01-01

    Full Text Available Diagnoses of human musculoskeletal dysfunction of the cervical spine are indicated by palpable clues of a patient’s structural compliance/noncompliance as this body segment responds to diagnostic motion demands applied by a clinician. This process includes assessments of motion range, motion performance, and changes in tissue responses. However, biomechanical quantification of these diagnostic actions and their reproducible components is lacking. As a result, this study sought to use objective kinematic measures to capture aspects of the diagnostic process to compare inter- and intraexaminer motion behaviors when performing a specific clinical diagnostic protocol. Pain-free volunteers and a group determined to be symptomatic based on a psychometric pain score were examined by two clinicians while three-dimensional kinematic data were collected. Intraexaminer diagnostic motion ranges of cervical lateral flexion and secondary rotations were consistent for each examiner and for each subject group. However, interexaminer comparisons for motion range, secondary rotations, and average velocities yielded consistently larger measures for one examiner for both subject groups (P<0.05. This research demonstrates that fundamental aspects of the clinical diagnostic process for human neck disorders can be identified and measured using kinematic parameters. Further, these objective data have the potential to be linked to clinical decision making.

  7. Effects of the sustained computer work on upper cervical flexion motion.

    Science.gov (United States)

    Park, Se-Yeon; Yoo, Won-Gyu

    2014-03-01

    [Purpose] The purpose of this study was to evaluate the effect of sustained computer work on cervical flexion, especially the upper cervical region. [Subjects] We recruited 11 sedentary workers who used a computer for at least 4 hours a day. [Methods] Total range of cervical flexion, upper cervical flexion, and their ratio were measured before and after 1 hour of computer work. [Results] The total range of cervical flexion was not significantly different between pre-and post-measurement. However, upper cervical flexion, and the ratio between the upper cervical flexion and total cervical flexion significantly decreased after 1 hour of computer work, compared to pre-measurement. [Conclusion] Sustained computer work affects the range of cervical flexion, especially in the upper cervical region.

  8. Flexibility along the neck of the neogene terror bird Andalgalornis steulleti (Aves Phorusrhacidae.

    Directory of Open Access Journals (Sweden)

    Claudia P Tambussi

    Full Text Available BACKGROUND: Andalgalornis steulleti from the upper Miocene-lower Pliocene (≈6 million years ago of Argentina is a medium-sized patagornithine phorusrhacid. It was a member of the predominantly South American radiation of 'terror birds' (Phorusrhacidae that were apex predators throughout much of the Cenozoic. A previous biomechanical study suggests that the skull would be prepared to make sudden movements in the sagittal plane to subdue prey. METHODOLOGY/PRINCIPAL FINDINGS: We analyze the flexion patterns of the neck of Andalgalornis based on the neck vertebrae morphology and biometrics. The transitional cervical vertebrae 5th and 9th clearly separate regions 1-2 and 2-3 respectively. Bifurcate neural spines are developed in the cervical vertebrae 7th to 12th suggesting the presence of a very intricate ligamentary system and of a very well developed epaxial musculature. The presence of the lig. elasticum interespinale is inferred. High neural spines of R3 suggest that this region concentrates the major stresses during downstrokes. CONCLUSIONS/SIGNIFICANCE: The musculoskeletal system of Andalgalornis seems to be prepared (1 to support a particularly big head during normal stance, and (2 to help the neck (and the head rising after the maximum ventroflexion during a strike. The study herein is the first interpretation of the potential performance of the neck of Andalgalornis in its entirety and we considered this an important starting point to understand and reconstruct the flexion pattern of other phorusrhacids from which the neck is unknown.

  9. Quantitative Ultrasonic Nakagami Imaging of Neck Fibrosis After Head and Neck Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Xiaofeng [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Yoshida, Emi [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California (United States); Cassidy, Richard J.; Beitler, Jonathan J.; Yu, David S.; Curran, Walter J. [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Liu, Tian, E-mail: tliu34@emory.edu [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2015-06-01

    Purpose: To investigate the feasibility of ultrasound Nakagami imaging to quantitatively assess radiation-induced neck fibrosis, a common sequela of radiation therapy (RT) to the head and neck. Methods and Materials: In a pilot study, 40 study participants were enrolled and classified into 3 subgroups: (1) a control group of 12 healthy volunteers; (2) an asymptomatic group of 11 patients who had received intensity modulated RT for head and neck cancer and had experienced no neck fibrosis; and (3) a symptomatic group of 17 post-RT patients with neck fibrosis. Each study participant underwent 1 ultrasound study in which scans were performed in the longitudinal orientation of the bilateral neck. Three Nakagami parameters were calculated to quantify radiation-induced tissue injury: Nakagami probability distribution function, shape, and scaling parameters. Physician-based assessments of the neck fibrosis were performed according to the Radiation Therapy Oncology Group late morbidity scoring scheme, and patient-based fibrosis assessments were rated based on symptoms such as pain and stiffness. Results: Major discrepancies existed between physician-based and patient-based assessments of radiation-induced fibrosis. Significant differences in all Nakagami parameters were observed between the control group and 2 post-RT groups. Moreover, significant differences in Nakagami shape and scaling parameters were observed among asymptomatic and symptomatic groups. Compared with the control group, the average Nakagami shape parameter value increased by 32.1% (P<.001), and the average Nakagami scaling parameter increased by 55.7% (P<.001) for the asymptomatic group, whereas the Nakagami shape parameter increased by 74.1% (P<.001) and the Nakagami scaling parameter increased by 83.5% (P<.001) for the symptomatic group. Conclusions: Ultrasonic Nakagami imaging is a potential quantitative tool to characterize radiation-induced asymptomatic and symptomatic neck fibrosis.

  10. Effects of the Sustained Computer Work on Upper Cervical Flexion Motion

    OpenAIRE

    Park, Se-Yeon; Yoo, Won-gyu

    2014-01-01

    [Purpose] The purpose of this study was to evaluate the effect of sustained computer work on cervical flexion, especially the upper cervical region. [Subjects] We recruited 11 sedentary workers who used a computer for at least 4 hours a day. [Methods] Total range of cervical flexion, upper cervical flexion, and their ratio were measured before and after 1 hour of computer work. [Results] The total range of cervical flexion was not significantly different between pre-and post-measurement. Howe...

  11. Inter-individual variation in vertebral kinematics affects predictions of neck musculoskeletal models.

    Science.gov (United States)

    Nevins, Derek D; Zheng, Liying; Vasavada, Anita N

    2014-10-17

    Experimental studies have found significant variation in cervical intervertebral kinematics (IVK) among healthy subjects, but the effect of this variation on biomechanical properties, such as neck strength, has not been explored. The goal of this study was to quantify variation in model predictions of extension strength, flexion strength and gravitational demand (the ratio of gravitational load from the weight of the head to neck muscle extension strength), due to inter-subject variation in IVK. IVK were measured from sagittal radiographs of 24 subjects (14F, 10M) in five postures: maximal extension, mid-extension, neutral, mid-flexion, and maximal flexion. IVK were defined by the position (anterior-posterior and superior-inferior) of each cervical vertebra with respect to T1 and its angle with respect to horizontal, and fit with a cubic polynomial over the range of motion. The IVK of each subject were scaled and incorporated into musculoskeletal models to create models that were identical in muscle force- and moment-generating properties but had subject-specific kinematics. The effect of inter-subject variation in IVK was quantified using the coefficient of variation (COV), the ratio of the standard deviation to the mean. COV of extension strength ranged from 8% to 15% over the range of motion, but COV of flexion strength was 20-80%. Moreover, the COV of gravitational demand was 80-90%, because the gravitational demand is affected by head position as well as neck strength. These results indicate that including inter-individual variation in models is important for evaluating neck musculoskeletal biomechanical properties.

  12. Neck Kinematics in Rear-End Impacts

    Directory of Open Access Journals (Sweden)

    King H Yang

    2003-01-01

    Full Text Available The purpose of this study was to document the kinematics of the neck during low-speed rear-end impacts. In a series of experiments reported by Deng et al (2000, a pneumatically driven mini-sled was used to study cervical spine motion using six cadavers instrumented with metallic markers at each cervical level, a 9-accelerometer mount on the head, and a tri-axial accelerometers on the thorax. A 250-Hz x-ray system was used to record marker motion while acceleration data were digitized at 10,000 Hz. Results show that, in the global coordinate system, the head and all cervical vertebrae were primarily in extension during the entire period of x-ray data collection. In local coordinate systems, upper cervical segments were initially in relative flexion while lower segments were in extension. Facet joint capsular stretch ranged from 17 to 97%. In the vertical direction, the head and T1 accelerated upward almost instantaneously after impact initiation while there was delay for the head in the horizontal direction. This combination was the result of a force vector which was pointed in the forward and upward direction to generate an extension moment. Upward ramping of the torso was larger in tests with a 20-deg seatback angle. The study concluded that the kinematics of the neck is rather complicated and greatly influenced by the large rotations of the thoracic spine. Significant posterior shear deformation was found, as evidenced by the large facet capsular stretch. Although the neck forms a 'mild' S-shaped curve during whiplash, using its shape as an injury mechanism can be misleading because the source of pain is likely to be located in the facet capsules.

  13. Biomechanical analysis of posterior cruciate ligament retaining high-flexion total knee arthroplasty

    NARCIS (Netherlands)

    Zelle, J.; Zanden, van der A.C.; De Waal Malefijt, M.; Verdonschot, N.

    2009-01-01

    Background High-flexion knee replacements have been developed to accommodate a large range of flexion (>120°) after total knee arthroplasty. Both posterior cruciate ligament retaining and sacrificing high-flexion knee designs have been marketed. The main objective of this study was to evaluate the b

  14. Management of flexion distraction injuries to the thoracolumbar spine.

    Science.gov (United States)

    Lopez, Alejandro J; Scheer, Justin K; Smith, Zachary A; Dahdaleh, Nader S

    2015-12-01

    We present an updated overview of the literature regarding the management of flexion distraction injuries (FDI). FDI are unstable fractures of the thoracolumbar spine, which require surgical management by long segment open fusion or minimally invasive posterior fixation with pedicle screws. While associated with concomitant intra-abdominal injuries that may delay operative stabilization, FDI frequently involve reversible spinal cord injuries and rapid correction is indicated. Modern biomechanical studies have identified valuable prognostic indicators that may be elucidated from determining the mechanism of injury, including the degree of flexion and presence of compression at the time of injury. An improved understanding of FDI will contribute to more appropriate diagnoses and treatment of these fractures.

  15. Neuromuscular disorders associated with static lumbar flexion: a feline model.

    Science.gov (United States)

    Solomonow, M; Zhou, B; Baratta, R V; Zhu, M; Lu, Y

    2002-04-01

    Static flexion of the lumbar spine with constant load applied to the viscoelastic structures for 20 minutes and for 50 minutes resulted in development of spasms and inhibition in the multifidus muscles (e.g., deep erector spinae) and in creep of the supraspinous ligament in the feline model. The development of spasms and inhibition was not dependent on load magnitude. It is suggested that occupational and sports activities which require prolonged static lumbar flexion within the physiological range can cause a "sprain"-like injury to the ligaments, which in turn reflexively induce spasms and inhibition in some erector spinae muscles. Such disorder may take a long time to recover, in the order of days to weeks, depending on the level of creep developed in the tissues.

  16. Melanoma - neck (image)

    Science.gov (United States)

    This melanoma on the neck is variously colored with a very darkly pigmented area found centrally. It has irregular ... be larger than 0.5 cm. Prognosis in melanoma is best defined by its depth on resection.

  17. Head and Neck Cancers

    Science.gov (United States)

    ... oral cancer ( 12 , 13 ). Preserved or salted foods . Consumption of certain preserved or salted foods during childhood ... head and neck cancers―particularly those who use tobacco―should talk with their doctor about ways that ...

  18. Gravitational Shear, Flexion and Strong Lensing in Abell 1689

    CERN Document Server

    Leonard, A; Haaga, J L; Massey, R; Leonard, Adrienne; Goldberg, David M.; Haaga, Jason L.; Massey, Richard

    2007-01-01

    We present a gravitational lensing analysis of the galaxy cluster Abell 1689, incorporating measurements of the weak shear, flexion, and strong lensing induced in background galaxies. This is the first time that a shapelet technique has been used to reconstruct the distribution of mass in this cluster, and the first time that a flexion signal has been measured using cluster members as lenses. From weak shear measurements alone, we generate a non-parametric mass reconstruction, which shows significant substructure corresponding to groups of galaxies within the cluster. Additionally, our galaxy-galaxy flexion signal demonstrates that the cluster galaxies can be well-fit by a singular isothermal sphere model with a characteristic velocity dispersion of $\\sigma = 295\\pm 40 km/s $. We identify a major, distinct dark matter clump, offset by 40$h^{-1}$kpc from the central cluster members, which was not apparent from shear measurements alone. This secondary clump is present in both a non-parametric mass reconstructio...

  19. The effect of knee-flexion angle on wheelchair turning.

    Science.gov (United States)

    MacPhee, A H; Kirby, R L; Bell, A C; MacLeod, D A

    2001-05-01

    The increasingly popular hyperflexed knee-flexion angle was evaluated to determine its effects on wheelchair turning. Twenty able-bodied subjects were tested comparing the effect of full knee extension and full knee flexion on a number of parameters. We empirically measured the angular velocity of subjects spinning 720 degrees in place, subjects' perceived ease of wheelchair turning, the overall length of the wheelchair, the anteroposterior position of the center of mass (COM), rolling resistance, turning resistance and rear-wheel traction. The combined moment of inertia of the wheelchair and system was modeled. We found that, in comparison with full extension, fully flexing the knees increased angular velocity by 40% and was perceived to be 66% easier by subjects. Overall length decreased by 39%, COM moved rearward 38%, rolling and turning resistance decreased by 21% and 17% respectively, rear-wheel traction increased by 12% and moment of inertia decreased by 42%. All empirically tested parameters were statistically significant (pwheelchair turning. The implications of these findings for wheelchair design and prescription will need to be validated on actual wheelchair users and for smaller increments in knee-flexion range.

  20. Paw withdrawal thresholds and persistent hindlimb flexion in experimental mononeuropathies.

    Science.gov (United States)

    Wallas, Tanya R; Winterson, Barbara J; Ransil, Bernard J; Bove, Geoffrey M

    2003-05-01

    Hypersensitivity of the foot produced by a number of sciatic mononeuropathies was assessed and compared. A new tool was used, the strain-gauge algometer, that delivers a noxious stimulus and gives a direct measurement of the force for paw withdrawal. In addition, we report observations of another alteration of the flexion reflex, persistent hindlimb flexion. The mean mechanical threshold for naive rats was 5.9 +/- 0.97 centinewton (standard deviation). A superficial surgical procedure had no effect on mechanical sensitivity. Sham surgeries and a surgery in which a silicone pellet was glued to the sciatic nerve produced moderate increases in mechanical sensitivity. Interventions that produced the greatest reductions in thresholds were carrageenan neuritis, complete Freund's adjuvant neuritis, and the chronic constriction injury (CCI) model. Mechanical thresholds returned to baseline in 2 weeks in all groups. Neuropathic behaviors (licking and holding the paw after the stimulus) were observed more frequently in the CCI group. Persistent hindlimb flexion was only observed in the CCI group. The results support that midaxonal inflammation is sufficient to induce hyperalgesia. The strain-gauge algometer proved to be efficient and reliable, and calculations support that used as described in this report one can demonstrate changes in paw withdrawal thresholds as small as 15%.

  1. Head and neck teratomas

    OpenAIRE

    Shah, Ajaz; Latoo, Suhail; Ahmed, Irshad; Malik, Altaf H

    2009-01-01

    Teratomas are complex lesions composed of diverse tissues from all 3 germinal cell layers and may exhibit variable levels of maturity. Head and neck teratomas are most commonly cervical with the oropharynx (epignathus) being the second commonest location. In this article, clinical presentation, behaviour and associated significance of head and neck teratomas have been highlightened. Because of their obscure origin, bizarre microscopic appearance, unpredictable behaviour and often dramatic cli...

  2. Kinematics of a Head-Neck Model Simulating Whiplash

    Science.gov (United States)

    Colicchia, Giuseppe; Zollman, Dean; Wiesner, Hartmut; Sen, Ahmet Ilhan

    2008-02-01

    A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that qualitatively undergoes the same forces acting in whiplash and shows the same behavior is used to analyze the kinematics of both the head and the cervical spine and the resulting neck loads. The rapid acceleration during a whiplash event causes the extension and flexion of the cervical spine, which in turn can cause dislocated vertebrae, torn ligaments, intervertebral disc herniation, and other trauma that appear to be the likely causes of subsequent painful headache or neck pain symptoms. Thus, whiplash provides a connection between the dynamics of the human body and physics. Its treatment can enliven the usual teaching in kinematics, and both theoretical and experimental approaches provide an interesting biological context to teach introductory principles of mechanics.

  3. A mountain among molehills: removing an impinging large femoral neck osteochondroma in a man with hereditary multiple exostoses.

    LENUS (Irish Health Repository)

    Fitzgerald, Conall W R

    2014-01-01

    A 31-year-old man with a history of hereditary multiple exostoses (HME) presented with persistent right groin pain and reduced hip range of movement. Examination demonstrated a positive FADIR (flexion, adduction and internal rotation) test suggesting femoroacetabular impingement (FAI). Investigations showed multiple sessile osteochondromata of the right femur with a dominant anterolateral femoral neck osteochondroma causing flexion block. The patient underwent an uncomplicated proximal femoral exostectomy. Six-week postoperative pain, range of movement and daily activity had greatly improved. This case highlights that even in the setting of multiple osteochondromata, excellent impingement relief can be achieved following selective proximal femoral exostectomy.

  4. Differential impact of visual feedback on plantar- and dorsi-flexion maximal torque output.

    Science.gov (United States)

    Toumi, Anis; Jakobi, Jennifer M; Simoneau-Buessinger, Emilie

    2016-05-01

    The effect of visual feedback on enhancing isometric maximal voluntary contractions (MVC) was evaluated. Twelve adults performed plantar-flexion and dorsi-flexion MVCs in 3 conditions (no visual feedback, visual feedback, and visual feedback with target). There was no significant effect of visual conditions on dorsi-flexion MVC but there was an effect on plantar-flexion. Irrespective of whether a target was evident, visual feedback increased plantar-flexion MVC by ∼15%. This study highlights the importance of optimal feedback to enhance MVC.

  5. The relation between pain extent and quality-of-life, psychological factors and neck funktion in patients with chronic neck pain

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Barbero, Marco; Falla, Deborah

    of Kinesiophobia (TSK), Beck Depression Inventory-II (BDI-ll), Neck Disability Index (NDI) and clinical tests: Craniocervical Flexion Test (CCFT), Cervical Extension Test (CE), and Cervical Range of Motion (CROM). Results: Significant positive correlations were observed between pain extent and NDI (r = 0.33; p... factors and/or decreased function of the involved body parts. Purpose: To study the relation between pain extent with 1) quality of life, 2) kinesiophobia, depression, 3) cervical muscle function and mobility and additionally the relation of pain extent with the origin of pain being traumatic or non...... to the origin being traumatic or non-traumatic. Conclusion: Pain extent extracted from pain drawings are moderately correlated with patient-reported neck function, and weakly correlated with depression, kinesiophobia and cervical clinical tests. In clinical decision-making, pain extent may indicate reduced neck...

  6. Comparison of Pressure Changes by Head and Neck Position between High-Volume Low-Pressure and Taper-Shaped Cuffs: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Nobuyasu Komasawa

    2015-01-01

    Full Text Available The present study compared changes in cuff pressure by head and neck position between high-volume low-pressure (HVLP and taper-shaped (taper cuffs in a prospective randomized clinical trial. Methods. Forty patients were intubated using tracheal tubes with either HVLP (n=20; HVLP group or taper-shaped (n=20; Taper group cuffs. Initial cuff pressure was adjusted to 15, 20, or 25 cmH2O in the neutral position. Cuff pressure was evaluated after changing the head and neck positions to flexion, extension, and rotation. Results. Cuff pressure significantly increased with flexion in both HVLP and Taper groups at all initial cuff pressures. It significantly increased with extension in the HVLP group, but not in the Taper group. Cuff pressure did not significantly differ with rotation in either group and was significantly smaller in the Taper group during flexion and extension than in the HVLP group, regardless of initial cuff pressure. Conclusion. Cuff pressure changes with head and neck flexion and extension were smaller in the Taper group than in the HVLP group. Our results highlight the potential for taper cuffs to prevent excessive cuff pressure increases with positional changes in the head and neck. This trial is registered with UMIN000016119.

  7. Comparison of Pressure Changes by Head and Neck Position between High-Volume Low-Pressure and Taper-Shaped Cuffs: A Randomized Controlled Trial.

    Science.gov (United States)

    Komasawa, Nobuyasu; Mihara, Ryosuke; Imagawa, Kentaro; Hattori, Kazuo; Minami, Toshiaki

    2015-01-01

    The present study compared changes in cuff pressure by head and neck position between high-volume low-pressure (HVLP) and taper-shaped (taper) cuffs in a prospective randomized clinical trial. Methods. Forty patients were intubated using tracheal tubes with either HVLP (n = 20; HVLP group) or taper-shaped (n = 20; Taper group) cuffs. Initial cuff pressure was adjusted to 15, 20, or 25 cmH2O in the neutral position. Cuff pressure was evaluated after changing the head and neck positions to flexion, extension, and rotation. Results. Cuff pressure significantly increased with flexion in both HVLP and Taper groups at all initial cuff pressures. It significantly increased with extension in the HVLP group, but not in the Taper group. Cuff pressure did not significantly differ with rotation in either group and was significantly smaller in the Taper group during flexion and extension than in the HVLP group, regardless of initial cuff pressure. Conclusion. Cuff pressure changes with head and neck flexion and extension were smaller in the Taper group than in the HVLP group. Our results highlight the potential for taper cuffs to prevent excessive cuff pressure increases with positional changes in the head and neck. This trial is registered with UMIN000016119.

  8. Head and neck cancers masquerading as deep neck abscesses.

    Science.gov (United States)

    Soon, Sue Rene; Kanagalingam, Jeevendra; Johari, Shirish; Yuen, Heng Wai

    2012-12-01

    Deep neck space abscesses are common otolaryngological emergencies, and prompt incision and drainage is the treatment of choice. Head and neck cancers often present with cervical metastases that may become secondarily infected. Clinical presentation is similar to a deep neck abscess. Surgical drainage of such collections has implications on subsequent treatment. In this case series, we describe six cases with this unusual presentation that were subsequently found to have a head and neck malignancy, and where three patients had their abscesses treated surgically. We aim to raise awareness of this unusual presentation of a head and neck carcinoma, and to avoid a potential pitfall in the management of deep neck abscess.

  9. In vivo movement of femoral flexion axis of a single-radius total knee arthroplasty.

    Science.gov (United States)

    Shimizu, Norimasa; Tomita, Tetsuya; Yamazaki, Takaharu; Yoshikawa, Hideki; Sugamoto, Kazuomi

    2014-12-01

    The objective of this study was to investigate in vivo femoro-tibial motion using the movement of femoral flexion axis of a single-radius TKA. We examined 20 clinically successful knees with a single-radius posterior stabilized TKA to evaluate the kinematics of deep knee flexion using 2-3-dimensional registration techniques. The mean knee flexion range of motion was 117.8°. The mean rotation of the femoral component was 7.6° external rotation. The mean knee flexion angle at initial post-cam engagement was 55.2°. No paradoxical movement of femoral component was shown until 70° flexion, afterward the femoral component rolled back with flexion. The data showed that the design of this prosthesis might contribute to reduce the paradoxical anterior femoral movement and provide stability in mid-flexion ranges.

  10. Effects of manipulation of the thorax and intensity of the pressure biofeedback unit on the superficial cervical flexors muscle during craniocervical flexion exercise

    Science.gov (United States)

    Yang, Jin Mo; Cha, Hyun-Gyu; Kim, Myoung-Kwon

    2017-01-01

    [Purpose] This study examined the effects of manipulation of the thorax and the intensity of the pressure biofeedback unit on the superficial cervical flexors muscle during craniocervical flexion exercise. [Subjects and Methods] Thirty three subjects participated in the experiment. Thirty three healthy people without any orthopedic history were also selected. The subjects could monitor the pressure applied to cervical vertebra 3 of the craniocervical junction by markings on the pressure biofeedback unit. Craniocervical flexion exercise was performed for 20 seconds per pressure, and two minutes of rest was allowed after exercise to reduce muscle fatigue. [Results] Significant differences in the post-training gains in the sternocleidomastoid and scalene were observed between the thorax fixation group and thorax non-fixation group. The thorax fixation group showed that muscle activation of the sternocleidomastoid and scalene was increased when the pressure biofeedback unit intensity was 40 mmHg than when pressure biofeedback unit intensity was 20 mmHg and 30 mmHg in the post-hoc result. The thorax non-fixation group showed that muscle activation of the sternocleidomastoid and scalene was higher when the pressure biofeedback unit intensity was 40mmHg compared to that when the pressure biofeedback unit intensity was 20mmHg in the post-hoc result. [Conclusion] Craniocervical flexion exercise is a clinically effective method that reduces the superficial neck flexor muscle activation. PMID:28265158

  11. Pediatric Neck Mass

    Directory of Open Access Journals (Sweden)

    Guilherme Machado de Carvalho

    2015-11-01

    Full Text Available Introduction  Neck masses include a wide variety of diagnostic possibilities, with more than 60 etiologies that depend on clinical aspects such as age, location and time of disease progression. The interview and physical examination guide research that cross the neck masses in pediatric patients in 3 groups: infectious / inflammatory, and neoplastic embryonic remnants. The aim of this study was to present a protocol for evaluation of neck masses in the pediatric age group, based on a review of literature on the subject and experience of this service. Materials and Methods Survey of literature data from PubMed / Medline, Google Scholar and Scopus Database without language restriction, since 1980 sources, with the MeSH term "Pediatric neck mass".  Results Prepared flowchart guidelines to be followed according with diagnostic suspicions. Patients were divided into 3 groups according to the initial clinical manifestations and according to etiological hypotheses formulated recommend evaluations protocols.  Conclusion The standardization of the evaluation of neck masses in children proves valuable and can help in the differential diagnosis of different etiologies involved.

  12. Contributions of knee swing initiation and ankle plantar flexion to the walking mechanics of amputees using a powered prosthesis.

    Science.gov (United States)

    Ingraham, Kimberly A; Fey, Nicholas P; Simon, Ann M; Hargrove, Levi J

    2014-01-01

    Recently developed powered prostheses are capable of producing near-physiological joint torque at the knee and/or ankle joints. Based on previous studies of biological joint impedance and the mechanics of able-bodied gait, an impedance-based controller has been developed for a powered knee and ankle prosthesis that integrates knee swing initiation and powered plantar flexion in late stance with increasing ankle stiffness throughout stance. In this study, five prosthesis configuration conditions were tested to investigate the individual contributions of each sub-strategy to the overall walking mechanics of four unilateral transfemoral amputees as they completed a clinical 10-m walk test using a powered knee and ankle prosthesis. The baseline condition featured constant ankle stiffness and no swing initiation or powered plantar flexion. The four remaining conditions featured knee swing initiation alone (SI) or in combination with powered plantar flexion (SI+PF), increasing ankle stiffness (SI+IK), or both (SI+PF+IK). Self-selected walking speed did not significantly change between conditions, although subjects tended to walk the slowest in the baseline condition compared to conditions with swing initiation. The addition of powered plantar flexion resulted in significantly higher ankle power generation in late stance irrespective of ankle stiffness. The inclusion of swing initiation resulted in a significantly more flexed knee at toe off and a significantly higher average extensor knee torque following toe off. Identifying individual contributions of intrinsic control strategies to prosthesis biomechanics could help inform the refinement of impedance-based prosthesis controllers and simplify future designs of prostheses and lower-limb assistive devices alike.

  13. Assessment of neck pain and cervical mobility among female computer workers at Hail University.

    Science.gov (United States)

    Mohammad, Walaa S; Hamza, Hayat H; ElSais, Walaa M

    2015-01-01

    The aims of this study were to investigate the prevalence of neck pain among computer workers at Hail University, Saudi Arabia and to compare the cervical range of motion (ROM) of female computer workers suffering from neck pain to the cervical ROM of healthy female computer workers. One hundred and seventy-six female volunteers between 20 and 46 years of age were investigated. Fifty-six of these volunteers were staff members, 22 were administrators and 98 were students. The Cervical Range of Motion (CROM) instrument was used to measure the ROM of the cervical spine. A questionnaire was used to assess participants for the presence of neck pain. The data were analyzed using the Statistical Package for Social Sciences (SPSS) software, and the level of significant was set at p cervical lateral flexion, rotation to the right side and protraction range between the pain and pain-free groups. Our results demonstrated that cervical ROM measurements, particularly cervical lateral flexion, rotation and protraction, could be useful for predicting changes in head and neck posture after long-term computer work.

  14. SHORT TERM EFFICACY OF KINESIOTAPING AND EXERCISES ON CHRONIC MECHANICAL NECK PAIN

    Directory of Open Access Journals (Sweden)

    Kulkarni Prachi Sanjay 1 , 2 , 3 ,

    2013-12-01

    Full Text Available Background and introduction:The purpose of study is to determine the short term effectiveness of Kinesiotapingcombined with Exercises in reducing pain and improving Cervical range of motion and functional ability forsubjects with Chronic Mechanical Neck pain.Method::Pre to post test experimental study design randomised thirty Chronic Mechanical Neck pain patientseach 15 into KT and control group. KT group received kinesiotaping with exercises and Control groupreceivedonly exercises for 3 times a week for 4 weeks.Pain, active cervical range of motion and functional ability weremeasured before and after 4 weeks of intervention.Results:Comparative analysis using Independent‘t’ test and Mann Whitney U test found that there is a statisticallysignificant difference (p<0.05 in means of NPRS, active Flexion, Extension, Rotation to right, Rotation to LeftROM, Neck Disability Index (NDI in percentage when compared post intervention means between the groups.Pre to post test within the group analysis in both the groups using Paired‘t’ test and Wilcoxon signed rank testfound that there is a statistically significant change in means of NPRS, Flexion, Extension, Rotation to right,Rotation to Left ROM, NDI.Conclusion:Kinesiotaping combined with exercises for 4 weeks found short term effect in improving pain,active cervical ROM and functional ability than exercises alone in treatment of chronic Mechanical neck pain

  15. Free groin flap for recurrent severe contractures of the neck in children

    Directory of Open Access Journals (Sweden)

    Ghosh Abhishek

    2010-10-01

    Full Text Available Context: Severe post burns contracture in children not only leads to functional impairment but also has profound psychological impact on the child. Untreated neck contractures have been shown to inhibit mandibular growth. Skin grafting in children has a higher rate of recurrence and in these cases a thin pliable flap seems to provide a durable solution. Aim : To study the feasibility of using primarily thinned free groin flap in the treatment of recurrent neck contractures in children. Materials and Methods: Five patients, in the age group of 5-10 years, with recurrent neck contractures and operated between 2005 and 2008 were included in this study. The sternomental distance, lateral flexion angle and cervicomental angle were measured preoperatively, postoperatively and during the subsequent follow-up visits. The patients were followed up for a period between 1 and 3 years with a mean of 29 months. Results: All the flaps survived. The cervicomental angle improved significantly to 90-105°, the lateral flexion angle improved to 35-45° and the sternomental distance increased considerably. Conclusions: Recurrent post burns contracture of the neck in children causes not only functional and aesthetic impairment but also psychological problems. A free micro-thinned groin flap provides a very attractive solution for this problem and should be seen as an effective alternative in recurrent cases.

  16. Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Björklund Martin

    2012-05-01

    Full Text Available Abstract Background A major problem with rehabilitation interventions for neck pain is that the condition may have multiple causes, thus a single treatment approach is seldom efficient. The present study protocol outlines a single blinded randomised controlled trial evaluating the effect of tailored treatment for neck-shoulder pain. The treatment is based on a decision model guided by standardized clinical assessment and functional tests with cut-off values. Our main hypothesis is that the tailored treatment has better short, intermediate and long-term effects than either non-tailored treatment or treatment-as-usual (TAU on pain and function. We sub-sequentially hypothesize that tailored and non-tailored treatment both have better effect than TAU. Methods/Design 120 working women with minimum six weeks of nonspecific neck-shoulder pain aged 20–65, are allocated by minimisation with the factors age, duration of pain, pain intensity and disability in to the groups tailored treatment (T, non-tailored treatment (NT or treatment-as-usual (TAU. Treatment is given to the groups T and NT for 11 weeks (27 sessions evenly distributed. An extensive presentation of the tests and treatment decision model is provided. The main treatment components are manual therapy, cranio-cervical flexion exercise and strength training, EMG-biofeedback training, treatment for cervicogenic headache, neck motor control training. A decision algorithm based on the baseline assessment determines the treatment components given to each participant of T- and NT-groups. Primary outcome measures are physical functioning (Neck Disability Index and average pain intensity last week (Numeric Rating Scale. Secondary outcomes are general improvement (Patient Global Impression of Change scale, symptoms (Profile Fitness Mapping neck questionnaire, capacity to work in the last 6 weeks (quality and quantity and pressure pain threshold of m. trapezius. Primary and secondary outcomes will

  17. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... oncologist will listen to the history of your problem and perform a physical examination. Consultations with other members of the head and neck team, such as the head and neck surgeon, pathologist, ...

  18. A painful stiff neck following an ear, nose, and throat surgical procedure: case report.

    Science.gov (United States)

    Pavlidis, Elena; Copioli, Cristiana; Spagnoli, Carlotta; Mazzotta, Silvia; Ormitti, Francesca; Crisi, Girolamo; Pisani, Francesco

    2015-02-01

    Grisel syndrome is a rare, nontraumatic atlantoaxial subluxation, typical of developmental ages and characterized by head flexion/rotation and painful fixation. Neurological symptoms may occur. It is secondary to head/neck infections and ear, nose, and throat surgery (adenoidectomy, tonsillectomy, and mastoidectomy). Here, we report the case of a child who presented a painful stiff neck following an adenotonsillectomy, with imaging evidencing an atlantoaxial subluxation. The child showed improvement in his condition following a conservative treatment with antibiotics, anti-inflammatory, and analgesic therapy and cervical collar. We believe it is of great significance for clinicians taking into account this peculiar condition in the differential diagnosis of a stiff neck in pediatric patients, thus avoiding misdiagnosis and delays. Indeed, its diagnosis is mainly based on a focused anamnesis associated with the detection of the typical neuroradiological findings.

  19. Reliability, construct and discriminative validity of clinical testing in subjects with and without chronic neck pain

    DEFF Research Database (Denmark)

    Jørgensen, René; Ris Hansen, Inge; Falla, Deborah

    2014-01-01

    Flexion Test (CCFT), Range of Movement (ROM), Joint Position Error (JPE), Gaze Stability (GS), Smooth Pursuit Neck Torsion Test (SPNTT), and neuromuscular control of the Deep Cervical Extensors (DCE). Test-retest reliability was assessed for Postural Control (SWAY) and Pressure Pain Threshold (PPT) over......BACKGROUND: The reliability of clinical tests for the cervical spine has not been adequately evaluated. Six cervical clinical tests, which are low cost and easy to perform in clinical settings, were tested for intra- and inter-examiner reliability, and two performance tests were assessed for test......-retest reliability in people with and without chronic neck pain. Moreover, construct and between-group discriminative validity of the tests were examined. METHODS: Twenty-one participants with chronic neck pain and 21 asymptomatic participants were included. Intra- and inter-reliability were evaluated for the Cranio-Cervical...

  20. Maximum Velocities in Flexion and Extension Actions for Sport

    Directory of Open Access Journals (Sweden)

    Jessop David M.

    2016-04-01

    Full Text Available Speed of movement is fundamental to the outcome of many human actions. A variety of techniques can be implemented in order to maximise movement speed depending on the goal of the movement, constraints, and the time available. Knowing maximum movement velocities is therefore useful for developing movement strategies but also as input into muscle models. The aim of this study was to determine maximum flexion and extension velocities about the major joints in upper and lower limbs. Seven university to international level male competitors performed flexion/extension at each of the major joints in the upper and lower limbs under three conditions: isolated; isolated with a countermovement; involvement of proximal segments. 500 Hz planar high speed video was used to calculate velocities. The highest angular velocities in the upper and lower limb were 50.0 rad·s-1 and 28.4 rad·s-1, at the wrist and knee, respectively. As was true for most joints, these were achieved with the involvement of proximal segments, however, ANOVA analysis showed few significant differences (p<0.05 between conditions. Different segment masses, structures and locations produced differing results, in the upper and lower limbs, highlighting the requirement of segment specific strategies for maximal movements.

  1. Velocity of lordosis angle during spinal flexion and extension.

    Directory of Open Access Journals (Sweden)

    Tobias Consmüller

    Full Text Available The importance of functional parameters for evaluating the severity of low back pain is gaining clinical recognition, with evidence suggesting that the angular velocity of lordosis is critical for identification of musculoskeletal deficits. However, there is a lack of data regarding the range of functional kinematics (RoKs, particularly which include the changing shape and curvature of the spine. We address this deficit by characterising the angular velocity of lordosis throughout the thoracolumbar spine according to age and gender. The velocity of lumbar back shape changes was measured using Epionics SPINE during maximum flexion and extension activities in 429 asymptomatic volunteers. The difference between maximum positive and negative velocities represented the RoKs. The mean RoKs for flexion decreased with age; 114°/s (20-35 years, 100°/s (36-50 years and 83°/s (51-75 years. For extension, the corresponding mean RoKs were 73°/s, 57°/s and 47°/s. ANCOVA analyses revealed that age and gender had the largest influence on the RoKs (p<0.05. The Epionics SPINE system allows the rapid assessment of functional kinematics in the lumbar spine. The results of this study now serve as normative data for comparison to patients with spinal pathology or after surgical treatment.

  2. Entretien sur la psychanalyse: réflexions en marge

    Directory of Open Access Journals (Sweden)

    Giuseppe Martini

    2016-08-01

    Full Text Available L’auteur propose ici un commentaire sur les points les plus importants de son entretien de février 2003 avec Paul Ricœur consacré aux rapports entre herméneutique et psychanalyse. Bien que le philosophe se situe dans une réelle continuité par rapport à sa contribution de 1965, il enrichit toutefois sa réflexion philosophique sur la psychanalyse en proposant plusieurs innovations, en ce qui concerne plus particulièrement les thèmes du récit, du soi et de l’éthique. Dans les conclusions de son commentaire, l’auteur souligne l’importance des concepts d’“irreprésentable” et d’“intraduisible”: non seulement, en effet, ces concepts sont dans la ligne de nombreuses contributions de la psychanalyse contemporaine, mais la profondeur de la réflexion ricœurienne augmente en outre leur potentiel théorique et même clinique.

  3. Lower cervical spine loading in frontal sled tests using inverse dynamics: potential applications for lower neck injury criteria.

    Science.gov (United States)

    Pintar, Frank A; Yoganandan, Narayan; Maiman, Dennis J

    2010-11-01

    Lower cervical spine injuries are more common in survivors of motor vehicle crashes sustaining neck trauma. Injury criteria are determined using upper neck loads in dummies although a lower neck load cell exists. Due to a paucity of lower neck data from post mortem human subject (PMHS) studies, this research was designed to determine the head-neck biomechanics with a focus on lower neck metrics and injuries. Sixteen frontal impact tests were conducted using five belted PMHS. Instrumentation consisted of a pyramid shaped nine accelerometer package on the head, tri-axial accelerometer on T1, and uniaxial accelerometer on the sled. Three-dimensional kinematics of the head-neck complex were obtained using a 20- camera high-speed motion analysis system. Testing sequence was: low (3.6 m/s), medium (6.9 m/s), repeat low, and high (15.8 m/s) velocities. Trauma evaluations were made between tests. Testing was terminated upon confirmation of injuries. Autopsy was conducted, and geometric and inertial properties of the head were determined. Using inverse dynamics, upper and lower neck loads were determined, along with head and T1 kinematics. Lower cervical injuries occurred in four specimens during the loading phase and were attributed to the flexion mechanism. Peak upper and lower neck loading magnitudes and head-neck and T1 kinematics are given for each test. Sagittal plane head center of gravity and T1 kinematic data along with upper and lower neck forces and moments, hitherto not reported in literature, may be used to determine the biofidelity responses of frontal impact dummies and establish lower neck injury criteria.

  4. Lipoblastoma of the neck

    DEFF Research Database (Denmark)

    Lorenzen, Jacob C; Godballe, Christian; Kerndrup, Gitte B

    2005-01-01

    with lipoblastomatous tumours in the neck is presented. A 6-year-old boy with complains of stridorous respiration and significant reduction in physical capacity was referred to the ENT Department, Odense University Hospital, Denmark. He was treated with total surgical resection of a soft and slowly growing tumour...

  5. Reconstruction of small-scale galaxy cluster substructure with lensing flexion

    Science.gov (United States)

    Cain, Benjamin; Bradač, Maruša; Levinson, Rebecca

    2016-09-01

    We present reconstructions of galaxy-cluster-scale mass distributions from simulated gravitational lensing data sets including strong lensing, weak lensing shear, and measurements of quadratic image distortions - flexion. The lensing data is constructed to make a direct comparison between mass reconstructions with and without flexion. We show that in the absence of flexion measurements, significant galaxy-group scale substructure can remain undetected in the reconstructed mass profiles, and that the resulting profiles underestimate the aperture mass in the substructure regions by ˜25 - 40%. When flexion is included, subhaloes down to a mass of ˜3 × 1012 M⊙ can be detected at an angular resolution smaller than 10″. Aperture masses from profiles reconstructed with flexion match the input distribution values to within an error of ˜13%, including both statistical error and scatter. This demonstrates the important constraint that flexion measurements place on substructure in galaxy clusters and its utility for producing high-fidelity mass reconstructions.

  6. Proportional EMG control of ankle plantar flexion in a powered transtibial prosthesis.

    OpenAIRE

    Wang, Jing; Kannape, Oliver; Herr, Hugh M.

    2013-01-01

    The human calf muscle generates 80% of the mechanical work to walk throughout stance-phase, powered plantar flexion. Powered plantar flexion is not only important for walking energetics, but also to minimize the impact on the leading leg at heel-strike. For unilateral transtibial amputees, it has recently been shown that knee load on the leading, intact limb decreases as powered plantar flexion in the trailing prosthetic ankle increases. Not surprisingly, excessive loads on the leading, intac...

  7. Narrowing of the neck in resurfacing arthroplasty of the hip: a radiological study.

    Science.gov (United States)

    Hing, C B; Young, D A; Dalziel, R E; Bailey, M; Back, D L; Shimmin, A J

    2007-08-01

    Narrowing of the femoral neck after resurfacing arthroplasty of the hip has been described previously in both cemented and uncemented hip resurfacing. The natural history of narrowing of the femoral neck is unknown. We retrospectively measured the diameter of the femoral neck in a series of 163 Birmingham hip resurfacings in 163 patients up to a maximum of six years after operation to determine the extent and progression of narrowing. There were 105 men and 58 women with a mean age of 52 years (18 to 82). At a mean follow-up of five years, the mean Harris hip score was 94.8 (47 to 100) and the mean flexion of the hip 112.5 degrees (80 degrees to 160 degrees ). There was some narrowing of the femoral neck in 77% (125) of the patients reviewed, and in 27.6% (45) the narrowing exceeded 10% of the diameter of the neck. A multiple logistic regression analysis showed a significant association (chi-squared test (derived from logistic regression) p = 0.01) of narrowing with female gender and a valgus femoral neck/shaft angle. There was no significant association between the range of movement, position or size of the component or radiological lucent lines and narrowing of the neck (chi-squared test; p = 0.10 (flexion), p = 0.08 (size of femoral component), p = 0.09 (size of acetabular component), p = 0.71 (femoral component angulation), p = 0.99 (lucent lines)). There was no significant difference between the diameter of the neck at a mean of three years (2.5 to 3.5) and that at five years (4.5 to 5.5), indicating that any change in the diameter of the neck had stabilised by three years (sign rank test, p = 0.60). We conclude that narrowing of the femoral neck which is found with the Birmingham hip resurfacing arthroplasty is in most cases associated with no adverse clinical or radiological outcome up to a maximum of six years after the initial operation.

  8. Aggregation and Averaging.

    Science.gov (United States)

    Siegel, Irving H.

    The arithmetic processes of aggregation and averaging are basic to quantitative investigations of employment, unemployment, and related concepts. In explaining these concepts, this report stresses need for accuracy and consistency in measurements, and describes tools for analyzing alternative measures. (BH)

  9. Developmental biomechanics of neck musculature

    OpenAIRE

    Lavallee, Amy V.; Ching, Randal P.; Nuckley, David J.

    2012-01-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A fa...

  10. On Averaging Rotations

    DEFF Research Database (Denmark)

    Gramkow, Claus

    1999-01-01

    In this article two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very offten the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belong...... approximations to the Riemannian metric, and that the subsequent corrections are inherient in the least squares estimation. Keywords: averaging rotations, Riemannian metric, matrix, quaternion...

  11. Diagnostic Value of Multidetector Computed Tomography in Radial Head or Neck Fractures

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hyun Hae; Hwang, Ji Young; Lee, Sun Wha; Shin, Sang Jin [School of Medicine, Ewha Womans University, Mokdong Hospital, Seoul (Korea, Republic of)

    2012-11-15

    To evaluate the diagnostic value of multidetector computed tomography (MDCT) in radial head or neck fracture, and to evaluate factors that affect MDCT image quality. Sixty-six radial fractures in 65 patients, who underwent both radiography and MDCT, were included. Detection of fracture and classification of types were recorded for each modality. Patients were divided into the good (A) and poor (B) image quality groups, and recorded the factors, such as arm positioning, flexion angle, and cancellous bone density. The detection rate of fracture showed no significant difference between the two modalities. However, classification of the fracture type was significantly accurate by MDCT (p < 0.0001). Eight cases were only detected on MDCT and three cases were only detected on radiography. Fracture type was discordant in 11 cases. MDCT scanning with raising arm (p < 0.0001), with lesser flexion angle (p = 0.004), and higher cancellous bone density (p 0.010) showed better image quality. Radiography is a good primary tool for detecting radial head or neck fracture. However, MDCT can be an additional tool for classifying the fracture type and cases with negative radiographic findings. Arm positioning, flexion angle, and cancellous bone density affect MDCT image quality.

  12. Change in neck circumference after shoulder arthroscopy: An observational study

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2015-01-01

    Full Text Available Background and Aims: Shoulder arthroscopy requires fluid irrigation, which causes soft-tissue oedema around chest, neck, and arm intraoperatively, leading to postoperative airway complications. We decided to study the incidence of increase in the neck circumference in shoulder arthroscopy and its effects on the airway. Methods: We studied 32 cases of shoulder arthroscopies over a period of 1-year, performed under general anaesthesia with interscalene block. The neck circumference of patients before and after the procedure was measured along with other parameters. The endotracheal tube cuff was deflated at the end of surgery to determine air leak around the tube. The negative leak test suggested airway oedema. Results: Thirty out of 32 patients showed positive air leak test. The average change in neck circumference was 1.17 ± 1.16 cm and all could be extubated uneventfully. Two showed negative leak test with an increase in neck circumference by 4.5 and 6.4 cm and were not extubated. Multiple regression analysis for risk factors showed intraoperative hypertension as a single predictor for an increase in neck circumference. Conclusion: Change in the neck circumference beyond 4 cm may suggest airway compromise and below 4 cm, airway compromise is unlikely even in the presence of extensive soft-tissue oedema around the shoulder, upper arm and chest.

  13. Clinimetric evaluation of methods to measure muscle functioning in patients with non-specific neck pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Smits-Engelsman Bouwien CM

    2008-10-01

    Full Text Available Abstract Background Neck pain is a significant health problem in modern society. There is evidence to suggest that neck muscle strength is reduced in patients with neck pain. This article provides a critical analysis of the research literature on the clinimetric properties of tests to measure neck muscle strength or endurance in patients with non-specific neck pain, which can be used in daily practice. Methods A computerised literature search was performed in the Medline, CINAHL and Embase databases from 1980 to January 2007. Two reviewers independently assessed the clinimetric properties of identified measurement methods, using a checklist of generally accepted criteria for reproducibility (inter- and intra-observer reliability and agreement, construct validity, responsiveness and feasibility. Results The search identified a total of 16 studies. The instruments or tests included were: muscle endurance tests for short neck flexors, craniocervical flexion test with an inflatable pressure biofeedback unit, manual muscle testing of neck musculature, dynamometry and functional lifting tests (the cervical progressive iso-inertial lifting evaluation (PILE test and the timed weighted overhead test. All the articles included report information on the reproducibility of the tests. Acceptable intra- and inter-observer reliability was demonstrated for t enduranctest for short neck flexors and the cervical PILE test. Construct validity and responsiveness have hardly been documented for tests on muscle functioning. Conclusion The endurance test of the short neck flexors and the cervical PILE test can be regarded as appropriate instruments for measuring different aspects of neck muscle function in patients with non-specific neck pain. Common methodological flaws in the studies were their small sample size and an inappropriate description of the study design.

  14. Application of the restoring force method for identification of lumbar spine flexion-extension motion under flexion-extension moment.

    Science.gov (United States)

    Borkowski, Sean L; Ebramzadeh, Edward; Sangiorgio, Sophia N; Masri, Sami F

    2014-04-01

    The restoring force method (RFM), a nonparametric identification technique established in applied mechanics, was used to maximize the information obtained from moment-rotation hysteresis curves under pure moment flexion-extension testing of human lumbar spines. Data from a previous study in which functional spine units were tested intact, following simulated disk injury, and following implantation with an interspinous process spacer device were used. The RFM was used to estimate a surface map to characterize the dependence of the flexion-extension rotation on applied moment and the resulting axial displacement. This described each spine response as a compact, reduced-order model of the complex underlying nonlinear biomechanical characteristics of the tested specimens. The RFM was applied to two datasets, and successfully estimated the flexion-extension rotation, with error ranging from 3 to 23%. First, one specimen, tested in the intact, injured, and implanted conditions, was analyzed to assess the differences between the three specimen conditions. Second, intact specimens (N = 12) were analyzed to determine the specimen variability under equivalent testing conditions. Due to the complexity and nonlinearity of the hysteretic responses, the mathematical fit of each surface was defined in terms of 16 coefficients, or a bicubic fit, to minimize the identified (estimated) surface fit error. The results of the first analysis indicated large differences in the coefficients for each of the three testing conditions. For example, the coefficient corresponding to the linear stiffness (a01) had varied magnitude among the three conditions. In the second analysis of the 12 intact specimens, there was a large variability in the 12 unique sets of coefficients. Four coefficients, including two interaction terms comprised of both axial displacement and moment, were different from zero (p < 0.05), and provided necessary quantitative information to describe the hysteresis in

  15. Your Average Nigga

    Science.gov (United States)

    Young, Vershawn Ashanti

    2004-01-01

    "Your Average Nigga" contends that just as exaggerating the differences between black and white language leaves some black speakers, especially those from the ghetto, at an impasse, so exaggerating and reifying the differences between the races leaves blacks in the impossible position of either having to try to be white or forever struggling to…

  16. On Averaging Rotations

    DEFF Research Database (Denmark)

    Gramkow, Claus

    2001-01-01

    In this paper two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very often the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belong...

  17. Evaluation of plantar flexion contracture contribution during the gait of children with Duchenne muscular dystrophy.

    Science.gov (United States)

    Gaudreault, Nathaly; Gravel, Denis; Nadeau, Sylvie

    2009-06-01

    Because of extensor weakness, children with Duchenne muscular dystrophy (DMD) maintain internal flexion moments at the joints of the lower extremities when they walk. We believe that at the ankle, the plantar flexion moments caused by contractures may contribute significantly to the production of the net ankle flexion moment during the gait in these children. The goal of the present study is to quantify ankle plantar flexion passive moments that may be associated with the presence of flexion contractures and to estimate their contribution to the net moment during the gait of children with DMD. Kinematic and kinetic parameters were collected during gait of eleven subjects with DMD. Ankle plantar flexion passive moments were also measured experimentally during the same session. Fourteen control children participated in the study in order to have normal reference values. The presence of ankle plantar flexion contractures in children with DMD was reflected by a rigidity coefficient obtained at a common moment of -7 Nm that was higher for these children (0.75 Nm/degrees vs. 0.48 Nm/degrees; p<0.05). The relative passive moment contribution to the net plantar flexion moments was higher for the children with DMD at the end of the lengthening phase of the plantar flexors (25% vs. 18%; p<0.05). We believe that the passive moments can compensate for the presence of progressive muscle weakness in the children with DMD and help these children with gait.

  18. Changes in the flexion-relaxation response induced by hip extensor and erector spinae muscle fatigue

    Directory of Open Access Journals (Sweden)

    Cantin Vincent

    2010-06-01

    Full Text Available Abstract Background The flexion-relaxation phenomenon (FRP is defined by reduced lumbar erector spinae (ES muscle myoelectric activity during full trunk flexion. The objectives of this study were to quantify the effect of hip and back extensor muscle fatigue on FRP parameters and lumbopelvic kinematics. Methods Twenty-seven healthy adults performed flexion-extension tasks under 4 different experimental conditions: no fatigue/no load, no fatigue/load, fatigue/no load, and fatigue/load. Total flexion angle corresponding to the onset and cessation of myoelectric silence, hip flexion angle, lumbar flexion angle and maximal trunk flexion angle were compared across different experimental conditions by 2 × 2 (Load × Fatigue repeated-measures ANOVA. Results The angle corresponding to the ES onset of myoelectric silence was reduced after the fatigue task, and loading the spine decreased the lumbar contribution to motion compared to the hip during both flexion and extension. A relative increment of lumbar spine motion compared to pelvic motion was also observed in fatigue conditions. Conclusions Previous results suggested that ES muscles, in a state of fatigue, are unable to provide sufficient segmental stabilization. The present findings indicate that, changes in lumbar-stabilizing mechanisms in the presence of muscle fatigue seem to be caused by modulation of lumbopelvic kinematics.

  19. The Effects of Psoas Major and Lumbar Lordosis on Hip Flexion and Sprint Performance

    Science.gov (United States)

    Copaver, Karine; Hertogh, Claude; Hue, Olivier

    2012-01-01

    In this study, we analyzed the correlations between hip flexion power, sprint performance, lumbar lordosis (LL) and the cross-sectional area (CSA) of the psoas muscle (PM). Ten young adults performed two sprint tests and isokinetic tests to determine hip flexion power. Magnetic resonance imaging was used to determine LL and PM CSA. There were…

  20. EFFECTIVENESS OF ISCHEMIC COMPRESSION ON TRAPEZIUS MYOFASCIAL TRIGGER POINTS IN NECK PAIN

    Directory of Open Access Journals (Sweden)

    Pragnya Ravichandran

    2016-04-01

    Full Text Available Background: Neck pain is a common disorder prevailing among individuals of different populations. The myofascial pain syndrome is a disorder related to myofascial trigger points. It is defined as a hyperirritable locus in skeletal muscle and that is associated with a hypersensitive palpable nodule in a taut band of muscle. Manual therapy has got a profound role in treating and ischemic compression technique has been researched widely. Thus the study intends to analyse the effectiveness of Manual Therapy (Ischemic Compression on functional outcome in neck pain. Methods: A single blinded randomized control study was conducted for subjects of sample size 30 who met the inclusion criteria and random allocation was made. The baseline parameters as like pain severity using VAS, pain pressure threshold using pressure Algometer, active cervical lateral flexion using 360 degree goniometer and disability using NDI were recorded. Study group received ischemic compression followed by myofascial stretches while the control group received ultrasonic therapy of 1.4watts/cm2. Both received Cryotherapy post session. After 2 weeks the baseline parameters were again recorded for t-test analysis. Result: There was no statistical significance between groups (p≥0.05. But active cervical lateral flexion showed improved mobility in study group and a high statistical significance within groups (p≤0.01 in relation to all parameters. Conclusion: Both ultrasonic therapy and Ischemic compression technique was found to show better improvement in pain pressure threshold and functional outcome in neck pain.

  1. Neck pain in different cephalalgias

    OpenAIRE

    E. A. Chechet; G. R. Tabeeva

    2014-01-01

    The paper reviews the literature related to the investigations of neck pain (cervicalgia) in patients with headache (cephalalgia). Neck pain is second to lower back pain as a reason for considerable socioeconomic damage to society. The prevalence of cervicalgia in the population ranges from 5.9 to 38%; the annual incidence is 10.4–21.3%; 14.2 to 71% of people report to have neck pain at some time in their lifetime. Neck pain is concurrent with cephalalgia in 70% of cases. In patients with cer...

  2. Head repositioning errors in normal student volunteers: a possible tool to assess the neck's neuromuscular system

    Directory of Open Access Journals (Sweden)

    Gudavalli M Ram

    2006-03-01

    Full Text Available Abstract Background A challenge for practitioners using spinal manipulation is identifying when an intervention is required. It has been recognized that joint pain can interfere with the ability to position body parts accurately and that the recent history of muscle contraction can play a part in that interference. In this study, we tested whether repositioning errors could be induced in a normal population by contraction or shortening of the neck muscles. Methods In the experimental protocol, volunteers free of neck problems first found a comfortable neutral head posture with eyes closed. They deconditioned their cervical muscles by moving their heads 5 times in either flexion/extension or lateral flexion and then attempted to return to the same starting position. Two conditioning sequences were interspersed within the task: hold the head in an extended or laterally flexed position for 10 seconds; or hold a 70% maximum voluntary contraction in the same position for 10 seconds. A computer-interfaced electrogoniometer was used to measure head position while a force transducer coupled to an auditory alarm signaled the force of isometric contraction. The difference between the initial and final head orientation was calculated in 3 orthogonal planes. Analysis of variance (1-way ANOVA with a blocking factor (participants was used to detect differences in proprioceptive error among the conditioning sequences while controlling for variation between participants. Results Forty-eight chiropractic students participated: 36 males and 12 females, aged 28.2 ± 4.8 yrs. During the neck extension test, actively contracting the posterior neck muscles evoked an undershoot of the target position by 2.1° (p Conclusion The results suggest that the recent history of cervical paraspinal muscle contraction can influence head repositioning in flexion/extension. To our knowledge this is the first time that muscle mechanical history has been shown to influence

  3. The Occupancy of the Components in the Cervical Spine and Their Changes with Extension and Flexion.

    Science.gov (United States)

    Sayıt, Emrah; Aghdasi, Bayan; Daubs, Michael D; Wang, Jeffrey C

    2015-10-01

    Study Design Retrospective case series. Objectives The kinematics of the cervical spine has been investigated by many researchers. However, the occupancy of the disk bulges, spinal cord, ligamentum flavum, and the rest of the canal as well as the changes of these structures with motion have not yet been investigated. The goal of this study is to investigate these dynamic changes. Methods The kinetic magnetic resonance images of 248 patients (124 men and 124 women) were evaluated, and the occupancy of each structure for each cervical level at neutral, flexion, and extension were calculated. Results Whole canal anteroposterior (AP) diameters showed significant differences between neutral-extension and flexion-extension at the C4-C5 and C5-C6 levels (p flexion and flexion-extension at the C4-C5, C5-C6, C6-C7, and C7-T1 levels (p flexion-extension and neutral-extension at the C3-C4, C4-C5, C5-C6, and C6-C7 levels (p flexion at the C4-C5, C5-C6, and C6-C7 levels (p flexion-extension at the C3-C4, C4-C5, C5-C6, and C6-C7 levels (p flexion at the C5-C6 and C6-C7 levels (p flexion at the C2-C3 and C3-C4 levels (p flexion-extension at the C3-C4 and C4-C5 levels (p flexion-extension at the C3-C4, C4-C5, C5-C6, and C6-C7 levels (p flexion at the C5-C6 and C6-C7 levels (p cervical spine for each level was revealed by this study. In addition, the dynamic changes in the cervical spine with flexion and extension were seen to have different characteristics for each level.

  4. Aggressive Fibromatosis in Neck.

    Directory of Open Access Journals (Sweden)

    Namita Kabdwal

    2013-01-01

    Full Text Available Aggressive fibromatosis (AF is a locally aggressive infiltrative low-grade benign tumor that accounts for approximately less than 3% of all soft tissue tumors. In the head and neck region this tumor tends to be more aggressive and associated with significant morbidity. Aggressive surgery is a viable management option and may be successfully used as a single modality treatment, or in combination with radiotherapy. We report a rare case of AF in a 38 year old female, who presented with a painless mass over the left supraclavicular fossa, extending inferiorly into the thoracic inlet, which was excised successfully in toto with the help of cardiothoracic vascular surgeon (CTVS.

  5. Interventional radiology neck procedures.

    Science.gov (United States)

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L

    2016-05-01

    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation.

  6. Negative Average Preference Utilitarianism

    Directory of Open Access Journals (Sweden)

    Roger Chao

    2012-03-01

    Full Text Available For many philosophers working in the area of Population Ethics, it seems that either they have to confront the Repugnant Conclusion (where they are forced to the conclusion of creating massive amounts of lives barely worth living, or they have to confront the Non-Identity Problem (where no one is seemingly harmed as their existence is dependent on the “harmful” event that took place. To them it seems there is no escape, they either have to face one problem or the other. However, there is a way around this, allowing us to escape the Repugnant Conclusion, by using what I will call Negative Average Preference Utilitarianism (NAPU – which though similar to anti-frustrationism, has some important differences in practice. Current “positive” forms of utilitarianism have struggled to deal with the Repugnant Conclusion, as their theory actually entails this conclusion; however, it seems that a form of Negative Average Preference Utilitarianism (NAPU easily escapes this dilemma (it never even arises within it.

  7. Effect of Neck Muscle Strength and Anticipatory Cervical Muscle Activation on the Kinematic Response of the Head to Impulsive Loads

    Science.gov (United States)

    Eckner, James T.; Oh, Youkeun K.; Joshi, Monica S.; Richardson, James K.; Ashton-Miller, James A.

    2015-01-01

    Background Greater neck strength and activating the neck muscles to brace for impact are both thought to reduce an athlete's risk of concussion during a collision by attenuating the head's kinematic response after impact. However, the literature reporting the neck's role in controlling postimpact head kinematics is mixed. Furthermore, these relationships have not been examined in the coronal or transverse planes or in pediatric athletes. Hypotheses In each anatomic plane, peak linear velocity (DV) and peak angular velocity (Dv) of the head are inversely related to maximal isometric cervical muscle strength in the opposing direction (H1). Under impulsive loading, DV and Dv will be decreased during anticipatory cervical muscle activation compared with the baseline state (H2). Study Design Descriptive laboratory study. Methods Maximum isometric neck strength was measured in each anatomic plane in 46 male and female contact sport athletes aged 8 to 30 years. A loading apparatus applied impulsive test forces to athletes' heads in flexion, extension, lateral flexion, and axial rotation during baseline and anticipatory cervical muscle activation conditions. Multivariate linear mixed models were used to determine the effects of neck strength and cervical muscle activation on head DV and Dv. Results Greater isometric neck strength and anticipatory activation were independently associated with decreased head DV and Dv after impulsive loading across all planes of motion (all P\\.001). Inverse relationships between neck strength and head DV and Dv presented moderately strong effect sizes (r = 0.417 to r = 0.657), varying by direction of motion and cervical muscle activation. Conclusion In male and female athletes across the age spectrum, greater neck strength and anticipatory cervical muscle activation (“bracing for impact”) can reduce the magnitude of the head's kinematic response. Future studies should determine whether neck strength contributes to the observed sex and

  8. Self-administered physical exercise training as treatment of neck pain among military helicopter pilots and crew

    DEFF Research Database (Denmark)

    Murray, Mike; Lange, Britt; Nørnberg, Bo Riebeling

    ) and upper neck extensors (UNE). Secondary outcome: Maximal voluntary contraction (MVC) for cervical extension/flexion and shoulder elevation. Training compliance was self-reported and categorized as regular if performed ≥ 1 times a week. Results: Neck pain at baseline was 1.9±1.7 (mean±SD) in ETG and 2......), was 2.2±0.6 at baseline and 1.3±1.3 at follow-up, but not significantly different from REF. MVC for cervical extension/flexion was in ETG 248±64/184±60 N at baseline and 261±56/194±63 N at follow-up, and correspondingly for REF 241±60/174±52 N and 226±58/175±43 N. MVC for cervical extension...... was significantly improved in ETG compared to REF (p=0.016). Discussion: Specific neck training significantly increased MVC in UNE in ETG. Also, PPT decreased significantly in left TRA in ETG and in REF in both TRA and UNE. No significant difference was observed between groups for self-reported neck pain. This may...

  9. Clinical characteristics and surgical options of distractive flexion injuries in lower cervical spine%下颈椎屈曲分离型损伤的临床特点与手术选择

    Institute of Scientific and Technical Information of China (English)

    龙浩; 肖杰; 郭涛; 陈艺新; 邹伟; 吴陈

    2012-01-01

    目的 探讨下颈椎屈曲分离型损伤的临床特点与手术选择.方法 回顾性分析2007年1月~2010年12月收治的有随访资料的25例下颈椎屈曲分离型损伤病例.其中新鲜损伤(﹤11d)15例,5例出现脊髓损伤,4例出现神经根损伤;陈旧性损伤(1个月~25年)10例均出现明显的颈痛及不同程度脊髓压迫或者神经根刺激症状.15例新鲜损伤患者中11例牵引复位后行前路手术,4例复位失败者行前后路切开复位手术;10例陈旧性损伤患者均采用前路脱位椎下方椎体次全切除术.结果 25例术后随访平均13个月(6~21个月),15例新鲜损伤有9例合并脊髓及神经根损伤,其中7例完全恢复.10例陈旧性损伤中8例患者颈痛及脊髓压迫神经根牵拉症状完全消失.X线片及CT提示椎体间融合好,颈椎生理曲度恢复满意.结论 新鲜下颈椎屈曲分离型损伤患者应积极通过牵引或者手术复位,根据术前复位情况决定手术方式.陈旧性患者可不作勉强复位,通过脱位椎下方椎体次全切除亦能达到神经组织减压的目的.%O b jective To discuss tie clinical characteristics of distractive flexion injuries in kwer cervical spine and to give suggestion on surgical options M ethods Retrospective study was perfomed on25 patients with distractive flexion injuries in kwer cervical spine admitted from Jan2007 toDec2010. There werel5 cases of fresh injury, including5 cases of spinal cord injuries,4 cases of nerve root injuries There were 10 cases of old injuries, all of whan complained of neck pain and neurological dysfunction Preoperative reduction was achieved in 11 cases of fresh injuries, followed by anterior discectomy and fusion Reduction failed in the other4 cases and then they underwent anterior-posterior surgeries Ten cases of old injuries underwent anterior corpectany( the vertebra adjacent to the dislocated vertebrae). Results The average follow-up wasl3 months(6-21 months) in this group Seven

  10. Flexion strength of the toes in the normal foot. An evaluation using magnetic resonance imaging.

    Science.gov (United States)

    Green, S M; Briggs, P J

    2013-12-01

    Flexion of the toes may be active from muscle contraction or passive from the reversed windlass function of the plantar aponeurosis. The aim of this study was to estimate the flexion moments the muscles of the foot and long digital flexors may be capable of generating and compare these calculations with published data. Magnetic resonance images were used to measure the maximal cross-sectional area of the foot muscles and long digital flexors, along with the radius of curvature of the metatarsal heads. Using known physiological data the maximal flexion moments the muscles may be able to generate at the metatarsophalangeal (MTP) joints were calculated. The methodology overestimates muscle strength and flexion moments at the metatarsophalangeal joints. The calculated maximal flexion moment at the 1st MTP joint is 4.27-6.84 Nm, for the 2nd, 3rd and 4th MTP joints 3.06-4.91 Nm, and the 5th MTP joint 0.47-0.75 Nm. The flexion moments the muscles may generate at the MTP joints do not account for the flexion forces seen in normal walking. Given that maximal strength is not used in normal walking, we conclude that the reversed windlass mechanism of the plantar aponeurosis must be important in normal function of the toes.

  11. Biomechanical Considerations in the Design of High-Flexion Total Knee Replacements

    Directory of Open Access Journals (Sweden)

    Cheng-Kung Cheng

    2014-01-01

    Full Text Available Typically, joint arthroplasty is performed to relieve pain and improve functionality in a diseased or damaged joint. Total knee arthroplasty (TKA involves replacing the entire knee joint, both femoral and tibial surfaces, with anatomically shaped artificial components in the hope of regaining normal joint function and permitting a full range of knee flexion. In spite of the design of the prosthesis itself, the degree of flexion attainable following TKA depends on a variety of factors, such as the joint’s preoperative condition/flexion, muscle strength, and surgical technique. High-flexion knee prostheses have been developed to accommodate movements that require greater flexion than typically achievable with conventional TKA; such high flexion is especially prevalent in Asian cultures. Recently, computational techniques have been widely used for evaluating the functionality of knee prostheses and for improving biomechanical performance. To offer a better understanding of the development and evaluation techniques currently available, this paper aims to review some of the latest trends in the simulation of high-flexion knee prostheses.

  12. Maternal Obesity and Neck Circumference.

    Science.gov (United States)

    Anglim, B; O'Higgins, A; Daly, N; Farren, M; Turner, M J

    2015-06-01

    Obese women are more likely to require general anaesthesia for an obstetric intervention than non-obese. Difficult tracheal intubation and oxygen desaturation is more common in pregnancy. Failed tracheal intubation has been associated with an increase in neck circumference (NC). We studied the relationship between maternal obesity and NC as pregnancy advanced in women attending a standard antenatal clinic. Of the 96 women recruited, 13.5% were obese. The mean NC was 36.8cm (SD 1.9) in the obese women compared with 31.5cm (SD 1.6) in women with a normal BMI (p < 0.001) at 18-22 weeks gestation. In the obese women it increased on average by 1.5cm by 36-40 weeks compared with an increase of 1.6 cm in women with a normal BMI. The antenatal measurement of NC is a simple, inexpensive tool that is potentially useful for screening obese women who may benefit from an antenatal anaesthetic assessment.

  13. CT angiography - head and neck

    Science.gov (United States)

    ... often on the face or scalp Swallowing problems Stroke Transient ischemic attack (TIA) Weakness in one part of your body CTA of the neck may also be done: After trauma to the neck to look for damage to blood vessels For planning before carotid artery ...

  14. Neck dissection: then and now.

    NARCIS (Netherlands)

    Ferlito, A.; Rinaldo, A.; Silver, C.E.; Shah, J.P.; Suarez, C.; Medina, J.E.; Kowalski, L.P.; Johnson, J.T.; Strome, M.; Rodrigo, J.P.; Werner, J.A.; Takes, R.P.; Towpik, E.; Robbins, K.T.; Leemans, C.R.; Herranz, J.; Gavilan, J.; Shaha, A.R.; Wei, W.I.

    2006-01-01

    The significance of metastatic disease in the lymph nodes of the neck as a critical independent prognostic factor in head and neck cancer has long been appreciated. Although 19th century surgeons attempted to remove involved cervical lymph nodes at the time of resection of the primary cancer, a syst

  15. Biogeometry of femoral neck for implant placement

    Directory of Open Access Journals (Sweden)

    Patwa J

    2006-01-01

    Full Text Available Background : Treatment of fracture neck femur with three cannulated cancellous screws in an apex proximal configuration is practised in many parts of the world. Methods : Dimensions of femoral neck at the middle of transcervical neck using CT scan (live neck and vernier caliper (dry cadeveric neck in 20 subjects respectively were measured. Results : Inferior half of the neck is narrower than superior half. Conclusion : Biogeometry of the neck of femur does not accomodate two inferior screws and thus fixation of fracture neck femur with three canulated cancellous screws in an apex distal configuration is recommended.

  16. Neck pain causes respiratory dysfunction.

    Science.gov (United States)

    Kapreli, Eleni; Vourazanis, Evangelos; Strimpakos, Nikolaos

    2008-01-01

    This paper describes a presumptive mechanism for the development of changes in respiratory function due to chronic neck pain. The patient with neck pain presents a number of factors that could constitute a predisposition of leading to a respiratory dysfunction: (a) the decreased strength of deep neck flexors and extensors, (b) the hyperactivity and increased fatigability of superficial neck flexors, (c) the limitation of range of motion, (d) the decrease in proprioception and disturbances in neuromuscular control, (e) the existence of pain and (f) the psychosocial influence of dysfunction. The possible connection of neck pain and respiratory function could have a great impact on various clinical aspects notably patient assessment, rehabilitation and pharmacological prescription.

  17. Anthropometric characteristics, passive hip flexion, and spinal mobility in relation to back pain in athletes.

    Science.gov (United States)

    Swärd, L; Eriksson, B; Peterson, L

    1990-05-01

    Anthropometric characteristics, passive hip flexion, and spinal mobility were examined and back pain was registered in 116 top Swedish male athletes representing four different sports (wrestling, gymnastics, soccer, tennis). Differences in stature, body weight, passive hip flexion, mobility of the spine in forward flexion, and asymmetry of the back were found when each group of athletes was compared with the rest of the athletes. These differences could be explained by a natural selection of individuals with the physical constitution required for the sport concerned, but they may also be a long-term effect of training. A small sacral inclination, defined as the sacrohorizontal angle, correlated significantly with back pain.

  18. The virtual morphology and the main movements of the human neck simulations used for car crash studies

    Science.gov (United States)

    Ciunel, St.; Tica, B.

    2016-08-01

    The paper presents the studies made on a similar biomechanical system composed by neck, head and thorax bones. The models were defined in a CAD environment which includes Adams algorithm for dynamic simulations. The virtual models and the entire morphology were obtained starting with CT images made on a living human subject. The main movements analyzed were: axial rotation (left-right), lateral bending (left-right) and flexion- extension movement. After simulation was obtained the entire biomechanical behavior based on data tables or diagrams. That virtual model composed by neck and head can be included in complex system (as a car system) and supposed to several impact simulations (virtual crash tests). Also, our research team built main components of a testing device for dummy car crash neck-head system using anatomical data.

  19. EVALUATION OF BILATERAL ASYMMETRY OF CONCENTRIC AND ISOMETRIC KNEE EXTENSION- FLEXION STRENGTH IN MALE FENCERS

    Directory of Open Access Journals (Sweden)

    Yusuf ŞAHİN

    2016-08-01

    Full Text Available Fencing is an Olympic combat sport in which two athletes fight through their weapons such as epee, foil and sabre. During the competition, athletes hold the weapon with their dominant arm and stay in defense or attack positions by stepping forward, behind or right/left with dominant leg in front. Depending upon chronic applications structural and/or functional asymmetries between dominant and non-dominant extremities are shown with cross-sectional area and performance measurements. The aim of this study was to compare dominant and non-dominant knee flexion-extension strength values of epee fencers. The study was conducted on nine athletes whose age average was 18,1± 1,4 years. Strength measurements of dominant and non-dominant knees were carried out by using concentric and isometric modules of isokinetic dynamometers (Cybex II. Angular velocities were determined as 240- 180- 120- 60⁰/s and 5 repetitions were done at each velocity. The highest value was accepted as the maximal strength. Isometric contraction was carried out at 60⁰ knee joint angle (when full extension is accepted as 0⁰ during 5 seconds. Ratios of Hamstrings/ Quadriceps were calculated with ratios of strength of flexor and extensor muscles at every angular velocity. Results were analyzed with independent sample t-test and data were given as ±SEM. Strength values of dominant leg were found statistically significantly higher than those of non-dominant leg in 240⁰/s, 180⁰/s, 120⁰/s extension movement and isometric contraction (p<0.05. When examining flexion movement, it was recorded that strength of dominant leg was higher than that of non-dominant leg at 240⁰/s velocity and during isometric contraction (p<0.05. There was no meaningful difference in H/ Q ratios between dominant and non dominant legs (p<0.05. These findings suggest that, there is an important difference in terms of dominant and non-dominant leg strength in high level fencers, though ratio of H/Q is

  20. EFFECT OF THE CERVICAL ENDURANCE TRAINING PROGRAMME IN MECHANICAL NECK PAIN

    Directory of Open Access Journals (Sweden)

    Pranjal Gogoi

    2015-10-01

    Full Text Available Background: Mechanical neck pain commonly arises insidiously and is generally multifactorial in origin. Regardless of the primary source of pain, the prognosis for individual experiencing chronic neck pain is poor. Exercise interventions are important for effective management of patients with neck pain.the objective of the study is to compare the efficacy of cervical endurance training programme with cervical isometric exercise in alleviating symptoms of mechanical neck pain. Methods: 40 subjects were assessed and identified with Mechanical Neck Pain and recruited for the study and were randomly divided into two groups. In one group endurance training for cervical muscles and in another group resisted isometric had been given for 3 weeks. The post treatment scores regarding endurance, pain intensity, disability, Range of motion and muscle power were compared with the pre treatment scores. Results: Paired‘t’ test was done to compare the pretreatment scores with the post treatment scores .Unpaired ‘t’ test was done to compare the post treatment scores of both the groups. The pain intensity, disability were found to be significantly decreased in experimental group than the control group (p<0.001. While the endurance was found to be significantly increased in experimental group than the control group (p < 0.001. The muscle power was found to be slightly increased in the control group than the experimental group .The post treatment cervical range of motion does not have significant difference in between the groups (Flexion- p=0.35 and Extension-p=0.40. Conclusion: This study showed that the progressive endurance exercise is beneficial in alleviating mechanical neck pain and should be incorporated along with the conventional physiotherapy treatment for mechanical neck pain.

  1. Lateral neck injury assessments in side impact using post mortem human subject tests.

    Science.gov (United States)

    Yoganandan, Narayan; Humm, John; Pintar, Frank A; Wolfla, Christopher E; Maiman, Dennis J

    2011-01-01

    Current neck injury criteria are based on matching upper cervical spine injuries from piglet tests to airbag deployment loads and pairing kinematics from child dummies. These "child-based" scaled data together with adult human cadaver tolerances in axial loading are used to specify neck injury thresholds in axial compression and tension, and flexion and extension moment about the occipital condyles; no thresholds are specified for any other force or moment including lateral bending. The objective of this study was to develop a testing methodology and to determine the lateral bending moment injury threshold under coronal loading. Post mortem human subjects (PMHS) were used. Specimens consisted of whole body and isolated head-neck complexes with intact musculature. Intact specimen positioning included: sitting PMHS upright on a rigid seat, supporting the torso by a plate, maintaining Frankfurt plane horizontal. Isolated head-neck complexes were fixed at T1 with the occiput connected via a custom apparatus to a testing device to induce lateral bending motion. Head angular and linear accelerations and angular velocities were computed using a pyramid nine accelerometer package on the head; specimen-specific physical properties including center of gravity and moments of inertia in the three-dimensions; and equations of equilibrium. These data were used to determine neck loads at the occipital condyles. No specimens sustained injuries, identified by palpation, x-rays, CT, and autopsy. Results from 24 tests indicated that PMHS head-neck complexes can tolerate 75 Nm of coronal moment at low axial load without failure, and this level may be used as an initial estimate of the injury reference value under lateral loading to the human head-neck complex.

  2. The range of excursion of flexor tendons in Zone V: a comparison of active vs passive flexion mobilisation regimes.

    LENUS (Irish Health Repository)

    Panchal, J

    1997-10-01

    A number of early postoperative mobilisation regimes have been developed in an attempt to increase tendon excursion and gliding and thereby reduce formation of adhesions following repair of flexor tendons. Early active flexion mobilisation regimes are becoming more popular, and have replaced early passive flexion regimes in many centres. The aim of the present study was: (a) to determine the range of excursion of flexor tendons in Zone V, and (b) to compare the excursion ranges between active (Belfast) and passive (modified Duran) flexion mobilisation regimes postoperatively. This was done (a) in two cadavers, and (b) in two patients intraoperatively, and postoperatively at 10 days, 3 weeks and 6 weeks. With passive flexion, the mean tendon excursion in Zone V in cadavers was 1 mm for flexor digitorum superficialis (FDS), flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) tendons respectively. With simulated active flexion, the mean tendon excursion was 14 mm, 10 mm and 11 mm respectively. The mean tendon excursion in clinical cases intraoperatively following passive flexion was 2 mm for FDS, FDP and FPL respectively; following simulated active flexion it was 10 mm, 11 mm and 11 mm for FDS, FDP and FPL respectively. On the tenth day following repair, the mean excursions of FDS, FDP and FPL were 1 mm, 4 mm and 4 mm on passive flexion as compared to 3 mm, 10 mm and 12 mm on active flexion respectively. Three weeks postoperatively, the mean excursions of FDS, FDP and FPL tendons were 1 mm, 2 mm and 1 mm on passive flexion as compared to 5 mm, 15 mm on active flexion respectively. Six weeks postoperatively, the mean excursions of FDS, FDP and FPL tendons were 9 mm, 7 mm and 4 mm on passive flexion as compared to 12 mm, 33 mm and 20 mm on active flexion respectively. These results demonstrate an increased excursion of repaired flexor tendons in Zone V following an active flexion mobilisation regime as compared to a passive flexion mobilisation regime.

  3. PEMBERIAN TEKNIK MULLIGAN DAN SOFT TISSUE MOBILIZATION LEBIH BAIK DARIPADA HANYA SOFT TISSUE MOBILIZATION DALAM MENINGKATKAN LINGKUP GERAK SENDI EKSTENSI, ROTASI, LATERAL FLEKSI CERVICAL PADA MECHANICAL NECK PAIN

    Directory of Open Access Journals (Sweden)

    sudaryanto -

    2013-11-01

    Full Text Available Mechanical neck pain has the same high prevalence with low back pain, and commonly found in many of physiotherapy practice. Combination of Mulligan technique and Soft Tissue Mobilization are one of manual therapy technique highly effective and efficient to care the case of mechanical neck pain but still very rarely used by physiotherapist in fields of practice. This study aimed to know the effectiveness between Mulligan technique – Soft Tissue Mobilization and only Soft Tissue Mobilization to the increasing range of motion extension, rotation and side flexion cervical on the mechanical neck pain. The study design was a pre test – post test control group design using two group of samples are control groups that given intervention Soft Tissue Mobilization and treatment groups that given a combination of Mulligan technique and Soft Tissue Mobilization. Measuring instrument used for data collection was goniometer, that the goniometer was used to measure the range of motion extension, rotation and lateral flexion of the cervical either before the intervention and after the intervention. Sample of this study was 32 people who divided into 2 groups of samples were 16 people in the control group and 16 people in the treatment group. Samples in the control group had a mean age of 35,69 with male of 7 people (43,8% and female of 9 people (56,2% as well as limitations of the right direction were 12 people (75% and left direction were 4 people (25%. Whereas in the treatment group had e mean age of 35,94 with male of 10 people (62,5% and female of 6 people (37,5% as well as limitations of the right direction were 11 people (62,5% and left direction were 5 people (31,2%. The results of hypothesis testing using independent sampel t-test showed a significant difference between the mean post-intervention ROM extension, rotation, lateral flexion of the control groups and the mean post-intervention ROM extension, rotation, lateral flexion of the treatment

  4. [Death of an infant following 'craniosacral' manipulation of the neck and spine].

    Science.gov (United States)

    Holla, Micha; Ijland, Marloes M; van der Vliet, A M; Edwards, Michael; Verlaat, Carin W M

    2009-04-25

    A healthy 3-month-old girl died after manipulation of the cervical and thoracolumbar spine by a so-called craniosacral therapist. During persistent forced deep flexion of the neck and spine, the infant developed faecal incontinence, atonia and apnoea followed by an asystole. A physical examination, additional MRI studies and an autopsy indicated that the infant probably died as a consequence of local neurovascular lesions of the cervical spine or a mechanically-induced respiratory problem. This is the second reported case of an infant dying after forced manipulations of the neck. Until there is scientific evidence for the effectiveness and safety of forced manipulations of the vertebral column, we advise against this treatment in neonates and infants.

  5. New Constraints on the Complex Mass Substructure in Abell 1689 from Gravitational Flexion

    CERN Document Server

    Leonard, Adrienne; Goldberg, David M

    2010-01-01

    In a recent publication, the flexion aperture mass statistic was found to provide a robust and effective method by which substructure in galaxy clusters might be mapped. Moreover, we suggested that constraints on the masses and mass profile of structures might be constrained using this method. In this paper, we apply the flexion aperture mass technique to HST ACS images of Abell 1689. We compare this measure to the weak lensing shear aperture mass statistic, and demonstrate that the flexion aperture mass statistic is more sensitive to structures on the scales considered, dramatically outperforming the shear aperture mass statistic on this dataset, which suffers from persistent systematic noise. While the central potential is not constrained by our method, due largely to missing data in the central 0.5$^\\prime$ of the cluster, we are able to place constraints on the masses and mass profiles of prominent substructures. Considering 16 flexion aperture mass reconstructions, we identify 4 separate mass peaks, and ...

  6. High Resolution Weak Lensing Mass-Mapping Combining Shear and Flexion

    CERN Document Server

    Lanusse, Francois; Leonard, Adrienne; Pires, Sandrine

    2016-01-01

    We propose a new mass-mapping algorithm, specifically designed to recover small-scale information from a combination of gravitational shear and flexion. Including flexion allows us to supplement the shear on small scales in order to increase the sensitivity to substructures and the overall resolution of the convergence map without relying on strong lensing constraints. In order to preserve all available small scale information, we avoid any binning of the irregularly sampled input shear and flexion fields and treat the mass-mapping problem as a general ill-posed inverse problem, regularised using a robust multi-scale wavelet sparsity prior. The resulting algorithm incorporates redshift, reduced shear, and reduced flexion measurements for individual galaxies and is made highly efficient by the use of fast Fourier estimators. We test our reconstruction method on a set of realistic weak lensing simulations corresponding to typical HST/ACS cluster observations and demonstrate our ability to recover substructures ...

  7. On the validity of the Born approximation for weak cosmic flexions

    CERN Document Server

    Schaefer, Bjoern Malte; Kalovidouris, Angelos Fotios; Bacon, David J

    2011-01-01

    Weak lensing calculations are often made under the assumption of the Born approximation, where the ray path is approximated as a straight radial line. In addition, lens-lens couplings where there are several deflections along the light ray are often neglected. We examine the effect of dropping the Born approximation and taking lens-lens couplings into account, for weak lensing effects up to second order (cosmic flexion), by making a perturbative expansion in the light path. We present a diagrammatic representation of the resulting corrections to the lensing effects. The flexion signal, which measures the derivative of the density field, acquires correction terms proportional to the squared gravitational shear; we also find that by dropping the Born approximation, two further degrees of freedom of the lensing distortion can be excited (the twist components), in addition to the four standard flexion components. We derive angular power spectra of the flexion and twist, with and without the Born-approximation and...

  8. Activation of brain areas following ankle dorsiflexion versus plantar flexion Functional magnetic resonance imaging verification

    Institute of Scientific and Technical Information of China (English)

    Tianyu Jiang; Weiping Wu; Xinglin Wang; Changshui Weng; Qiuhua Wang; Yanmei Guo

    2012-01-01

    Changes in activated areas of the brain during ankle active dorsiflexion and ankle active plantar flexion were observed in six healthy subjects using functional magnetic resonance imaging.Excited areas of ankle active dorsiflexion involved the bilateral primary motor area and the primary somatosensory area, as well as the bilateral supplementary sensory area, the primary visual area, the right second visual area, and the vermis of cerebellum.Excited areas of ankle active plantar flexion included the ipsilateral supplementary motor area, the limbic system, and the contralateral corpus striatum.Fine movements of the cerebral cortex control the function of the ankle dorsiflexion to a larger extent than ankle plate flexion, and the function of ankle plate flexion is more controlled by the subcortical area.

  9. Development of a knee joint motion simulator to evaluate deep knee flexion of artificial knee joints.

    Science.gov (United States)

    Takano, Y; Ueno, M; Kiguchi, K; Ito, J; Mawatari, M; Hotokebuchi, T

    2008-01-01

    A purpose of this study is to examine the effect that quadriceps femoris force gives to rotation angle and joint reaction force of total knee prosthesis during deep knee flexion such as a unique sitting style called 'seiza' in Japanese. For the evaluation, we developed the knee motion simulator which could bend to 180 degrees continually simulating the passive flexion performed by clinicians. A total knee prosthesis, which is a specially-devised posterior stabilized type and capable of flexion up to 180 degrees, was inserted into bone model. And this prosthesis pulled by three kinds of quadriceps femoris forces to perform parameter study. The results obtained in this study were showed the same tendency with those in the past cadaveric experiment. It is suggested that the rotation angle and joint reaction force of total knee prosthesis are affected by shape of prosthesis, a vector of quadriceps femoris force, and bony aliments during deep knee flexion.

  10. Investigating the effects of movement speed on the lumbopelvic coordination during trunk flexion.

    Science.gov (United States)

    Zhou, Jie; Ning, Xiaopeng; Fathallah, Fadi

    2016-08-01

    Movement speed during trunk flexion has long been reported to affect task performance and biomechanical responses. The current study investigated how movement speed changed lumbopelvic coordination, especially lumbopelvic continuous relative phase and phase variability during trunk flexion. Eighteen subjects executed a paced trunk flexion routine over time periods of 3, 7, 11 and 15seconds. The results demonstrated that compared with the 3-s condition, lumbopelvic continuous relative phase was 98.8% greater in the 15-s condition, indicating a more anti-phase coordination pattern. This pattern is suggested to mitigate the increased spinal loading associated with the longer duration of muscle exertion. Additionally, phase variability was 18.8% greater in the 15-s trials than the 3-s trials, such an unstable coordination pattern is likely caused by the more active neuromuscular control. Findings of this study provide important information about the effects of movement speed on lumbopelvic coordination during trunk flexion.

  11. Constraining primordial non-Gaussianity with cosmological weak lensing: shear and flexion

    CERN Document Server

    Fedeli, C; Moscardini, L

    2012-01-01

    We examine the cosmological constraining power of future large-scale weak lensing surveys on the model of \\emph{Euclid}, with particular reference to primordial non-Gaussianity. Our analysis considers several different estimators of the projected matter power spectrum, based on both shear and flexion, for which we review the covariances and Fisher matrices. The bounds provided by cosmic shear alone for the local bispectrum shape, marginalized over $\\sigma_8$, are at the level of $\\Delta f_\\mathrm{NL} \\sim 100$. We consider three additional bispectrum shapes, for which the cosmic shear constraints range from $\\Delta f_\\mathrm{NL}\\sim 340$ (equilateral shape) up to $\\Delta f_\\mathrm{NL}\\sim 500$ (orthogonal shape). The competitiveness of cosmic flexion constraints against cosmic shear ones depends on the galaxy intrinsic flexion noise, that is still virtually unconstrained. Adopting the very high value that has been occasionally used in the literature results in the flexion contribution being basically negligib...

  12. Longitudinal study on physical fitness parameters influencing bone mineral density reduction in middle-aged and elderly women: bone mineral density in the lumbar spine, femoral neck, and femur.

    Science.gov (United States)

    Iida, Tadayuki; Ikeda, Hiromi; Shiokawa, Michihisa; Aoi, Satomi; Ishizaki, Fumiko; Harada, Toshihide; Ono, Yuichiro

    2012-06-01

    The prolongation of the average life span of women has been associated with the rapidly aging society. However, serious problem have arisen as a result, such as an increase in the number of bed-ridden elderly patients with osteoporosis-associated femoral neck fracture. As preventive measures against osteoporosis for middle-aged to elderly women, 10,000 steps per day and intense exercise have been reported to inhibit bone mineral density (BMD) reduction. However, only a few studies have concretely reported on the type of physical fitness that is effective for BMD in particular parts of the body. In this study, a one-year longitudinal survey was performed involving generally healthy postmenopausal women to investigate physical fitness parameters influencing BMD in the lumbar spine, femoral neck, and femur. The subjects were 38 female residents of M City, aged 49-73 years. As physical fitness parameters, sit-ups, anteflexion in a sitting position, grip strength, mean amount of exercise (kcal), and area of outer body sway on standing straight with the eyes closed (m2) were measured. The BMD was measured in the lumbar spine (L2-L4), femoral neck, and femur. Logistic regression analysis was performed regarding the physical fitness parameters as explanatory variables and groups with and without BMD reduction over one year as those with and without risk as dependent variables. The number of sit-ups (odds ratio: 0.76, 95% CI: 0.61-0.96, p=0.022) was a preventive factor against BMD reduction of the lumbar spine, and ante flexion in a sitting position was a preventive factor against BMD reduction of the femoral neck (odds ratio: 0.88, 95% CI: 0.78-0.99, p=0.029). Regarding BMD reduction of the femur, the area of outer body sway on standing straight with the eyes closed tended to be not significant to the risk. It is suggested that physical fitness and local muscle strength are associated with BMD reduction in the lumbar spine, femoral neck, and femur.

  13. Influence of flexion angle of files on the decentralization of oval canals during instrumentation

    OpenAIRE

    Maria Antonieta Veloso Carvalho OLIVEIRA; Letícia Duarte ALVES; Pereira,Analice Giovani; RAPOSO,Luís Henrique Araújo; João Carlos Gabrielli BIFFI

    2015-01-01

    The aim of this study was to evaluate the influence of the flexion angle of files on the decentralization of root canals during instrumentation. Fifteen lower incisors were instrumented with Protaper Universal files and radiographed in two directions (mesiodistal and buccolingual) before and after instrumentation with a #15 K-file in position for evaluating the flexion angle of files. The specimens were also scanned before and after instrumentation using micro-computed tomography to obtain th...

  14. Image Segmentation and Analysis of Flexion-Extension Radiographs of Cervical Spines

    OpenAIRE

    Eniko T. Enikov; Rein Anton

    2014-01-01

    We present a new analysis tool for cervical flexion-extension radiographs based on machine vision and computerized image processing. The method is based on semiautomatic image segmentation leading to detection of common landmarks such as the spinolaminar (SL) line or contour lines of the implanted anterior cervical plates. The technique allows for visualization of the local curvature of these landmarks during flexion-extension experiments. In addition to changes in the curvature of the SL lin...

  15. Dynamic splinting for knee flexion contracture following total knee arthroplasty: a case report

    OpenAIRE

    Finger, Eric; Willis, F Buck

    2008-01-01

    Total Knee Arthroplasty operations are increasing in frequency, and knee flexion contracture is a common pathology, both pre-existing and post-operative. A 61-year-old male presented with knee flexion contracture following a total knee arthroplasty. Physical therapy alone did not fully reduce the contracture and dynamic splinting was then prescribed for daily low-load, prolonged-duration stretch. After 28 physical therapy sessions, the active range of motion improved from -20° to -12° (stiff ...

  16. Location of the mandibular branch of the facial nerve according to the neck position.

    Science.gov (United States)

    Hwang, Kun; Huan, Fan; Ki, Sae Hwi; Nam, Yong Seok; Han, Seung Ho

    2012-09-01

    The aim of this study was to elucidate the exact location of the mandibular branch of the facial nerve according to different neck positions. Twenty-two hemifaces of 11 fresh human cadavers were used (age range, 53-89 y; mean age, 72.3 ± 10.5 y; 8 men and 3 women). Working through skin windows, the distance from the mandibular border to the mandibular branch of the facial nerve (border-nerve distance or BND) was measured at 3 points: (1) the mandible angle (gonion or Go point), (2) the point where the mandibular branch of the facial nerve crosses the facial artery (FA point), and (3) the one-fourth point from the gonion to the menton (1/4 point). Threads were hung on the skin windows along the mandibular border. With the neck in the neutral position and then full flexion (15 degrees), extension (15 degrees), and left and right rotations (30 degrees), the distance of the mandibular branch from the thread of the mandibular border was measured using calipers. In the neutral position, the mandibular branch was 3.50 ± 2.82 mm above the mandibular border at the Go point, 5.34 ± 2.98 mm above the mandibular border at the FA point, and 5.28 ± 1.86 mm above the mandibular border at the 1/4 point. At all 3 points, flexion or extension of the neck did not significantly move the mandibular branch. At the Go point and FA point, there was no significant difference between the ipsilateral rotation position and the contralateral rotation. Yet at the 1/4 point, the BND decreased (4.32 ± 2.60 mm) with the neck in ipsilateral rotation and the BND increased (5.97 ± 2.62 mm) with the neck in contralateral rotation. There was a significant difference between the ipsilateral rotation position and the contralateral rotation position (P = 0.020, t-test). Surgeons should keep in mind that at the 1/4 point, the mandibular branch of the facial nerve moves downward 1.10 ± 1.42 mm with the neck in ipsilateral rotation and moves upward 0.49 ± 1.84 mm with the neck in contralateral

  17. Image Segmentation and Analysis of Flexion-Extension Radiographs of Cervical Spines

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    Eniko T. Enikov

    2014-01-01

    Full Text Available We present a new analysis tool for cervical flexion-extension radiographs based on machine vision and computerized image processing. The method is based on semiautomatic image segmentation leading to detection of common landmarks such as the spinolaminar (SL line or contour lines of the implanted anterior cervical plates. The technique allows for visualization of the local curvature of these landmarks during flexion-extension experiments. In addition to changes in the curvature of the SL line, it has been found that the cervical plates also deform during flexion-extension examination. While extension radiographs reveal larger curvature changes in the SL line, flexion radiographs on the other hand tend to generate larger curvature changes in the implanted cervical plates. Furthermore, while some lordosis is always present in the cervical plates by design, it actually decreases during extension and increases during flexion. Possible causes of this unexpected finding are also discussed. The described analysis may lead to a more precise interpretation of flexion-extension radiographs, allowing diagnosis of spinal instability and/or pseudoarthrosis in already seemingly fused spines.

  18. Dynamic Elbow Flexion Force Estimation Through a Muscle Twitch Model and sEMG in a Fatigue Condition.

    Science.gov (United States)

    Na, Youngjin; Kim, Jung

    2016-11-14

    We propose a joint force estimation method to compute elbow flexion force using surface electromyogram (sEMG) considering time-varying effects in a fatigue condition. Muscle fatigue is a major cause inducing sEMG changes with respect to time over long periods and repetitive contractions. The proposed method composed the muscle-twitch model representing the force generated by a single spike and the spikes extracted from sEMG. In this study, isometric contractions at six different joint angles (ten subjects) and dynamic contractions with constant velocity (six subjects) were performed under non-fatigue and fatigue conditions. Performance of the proposed method was evaluated and compared with that of previous methods using mean absolute value (MAV). The proposed method achieved average 6.7±2.8 %RMSE for isometric contraction and 15.6±24.7 %RMSE for isokinetic contraction under fatigue condition with more accurate results than the previous methods.

  19. Neck pain in different cephalalgias

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    E. A. Chechet

    2014-01-01

    Full Text Available The paper reviews the literature related to the investigations of neck pain (cervicalgia in patients with headache (cephalalgia. Neck pain is second to lower back pain as a reason for considerable socioeconomic damage to society. The prevalence of cervicalgia in the population ranges from 5.9 to 38%; the annual incidence is 10.4–21.3%; 14.2 to 71% of people report to have neck pain at some time in their lifetime. Neck pain is concurrent with cephalalgia in 70% of cases. In patients with cervicalgia, the prevalence of headache is 20–40% higher than in those with musculoskeletal pain at another site. Neck pain is as a major risk factor for migraine and tension headache (TH. Neck pain in TH progresses with the increased intensity, frequency, and strength of headache. There is a direct relationship of the quality of life worsening associated withcervicalgia to the frequency of migraine attacks and the risk of its chronization. Neck pain is noted in cervicogenic headache belonging to secondary headaches. The identification of mixed headache in a patient with cervicalgia allows the prescription of a treatment option that may be effective in relieving both headache and neck pain. The paper discusses the causes and pathogenesis of cervicalgia in patients with headache, examination methods, and main approaches to drug and nondrug therapies in relation to the leading pathophysiological mechanism, as well as new possibilities for the effective and safe relief of pain syndrome in this category of patients. Nonsteroidal anti-inflammatory drugs, myorelaxants,and their combination are observed to be effective in treating patients with cervicalgia and cephalalgia.

  20. Effect of hair and clothing on neck immobilization using a cervical collar.

    Science.gov (United States)

    Chi, Chih-Hsien; Wu, Fong-Gong; Tsai, Shu-Hui; Wang, Chun-Hsiang; Stern, Susan A

    2005-05-01

    An important step during spine immobilization is application of a cervical collar. Clothing or hair covering the neck may impinge on this process. The purpose of this study was to evaluate the effect of clothing and hair covering the neck on immobilization using a cervical collar. Study participants were 18 female volunteers with long hair aged 20 to 28 years. Cervical range of motion (ROM) was tested in 6 directions (flexion, extension, right and left lateral bending, right and left axial rotation) using a cervical ROM (CROM) device. After measuring unrestricted ROM (no cervical collar), a 1-piece rigid cervical collar was placed the neck (1) covered by hair and clothing; (2) covered by clothing; (3) covered by hair; or (4) uncovered. Range of motion was retested under all 4 conditions. Data were compared using crossover-design analysis of variance (Pcervical collar placement under all conditions. Unrestricted ROM in all directions ranged from 41.50 degrees (7.25 degrees) to 70.76 degrees (15.4 degrees). In contrast, ROM with a cervical collar under the 4 conditions in all directions ranged from 10.80 degrees (5.10 degrees) to 18.81 degrees (7.37 degrees). We were unable to detect any significant differences in ROM between the 4 conditions. Our data suggest that long hair and clothing, which cover the neck, do not alter the effectiveness of cervical collar immobilization as measured by the cervical ROM device.

  1. The clinical examination of neck pain patients: the validity of a group of tests.

    Science.gov (United States)

    De Hertogh, Willem J; Vaes, Peter H; Vijverman, Veerle; De Cordt, Ann; Duquet, William

    2007-02-01

    We evaluated whether a blinded observer could identify the neck pain patients in a sample of 42 subjects consisting of neck pain patients and asymptomatic controls.The allocation of subjects to either the control or patient group was based on the scoring of a VAS scale for pain intensity, a Bournemouth Questionnaire (BQ), a manual examination of the rotation of C0-2-7 (rated for Range Of Motion, end feel, onset of pain), an adapted Spurling test and Cervical Range Of Motion (CROM) measurements.The VAS and BQ resulted in a high % of correct allocations (>/= 77.5%) and a high specificity (90.9%). The Manual Examination Procedures (MEPs) have similar results especially when clustered. The combination of the VAS score, BQ and MEPs resulted in a sensitivity and specificity of 100% and 86.4%, respectively. Except for the flexion movement all CROM allocation percentages are around 50%, indicating a lesser diagnostic value.Our findings reinforce the validity of MEPs. Clustering pain measurements, BQ and MEPs provides the highest diagnostic value to identify neck pain patients or necks in need of treatment.

  2. The effectiveness of Long's manipulation on patients with chronic mechanical neck pain: a randomized controlled trial.

    Science.gov (United States)

    Lin, Jian Hua; Shen, Tong; Chung, Raymond Chi Keung; Chiu, Thomas Tai Wing

    2013-08-01

    Long's manipulation (LM) is a representative Chinese manipulation approach incorporating both spinal manipulation and traditional Chinese massage (TCM) techniques. This randomized controlled trial (RCT) aimed to compare the immediate and short-term relative effectiveness of LM to TCM on patients with chronic neck pain. Patients were randomly assigned to either LM group or TCM group. LM group was treated with Long's manipulation, while the TCM group received TCM therapy. Patients attended 8 sessions of treatment (one session every three days). Outcome measures included neck disability (Northwick Park Neck Pain Questionnaire; NPQ), pain intensity (Numeric Pain Rating Scale; NPRS), patient perceived satisfaction of care (PPS) (11-point scale), craniovertebral angle (CV angle) and cervical range of motion (ROM). A blinded assessor performed assessment at baseline, immediate after treatment and 3 months post treatment. LM group achieved significantly greater improvement than TCM group in pain intensity (p angle and most of cervical ROM between groups (p = 0.169 ∼ 0.888) with an exception of flexion at 3-month follow-up (p = 0.005). This study shows that LM could produce better effects than TCM in relieving pain and improving disability in the management of patients with chronic mechanical neck pain.

  3. Acute effects of single and multiple level thoracic manipulations on chronic mechanical neck pain: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Puntumetakul R

    2015-01-01

    Full Text Available Rungthip Puntumetakul,1,2 Thavatchai Suvarnnato,1,3 Phurichaya Werasirirat,1 Sureeporn Uthaikhup,2 Junichiro Yamauchi,4,5 Rose Boucaut6 1School of Physical Therapy, Faculty of Associated Medical Sciences, 2Research Center in Back, Neck, Other Joint Pain and Human Performance, 3Physical Therapy Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 4Graduate School of Human Health Sciences, Tokyo Metropolitan University, 5Future Institute for Sport Sciences, Tokyo, Japan; 6School of Health Sciences (Physiotherapy, University of South Australia, Adelaide, SA, Australia Background: Thoracic spine manipulation has become a popular alternative to local cervical manipulative therapy for mechanical neck pain. This study investigated the acute effects of single-level and multiple-level thoracic manipulations on chronic mechanical neck pain (CMNP.Methods: Forty-eight patients with CMNP were randomly allocated to single-level thoracic manipulation (STM at T6–T7 or multiple-level thoracic manipulation (MTM, or to a control group (prone lying. Cervical range of motion (CROM, visual analog scale (VAS, and the Thai version of the Neck Disability Index (NDI-TH scores were measured at baseline, and at 24-hour and at 1-week follow-up.Results: At 24-hour and 1-week follow-up, neck disability and pain levels were significantly (P<0.05 improved in the STM and MTM groups compared with the control group. CROM in flexion and left lateral flexion were increased significantly (P<0.05 in the STM group when compared with the control group at 1-week follow-up. The CROM in right rotation was increased significantly after MTM compared to the control group (P<0.05 at 24-hour follow-up. There were no statistically significant differences in neck disability, pain level at rest, and CROM between the STM and MTM groups.Conclusion: These results suggest that both single-level and multiple-level thoracic manipulation improve neck disability

  4. Neuromuscular Activation of the Vastus Intermedius Muscle during Isometric Hip Flexion.

    Science.gov (United States)

    Saito, Akira; Akima, Hiroshi

    2015-01-01

    Although activity of the rectus femoris (RF) differs from that of the other synergists in quadriceps femoris muscle group during physical activities in humans, it has been suggested that the activation pattern of the vastus intermedius (VI) is similar to that of the RF. The purpose of present study was to examine activation of the VI during isometric hip flexion. Ten healthy men performed isometric hip flexion contractions at 25%, 50%, 75%, and 100% of maximal voluntary contraction at hip joint angles of 90°, 110° and 130°. Surface electromyography (EMG) was used to record activity of the four quadriceps femoris muscles and EMG signals were root mean square processed and normalized to EMG amplitude during an isometric knee extension with maximal voluntary contraction. The normalized EMG was significantly higher for the VI than for the vastus medialis during hip flexion at 100% of maximal voluntary contraction at hip joint angles of 110° and 130° (P < 0.05). The onset of VI activation was 230-240 ms later than the onset of RF activation during hip flexion at each hip joint angle, which was significantly later than during knee extension at 100% of maximal voluntary contraction (P < 0.05). These results suggest that the VI is activated later than the RF during hip flexion. Activity of the VI during hip flexion might contribute to stabilize the knee joint as an antagonist and might help to smooth knee joint motion, such as in the transition from hip flexion to knee extension during walking, running and pedaling.

  5. Changes in the flexion relaxation response induced by lumbar muscle fatigue

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    Cantin Vincent

    2008-01-01

    Full Text Available Abstract Background The flexion relaxation phenomenon (FRP is an interesting model to study the modulation of lumbar stability. Previous investigations have explored the effect of load, angular velocity and posture on this particular response. However, the influence of muscular fatigue on FRP parameters has not been thoroughly examined. The objective of the study is to identify the effect of erector spinae (ES muscle fatigue and spine loading on myoelectric silence onset and cessation in healthy individuals during a flexion-extension task. Methods Twenty healthy subjects participated in this study and performed blocks of 3 complete trunk flexions under 4 different experimental conditions: no fatigue/no load (1, no fatigue/load (2, fatigue/no load(3, and fatigue/load (4. Fatigue was induced according to the Sorenson protocol, and electromyographic (EMG power spectral analysis confirmed that muscular fatigue was adequate in each subject. Trunk and pelvis angles and surface EMG of the ES L2 and L5 were recorded during a flexion-extension task. Trunk flexion angle corresponding to the onset and cessation of myoelectric silence was then compared across the different experimental conditions using 2 × 2 repeated-measures ANOVA. Results Onset of myoelectric silence during the flexion motion appeared earlier after the fatigue task. Additionally, the cessation of myoelectric silence was observed later during the extension after the fatigue task. Statistical analysis also yielded a main effect of load, indicating a persistence of ES myoelectric activity in flexion during the load condition. Conclusion The results of this study suggest that the presence of fatigue of the ES muscles modifies the FRP. Superficial back muscle fatigue seems to induce a shift in load-sharing towards passive stabilizing structures. The loss of muscle contribution together with or without laxity in the viscoelastic tissues may have a substantial impact on post fatigue stability.

  6. Cervicocephalic kinesthetic sensibility and postural balance in patients with nontraumatic chronic neck pain – a pilot study

    Directory of Open Access Journals (Sweden)

    Eriksson Magnus

    2009-06-01

    Full Text Available Abstract Background Although cervical pain is widespread, most victims are only mildly and occasionally affected. A minority, however, suffer chronic pain and/or functional impairments. Although there is abundant literature regarding nontraumatic neck pain, little focuses on diagnostic criteria. During the last decade, research on neck pain has been designed to evaluate underlying pathophysiological mechanisms, without noteworthy success. Independent researchers have investigated postural balance and cervicocephalic kinesthetic sensibility among patients with chronic neck pain, and have (in most cases concluded the source of the problem is a reduced ability in the neck's proprioceptive system. Here, we investigated cervicocephalic kinesthetic sensibility and postural balance among patients with nontraumatic chronic neck pain. Methods Ours was a two-group, observational pilot study of patients with complaints of continuous neck pain during the 3 months prior to recruitment. Thirteen patients with chronic neck pain of nontraumatic origin were recruited from an institutional outpatient clinic. Sixteen healthy persons were recruited as a control group. Cervicocephalic kinesthetic sensibility was assessed by exploring head repositioning accuracy and postural balance was measured with computerized static posturography. Results Parameters of cervicocephalic kinesthetic sensibility were not reduced. However, in one of six test movements (flexion, global repositioning errors were significantly larger in the experimental group than in the control group (p Conclusion In patients with nontraumatic chronic neck pain, we found statistically significant global repositioning errors in only one of six test movements. In this cohort, we found no evidence of impaired postural balance. Head repositioning accuracy and computerized static posturography are imperfect measures of functional proprioceptive impairments. Validity of (and procedures for using these

  7. Influence of knee flexion angle and age on triceps surae muscle fatigue during heel raises.

    Science.gov (United States)

    Hébert-Losier, Kim; Schneiders, Anthony G; García, José A; Sullivan, S John; Simoneau, Guy G

    2012-11-01

    The triceps surae (TS) muscle-tendon unit is 1 of the most commonly injured in elite and recreational athletes, with a high prevalence in middle-aged adults. The performance of maximal numbers of unilateral heel raises is used to assess, train, and rehabilitate TS endurance and conventionally prescribed in 0° knee flexion (KF) for the gastrocnemius and 45° for the soleus (SOL). However, the extent of muscle selectivity conferred through the change in the knee angle is lacking for heel raises performed to volitional fatigue. This study investigated the influence of knee angle on TS muscle fatigue during heel raises and determined whether fatigue differed between middle-aged and younger-aged adults. Forty-eight healthy individuals aged 18-25 and 35-45 years performed maximal numbers of unilateral heel raises in 0° and 45° KF. Median frequencies and linear regression slopes were calculated from the SOL, gastrocnemius medialis (GM), and gastrocnemius lateralis (GL) surface electromyographic signals. Stepwise mixed-effect regressions were used for analysis. The subjects completed an average of 45 and 48 heel raises in 0° and 45° KF, respectively. The results indicated that the 3 muscles fatigued during testing as all median frequencies decreased, and regression slopes were negative. Consistent with muscle physiology and fiber typing, fatigue was greater in the GM and GL than in the SOL (p < 0.001). However, knee angle did not influence TS muscle fatigue parameters (p = 0.814), with similar SOL, GM, and GL fatigue in 0° and 45° KF. These findings are in contrast with the traditionally described clinical use of heel raises in select knee angles for the gastrocnemius and the SOL. Furthermore, no difference in TS fatigue between the 2 age groups was able to be determined, despite the reported higher prevalence of injury in middle-aged individuals.

  8. Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study

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    Irene Campa-Moran

    2015-01-01

    Full Text Available Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT, dry needling and stretching (DN-S, and soft tissue techniques (STT. All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM, pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale. Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation and DN-S (i.e., side-bending and rotation groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.

  9. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset.

    Science.gov (United States)

    Ito, K; Minka, M A; Leunig, M; Werlen, S; Ganz, R

    2001-03-01

    We have observed damage to the labrum as a result of repetitive acetabular impingement in non-dysplastic hips, in which the femoral neck appears to abut against the acetabular labrum and a non-spherical femoral head to press against the labrum and adjacent cartilage. In both mechanisms anatomical variations of the proximal femur may be a factor. We have measured the orientation of the femoral neck and the offset of the head at various circumferential positions, using MRI data from volunteers with no osteoarthritic changes on standard radiographs. Compared with the control subjects, paired for gender and age, patients showed a significant reduction in mean femoral anteversion and mean head-neck offset on the anterior aspect of the neck. This was consistent with the site of symptomatic impingement in flexion and internal rotation, and with lesions of the adjacent rim. Furthermore, when stratified for gender and age, and compared with the control group, the mean femoral head-neck offset was significantly reduced in the lateral-to-anterior aspect of the neck for young men, and in the anterolateral-to-anterior aspect of the neck for older women. For patients suspected of having impingement of the rim, anatomical variations in the proximal femur should be considered as a possible cause.

  10. Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study.

    Science.gov (United States)

    Campa-Moran, Irene; Rey-Gudin, Etelvina; Fernández-Carnero, Josué; Paris-Alemany, Alba; Gil-Martinez, Alfonso; Lerma Lara, Sergio; Prieto-Baquero, Almudena; Alonso-Perez, José Luis; La Touche, Roy

    2015-01-01

    Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT), dry needling and stretching (DN-S), and soft tissue techniques (STT). All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM), pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale). Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation) and DN-S (i.e., side-bending and rotation) groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.

  11. CAN A SPECIFIC NECK STRENGTHENING PROGRAM DECREASE CERVICAL SPINE INJURIES IN A MEN'S PROFESSIONAL RUGBY UNION TEAM? A RETROSPECTIVE ANALYSIS

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    Robert Naish

    2013-09-01

    Full Text Available Cervical spine injuries in Rugby Union are a concerning issue at all levels of the game. The primary aim of this retrospective analysis conducted in a professional Rugby Union squad was to determine whether a 26-week isometric neck strengthening intervention program (13-week strengthening phase and 13-week maintenance phase was effective in reducing the number and severity of cervical spine injuries. The secondary aim was to determine whether at week five, where the program had been the similar for all players, there was increased isometric neck strength. All 27 players who were common to both the 2007-2008 and 2008-2009 seasons were included in this analysis and data was extracted from a Sports Medicine/Sports Science database which included the squad's injury records. Primary outcome variables included; the number of cervical spine injuries and the severity of these injuries as determined by the total number of days lost from training and competition. Secondary outcome variables included isometric neck strength in flexion, extension and left and right lateral flexion. Using non-parametric statistical methods, no significant differences were evident for the total number of cervical spine injuries (n = 8 in 2007-2008, n = 6 in 2008-2009 or time loss due to these injuries (100 days in 2007-2008, 40 days in 2008-2009. However, a significant (p = 0.03 reduction in the number of match injuries was evident from 2007-2008 (n = 11 to 2008-09 (n = 2. Non-significant increases in isometric neck strength were found in all directions examined. A significant reduction in the number of match injuries was evident in this study. However, no other significant changes to primary outcome variables were achieved. Further, no significant increases in isometric neck strength were found in this well-trained group of professional athletes

  12. On the validity of the Born approximation for weak cosmic flexions

    Science.gov (United States)

    Schäfer, Björn Malte; Heisenberg, Lavinia; Kalovidouris, Angelos F.; Bacon, David J.

    2012-02-01

    Weak lensing calculations are often made under the assumption of the Born approximation, where the ray path is approximated as a straight radial line. In addition, lens-lens couplings where there are several deflections along the light ray are often neglected. We examine the effect of dropping the Born approximation and taking lens-lens couplings into account, for weak lensing effects up to second order (cosmic flexion), by making a perturbative expansion in the light path. We present a diagrammatic representation of the resulting corrections to the lensing effects. The flexion signal, which measures the derivative of the density field, acquires correction terms proportional to the squared gravitational shear; we also find that by dropping the Born approximation, two further degrees of freedom of the lensing distortion can be excited (the twist components), in addition to the four standard flexion components. We derive angular power spectra of the flexion and twist, with and without the Born approximation and lens-lens couplings and confirm that the Born approximation is an excellent approximation for weak cosmic flexions, but may fail in the strong lensing regime.

  13. Proportional EMG control of ankle plantar flexion in a powered transtibial prosthesis.

    Science.gov (United States)

    Wang, Jing; Kannape, Oliver A; Herr, Hugh M

    2013-06-01

    The human calf muscle generates 80% of the mechanical work to walk throughout stance-phase, powered plantar flexion. Powered plantar flexion is not only important for walking energetics, but also to minimize the impact on the leading leg at heel-strike. For unilateral transtibial amputees, it has recently been shown that knee load on the leading, intact limb decreases as powered plantar flexion in the trailing prosthetic ankle increases. Not surprisingly, excessive loads on the leading, intact knee are believed to be causative of knee osteoarthritis, a leading secondary impairment in lower-extremity amputees. In this study, we hypothesize that a transtibial amputee can learn how to control a powered ankle-foot prosthesis using a volitional electromyographic (EMG) control to directly modulate ankle powered plantar flexion. We here present preliminary data, and find that an amputee participant is able to modulate toe-off angle, net ankle work and peak power across a broad range of walking speeds by volitionally modulating calf EMG activity. The modulation of these key gait parameters is shown to be comparable to the dynamical response of the same powered prosthesis controlled intrinsically (No EMG), suggesting that transtibial amputees can achieve an adequate level of powered plantar flexion controllability using direct volitional EMG control.

  14. Gradation of Neck Muscle Responses and Head/Neck Kinematics to Acceleration and Speed Change in Rear-end Collisions.

    Science.gov (United States)

    Siegmund, Gunter P; Sanderson, David J; Inglis, J Timothy

    2004-11-01

    Recent epidemiological evidence shows that the potential for whiplash injury varies with both the average acceleration and speed change of a rear-end collision. The goal of this study was to examine the gradation of neck muscle responses and the head and neck kinematics to rear-end collision pulses in which the acceleration and speed change were independently varied. Thirty subjects (15F, 15M) underwent 36 consecutive rear-end collisions consisting of three different average accelerations (ā = 0.5, 0.9 and 1.3 g) and three different speed changes (Deltav = 0.25, 0.50 and 0.75 m/s). Onset and amplitude of the sternocleidomastoid (SCM) and cervical paraspinal (PARA) muscle responses were measured using surface electromyography. Kinematic measures included linear and angular accelerations and displacements of the head and torso. The results showed that the amplitude of the muscle and kinematics responses was graded to both collision acceleration and speed change. The magnitude of early peaks in the head/neck kinematics correlated more strongly with collision acceleration (r(2) = 0.63 to 0.69), whereas the magnitude of later kinematic peaks correlated more strongly with collision speed change (r(2) = 0.59 to 0.95). Onset of the SCM muscle response correlated only weakly with collision acceleration and speed change (r(2) acceleration and speed change (āDeltav) yielded the strongest and most consistent correlations with neck muscle (r(2) = 0.48 to 0.58) and head/neck kinematic responses (r(2) = 0.78 to 0.94). This measure of collision severity is also consistent with the recent epidemiological evidence that whiplash symptom intensity and duration increases with both average acceleration and speed change.

  15. Physical Theories with Average Symmetry

    OpenAIRE

    Alamino, Roberto C.

    2013-01-01

    This Letter probes the existence of physical laws invariant only in average when subjected to some transformation. The concept of a symmetry transformation is broadened to include corruption by random noise and average symmetry is introduced by considering functions which are invariant only in average under these transformations. It is then shown that actions with average symmetry obey a modified version of Noether's Theorem with dissipative currents. The relation of this with possible violat...

  16. Average Convexity in Communication Situations

    NARCIS (Netherlands)

    Slikker, M.

    1998-01-01

    In this paper we study inheritance properties of average convexity in communication situations. We show that the underlying graph ensures that the graphrestricted game originating from an average convex game is average convex if and only if every subgraph associated with a component of the underlyin

  17. A new tool to determine masses and mass profiles using gravitational flexion

    CERN Document Server

    Leonard, Adrienne

    2009-01-01

    In a recent publication, an aperture mass statistic for gravitational flexion was derived and shown to be effective, at least with simulated data, in detecting massive structures and substructures within clusters of galaxies. Further, it was suggested that the radius at which the flexion aperture mass signal falls to zero might allow for estimation of the mass or density profile of the structures detected. In this paper, we more fully explore this possibility, considering the behaviour both of the peak signal and the zero-signal contours for two mass models--the singular isothermal sphere and Navarro-Frenk-White profiles--under varying aperture size, filter shape and mass concentration parameter. We demonstrate the effectiveness of the flexion aperture mass statistic in discriminating between mass profiles and concentration parameters, and in providing an accurate estimate of the mass of the lens, to within a factor of 2 or better.

  18. Modelling and Analysis on Biomechanical Dynamic Characteristics of Knee Flexion Movement under Squatting

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    Jianping Wang

    2014-01-01

    Full Text Available The model of three-dimensional (3D geometric knee was built, which included femoral-tibial, patellofemoral articulations and the bone and soft tissues. Dynamic finite element (FE model of knee was developed to simulate both the kinematics and the internal stresses during knee flexion. The biomechanical experimental system of knee was built to simulate knee squatting using cadaver knees. The flexion motion and dynamic contact characteristics of knee were analyzed, and verified by comparing with the data from in vitro experiment. The results showed that the established dynamic FE models of knee are capable of predicting kinematics and the contact stresses during flexion, and could be an efficient tool for the analysis of total knee replacement (TKR and knee prosthesis design.

  19. Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain.

    Science.gov (United States)

    Ylinen, Jari; Takala, Esa-Pekka; Kautiainen, Hannu; Nykänen, Matti; Häkkinen, Arja; Pohjolainen, Timo; Karppi, Sirkka-Liisa; Airaksinen, Olavi

    2004-10-01

    Several studies have reported lower neck muscle strength in patients with chronic neck pain compared to healthy controls. The aim of the present study was to evaluate the association between the severity of neck pain and disability with neck strength and range of movement in women suffering from chronic neck pain. One hundred and seventy-nine female office workers with chronic neck pain were selected to the study. The outcome was assessed by the self-rating questionnaires on neck pain (visual analogue scale, Vernon's disability index, Neck pain and disability index) and by measures of the passive range of movement (ROM) and maximal isometric neck muscle strength. No statistically significant correlation was found between perceived neck pain and the disability indices and the maximal isometric neck strength and ROM measures. However, the pain values reported during the strength tests were inversely correlated with the results of strength tests (r=-0.24 to -0.46), showing that pain was associated with decreased force production. About two-thirds of the patients felt pain during test efforts. Pain may prevent full effort during strength tests and hence the production of maximal force. Thus in patients with chronic neck pain the results do not always describe true maximal strength, but rather the patients' ability to bear strain, which may be considerably influenced by their painful condition. The results of the present study suggest that rehabilitation in cases of chronic neck pain should aim at raising tolerance to mechanical strain.

  20. Sampling Based Average Classifier Fusion

    Directory of Open Access Journals (Sweden)

    Jian Hou

    2014-01-01

    fusion algorithms have been proposed in literature, average fusion is almost always selected as the baseline for comparison. Little is done on exploring the potential of average fusion and proposing a better baseline. In this paper we empirically investigate the behavior of soft labels and classifiers in average fusion. As a result, we find that; by proper sampling of soft labels and classifiers, the average fusion performance can be evidently improved. This result presents sampling based average fusion as a better baseline; that is, a newly proposed classifier fusion algorithm should at least perform better than this baseline in order to demonstrate its effectiveness.

  1. Effect of compressive follower preload on the flexion-extension response of the human lumbar spine.

    Science.gov (United States)

    Patwardhan, Avinash G; Havey, Robert M; Carandang, Gerard; Simonds, James; Voronov, Leonard I; Ghanayem, Alexander J; Meade, Kevin P; Gavin, Thomas M; Paxinos, Odysseas

    2003-05-01

    Traditional experimental methods are unable to study the kinematics of whole lumbar spine specimens under physiologic compressive preloads because the spine without active musculature buckles under just 120 N of vertical load. However, the lumbar spine can support a compressive load of physiologic magnitude (up to 1200 N) without collapsing if the load is applied along a follower load path. This study tested the hypothesis that the load-displacement response of the lumbar spine in flexion-extension is affected by the magnitude of the follower preload and the follower preload path. Twenty-one fresh human cadaveric lumbar spines were tested in flexion-extension under increasing compressive follower preload applied along two distinctly different optimized preload paths. The first (neutral) preload path was considered optimum if the specimen underwent the least angular change in its lordosis when the full range of preload (0-1200 N) was applied in its neutral posture. The second (flexed) preload path was optimized for an intermediate specimen posture between neutral and full flexion. A twofold increase in flexion stiffness occurred around the neutral posture as the preload was increased from 0 to 1200 N. The preload magnitude (400 N and larger) significantly affected the range of motion (ROM), with a 25% decrease at 1200 N preload applied along the neutral path. When the preload was applied along a path optimized for an intermediate forward-flexed posture, only a 15% decrease in ROM occurred at 1200 N. The results demonstrate that whole lumbar spine specimens can be subjected to compressive follower preloads of in vivo magnitudes while allowing physiologic mobility under flexion-extension moments. The optimized follower preload provides a method to simulate the resultant vector of the muscles that allow the spine to support physiologic compressive loads induced during flexion-extension activities.

  2. Are magnetic resonance flexion views useful in evaluating the cervical spine of patients with rheumatoid arthritis?

    Energy Technology Data Exchange (ETDEWEB)

    Reijnierse, M.; Kroon, H.M.; Bloem, J.L. [Dept. of Radiology, Leiden University Medical Center (Netherlands); Breedveld, F.C. [Dept. of Rheumatology, Leiden University Medical Center, Leiden (Netherlands); Hansen, B. [Dept. of Medical Statistics, Leiden University Medical Center, Leiden (Netherlands); Pope, T.L. [Dept. of Diagnostic Radiology, Bowman Gray School of Medicine, Winston-Salem (United States)

    2000-02-01

    Objective. To determine whether MR imaging in flexion adds value relative to imaging in the neutral position with respect to displaying involvement of the subarachnoid space, brainstem and spinal cord. Design and patients. T1-weighted MR images of the cervical spine in 42 rheumatoid arthritis patients with cervical spine involvement were obtained and analyzed prospectively. We assessed changes between images obtained in the neutral position and following active flexion, especially horizontal atlantoaxial and subaxial motion, presence or absence of brainstem compression, subarachnoid space involvement at the atlantoaxial and subaxial level and the cervicomedullary angle. Vertical atlantoaxial subluxation and the amount of pannus were correlated with motion and change in subarachnoid space. Results. The flexion images showed horizontal atlantoaxial motion in 21 patients and subaxial motion in one patient. The flexion view displayed brainstem compression in only one patient. Involvement of the subarachnoid space increased at the atlantoaxial level in eight (19%) patients (P=0.004) and at the level below C2 in five (12%) patients (P=0.03). There were no patients with a normal subarachnoid space in neutral position and compression in the flexed position. The cervicomedullary angle changed significantly with flexion. Vertical atlantoaxial subluxation and the amount of pannus did not show a significant correlation with motion or subarachnoid space involvement. Conclusion. MR imaging in the flexed position shows a statistically significant narrowing of the subarachnoid space at the atlantoaxial level and below C2. Cord compression is only observed on flexion views if the subarachnoid space in neutral position is already decreased. MR imaging in the flexed position might be useful, since subarachnoid space involvement may be an indicator for the development of neurologic dysfunction. (orig.)

  3. Dynamic splinting for knee flexion contracture following total knee arthroplasty: a case report.

    Science.gov (United States)

    Finger, Eric; Willis, F Buck

    2008-01-01

    Total Knee Arthroplasty operations are increasing in frequency, and knee flexion contracture is a common pathology, both pre-existing and post-operative. A 61-year-old male presented with knee flexion contracture following a total knee arthroplasty. Physical therapy alone did not fully reduce the contracture and dynamic splinting was then prescribed for daily low-load, prolonged-duration stretch. After 28 physical therapy sessions, the active range of motion improved from -20 degrees to -12 degrees (stiff knee still lacking full extension), and after eight additional weeks with nightly wear of dynamic splint, the patient regained full knee extension, (active extension improved from -12 degrees to 0 degrees ).

  4. A new hybrid spring brake orthosis for controlling hip and knee flexion in the swing phase.

    Science.gov (United States)

    Gharooni, S; Heller, B; Tokhi, M O

    2001-03-01

    In this study it is proposed that active contraction of muscles might be artificially replaced by a spring brake orthosis (SBO) to provide near-natural knee and hip swing phase trajectories for gait in spinal cord injured subjects. The SBO is a new gait restoration system in which stored spring elastic energy and potential energy of limb segments are utilized to aid gait. It is also shown that hip flexion can be produced without the need for withdrawal reflex, hip flexor stimulus or any mechanical actuator at the hip. A hip flexion angle of 21 degrees was achieved by a nonimpaired subject wearing a prototype orthosis.

  5. Bilateral Distal Femoral Flexion Deformity After Total Knee Arthroplasty in a Patient with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Jimmy Chan Chun-Ming

    2013-12-01

    Full Text Available Rheumatoid arthritis is an autoimmune systemic disease with predominant peripheral polyarthritis, often leading to severe joint destruction. This is a case report of an 81-year-old woman with long-standing severe rheumatoid arthritis requiring multiple orthopaedic operations for joint destruction since 2000. These operated joints improved her functional mobility until recently, when she found that her knees were fixed at around 70° of flexion with limited motion. There was chronic progressive flexion deformity of bilateral distal femurs, which was an extremely rare complication of total knee arthroplasty.

  6. Deep space infections of neck.

    Science.gov (United States)

    Kaluskar, S; Bajaj, P; Bane, P

    2007-03-01

    A retrospective study was performed on fourteen cases of deep cervical space infections in the neck admitted for diagnosis and treatment to the ENT Department, during a period of seven years from 1989-1997. Of the fourteen, four patients had Ludwig's angina and of the fourteen, one had a very serious complication resulting in death. Early diagnosis and adequate treatment were of paramount importance. The role of tracheostomy and management of airway in deep cervical space infections of the neck is discussed to gether with bacteriology, antibiotic treatment and surgical management.

  7. Neck Circumference and Cardio- Metabolic Syndrome

    OpenAIRE

    Kumar, Nagendran Vijaya; Ismail, Mohammed H.; P, Mahesha; M, Girish; Tripathy, Monica

    2014-01-01

    Background: Only few studies about neck circumference (NC) as a measure of cardio metabolic syndrome available from India. Study was conducted to establish an association between neck circumference and cardio metabolic syndrome.

  8. Inclusion of thoracic spine thrust manipulation into an electro-therapy/thermal program for the management of patients with acute mechanical neck pain: a randomized clinical trial.

    Science.gov (United States)

    González-Iglesias, Javier; Fernández-de-las-Peñas, Cesar; Cleland, Joshua A; Alburquerque-Sendín, Francisco; Palomeque-del-Cerro, Luis; Méndez-Sánchez, Roberto

    2009-06-01

    Our aim was to examine the effects of a seated thoracic spine distraction thrust manipulation included in an electrotherapy/thermal program on pain, disability, and cervical range of motion in patients with acute neck pain. This randomized controlled trial included 45 patients (20 males, 25 females) between 23 and 44 years of age presenting with acute neck pain. Patients were randomly divided into 2 groups: an experimental group which received a thoracic manipulation, and a control group which did not receive the manipulative procedure. Both groups received an electrotherapy program consisting of 6 sessions of TENS (frequency 100Hz; 20min), superficial thermo-therapy (15min) and soft tissue massage. The experimental group also received a thoracic manipulation once a week for 3 consecutive weeks. Outcome measures included neck pain (numerical pain rate scale; NPRS), level of disability (Northwick Park Neck Pain Questionnaire; NPQ) and neck mobility. These outcomes were assessed at baseline and 1 week after discharge. A 2-way repeated-measures ANOVA with group as between-subject variable and time as within-subject variable was used. Patients receiving thoracic manipulation experienced greater reductions in both neck pain, with between-group difference of 2.3 (95% CI 2-2.7) points on a 11-NPRS, and perceived disability with between-group differences 8.5 (95% CI 7.2-9.8) points. Further, patients receiving thoracic manipulation experienced greater increases in all cervical motions with between-group differences of 10.6 degrees (95% CI 8.8-12.5 degrees) for flexion; 9.9 degrees (95% CI 8.1-11.7 degrees) for extension; 9.5 degrees (95% CI 7.6-11.4 degrees) for right lateral-flexion; 8 degrees (95% CI 6.2-9.8 degrees) for left lateral-flexion; 9.6 degrees (95% CI 7.7-11.6 degrees) for right rotation; and 8.4 degrees (95% CI 6.5-10.3 degrees) for left rotation. We found that the inclusion of a thoracic manipulation into an electrotherapy/thermal program was effective in

  9. Clinical outcomes in high flexion total knee arthroplasty were not superior to standard posterior stabilized total knee arthroplasty. A multicenter, prospective, randomized study.

    Science.gov (United States)

    Guild, George N; Labib, Sameh A

    2014-03-01

    High flexion prostheses have been introduced to achieve high flexion and improve clinical outcomes. Controversy exists in the literature regarding outcomes of high flexion vs. standard implants. This multicenter study compares outcomes in patients receiving a high flexion prosthesis vs. standard prosthesis. 278 high flexion and standard knee prostheses were used. Patients were followed for two years and evaluated prospectively. The mean HSS was 87.3 for the standard group and 88.9 for the flexion group. At two-year follow up the standard prosthesis group had mean flexion of 121° and the high flexion group had mean flexion 120°. No knee had aseptic loosening, infection, or osteolysis. At two-year follow up, there were no significant differences in range of motion, clinical outcome, or radiographic evaluation. Pre-operative motion and functional status have greater impact on clinical outcome than implant alone.

  10. Does a combination of physical training, specific exercises and pain education improve health-related quality of life in patients with chronic neck pain?

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Søgaard, Karen; Gram, Bibi

    2016-01-01

    anterior and cervical spine, Cranio-cervical Flexion, Cervical Extension muscle function, and oculomotion) were recorded at baseline and after 4 months. RESULTS: The exercise group showed statistically significant improvement in physical HR-QoL, mental HR-QoL, depression, cervical pressure pain threshold...... controlled trial of 200 neck pain patients receiving pain education. The exercise group received additional exercises for neck/shoulder, balance and oculomotor function, plus graded physical activity training. Patient-reported outcome measures (Short Form-36 Physical and Mental component summary scores, Euro......AIM: To investigate the effect of combining pain education, specific exercises and graded physical activity training (exercise) compared with pain education alone (control) on physical health-related quality of life (HR-QoL) in chronic neck pain patients. METHODS: A multicentre randomised...

  11. Thyroid doses and risk to paediatric patients undergoing neck CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Spampinato, Maria Vittoria; Tipnis, Sameer; Huda, Walter [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Tavernier, Joshua [Medical University of South Carolina, College of Medicine, Charleston, SC (United States)

    2015-07-15

    To estimate thyroid doses and cancer risk for paediatric patients undergoing neck computed tomography (CT). We used average CTDI{sub vol} (mGy) values from 75 paediatric neck CT examinations to estimate thyroid dose in a mathematical anthropomorphic phantom (ImPACT Patient CT Dosimetry Calculator). Patient dose was estimated by modelling the neck as mass equivalent water cylinder. A patient size correction factor was obtained using published relative dose data as a function of water cylinder size. Additional correction factors included scan length and radiation intensity variation secondary to tube-current modulation. The mean water cylinder diameter that modelled the neck was 14 ± 3.5 cm. The mathematical anthropomorphic phantom has a 16.5-cm neck, and for a constant CT exposure, would have thyroid doses that are 13-17 % lower than the average paediatric patient. CTDI{sub vol} was independent of age and sex. The average thyroid doses were 31 ± 18 mGy (males) and 34 ± 15 mGy (females). Thyroid cancer incidence risk was highest for infant females (0.2 %), lowest for teenage males (0.01 %). Estimated absorbed thyroid doses in paediatric neck CT did not significantly vary with age and gender. However, the corresponding thyroid cancer risk is determined by gender and age. (orig.)

  12. X-Ray Exam: Neck (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Neck KidsHealth > For Parents > X-Ray Exam: Neck A A A What's in ... español Radiografía: cuello What It Is A neck X-ray is a safe and painless test that ...

  13. Influence of an eccentric load added at the back of the head on head-neck posture.

    Science.gov (United States)

    Pavan, Esteban E; Frigo, Carlo A; Pedotti, Antonio

    2013-09-01

    A biomechanical study of the head-neck complex in seated subjects was conducted to verify whether a slight load, applied at the back of the head, could beneficially affect the head-neck posture, one of the factors of postural neck pain. An eccentric load of 0.5 kg was applied to the subjects' head by means of a special cap. A group of asymptomatic subjects (n=10, 28.9±12.1 yrs), and a group of subjects that had experienced mild, occasional neck pain (n=10, 39.6±18.4 yrs) were compared. They were analyzed while maintaining a still posture that was periodically perturbed to avoid habituation. A 3D motion analyzer and reflective markers placed over the head, the neck and the trunk, were used to compute head inclination and translation and head/neck flexion angle in different conditions: before, during and after having had the load applied for 15 min. Although the moment induced by the load was extensor, a forward-oriented movement of the head was observed in both groups. However, the forward displacement, in relation to the initial position, was smaller in the mild neck pain group than in the asymptomatic group (5.7±4.7 mm vs. 8.9±5.5 mm, Pneck pain subjects assumed a retracted position (-3.8±2.7 mm) while the asymptomatic subjects stayed protracted (+3.5±5.1 mm, Pneck extensor muscle contraction.

  14. Planned Neck Dissection Following Radiation Treatment for Head and Neck Malignancy

    Directory of Open Access Journals (Sweden)

    J. F. Dautremont

    2012-01-01

    Full Text Available Introduction. Optimal therapy for patients with metastatic neck disease remains controversial. Neck dissection following radiotherapy has traditionally been used to improve locoregional control. Methods. A retrospective review of 28 patients with node-positive head and neck malignancy treated with planned neck dissection following radiotherapy between January 2002 and December 2005 was performed to assess treatment outcomes. Results. Median interval to neck dissection was 9.6 weeks with a median number of 21 + 9 lymph nodes per specimen. Ten of 31 (32% neck dissection specimens demonstrated evidence of residual carcinoma. Overall survival at two years was 85%; five-year overall survival was 65%. Concurrent chemotherapy did not impact the presence of residual neck disease. Conclusion. Based on the frequency of residual malignancy in the neck of patients treated with primary radiotherapy, a planned, postradiotherapy neck dissection should be strongly advocated for all patients with advanced-stage neck disease.

  15. Instantaneous helical axis estimation from 3-D video data in neck kinematics for whiplash diagnostics.

    Science.gov (United States)

    Woltring, H J; Long, K; Osterbauer, P J; Fuhr, A W

    1994-12-01

    To date, the diagnosis of whiplash injuries has been very difficult and largely based on subjective, clinical assessment. The work by Winters and Peles Multiple Muscle Systems--Biomechanics and Movement Organization. Springer, New York (1990) suggests that the use of finite helical axes (FHAs) in the neck may provide an objective assessment tool for neck mobility. Thus, the position of the FHA describing head-trunk motion may allow discrimination between normal and pathological cases such as decreased mobility in particular cervical joints. For noisy, unsmoothed data, the FHAs must be taken over rather large angular intervals if the FHAs are to be reconstructed with sufficient accuracy; in the Winters and Peles study, these intervals were approximately 10 degrees. in order to study the movements' microstructure, the present investigation uses instantaneous helical axes (IHAs) estimated from low-pass smoothed video data. Here, the small-step noise sensitivity of the FHA no longer applies, and proper low-pass filtering allows estimation of the IHA even for small rotation velocity omega of the moving neck. For marker clusters mounted on the head and trunk, technical system validation showed that the IHAs direction dispersions were on the order of one degree, while their position dispersions were on the order of 1 mm, for low-pass cut-off frequencies of a few Hz (the dispersions were calculated from omega-weighted errors, in order to account for the adverse effects of vanishing omega). Various simple, planar models relating the instantaneous, 2-D centre of rotation with the geometry and kinematics of a multi-joint neck model are derived, in order to gauge the utility of the FHA and IHA approaches. Some preliminary results on asymptomatic and pathological subjects are provided, in terms of the 'ruled surface' formed by sampled IHAs and of their piercing points through the mid-sagittal plane during a prescribed flexion-extension movement of the neck.

  16. Physical Theories with Average Symmetry

    CERN Document Server

    Alamino, Roberto C

    2013-01-01

    This Letter probes the existence of physical laws invariant only in average when subjected to some transformation. The concept of a symmetry transformation is broadened to include corruption by random noise and average symmetry is introduced by considering functions which are invariant only in average under these transformations. It is then shown that actions with average symmetry obey a modified version of Noether's Theorem with dissipative currents. The relation of this with possible violations of physical symmetries, as for instance Lorentz invariance in some quantum gravity theories, is briefly commented.

  17. Postburn Neck Lateral Contracture Anatomy and Treatment: A New Approach.

    Science.gov (United States)

    Grishkevich, Viktor M; Grishkevich, Max

    2015-01-01

    Lateral contracture of the neck is a rare and insufficiently researched burn consequent. Contracture restricts head motion, can cause a secondary face deformity, presents severe cosmetic defects, and, therefore, requires surgical reconstruction. Literature does not sufficiently address the issue; therefore, anatomy not researched and treatment techniques not developed. The anatomy of postburn lateral cervical flexion contracture was studied in 21 operated patients. Using obtained data, new approaches were investigated, which were directed toward maximal efficacy of the local tissues use. Follow-up results were observed from 6 months to 9 years. Lateral cervical contractures were divided into two types based on their anatomy: edge and medial. Edge contractures were caused by burns and scars located on the posterior neck surface and were characterized by the presence of the fold in central lateral zone. In the fold, only one (posterior) sheet is scars that cause the contracture. Medial contractures were caused by scars located on the lateral cervical surface and were characterized by the presence of the fold in which both sheets were scars. In both types, contracture was caused by scar sheet surface deficiency in length, which has a trapezoid form (contracture cause). In all cases, there was surface surplus in the fold's sheets allowed contracture release with local tissue. The technique that allows the maximum local tissue use and ensures full contracture elimination is the trapeze-flap plasty. Two anatomic types of lateral cervical scar contractures were identified: edge and medial. An anatomically justified efficacy reconstructive technique for both types is trapeze-flap plasty.

  18. Influence of Head and Neck Position on Oropharyngeal Leak Pressure and Cuff Position with the ProSeal Laryngeal Mask Airway and the I-Gel: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar Mishra

    2015-01-01

    Full Text Available Background. This study was designed to assess and compare the effect of head and neck position on the oropharyngeal leak pressures and cuff position (employing fibreoptic view of the glottis and ventilation scores between ProSeal LMA and the I-gel. Material and Methods. After induction of anesthesia, the supraglottic device was inserted and ventilation confirmed. The position of the head was randomly changed from neutral to flexion, extension, and lateral rotation (left. The oropharyngeal leak pressures, fibreoptic view of glottis, ventilation scores, and delivered tidal volumes and end tidal CO2 were noted in all positions. Results. In both groups compared with neutral position, oropharyngeal leak pressures were significantly higher with flexion and lower with extension but similar with rotation of head and neck. However the oropharyngeal leak pressure was significantly higher for ProSeal LMA compared with the I-gel in all positions. Peak airway pressures were significantly higher with flexion in both groups (however this did not affect ventilation, lower with extension in ProSeal group, and comparable in I-gel group but did not change significantly with rotation of head and neck in both groups. Conclusion. Effective ventilation can be done with both ProSeal LMA and I-gel with head in all the above positions. ProSeal LMA has a better margin of safety than I-gel due to better sealing pressures except in flexion where the increase in airway pressure is more with the former. Extreme precaution should be taken in flexion position in ProSeal LMA.

  19. Detecting Mass Substructure in Galaxy Clusters: An Aperture Mass Statistic for Gravitational Flexion

    CERN Document Server

    Leonard, Adrienne; Wilkins, Stephen M

    2008-01-01

    Gravitational flexion has recently been introduced as a technique by which one can map out and study substructure in clusters of galaxies. Previous analyses involving flexion have measured the individual galaxy-galaxy flexion signal, or used either parametric techniques or a KSB-type inversion to reconstruct the mass distribution in Abell 1689. In this paper, we present an aperture mass statistic for flexion, and apply it to the lensed images of background galaxies obtained by ray-tracing simulations through a simple analytic mass distribution and through a galaxy cluster from the Millennium simulation. We show that this method is effective at detecting and accurately tracing structure within clusters of galaxies on sub-arcminute scales with high signal-to-noise even using a moderate background source number density and image resolution. In addition, the method provides much more information about both the overall shape and the small-scale structure of a cluster of galaxies than can be achieved through a weak...

  20. Evaluation of movements of lower limbs in non-professional ballet dancers: hip abduction and flexion

    Directory of Open Access Journals (Sweden)

    Valenti Erica E

    2011-08-01

    Full Text Available Abstract Background The literature indicated that the majority of professional ballet dancers present static and active dynamic range of motion difference between left and right lower limbs, however, no previous study focused this difference in non-professional ballet dancers. In this study we aimed to evaluate active movements of the hip in non-professional classical dancers. Methods We evaluated 10 non professional ballet dancers (16-23 years old. We measured the active range of motion and flexibility through Well Banks. We compared active range of motion between left and right sides (hip flexion and abduction and performed correlation between active movements and flexibility. Results There was a small difference between the right and left sides of the hip in relation to the movements of flexion and abduction, which suggest the dominant side of the subjects, however, there was no statistical significance. Bank of Wells test revealed statistical difference only between the 1st and the 3rd measurement. There was no correlation between the movements of the hip (abduction and flexion, right and left sides with the three test measurements of the bank of Wells. Conclusion There is no imbalance between the sides of the hip with respect to active abduction and flexion movements in non-professional ballet dancers.

  1. Effects of hamstring stretching on passive muscle stiffness vary between hip flexion and knee extension maneuvers.

    Science.gov (United States)

    Miyamoto, N; Hirata, K; Kanehisa, H

    2017-01-01

    The purpose of this study was to examine whether the effects of hamstring stretching on the passive stiffness of each of the long head of the biceps femoris (BFl), semitendinosus (ST), and semimembranosus (SM) vary between passive knee extension and hip flexion stretching maneuvers. In 12 male subjects, before and after five sets of 90 s static stretching, passive lengthening measurements where knee or hip joint was passively rotated to the maximal range of motion (ROM) were performed. During the passive lengthening, shear modulus of each muscle was measured by ultrasound shear wave elastography. Both stretching maneuvers significantly increased maximal ROM and decreased passive torque at a given joint angle. Passive knee extension stretching maneuver significantly reduced shear modulus at a given knee joint angle in all of BFl, ST, and SM. In contrast, the stretching effect by passive hip flexion maneuver was significant only in ST and SM. The present findings indicate that the effects of hamstring stretching on individual passive muscles' stiffness vary between passive knee extension and hip flexion stretching maneuvers. In terms of reducing the muscle stiffness of BFl, stretching of the hamstring should be performed by passive knee extension rather than hip flexion.

  2. Reliability of Subjective Pain Ratings and Nociceptive Flexion Reflex Responses as Measures of Conditioned Pain Modulation

    Directory of Open Access Journals (Sweden)

    Carlo Jurth

    2014-01-01

    Full Text Available BACKGROUND: The endogenous modulation of pain can be assessed through conditioned pain modulation (CPM, which can be quantified using subjective pain ratings or nociceptive flexion reflexes. However, to date, the test-retest reliability has only been investigated for subjective pain ratings.

  3. Post-traumatic flexion contractures of the elbow: Operative treatment via the limited lateral approach

    Directory of Open Access Journals (Sweden)

    Carr Andrew J

    2008-09-01

    Full Text Available Abstract Varying surgical techniques, patient groups and results have been described regards the surgical treatment of post traumatic flexion contracture of the elbow. We present our experience using the limited lateral approach on patients with carefully defined contracture types. Surgical release of post-traumatic flexion contracture of the elbow was performed in 23 patients via a limited lateral approach. All patients had an established flexion contracture with significant functional deficit. Contracture types were classified as either extrinsic if the contracture was not associated with damage to the joint surface or as intrinsic if it was. Overall, the mean pre-operative deformity was 55 degrees (95%CI 48 – 61 which was corrected at the time of surgery to 17 degrees (95%CI 12 – 22. At short-term follow-up (7.5 months the mean residual deformity was 25 degrees (95%CI 19 – 30 and at medium-term follow-up (43 months it was 32 degrees (95%CI 25 – 39. This deformity correction was significant (p Surgical release of post-traumatic flexion contracture of the elbow via a limited lateral approach is a safe technique, which reliably improves extension especially for extrinsic contractures. In this series all patients with an extrinsic contracture regained a functional range of movement and were satisfied with their surgery.

  4. In vivo knee laxity in flexion and extension: a radiographic study in 30 older healthy subjects.

    NARCIS (Netherlands)

    Heesterbeek, P.J.; Verdonschot, N.J.J.; Wymenga, A.B.

    2008-01-01

    In order to determine how "tight" a total knee prosthesis should be implanted, it is important to know the amount of laxity in a healthy knee. The objective of this study was to determine knee laxity in extension and flexion in healthy, non-arthritic knees of subjects similar in age to patients unde

  5. Retrospective comparison of functional and radiological outcome, between two contemporary high flexion knee designs

    Directory of Open Access Journals (Sweden)

    Kapoor Vikash

    2016-01-01

    Full Text Available Introduction: Patient satisfaction after total knee replacement (TKR depends on the amount of pain relief and the functional activities achieved. An important criterion of good functional outcome is the amount of flexion achieved and whether the patient can manage high flexion activities. In order to increase the amount of safe flexion, various implant designs have been developed. This study aims to compare the outcome after TKR using two contemporary high flexion knee designs: Sigma CR150 High Flex Knee prosthesis (Depuy, Warsaw, Indiana and NexGen High Flex Knee prosthesis (Zimmer, Warsaw, Indiana. Material: A retrospective study was conducted with 100 cases of each design and their functional and radiological outcome was assessed after two years of follow-up. Results: The two groups had comparable results in terms of subjective satisfaction, range of motion achieved and radiological outcome. Depuy group fared better than Zimmer in terms of functional outcome (modified Oxford knee score. Conclusion: Depuy group was found to have fared better than Zimmer in terms of functional outcome. However, it is very difficult to rate one design above the other based on our small sample size and short duration of follow-up.

  6. Retrospective comparison of functional and radiological outcome, between two contemporary high flexion knee designs

    Science.gov (United States)

    Kapoor, Vikash; Chatterjee, Daipayan; Hazra, Sutanu; Chatterjee, Anirban; Garg, Parag; Debnath, Kaustav; Mandal, Soham; Sarkar, Sudipto

    2016-01-01

    Introduction: Patient satisfaction after total knee replacement (TKR) depends on the amount of pain relief and the functional activities achieved. An important criterion of good functional outcome is the amount of flexion achieved and whether the patient can manage high flexion activities. In order to increase the amount of safe flexion, various implant designs have been developed. This study aims to compare the outcome after TKR using two contemporary high flexion knee designs: Sigma CR150 High Flex Knee prosthesis (Depuy, Warsaw, Indiana) and NexGen High Flex Knee prosthesis (Zimmer, Warsaw, Indiana). Material: A retrospective study was conducted with 100 cases of each design and their functional and radiological outcome was assessed after two years of follow-up. Results: The two groups had comparable results in terms of subjective satisfaction, range of motion achieved and radiological outcome. Depuy group fared better than Zimmer in terms of functional outcome (modified Oxford knee score). Conclusion: Depuy group was found to have fared better than Zimmer in terms of functional outcome. However, it is very difficult to rate one design above the other based on our small sample size and short duration of follow-up. PMID:27748254

  7. Scaphoid dislocation associated with axial carpal dissociation during volar flexion of the wrist: a case report.

    Science.gov (United States)

    Kanaya, Kohei; Wada, Takuro; Yamashita, Toshihiko

    2010-01-01

    We present the first report of a patient with an isolated scaphoid dislocation with axial carpal dissociation sustained during volar flexion of the wrist. The scaphoid was dislocated to the radial side of the radial styloid process and was slightly shifted to the dorsal side. It was shown that the position of the wrist played an irrelevant role for occurring scaphoid dislocation.

  8. Muscular coordination of biceps brachii and brachioradialis in elbow flexion with respect to hand position

    Directory of Open Access Journals (Sweden)

    Tim eKleiber

    2015-08-01

    Full Text Available Contribution of synergistic muscles towards specific movements over multi joint systems may change with varying position of distal or proximal joints. Purpose of this study is to reveal the relationship of muscular coordination of brachioradialis and biceps brachii during elbow flexion with respect to hand position and biomechanical advantages and disadvantages of biceps brachii. A group of 16 healthy subjects has been advised to perform 20 repetitions of single elbow flexion movements in different hand positions (pronated, neutral and supinated. With a speed of 20°/s, simultaneously sEMG of biceps brachii and brachioradialis and kinematics of the movement were recorded in a motion analysis laboratory. Normalized to MVC the sEMG amplitudes of both muscles contributing to elbow flexion movements were compared in pronated, supinated and neutral hand position over elbow joint angle. Significant differences in the contribution of brachioradialis were found in pronated hand position compared to supinated and neutral hand position while the muscular activity of biceps brachii shows no significant changes in any hand position.In conclusion, a statistical significant dependency of the inter-muscular coordination between biceps brachii and brachioradialis during elbow flexion with respect to hand position has been observed depending on a biomechanical disadvantage of biceps brachii.

  9. Isokinetic Leg Flexion and Extension Strength of Elite Adolescent Female Track and Field Athletes.

    Science.gov (United States)

    Housh, Terry J.; And Others

    1984-01-01

    Adolescent female track-and-field athletes were measured to compare isokinetic strength of leg flexion and extension movements. Throwers, jumpers, middle-distance runners, and sprinters participated in the study. Throwers were found to be stronger in absolute strength, but there were no significant differences in relative strength. Results are…

  10. Influences of trunk flexion on mechanical energy flow in the lower extremities during gait

    Science.gov (United States)

    Takeda, Takuya; Anan, Masaya; Takahashi, Makoto; Ogata, Yuta; Tanimoto, Kenji; Shinkoda, Koichi

    2016-01-01

    [Purpose] The time-series waveforms of mechanical energy generation, absorption, and transfer through the joints indicate how movements are produced and controlled. Previous studies have used these waveforms to evaluate and describe the efficiency of human movements. The purpose of this study was to examine the influence of trunk flexion on mechanical energy flow in the lower extremities during gait. [Subjects and Methods] The subjects were 8 healthy young males (mean age, 21.8 ± 1.3 years, mean height, 170.5 ± 6.8 cm, and mean weight, 60.2 ± 6.8 kg). Subjects walked at a self-selected gait speed under 2 conditions: normal gait (condition N), and gait with trunk flexion formed with a brace to simulate spinal curvature (condition TF). The data collected from initial contact to the mid-stance of gait was analyzed. [Results] There were no significant differences between the 2 conditions in the mechanical energy flow in the knee joint and negative mechanical work in the knee joint. However, the positive mechanical work of the knee joint under condition TF was significantly less than that under condition N. [Conclusion] Trunk flexion led to knee flexion in a standing posture. Thus, a strategy of moving of center of mass upward by knee extension using less mechanical energy was selected during gait in the trunk flexed posture. PMID:27313351

  11. Variable and Asymmetric Range of Enslaving: Fingers Can Act Independently over Small Range of Flexion

    NARCIS (Netherlands)

    Noort, J.C. van den; Beek, N. van; Kraan, T. van der; Veeger, D.H.; Stegeman, D.F.; Veltink, P.H.; Maas, H.

    2016-01-01

    The variability in the numerous tasks in which we use our hands is very large. However, independent movement control of individual fingers is limited. To assess the extent of finger independency during full-range finger flexion including all finger joints, we studied enslaving (movement in non-instr

  12. Variable and asymmetric range of enslaving: fingers can act independently over small range of flexion

    NARCIS (Netherlands)

    Noort, van den Josien C.; Beek, van Nathalie; Kraan, van der Thomas; Veeger, DirkJan H.E.J.; Stegeman, Dick F.; Veltink, Peter H.; Maas, Huub; Cymbalyuk, G.

    2016-01-01

    The variability in the numerous tasks in which we use our hands is very large. However, independent movement control of individual fingers is limited. To assess the extent of finger independency during full-range finger flexion including all finger joints, we studied enslaving movement in non-instru

  13. Influences of trunk flexion on mechanical energy flow in the lower extremities during gait.

    Science.gov (United States)

    Takeda, Takuya; Anan, Masaya; Takahashi, Makoto; Ogata, Yuta; Tanimoto, Kenji; Shinkoda, Koichi

    2016-05-01

    [Purpose] The time-series waveforms of mechanical energy generation, absorption, and transfer through the joints indicate how movements are produced and controlled. Previous studies have used these waveforms to evaluate and describe the efficiency of human movements. The purpose of this study was to examine the influence of trunk flexion on mechanical energy flow in the lower extremities during gait. [Subjects and Methods] The subjects were 8 healthy young males (mean age, 21.8 ± 1.3 years, mean height, 170.5 ± 6.8 cm, and mean weight, 60.2 ± 6.8 kg). Subjects walked at a self-selected gait speed under 2 conditions: normal gait (condition N), and gait with trunk flexion formed with a brace to simulate spinal curvature (condition TF). The data collected from initial contact to the mid-stance of gait was analyzed. [Results] There were no significant differences between the 2 conditions in the mechanical energy flow in the knee joint and negative mechanical work in the knee joint. However, the positive mechanical work of the knee joint under condition TF was significantly less than that under condition N. [Conclusion] Trunk flexion led to knee flexion in a standing posture. Thus, a strategy of moving of center of mass upward by knee extension using less mechanical energy was selected during gait in the trunk flexed posture.

  14. Quantized average consensus with delay

    NARCIS (Netherlands)

    Jafarian, Matin; De Persis, Claudio

    2012-01-01

    Average consensus problem is a special case of cooperative control in which the agents of the network asymptotically converge to the average state (i.e., position) of the network by transferring information via a communication topology. One of the issues of the large scale networks is the cost of co

  15. Changes in proprioception and pain in patients with neck pain after upper thoracic manipulation.

    Science.gov (United States)

    Yang, Jinmo; Lee, Byoungkwon; Kim, Changbeom

    2015-03-01

    [Purpose] The purpose of this study was to conduct cervical stability training and upper thoracic manipulation for patients with chronic neck pain and then investigate the changes of cervical proprioception and pain. [Subjects and Methods] Subjects were 30 workers with mechanical neck pain, who were randomly divided into an upper thoracic manipulation group and a cervical stability training group. Upper thoracic manipulation after cervical stability training was conducted for the upper thoracic manipulation group, and only stability training was conducted for the cervical stability training group. The intervention period was six weeks, and consisted of three sessions a week, each of which lasted for 30 minutes. For proprioception measurement, an electro-goniometer was used to measure reposition sense before and after the intervention. The visual analogue scale was used to assess pain. [Results] After the intervention, the error angle was significantly smaller in flexion and right left side-bending, and pain was significantly reduced in the upper thoracic manipulation group. According to the post intervention comparison of the two groups, there were significant differences in the proprioception and pain values. [Conclusion] Conducting both cervical stability training and upper thoracic manipulation for patients with chronic neck pain was more helpful for the improvement of proprioception and pain than cervical stability training alone.

  16. Postnatal temporal, spatial and modality tuning of nociceptive cutaneous flexion reflexes in human infants.

    Directory of Open Access Journals (Sweden)

    Laura Cornelissen

    Full Text Available Cutaneous flexion reflexes are amongst the first behavioural responses to develop and are essential for the protection and survival of the newborn organism. Despite this, there has been no detailed, quantitative study of their maturation in human neonates. Here we use surface electromyographic (EMG recording of biceps femoris activity in preterm (4 seconds to a single noxious skin lance which decreases significantly with gestational age. This reflex is not restricted to the stimulated limb: heel lance evokes equal ipsilateral and contralateral reflexes in preterm and term infants. We further show that infant flexion withdrawal reflexes are not always nociceptive specific: in 29% of preterm infants, tactile stimulation evokes EMG activity that is indistinguishable from noxious stimulation. In 40% of term infants, tactile responses are also present but significantly smaller than nociceptive reflexes. Infant flexion reflexes are also evoked by application of calibrated punctate von Frey hairs (vFh, 0.8-17.2 g, to the heel. Von Frey hair thresholds increase significantly with gestational age and the magnitude of vFh evoked reflexes are significantly greater in preterm than term infants. Furthermore flexion reflexes in both groups are sensitized by repeated vFh stimulation. Thus human infant flexion reflexes differ in temporal, modality and spatial characteristics from those in adults. Reflex magnitude and tactile sensitivity decreases and nociceptive specificity and spatial organisation increases with gestational age. Strong, relatively non-specific, reflex sensitivity in early life may be important for driving postnatal activity dependent maturation of targeted spinal cord sensory circuits.

  17. Jugular neck dissection for NO neck supraglottic carcinoma

    Directory of Open Access Journals (Sweden)

    Petrović Željko

    2004-01-01

    Full Text Available Appropriate management of patients with supraglottic laryngeal carcinoma and negative findings in the neck is still controversial. A prospective and retrospective study comprised 193 patients who were treated primary surgically between 1976 and 1993. They all had clinically and ultrasound negative findings on the neck (NO. Supraglottic carcinomas usually spread regionally. Metastases develop in the jugular group, between level II-IV. The incidence of metastases has been reported to vary from 12 to 62.5%. The size and localization of the primary tumor, its histological grade, genotype of the malignant cells, imunological and other elucidated factors can all affect the incidence of regional spread. AIM Aim of this study was to specify the incidence of occult cervical metastases; to analyze the distribution of occult metastases related to tumor localization; to specify the distribution of occult metastases related to local spread; to analyze the distribution of occult metastases according to localization in the neck. RESULTS All patients had primary surgery of primary tumor and bilateral jugular, selective neck dissection at the level II-IV with histological examination of removed lymphoid tissue. Out of 193 patients, metastatic deposits were detected in 35(18%. Occult metastases were found in patients with carcinoma of the epilarynx in 19% (14/72 of cases, and in 17% (21/121 patients with carcinoma of the supraglottis excluding the epilarynx. This difference in frequency is not statistically significant. The incidence of occult metastases in epilaryngeal tumors did not depend on the degree of local spread. Even relatively small tumors (T1 and T2 yielded occult metastases in 33% (5/15, and 24% (6/25 of patients, respectively. In patients with T1 tumors localized at the supraglottis, excluding the epilarinx, occult metastases were not found. In the supragiottis excluding the epilarynx increased local spread was associated an increase of occult

  18. [Spinal accessory nerve and lymphatic neck dissection].

    Science.gov (United States)

    Pinsolle, V; Michelet, V; Majoufre, C; Caix, P; Siberchicot, F; Pinsolle, J

    1997-09-01

    Radical neck dissection was the golden standard of treatment for cervical nodes in head and neck tumors. From the seventies, the preservation of the spinal accessory nerve has become increasingly popular in order to improve the functional result of the neck dissections. The aim of this study was to assess the degree of functional disability associated with each type of neck dissection and the value of anatomical references for dissection of the spinal accessory nerve. One hundred twenty seven patients were evaluated 1 month and 1 year after radical, functional or supraomohyoid neck dissection with a questionnaire and a physical examination. Anatomical measurements of the spinal accessory nerve were performed in 20 patients. We found considerable or severe shoulder dysfunction in 7%, 34% and 51% respectively of patients in whom supraomohyoid, functional and radical neck dissections were performed. Furthermore 49% of patients having undergone a radical neck dissection had little or no symptoms. Sacrifice of the spinal accessory nerve in radical neck dissection may lead to shoulder dysfunction. A functional disability may also be associated, although in a less extent, with any neck dissection in which the spinal accessory nerve is dissected and placed in traction. There is a large variation in the degree of functional disability and pain in patients with similar neck dissections. The course of the spinal accessory nerve in the neck makes it particularly vulnerable to injury during the dissection near the sternocleidomastoid muscle and in the posterior cervical triangle.

  19. Gaussian moving averages and semimartingales

    DEFF Research Database (Denmark)

    Basse-O'Connor, Andreas

    2008-01-01

    In the present paper we study moving averages (also known as stochastic convolutions) driven by a Wiener process and with a deterministic kernel. Necessary and sufficient conditions on the kernel are provided for the moving average to be a semimartingale in its natural filtration. Our results...... are constructive - meaning that they provide a simple method to obtain kernels for which the moving average is a semimartingale or a Wiener process. Several examples are considered. In the last part of the paper we study general Gaussian processes with stationary increments. We provide necessary and sufficient...

  20. Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: Design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Hansen Inge

    2011-12-01

    Full Text Available Abstract Background Many patients suffer from chronic neck pain following a whiplash injury. A combination of cognitive, behavioural therapy with physiotherapy interventions has been indicated to be effective in the management of patients with chronic whiplash-associated disorders. The objective is to present the design of a randomised controlled trial (RCT aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline. Methods/Design The design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited from physiotherapy clinics and an out-patient hospital department in Denmark. Patients will be randomised to either a pain management (control group or a combined pain management and training (interventiongroup. The control group will receive four educational sessions on pain management, whereas the intervention group will receive the same educational sessions on pain management plus 8 individual training sessions for 4 months, including guidance in specific neck exercises and an aerobic training programme. Patients and physiotherapists are aware of the allocation and the treatment, while outcome assessors and data analysts are blinded. The primary outcome measures will be Medical Outcomes Study Short Form 36 (SF36, Physical Component Summary (PCS. Secondary outcomes will be Global Perceived Effect (-5 to +5, Neck Disability Index (0-50, Patient Specific Functioning Scale (0-10, numeric rating scale for pain bothersomeness (0-10, SF-36 Mental Component Summary (MCS, TAMPA scale of Kinesiophobia (17-68, Impact of Event Scale (0-45, EuroQol (0

  1. The role of a posteriorly inclined condylar neck in condylar resorption after orthognathic surgery.

    Science.gov (United States)

    Hwang, S J; Haers, P E; Sailer, H F

    2000-04-01

    Recently, it has been reported that a posteriorly inclined condylar neck is associated with condylar resorption following orthognathic surgery, although its role in resorption remains unknown. By cephalometric screening of 240 patients with Angle Class II occlusion 2 years after orthognathic surgery, 11 patients with postoperative condylar resorption were identified. The preoperative posterior inclination of the condylar neck and the surgical risk factors mentioned in the literature, particularly surgically induced counterclockwise rotation of the mandibular proximal segment were evaluated. In all 11 cases, the condylar neck was clearly inclined posteriorly. Counterclockwise rotation of the proximal segment was also observed in all cases, and it amounted to 6.7 degrees (2.5-12 degrees) on average. The contributing role of a posteriorly inclined condylar neck in connection with surgical mandibular movement in postoperative condylar resorption is discussed.

  2. Arthur Simons (1877-1942) and Tonic Neck Reflexes With Hemiplegic "Mitbewegungen" (Associated Reactions): Cinematography From 1916-1919.

    Science.gov (United States)

    Holdorff, Bernd

    2016-01-01

    Tonic neck reflexes were investigated by Rudolf Magnus and Adriaan de Kleijn in animals and men in 1912 and eventually by Arthur Simons, a neurologist in Berlin and coworker of Hermann Oppenheim. Simons studied these reflexes in hemiplegic patients, who were mainly victims of World War I. This work became his most important contribution and remained unsurpassed for many years. The film (Filmarchiv, Bundesarchiv [Film Archive, National Archive] Berlin) with Simons as an examiner shows 11 war casualties with brain lesions that occurred between 1916 and 1919. The injuries reveal asymmetric neck reflexes with "Mitbewegungen," that is, flexion or extension on the hemiplegic side. Mitbewegungen is identical with Francis Walshe's "associated reactions" caused by neck rotation and/or by cocontraction of the nonaffected extremities, for example, by closing of the fist (Walshe). The knowledge of the neck reflexes is important in acute neurology and in rehabilitation therapy of hemiplegics for antispastic positions. Simons' investigations were conducted in the early era of increasing use of cinematography in medical studies. The film had been nearly forgotten until its rediscovery in 2010.

  3. NSE-1飞行员颈肌训练器的研制及其应用%Research, Design and Application of Model NSE-1 Neck Muscle Training Machine for Pilots

    Institute of Scientific and Technical Information of China (English)

    成海平; 王致洁; 柳松杨; 杨毅; 赵广; 丛红; 韩学平; 刘敏; 俞梦孙

    2011-01-01

    空军飞行员暴露于高G载荷下导致颈部疼痛是一个特殊的职业问题,为了减少这方面的问题有必要进行特殊的颈肌强度训练.为了安全有效地进行颈肌强度训练,提供颈肌强度训练的最佳阻抗是非常重要的.本研究设计了NSE-1型飞行员颈肌训练器.为实现可变阻力和可变速度(CVR)肌力训练以及等长训练,本研究采用了自适应液压技术、传感技术、视觉和听觉生物反馈技术和信号处理技术,系统由机械部分(前屈后伸和左右侧屈训练器座椅、液压组件、力矩传递组件)、信号处理和生物反馈软件组成.为验证该训练器的有效性和安全性,对11名志愿者进行前屈后伸和左右侧屈的CVR训练和等长训练,每周三次,共6周.前屈、后伸、左右侧屈肌群的相对强度分别增长70.8%、83.7%、78.6%和75.2%.结果表明:应用NSE-1飞行员颈肌训练器进行颈肌训练,能安全高效地提高颈肌各肌群的强度.%Pain in the cervical region of air force pilots, who are exposed to high G-forces, is a specifically occupational health problem. To minimize neck problems, the cervical muscles need specific strength exercise. It is important that the training for the neck must be carried out with optimal resistance in exercises. The model NSE-1 neck training machine for pilots was designed for neck strengthening exercises under safe and effective conditions. In order to realize the functions of changeable velocity and resistant (CVR) training and neck isometric contractive exercises, the techniques of adaptive hydraulics, sensor, optic and auditory biological feedback, and signal processing were applied to this machine. The training system mainly consists of mechanical parts (including the chair of flexion and extension, the chair of right and left lateral flexion, the components of hydraulics and torque transformer, etc. ) , and the software of signal processing and biological feedback. Eleven

  4. Comparison of the Symmetry of Right and Left Lateral Cervical Flexion and Rotation and the Cervical FRR in Young Computer Workers

    OpenAIRE

    Yoo, Won-gyu

    2014-01-01

    [Purpose] This study compared the symmetry of right and left lateral cervical flexion and rotation, and the cervical flexion-relaxation ratio (FRR) in young computer workers in Korea. [Subjects and Methods] Twenty computer workers (14 males and 6 females) participated in this study. We measured their right and left lateral cervical flexion, rotation, and FRR. [Results] Right and left lateral flexion and right and left rotation showed no significant differences between the sides. The left cerv...

  5. Vocal attractiveness increases by averaging.

    Science.gov (United States)

    Bruckert, Laetitia; Bestelmeyer, Patricia; Latinus, Marianne; Rouger, Julien; Charest, Ian; Rousselet, Guillaume A; Kawahara, Hideki; Belin, Pascal

    2010-01-26

    Vocal attractiveness has a profound influence on listeners-a bias known as the "what sounds beautiful is good" vocal attractiveness stereotype [1]-with tangible impact on a voice owner's success at mating, job applications, and/or elections. The prevailing view holds that attractive voices are those that signal desirable attributes in a potential mate [2-4]-e.g., lower pitch in male voices. However, this account does not explain our preferences in more general social contexts in which voices of both genders are evaluated. Here we show that averaging voices via auditory morphing [5] results in more attractive voices, irrespective of the speaker's or listener's gender. Moreover, we show that this phenomenon is largely explained by two independent by-products of averaging: a smoother voice texture (reduced aperiodicities) and a greater similarity in pitch and timbre with the average of all voices (reduced "distance to mean"). These results provide the first evidence for a phenomenon of vocal attractiveness increases by averaging, analogous to a well-established effect of facial averaging [6, 7]. They highlight prototype-based coding [8] as a central feature of voice perception, emphasizing the similarity in the mechanisms of face and voice perception.

  6. Reduced Neck Muscle Strength and Altered Muscle Mechanical Properties in Cervical Dystonia Following Botulinum Neurotoxin Injections: A Prospective Study

    Science.gov (United States)

    Mustalampi, Sirpa; Ylinen, Jari; Korniloff, Katariina; Weir, Adam; Häkkinen, Arja

    2016-01-01

    Objective To evaluate changes in the strength and mechanical properties of neck muscles and disability in patients with cervical dystonia (CD) during a 12-week period following botulinum neurotoxin (BoNT) injections. Methods Eight patients with CD volunteered for this prospective clinical cohort study. Patients had received BoNT injections regularly in neck muscles at three-month intervals for several years. Maximal isometric neck strength was measured by a dynamometer, and the mechanical properties of the splenius capitis were evaluated using two myotonometers. Clinical assessment was performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) before and at 2, 4, 8, and 12 weeks after the BoNT injections. Results Mean maximal isometric neck strength at two weeks after the BoNT injections decreased by 28% in extension, 25% in rotation of the affected side and 17% in flexion. At four weeks, muscle stiffness of the affected side decreased by 17% and tension decreased by 6%. At eight weeks, the muscle elasticity on the affected side increased by 12%. At two weeks after the BoNT injections, the TWSTRS-severity and TWSTRS-total scores decreased by 4.3 and 6.4, respectively. The strength, muscle mechanical properties and TWSTRS scores returned to baseline values at 12 weeks. Conclusions Although maximal neck strength and muscle tone decreased after BoNT injections, the disability improved. The changes observed after BoNT injections were temporary and returned to pre-injection levels within twelve weeks. Despite having a possible negative effect on function and decreasing neck strength, the BoNT injections improved the patients reported disability. PMID:26828215

  7. Reduced Neck Muscle Strength and Altered Muscle Mechanical Properties in Cervical Dystonia Following Botulinum Neurotoxin Injections: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Sirpa Mustalampi

    2016-01-01

    Full Text Available Objective To evaluate changes in the strength and mechanical properties of neck muscles and disability in patients with cervical dystonia (CD during a 12-week period following botulinum neurotoxin (BoNT injections. Methods Eight patients with CD volunteered for this prospective clinical cohort study. Patients had received BoNT injections regularly in neck muscles at three-month intervals for several years. Maximal isometric neck strength was measured by a dynamometer, and the mechanical properties of the splenius capitis were evaluated using two myotonometers. Clinical assessment was performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS before and at 2, 4, 8, and 12 weeks after the BoNT injections. Results Mean maximal isometric neck strength at two weeks after the BoNT injections decreased by 28% in extension, 25% in rotation of the affected side and 17% in flexion. At four weeks, muscle stiffness of the affected side decreased by 17% and tension decreased by 6%. At eight weeks, the muscle elasticity on the affected side increased by 12%. At two weeks after the BoNT injections, the TWSTRS-severity and TWSTRS-total scores decreased by 4.3 and 6.4, respectively. The strength, muscle mechanical properties and TWSTRS scores returned to baseline values at 12 weeks. Conclusions Although maximal neck strength and muscle tone decreased after BoNT injections, the disability improved. The changes observed after BoNT injections were temporary and returned to pre-injection levels within twelve weeks. Despite having a possible negative effect on function and decreasing neck strength, the BoNT injections improved the patients reported disability.

  8. Correlation of non-traumatic neck pain with cervical angle and shoulder retractor power in adult clerical population

    Directory of Open Access Journals (Sweden)

    Isha Avadhut Godbole

    2015-04-01

    Full Text Available Background: A forward head posture (or chin poking is perhaps the most common abnormality associated with NP and is commonly defined as the protrusion of the head in the sagittal plane so that the head is placed anterior to the trunk. Forward head posture can occur because of an anterior translation of the head, lower cervical flexion, or both, and it is claimed to be associated with an increase in upper-cervical extension. It is suggested that forward head posture leads to an increase in the compressive forces on the cervical apophyseal joints and posterior part of the vertebra and to changes in connective tissue length and strength (because of stretching of the anterior structures of the neck and shortening of the posterior muscles resulting in pain. The objective of the study was to correlate neck pain with cervical angle and shoulder retractor power in non-traumatic neck pain patients. Methods: 50 clerical workers having non traumatic neck pain were included. Neck pain was measured on VAS, cervical angle was measured using photometric method and shoulder retractor power was measured. Results: VAS showed moderate positive correlation with cervical angles (0.63 and 0.72 and moderate negative correlation with shoulder retractor power (-0.59 and -0.71. A moderate positive correlation of craniocervical angle to VAS seen (0.66 whereas there was negative correlation with shoulder retractors I and II (-0.59 and -0.61 A positive correlation was seen between VAS and craniocervical angle but is moderately negative with shoulder retractors I (Rhomboids and II (Middle trapezius (0.78, 0.04, -0.69 and -0.64. Conclusion: A moderate increase in cranio vertebral and craniocervical angle showed plausible weakness in lower Trapezius and rhomboids among clerks` having Non-traumatic neck pain. [Int J Res Med Sci 2015; 3(4.000: 859-862

  9. The influence of breathing type, expiration and cervical posture on the performance of the cranio-cervical flexion test in healthy subjects.

    Science.gov (United States)

    Cagnie, Barbara; Danneels, Lieven; Cools, Ann; Dickx, Nele; Cambier, Dirk

    2008-06-01

    The cranio-cervical flexion test (CCF-T) is used as a clinical evaluation tool for the deep cervical flexors (DCF). The influence of breathing type, expiration and cervical posture on the performance of the test is evaluated in asymptomatic subjects. Thirty volunteers participated in the study and were classified according to their breathing type: costo-diaphragmatic breathing type and upper costal breathing type. Sternocleidomastoid (SCM) electromyographic (EMG) activity was recorded during five incremental levels of CCF during normal breathing as well as during expiration. The cranio-vertebral angle of each subject was measured to quantify cervical posture. During normal inspiration, higher EMG activity of the SCM muscles was observed in subjects with an upper costal breathing pattern compared to costo-diaphragmatic breathing subjects. This difference was statistically significant (Pangle and the EMG activity of the SCM muscles. Performing the CCF-T during slow expiration diminishes the activity of the SCM muscles in subjects with a predominantly upper costal breathing pattern. Using a costo-diaphragmatic breathing pattern while performing the test will optimize the performance. Studies on neck pain patients are required to further clarify this issue.

  10. Utility of flexion-extension radiography for the detection of ligamentous cervical spine injury and its current role in the clearance of the cervical spine.

    Science.gov (United States)

    Oh, Jason Jaeseong; Asha, Stephen Edward

    2016-04-01

    Detecting the presence of injuries to the cervical spine is an important component of the initial assessment of patients sustaining blunt trauma. A small proportion of cervical spine injuries consists of ligamentous disruption. Accurate detection of ligamentous injury is essential as it may result in sequelae including radiculopathy, quadriplegia and death. Flexion-extension (FE) radiography has traditionally been utilised for the detection of ligamentous injury in patients who have been cleared of bony injury. There are controversies surrounding the use of FE for alert patients with neck pain. There are studies that call into question the diagnostic accuracy of FE, the high proportion of inadequate FE images due to muscle spasm and the adverse effects of prolonged cervical collar immobilisation while awaiting FE. Other literature indicates that FE provides no additional diagnostic information following a multi-detector helical computed tomography. This review evaluates the literature on the utility of FE for the detection of ligamentous injury and explores alternate strategies for clearing the cervical spine of ligamentous injury.

  11. Head and neck position sense.

    Science.gov (United States)

    Armstrong, Bridget; McNair, Peter; Taylor, Denise

    2008-01-01

    Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or

  12. Distraction correction for flexion contractures of the fingers: A minimally invasive technique

    Directory of Open Access Journals (Sweden)

    Ravishanker R

    2003-01-01

    Full Text Available Burns injuries account for over 2 million cases in our country. With over 75% of the patients sustaining injuries to the hands, post burn contractures of the finger are a very common condition presenting for treatment. Similarly trauma to the upper limbs, accounting for about a third of all injuries to the body also result in flexion deformities of the fingers. Standard treatment for these deformities is by way of surgical release of the contractures, skin cover with split skin grafting or full thickness grafts followed by prolonged immobilization and splintage. The relatively minimally invasive technique of distraction has been used in this small but representative series to correct flexion deformities caused by burns and other injuries. Results have been very gratifying.

  13. Decoding Finger Flexion using amplitude modulation from band-specific ECoG

    CERN Document Server

    Liang, Nanying

    2009-01-01

    EEG-BCIs have been well studied in the past decades and implemented into several famous applications, like P300 speller and wheelchair controller. However, these interfaces are indirect due to low spatial resolution of EEG. Recently, direct ECoG-BCIs attract intensive attention because ECoG provides a higher spatial resolution and signal quality. This makes possible localization of the source of neural signals with respect to certain brain functions. In this article, we present a realization of ECoG-BCIs for finger flexion prediction provided by BCI competition IV. Methods for finger flexion prediction including feature extraction and selection are provided in this article. Results show that the predicted finger movement is highly correlated with the true movement when we use band-specific amplitude modulation.

  14. Soft tissue distraction using pentagonal frame for long-standing traumatic flexion deformity of interphalangeal

    Directory of Open Access Journals (Sweden)

    Nazerani Shahram

    2012-08-01

    Full Text Available 【Abstract】Objective: Interphalangeal joint con-tracture is a challenging complication of hand trauma, which reduces the functional capacity of the entire hand. In this study we evaluated the results of soft tissue distraction with no collateral ligament transection or volar plate removal in comparison with traditional operation of contracture re-lease and partial ligament transection and volar plate removal. Methods: In this prospective study, a total of 40 pa-tients in two equal groups (A and B were studied. Patients suffering from chronic flexion contracture of abrasive trau-matic nature were included. Group A were treated by soft tissue distraction using pentagonal frame technique and in Group B the contracture release was followed by finger splinting. Results: Analyzed data revealed a significant differ-ence between the two groups for range of motion in the proximal interphalangeal joints (P<0.05, while it was not meaningful in the distal interphalangeal joints (P>0.05. There was not a significant difference in the degrees of flexion contracture between groups (P>0.05. Regression analysis showed that using pentagonal frame technique significantly increased the mean improvement in range of motion of proxi-mal interphalangeal joints (P<0.001, while the higher the preoperative flexion contracture was observed in proximal interphalangeal joints, the lower improvement was achieved in range of motion of proximal interphalangeal joints after intervention (P<0.001. Conclusion: Soft tissue distraction using pentagonal frame technique with gradual and continuous collateral liga-ment and surrounding joint tissues distraction combined with skin Z-plasty significantly improves the range of mo-tion in patients with chronic traumatic flexion deformity of proximal and/or distal interphalangeal joints. Key words: Osteogenesis, distraction; Finger joint; Hand deformities

  15. Posterior Vertebral Injury; Is This a Burst Fracture or a Flexion-Distraction Injury?

    Directory of Open Access Journals (Sweden)

    Farzad Omidi-Kashani

    2014-06-01

    Full Text Available In thoracolumbar spinal fractures with posterior column injury for applying proper management, it is important to distinguish a flexion-distraction injury (FDI from a three column burst fracture (BF as in clinical examination, both may have a similar significant tenderness on direct spinal palpation. Careful attention to the comprehensive clinical examination and detailed imaging features are essential in making an accurate diagnosis and thus appropriate treatment.    

  16. THE INFLUENCE OF BODY POSITION ON LOAD RANGE DURING ISOKINETIC KNEE EXTENSION/FLEXION

    Directory of Open Access Journals (Sweden)

    Brian W. Findley

    2006-09-01

    Full Text Available Isokinetic range of motion (ROM has three distinct phases: rate of velocity development (RVD, load range (LR, and deceleration (DCC. The purpose of this study was to determine if differences in isokinetic knee extension/flexion LR exist between body positions. Ten subjects (4 males and 6 females, age 29.3 ± 5.4 yrs, ht 1.71 ± 0.10 m, wt 71.9 ± 12.9 kg volunteered to participate in the seated vs. prone investigation and nine different subjects (4 males and 5 females, age 29.5 ± 6.9 yrs, ht 1.72 ± 0.09 m, wt 69.0 ± 13.8 kg volunteered to participate in the seated vs. supine study. Each subject completed 3 maximal reciprocal concentric/concentric repetitions of dominant knee extension/flexion on a Biodex System 2 isokinetic dynamometer at 60, 120, 180, 240 and 360 deg·sec-1 in the supine or prone and seated positions. Repeated measures ANOVA revealed that only seated flexion at 360 deg·sec-1 (57.6 ± 1.7 degrees elicited significantly (p < 0.05 greater LR than prone (49.2 ± 2.8 degrees. No significant differences in LR extension or flexion existed at any velocity between the supine vs. seated positions. ANOVA also demonstrated differences between seated vs. prone torque, work and power at most velocities while there was no difference between seated vs. supine. LR is the only phase of an isokinetic repetition where quantifiable resistance is maintained and this data appears to support that it may not be position-dependent but position may alter traditional performance variables

  17. Low incidence of flexion-type supracondylar humerus fractures but high rate of complications.

    Science.gov (United States)

    Kuoppala, Eira; Parviainen, Roope; Pokka, Tytti; Sirviö, Minna; Serlo, Willy; Sinikumpu, Juha-Jaakko

    2016-08-01

    Background and purpose - Supracondylar humerus fractures are the most common type of elbow fracture in children. A small proportion of them are flexion-type fractures. We analyzed their current incidence, injury history, clinical and radiographic findings, treatment, and outcomes. Patients and methods - We performed a population-based study, including all children <16 years of age. Radiographs were re-analyzed to include only flexion-type supracondylar fractures. Medical records were reviewed and outcomes were evaluated at a mean of 9 years after the injury. In addition, we performed a systematic literature review of all papers published on the topic since 1990 and compared the results with the findings of the current study. Results - During the study period, the rate of flexion-type fractures was 1.2% (7 out of 606 supracondylar humeral fractures). The mean annual incidence was 0.8 per 105. 4 fractures were multidirectionally unstable, according to the Gartland-Wilkins classification. All but 1 were operatively treated. Reduced range of motion, changed carrying angle, and ulnar nerve irritation were the most frequent short-term complications. Finally, in the long-term follow-up, mean carrying angle was 50% more in injured elbows (21°) than in uninjured elbows (14°). 4 patients of the 7 achieved a satisfactory long-term outcome according to Flynn's criteria. Interpretation - Supracondylar humeral flexion-type fractures are rare. They are usually severe injuries, often resulting in short-term and long-term complications regardless of the original surgical fixation used.

  18. Airway Management in Fixed Flexion Deformity using an Alternative Method of ILMA Insertion

    Directory of Open Access Journals (Sweden)

    Sudhir K Singh

    2008-01-01

    Full Text Available Fixed flexion deformity is a sequel of burns and their release under anaesthesia pose difficulty during intubation. Various modalities are used for airway management in such cases. Here we present the successful airway manage-ment in a patient with post burn contracture who was managed with use of intubating laryngeal mask airway (ILMA introduced in reverse direction with 180 0 rotation for insertion.

  19. Treatment of knee flexion contracture in patients with chronic juvenile arthritis: A case report

    OpenAIRE

    Matijević Radmila; Stanković Milan; Ninković Srđan; Savić Dragan; Milankov Miroslav

    2006-01-01

    Introduction. Knee flexion contractures are common after-effects of juvenile arthritis. Treatment is usually conservative and may include physical therapy and kinesitherapy. Surgical treatment, particularly of the soft parts, indicated for contractures resistant to conservative treatment, helps to correct the deformity, maintain movements, and relieves pain. Intensive postoperative physiotherapy is of special importance. Case report. A 23-year-old female patient with chronic juvenile arthriti...

  20. Computer mouse use predicts acute pain but not prolonged or chronic pain in the neck and shoulder

    DEFF Research Database (Denmark)

    Andersen, JH; Harhoff, M.; Grimstrup, S.

    2008-01-01

    BACKGROUND: Computer use may have an adverse effect on musculoskeletal outcomes. This study assessed the risk of neck and shoulder pain associated with objectively recorded professional computer use. METHODS: A computer programme was used to collect data on mouse and keyboard usage and weekly...... quartile increase in weekly mouse usage time. Mouse and keyboard usage time did not predict the onset of prolonged or chronic pain in the neck or shoulder. Women had higher risks for neck and shoulder pain. Number of keystrokes and mouse clicks, length of the average activity period, and micro-pauses did...... not influence reports of acute or prolonged pain. A few psychosocial factors predicted the risk of prolonged pain. CONCLUSIONS: Most computer workers have no or minor neck and shoulder pain, few experience prolonged pain, and even fewer, chronic neck and shoulder pain. Moreover, there seems...

  1. Increased neck muscle activity and impaired balance among females with whiplash-related chronic neck pain

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Clausen, Brian; Ris Hansen, Inge

    2013-01-01

    To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls.......To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls....

  2. Averaged Electroencephalic Audiometry in Infants

    Science.gov (United States)

    Lentz, William E.; McCandless, Geary A.

    1971-01-01

    Normal, preterm, and high-risk infants were tested at 1, 3, 6, and 12 months of age using averaged electroencephalic audiometry (AEA) to determine the usefulness of AEA as a measurement technique for assessing auditory acuity in infants, and to delineate some of the procedural and technical problems often encountered. (KW)

  3. Ergodic averages via dominating processes

    DEFF Research Database (Denmark)

    Møller, Jesper; Mengersen, Kerrie

    2006-01-01

    We show how the mean of a monotone function (defined on a state space equipped with a partial ordering) can be estimated, using ergodic averages calculated from upper and lower dominating processes of a stationary irreducible Markov chain. In particular, we do not need to simulate the stationary ...

  4. Speciation of Black-necked Crane

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Based on the concepts of species and speciation,the speciation of Black-necked Grane(Grus nigricollis) was discussed using bio-geographic principles and some evidences suggest that Black-necked Grane had a close relationship with Red-crowned Crane(Grus japonensis).The Qinghai-Tibetan Plateau uplift may be the most important factor in allopatric speciation for Black-necked Crane.

  5. Investigating the Effects of Knee Flexion during the Eccentric Heel-Drop Exercise

    Directory of Open Access Journals (Sweden)

    Robert A. Weinert-Aplin, Anthony M.J. Bull, Alison H. McGregor

    2015-06-01

    Full Text Available This study aimed to characterise the biomechanics of the widely practiced eccentric heel-drop exercises used in the management of Achilles tendinosis. Specifically, the aim was to quantify changes in lower limb kinematics, muscle lengths and Achilles tendon force, when performing the exercise with a flexed knee instead of an extended knee. A musculoskeletal modelling approach was used to quantify any differences between these versions of the eccentric heel drop exercises used to treat Achilles tendinosis. 19 healthy volunteers provided a group from which optical motion, forceplate and plantar pressure data were recorded while performing both the extended and flexed knee eccentric heel-drop exercises over a wooden step when barefoot or wearing running shoes. This data was used as inputs into a scaled musculoskeletal model of the lower limb. Range of ankle motion was unaffected by knee flexion. However, knee flexion was found to significantly affect lower limb kinematics, inter-segmental loads and triceps muscle lengths. Peak Achilles load was not influenced despite significantly reduced peak ankle plantarflexion moments (p < 0.001. The combination of reduced triceps lengths and greater ankle dorsiflexion, coupled with reduced ankle plantarflexion moments were used to provide a basis for previously unexplained observations regarding the effect of knee flexion on the relative loading of the triceps muscles during the eccentric heel drop exercises. This finding questions the role of the flexed knee heel drop exercise when specifically treating Achilles tendinosis.

  6. Segmental lumbar spine instability at flexion-extension radiography can be predicted by conventional radiography

    Energy Technology Data Exchange (ETDEWEB)

    Pitkaenen, M.T.; Manninen, H.I.; Lindgren, K.-A.J.; Sihvonen, T.A.; Airaksinen, O.; Soimakallio, S

    2002-07-01

    AIM: To identify plain radiographic findings that predict segmental lumbar spine instability as shown by functional flexion-extension radiography. MATERIALS AND METHODS: Plain radiographs and flexion-extension radiographs of 215 patients with clinically suspected lumbar spine instability were analysed. Instability was classified into anterior or posterior sliding instability. The registered plain radiographic findings were traction spur, spondylarthrosis, arthrosis of facet joints, disc degeneration, retrolisthesis, degenerative spondylolisthesis, spondylolytic spondylolisthesis and vacuum phenomena. Factors reaching statistical significance in univariate analyses (P < 0.05) were included in stepwise multiple logistic regression analysis. RESULTS: Degenerative spondylolisthesis (P = 0.004 at L3-4 level and P = 0.017 at L4-5 level in univariate analysis and odds ratio 16.92 at L4-5 level in multiple logistic regression analyses) and spondylolytic spondylolisthesis (P = 0.003 at L5-S1 level in univariate analyses) were the strongest independent determinants of anterior sliding instability. Retrolisthesis (odds ratio 10.97), traction spur (odds ratio 4.45) and spondylarthrosis (odds ratio 3.20) at L3-4 level were statistically significant determinants of posterior sliding instability in multivariate analysis. CONCLUSION: Sliding instability is strongly associated with various plain radiographic findings. In mechanical back pain, functional flexion-extension radiographs should be limited to situations when symptoms are not explained by findings of plain radiographs and/or when they are likely to alter therapy. Pitkaenen, M.T. et al. (2002)

  7. DOES RECTUS FEMORIS TRANSFER INCREASE KNEE FLEXION DURING STANCE PHASE IN CEREBRAL PALSY?

    Science.gov (United States)

    de Morais, Mauro César; Blumetti, Francesco Camara; Kawamura, Cátia Miyuki; Lopes, José Augusto Fernandes; Neves, Daniella Lins; Cardoso, Michelle de Oliveira

    2016-01-01

    ABSTRACT Objective: To evaluate whether distal rectus femoris transfer (DRFT) is related to postoperative increase of knee flexion during the stance phase in cerebral palsy (CP). Methods: The inclusion criteria were Gross Motor Function Classification System (GMFCS) levels I-III, kinematic criteria for stiff-knee gait at baseline, and individuals who underwent orthopaedic surgery and had gait analyses performed before and after intervention. The patients included were divided into the following two groups: NO-DRFT (133 patients), which included patients who underwent orthopaedic surgery without DRFT, and DRFT (83 patients), which included patients who underwent orthopaedic surgery that included DRFT. The primary outcome was to evaluate in each group if minimum knee flexion in stance phase (FMJFA) changed after treatment. Results: The mean FMJFA increased from 13.19° to 16.74° (p=0.003) and from 10.60° to 14.80° (p=0.001) in Groups NO-DRFT and DRFT, respectively. The post-operative FMJFA was similar between groups NO-DRFT and DRFT (p=0.534). The increase of FMJFA during the second exam (from 13.01° to 22.51°) was higher among the GMFCS III patients in the DRFT group (p<0.001). Conclusion: In this study, DRFT did not generate additional increase of knee flexion during stance phase when compared to the control group. Level of Evidence III, Retrospective Comparative Study. PMID:26997910

  8. Decoding Finger Flexion From Band-specific ECoG Signals in Humans

    Directory of Open Access Journals (Sweden)

    Nanying eLiang

    2012-06-01

    Full Text Available This article presents the method that won the BCI competition IV addressed to the pre- diction of the finger flexion from ECoG signals. ECoG-based BCIs have recently drawn the attention from the community. Indeed, ECoG can provide a higher spatial resolution, a higher signal quality and is more suitable for long-term use than classical EEG recordings. These characteristics allow to decode precise brain activities and to realize efficient ECoG-based neu- roprostheses. Signal processing is a very important task in BCIs research for translating brain signals into commands. Here, we present a linear regression method based on the amplitude modulation of band-specific ECoG including a short term memory for individual finger flexion prediction. The effectiveness of the method was proven by achieving the highest value of corre- lation coefficient between the predicted and recorded finger flexion values on data set 4 during the BCI competition IV.

  9. Detection method of flexion relaxation phenomenon based on wavelets for patients with low back pain

    Science.gov (United States)

    Nougarou, François; Massicotte, Daniel; Descarreaux, Martin

    2012-12-01

    The flexion relaxation phenomenon (FRP) can be defined as a reduction or silence of myoelectric activity of the lumbar erector spinae muscle during full trunk flexion. It is typically absent in patients with chronic low back pain (LBP). Before any broad clinical utilization of this neuromuscular response can be made, effective, standardized, and accurate methods of identifying FRP limits are needed. However, this phenomenon is clearly more difficult to detect for LBP patients than for healthy patients. The main goal of this study is to develop an automated method based on wavelet transformation that would improve time point limits detection of surface electromyography signals of the FRP in case of LBP patients. Conventional visual identification and proposed automated methods of time point limits detection of relaxation phase were compared on experimental data using criteria of accuracy and repeatability based on physiological properties. The evaluation demonstrates that the use of wavelet transform (WT) yields better results than methods without wavelet decomposition. Furthermore, methods based on wavelet per packet transform are more effective than algorithms employing discrete WT. Compared to visual detection, in addition to demonstrating an obvious saving of time, the use of wavelet per packet transform improves the accuracy and repeatability in the detection of the FRP limits. These results clearly highlight the value of the proposed technique in identifying onset and offset of the flexion relaxation response in LBP subjects.

  10. [Update on current care guidelines. Neck pain].

    Science.gov (United States)

    2009-01-01

    Neck pain is very common. Age, female gender, obesity, and several physical and psychological work related factors increase the risk while physical activity appears to decrease it. Non-specific neck pain is most common but serious or specific illness must be ruled out and neural compression identified. Patients are encouraged to remain active and improve their ergonomics. Acute neck pain often disappears without any special treatment. Paracetamol is the primary pain medication. Multidisciplinary treatment is recommended if disabling pain has lasted for two months, and intensive muscle exercises in chronic neck pain. Progressive muscle weakness and myelopathy indicate a surgical assessment.

  11. Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index

    NARCIS (Netherlands)

    Reneman, Michiel F.; Geertzen, Jan H. B.; Jorritsma, Wim; Knol-de Vries, Grietje; Dijkstra, Pieter U.

    2012-01-01

    To investigate relevant change on the Neck Pain and Disability Scale (NPAD) and Neck Disability Index (NDI) and which questionnaire is the most responsive in patients with non-specific chronic neck pain (CNP). Seventy-six patients with non-specific CNP in an outpatient tertiary rehabilitation settin

  12. Wipe and flexion reflexes of the frog. II. Response to perturbations.

    Science.gov (United States)

    Schotland, J L; Rymer, W Z

    1993-05-01

    1. To evaluate the hypothesis that the neural control of sensorimotor transformations may be simplified by using a single control variable, we compared the movement kinematics and muscle activity patterns [electromyograms (EMGs)] of the frog during flexion withdrawal and the hind limb-hind limb wipe reflex before and after adding an external load. In addition, the flexibility of spinal cord circuitry underlying the hind limb-hind limb wipe reflex was evaluated by comparing wipes before and after removal of one of the contributing muscles by cutting a muscle nerve. 2. The kinematics of the movements were recorded using a WATSMART infrared emitter-detector system and quantified using principal-components analysis to provide a measure of the shape (eigenvalues) and orientation (eigenvector coefficients) of the movement trajectories. The neural pattern coordinating the movements was characterized by the latencies and magnitudes of EMGs of seven muscles acting at the hip, knee, and ankle. These variables were compared 1) during flexion withdrawal and the initial movement segment of the limb during the hind limb-hind limb wipe reflex in both unrestrained movements and in movements executed when a load equal to approximately 10% of the animal's body weight was attached to a distal limb segment and 2) during the initial movement segment of the wipe reflex before and after cutting the nerve to the knee flexor-hip extensor, iliofibularis. 3. Addition of the load had no discernible effect on the end-point position of the foot during either reflex. However, during the loaded flexion reflex, the ankle joint did not move until after the hip and knee joints had moved to their normal positions. This delayed flexion of the ankle was accompanied by large increases in the magnitude of EMG activity in two ankle muscles that exceeded the levels found during unrestrained movements. Significant changes in the temporal organization of the EMG pattern accompanied the change in joint angle

  13. Dependability in Aggregation by Averaging

    CERN Document Server

    Jesus, Paulo; Almeida, Paulo Sérgio

    2010-01-01

    Aggregation is an important building block of modern distributed applications, allowing the determination of meaningful properties (e.g. network size, total storage capacity, average load, majorities, etc.) that are used to direct the execution of the system. However, the majority of the existing aggregation algorithms exhibit relevant dependability issues, when prospecting their use in real application environments. In this paper, we reveal some dependability issues of aggregation algorithms based on iterative averaging techniques, giving some directions to solve them. This class of algorithms is considered robust (when compared to common tree-based approaches), being independent from the used routing topology and providing an aggregation result at all nodes. However, their robustness is strongly challenged and their correctness often compromised, when changing the assumptions of their working environment to more realistic ones. The correctness of this class of algorithms relies on the maintenance of a funda...

  14. High average power supercontinuum sources

    Indian Academy of Sciences (India)

    J C Travers

    2010-11-01

    The physical mechanisms and basic experimental techniques for the creation of high average spectral power supercontinuum sources is briefly reviewed. We focus on the use of high-power ytterbium-doped fibre lasers as pump sources, and the use of highly nonlinear photonic crystal fibres as the nonlinear medium. The most common experimental arrangements are described, including both continuous wave fibre laser systems with over 100 W pump power, and picosecond mode-locked, master oscillator power fibre amplifier systems, with over 10 kW peak pump power. These systems can produce broadband supercontinua with over 50 and 1 mW/nm average spectral power, respectively. Techniques for numerical modelling of the supercontinuum sources are presented and used to illustrate some supercontinuum dynamics. Some recent experimental results are presented.

  15. Measuring Complexity through Average Symmetry

    OpenAIRE

    Alamino, Roberto C.

    2015-01-01

    This work introduces a complexity measure which addresses some conflicting issues between existing ones by using a new principle - measuring the average amount of symmetry broken by an object. It attributes low (although different) complexity to either deterministic or random homogeneous densities and higher complexity to the intermediate cases. This new measure is easily computable, breaks the coarse graining paradigm and can be straightforwardly generalised, including to continuous cases an...

  16. The bilateral leg strength deficit is present in old, young and adolescent females during isokinetic knee extension and flexion.

    Science.gov (United States)

    Kuruganti, Usha; Seaman, Kenneth

    2006-06-01

    The bilateral limb deficit (BLD) describes the difference in maximal or near maximal force generating capacity of muscles when they are contracted alone or in combination with the contralateral muscles. A deficit occurs when the summed unilateral force is greater than the bilateral force. This study examined the presence of the BLD during isokinetic knee extensions and flexions in a group of adolescent females (n=8, mean of 15+/-1 years) and compared with previously reported data by this researcher of adult and older females. Data were collected from subjects during slow (45 deg/s) isokinetic knee extensions and flexions and it was found that a BLD exists during both extension and flexion regardless of age. Furthermore, this study is the first to examine the presence of the deficit in an adolescent population. Myoelectric signal (MES) data showed that there is no difference between bilateral and unilateral isokinetic knee extensions and flexions regardless of age group.

  17. A possible etiology for the dilaceration and flexion of permanent tooth roots relative to bone remodeling gradients in alveolar bone

    OpenAIRE

    2014-01-01

    Introduction: Trauma, altered tooth germ position and delayed tooth eruption have been hypothesized as possible causes of tooth root dilacerations and flexion, however these anatomical variations appear more commonly associated with posterior teeth and absence of traumatic history. The Hypothesis: Postulated is that tooth root dilaceration or flexion may be a result of tooth root sheath displacement due to gradients of bone remodeling present within alveolar bone. Evaluation of the Hypothesis...

  18. Quantitative analysis of the reversibility of knee flexion contractures with time: an experimental study using the rat model

    OpenAIRE

    Trudel, Guy; Uhthoff, Hans K.; Goudreau, Louis; Laneuville, Odette

    2014-01-01

    Background Knee flexion contractures prevent the full extension of the knee joint and cause disability. The etiology is not well defined. Extended periods of immobilization of joints lead to contractures difficult to completely reverse by rehabilitation treatments. Recovery of the complete range of motion without intervention has not been studied but is of importance to optimize clinical management. This study was designed to quantify the spontaneous reversibility of knee flexion contractures...

  19. Effects of spinal manipulation in patients with mechanical neck pain

    Directory of Open Access Journals (Sweden)

    Diana Gregoletto

    2014-12-01

    Full Text Available Objective: To analyse changes in the range of motion (ROM and pain after spinal manipulation of the cervical spine and thoracic spine in subjects with mechanical neck pain. Methods : Spinal manipulations were performed in the cervical and thoracic spine with the Gonstead and Diversified DTV techniques. To assess cervical ROM an inclinometer was used. Cervical pain was assessed by Visual Analogue Scale (VAS. The participation of 73 patients was obtained. Ages ranged from 18 to 63 years, with an average of 42.27 years. The subjects of this study were characterized by having mechanical neck pain and restricted cervical ROM. Results: We observed a reduction in the intensity of pain perceived by patients and increased cervical ROM. There were significant differences between pre-treatment values (first visit and the fifth and tenth visits (p<0.01, and between the fifth and tenth visits (p<0.01 in all parameters except in the cervical extension of 70º. Conclusions: The results of this study suggest that spinal manipulation of the cervical and thoracic regions with the Gonstead and Diversified DTV techniques could subjectively reduce pain and produce considerable increase in cervical ROM in adults with mechanical neck pain.

  20. Non-specific neck pain in preadolescent to adolescent populations

    OpenAIRE

    2014-01-01

    Neck pain is a common health problem globally. In addition to individual suffering, it causes a huge burden on societies. Some evidence suggests that neck pain in adolescence predicts frequent neck symptoms also in adulthood. A steady increase in prevalence of frequent and persistent neck pain among Finnish adolescents was observed in the 1990s, which might predict an increasing amount of adults with chronic neck pain in the near future. Thus, better understanding neck pain in children and ad...

  1. Preventing head and neck injury.

    Science.gov (United States)

    McIntosh, A S; McCrory, P

    2005-06-01

    A wide range of head and neck injury risks are present in sport, including catastrophic injury. The literature since 1980 on prevention of head and neck injury in sport was reviewed, focusing on catastrophic and brain injury and identifying the range of injury prevention methods in use. There have been few formal evaluations of injury prevention methods. Approaches that are considered, or have been proven, to be successful in preventing injury include: modification of the baseball; implementation of helmet standards in ice hockey and American football and increased wearing rates; use of full faceguards in ice hockey; changes in rules associated with body contact; implementation of rules to reduce the impact forces in rugby scrums. Helmets and other devices have been shown to reduce the risk of severe head and facial injury, but current designs appear to make little difference to rates of concussion. Research methods involving epidemiological, medical, and human factors are required in combination with biomechanical and technological approaches to reduce further injury risks in sport.

  2. Reduced neck-shoulder muscle strength and aerobic power together with increased pericranial tenderness are associated with tension-type headache in girls

    DEFF Research Database (Denmark)

    Tornoe, Birte; Andersen, Lars L; Skotte, Jørgen H

    2013-01-01

    and pericranial tenderness in girls with TTH compared with healthy controls. METHODS: A blinded case-control study comprising 41 girls with TTH and 41 age-matched healthy controls. Standardised testing of isometric maximal voluntary contraction (MVC) and force steadiness of neck flexion and extension, as well...... as MVC and rate-of-force development of dominant shoulder, was conducted. VO2 max was recorded by a submaximal ergometer test and pericranial tenderness by standardised manual palpation. Logistic regression analyses were applied. RESULTS: Girls with TTH demonstrated significantly higher pericranial...

  3. Acute Neck Pain in General Practice

    NARCIS (Netherlands)

    C.J. Vos (Kees)

    2006-01-01

    textabstractWe performed a prospective cohort study with one-year follow-up of patients with acute neck pain in general practice. Patients above 18 years of age consulting their GP for non-specific acute neck pain lasting no longer than six weeks were invited to participate. Self-administered quest

  4. Initial conformation of kinesin's neck linker

    CERN Document Server

    Geng, Yi-Zhao; Liu, Shu-Xia; Yan, Shiwei

    2013-01-01

    How ATP binding initiates the docking process of kinesin's neck linker is a key question in understanding kinesin mechanism. It is believed that the formation of an extra turn structure by the first three amino acids of neck linker (LYS325, THR326, ILE327 in 2KIN) is crucial for initiating the docking process. But the initial conformation of neck linker (specially the three amino acids of the extra turn) and the neck linker docking initiation mechanism remain unclear. By using molecular dynamics method, we investigate the initial conformation of kinesin's neck linker in the docking process. We find that, in the initial state of NL docking process, NL still has interactions with {\\beta}0 and forms a conformation similar to the "cover-neck bundle" structure proposed by Hwang et al. [Structure 2008, 16(1): 62-71]. From this initial structure, the docking of the "cover-neck bundle" structure can be achieved. The motor head provides a forward force on the initial cover-neck bundle structure through ATP-induced rot...

  5. Inter-vertebral flexibility of the ostrich neck: implications for estimating sauropod neck flexibility.

    Directory of Open Access Journals (Sweden)

    Matthew J Cobley

    Full Text Available The flexibility and posture of the neck in sauropod dinosaurs has long been contentious. Improved constraints on sauropod neck function will have major implications for what we know of their foraging strategies, ecology and overall biology. Several hypotheses have been proposed, based primarily on osteological data, suggesting different degrees of neck flexibility. This study attempts to assess the effects of reconstructed soft tissues on sauropod neck flexibility through systematic removal of muscle groups and measures of flexibility of the neck in a living analogue, the ostrich (Struthio camelus. The possible effect of cartilage on flexibility is also examined, as this was previously overlooked in osteological estimates of sauropod neck function. These comparisons show that soft tissues are likely to have limited the flexibility of the neck beyond the limits suggested by osteology alone. In addition, the inferred presence of cartilage, and varying the inter-vertebral spacing within the synovial capsule, also affect neck flexibility. One hypothesis proposed that flexibility is constrained by requiring a minimum overlap between successive zygapophyses equivalent to 50% of zygapophyseal articular surface length (ONP50. This assumption is tested by comparing the maximum flexibility of the articulated cervical column in ONP50 and the flexibility of the complete neck with all tissues intact. It is found that this model does not adequately convey the pattern of flexibility in the ostrich neck, suggesting that the ONP50 model may not be useful in determining neck function if considered in isolation from myological and other soft tissue data.

  6. Quantification of lymph nodes in the central compartment of the neck: a cadaveric study.

    Science.gov (United States)

    Ofo, Enyinnaya; Thavaraj, Selvam; Cope, Daron; Barr, James; Kapoor, Karan; Jeannon, Jean-Pierre; Oakley, Richard; Lock, Claire; Odell, Edward; Simo, Ricard

    2016-09-01

    Differentiated thyroid cancer (DTC) accounts for over 90 % of thyroid malignancies, and is frequently associated with central neck compartment nodal metastasis that requires a therapeutic central compartment neck dissection (CCND) for clinically evident nodes. Current knowledge on the expected lymph node yield from a CCND is limited, compared with data on the lateral neck. The aim of our study was to accurately quantify nodal yield from the cadaveric central neck compartment. Twenty-eight cadaveric necks were dissected and the central neck compartment was subdivided into four regions: pre-laryngeal (delphian), pre-tracheal, right and left para-tracheal regions. Each cadaver had a thyroid gland, which was also removed, and the CCND tissue in each compartment was processed and examined by a consultant histopathologist. Only lymphoid tissue with a defined microscopic fibrous capsule and subcapsular sinus was included in the node count. The median total lymph node count per cadaver was four (range 1-16), with a median of one node detectable in each para-tracheal region (range 0-7) and the pre-tracheal region (range 0-8). The median pre-laryngeal node count was 0 (range 0- 2). The average lymph node size across all compartments was 2.9 mm. This is the first European study to assess cadaveric central neck lymph nodes and establish baseline counts for nodal yield. If a prophylactic or therapeutic CCND is required during thyroid surgery, those involved in DTC management must recognise that there is a wide range, and low median yield of central neck compartment lymph nodes.

  7. Measuring neck collar loss of Pink-footed Geese Anser brachyrhynchus

    DEFF Research Database (Denmark)

    Clausen, Kevin Kuhlmann; Frederiksen, Morten; Madsen, Jesper

    2015-01-01

    The ability to estimate mark loss of ringed animals is important to assess demographic parameters from mark-recapture studies correctly. Based on 23 years of neck collar recovery data from the Svalbard breeding population of Pink-footed Geese, we estimate an overall average annual loss rate of 3...

  8. Is peak exposure to computer use a risk factor for neck and upper-extremity symptoms?

    NARCIS (Netherlands)

    Richter, J.M.; Heuvel, S.G. van den; Huysmans, M.A.; Beek, A.J. van der; Blatter, B.M.

    2012-01-01

    Objective Epidemiologic studies on physical exposure during computer use have mainly focused on average exposure duration. In this study, we aimed to relate periods of high peak exposure during computer use with the occurrence of neck-shoulder (NS) and arm-wrist-hand (AWH) symptoms. Methods A prospe

  9. Assessment of the local SAR Distortion by Major Anatomical Structures in a Cylindrical Neck Phantom

    NARCIS (Netherlands)

    M.M. Paulides (Maarten); D.H.M. Wielheesen (Dennis); J. van der Zee (Jill); G.C. van Rhoon (Gerard)

    2005-01-01

    textabstractThe objective of this work is to gain insight in the distortions on the local SAR distribution by various major anatomical structures in the neck. High resolution 3D FDTD calculations based on a variable grid are made for a semi-3D generic phantom based on average dimensions obtained fro

  10. Femoral neck non-union treatment by valgus intertrochanteric osteotomy

    Science.gov (United States)

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT OBJECTIVE : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis). CONCLUSIONS : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study. PMID:27057146

  11. Public knowledge of head and neck cancer.

    LENUS (Irish Health Repository)

    O'Connor, T E

    2010-04-01

    Studies show 60% of patients with newly diagnosed Head & Neck Squamous Cell Cancer in Ireland, present with advanced disease. A poor level of knowledge and awareness among the public of Head & Neck Cancer, is an important consideration in the often delayed presentation for medical attention in many of these cases. Our study surveyed 200 members of the public to assess their knowledge and awareness of Head & Neck Cancer. One hundred and forty (70%) of respondents had never encountered the term "Head & Neck Cancer". One hundred and forty six (73%) failed to identify excessive alcohol consumption as a risk factor. Less than 100 (50%) would have concern about persisting hoarseness or a prolonged oral ulcer. An urgent need exists to raise awareness of Head & Neck Cancer among the public in Ireland.

  12. 弹性髓内针治疗儿童桡骨颈骨折的临床应用研究%Clinical application of elastic stable intramedullary nail in treatment of radial neck fractures

    Institute of Scientific and Technical Information of China (English)

    李兵; 张军; 张亚军

    2014-01-01

    .Open reduction and internal fixation via medial incision of elbow joint as well as treatment of radial neck fracture were conducted at the same time in treatment of humeral medial epicondyle fracture.Postoperative management:All patients were given regular anti-inflammation therapy within 3 days after operation.The affected limb was externally fixed with plaster in 90°flexion of the elbow joint for 3 or 4 weeks.After removal of the plaster,the patients were instructed to take functional exercises of forearm pronation and supination as well as elbow flexion and extension.Follow-ups were conducted in the 6 th week,12 th week 6 th month,1 st year,2 nd year,and the 3 rd year,including taking X-ray films,understanding the state of fracture healing and change of radial head,and as well understanding the state of functional recovery of elbow joint and whether complications did exist.Results Evaluative criteria of curative effect:In accordance with Métaizeau postoperative X-ray assessment standards:Anatomic reduction is excellent;tilted angle 40°is poor.In accordance with Métaizeau functional evaluative standards in the later stage:No limitation of elbow and forearm activity is excellent;The sum of the limited elbow flexion and extension activity,or the limited forearm pronation and supination activity 40°is poor. 2 All patients of this group include 2 cases of open reduction,6 cases of percutaneous poking assisted reduction by Kirschner wire,and the remaining 1 5 cases of simple closed reduction and elastic intramedullary nail fixation.The operative time ranged from 20 to 50 minutes,and the mean time is 36.4 minutes.Intraoperative bleeding was from 5 to 20 ml with the average of 8.3 ml.The duration of external fixation with plaster was 3 to 12 months and the average period was 3.7 months.Fracture healing time after operation ranged from 3 to 4 months,and the mean time was 3.7 months.The time of removing internal fixator was 3 to 12 months with an average of 4.7 months

  13. Design of a mechanism to simulate the quasi-static moment-deflection behaviour of the osteoligamentous structure of the C3-C4 cervical spine segment in the flexion-extension and lateral bending directions.

    Science.gov (United States)

    Chen, Samuel; Arsenault, Marc; Moglo, Kodjo

    2012-11-01

    The human neck is susceptible to traumatic injuries due to impacts as well as chronic injuries caused by loads such as those attributed to the wearing of heavy headgear. To facilitate the analysis of the loads that cause injuries to the cervical spine, it is possible to replicate the human neck's behaviour with mechanical devices. The goal of this work is to lay the foundation for the eventual development of a novel mechanism used to simulate the behaviour of the cervical spine during laboratory experiments. The research presented herein focuses on the design of a mechanism capable of reproducing the non-linear relationships between moments applied to the C3 vertebra and its corresponding rotations with respect to the C4 vertebra. The geometrical and mechanical properties of the mechanism are optimized based on the ability of the latter to replicate the load-deflection profile of the osteoligamentous structure of the C3-C4 vertebral pair in the flexion-extension and lateral bending directions. The results show that the proposed design concept is capable of faithfully replicating the non-linear behaviour of the motion segment within acceptable tolerances.

  14. Short Term Effects of Mobilization Techniques on Neck Pain and Deep Neck Flexor Muscle Endurance in Patients with Mechanical Chronic Neck Pain

    OpenAIRE

    Kılınç, Hasan Erkan; Harput, Gülcan; Baltacı, Gül; İnce, Deniz İnal

    2014-01-01

    Objectives: The aim of the study was to investigate short term effects of cervical and scapular mobilization techniques on neck pain and deep cervical muscles endurance in chronical mechanical neck pain patients. Methods: 22 chronical mechanic neck pain patients four male 18 female (mean age: mean±sd 35.59± 15.85) were included. Before treatment, neck pain level (visual analog scale) and deep neck flexor muscles endurance (in supine position with digital chronometer) of all patients were eval...

  15. ANALYSIS OF ISOKINETIC KNEE EXTENSION / FLEXION IN MALE ELITE ADOLESCENT WRESTLERS

    Directory of Open Access Journals (Sweden)

    Sanli Sadi Kurdak

    2005-12-01

    Full Text Available Wrestling requires strength of the upper and lower body musculature which is critical for the athletic performance. Evaluation of the adolescent's skeletal muscle is important to understand body movement, especially including those involved in sports. Strength, power and endurance capacity are defined as parameters of skeletal muscle biomechanical properties. The isokinetic dynamometer is an important toll for making this type of evaluation. However, load range phase of range of motion has to be considered to interpret the data correctly. With this in mind we aimed to investigate the lover body musculature contractile characteristics of adolescent wrestlers together with detailed analyses of load range phase of motion. Thirteen boys aged 12 - 14 years participated to this study. Concentric load range torque, work and power of knee extension and flexion were measured by a Cybex Norm dynamometer at angular velocities from 450°/sec to 30°/sec with 30°/sec decrements for each set. None of the wrestlers were able to attain load range for angular velocities above 390°/sec and 420°/sec for extension and flexion respectively. Detailed analyses of the load range resulted in statistically significant differences in the normalized load range peak torque for extension at 270°/sec (1.44 ± 0.28 Nm·kg-1 and 1.14 ± 0.28 Nm·kg-1 for total and load range peak torque respectively, p < 0.05, and for flexion at 300°/sec (1.26 ± 0.28 Nm·kg-1 and 1.03 ± 0.23 Nm·kg-1 for total and load range peak torque respectively, p < 0.05, compared to total peak torque data. Similarly, the significant difference was found for the work values at 90°/sec (1.91 ± 0.23 Nm·kg-1 and 1.59 ± 0.24 Nm·kg-1 for total and load range work respectively for extension and 1.73 ± 0.21 Nm·kg-1 and 1.49 ± 0.19 Nm·kg-1 for total and load range work respectively for flexion, p < 0.05, and was evident at higher angular velocities (p < 0.001 for both extension and flexion. At

  16. Neural Adaptations Associated with Interlimb Transfer in a Ballistic Wrist Flexion Task.

    Science.gov (United States)

    Ruddy, Kathy L; Rudolf, Anne K; Kalkman, Barbara; King, Maedbh; Daffertshofer, Andreas; Carroll, Timothy J; Carson, Richard G

    2016-01-01

    Cross education is the process whereby training of one limb gives rise to increases in the subsequent performance of its opposite counterpart. The execution of many unilateral tasks is associated with increased excitability of corticospinal projections from primary motor cortex (M1) to the opposite limb. It has been proposed that these effects are causally related. Our aim was to establish whether changes in corticospinal excitability (CSE) arising from prior training of the opposite limb determine levels of interlimb transfer. We used three vision conditions shown previously to modulate the excitability of corticospinal projections to the inactive (right) limb during wrist flexion movements performed by the training (left) limb. These were: (1) mirrored visual feedback of the training limb; (2) no visual feedback of either limb; and (3) visual feedback of the inactive limb. Training comprised 300 discrete, ballistic wrist flexion movements executed as rapidly as possible. Performance of the right limb on the same task was assessed prior to, at the mid point of, and following left limb training. There was no evidence that variations in the excitability of corticospinal projections (assessed by transcranial magnetic stimulation (TMS)) to the inactive limb were associated with, or predictive of, the extent of interlimb transfer that was expressed. There were however associations between alterations in muscle activation dynamics observed for the untrained limb, and the degree of positive transfer that arose from training of the opposite limb. The results suggest that the acute adaptations that mediate the bilateral performance gains realized through unilateral practice of this ballistic wrist flexion task are mediated by neural elements other than those within M1 that are recruited at rest by single-pulse TMS.

  17. Does the wrist flexion affect on the electrophysiological studies in the healthy voluntaries?

    Directory of Open Access Journals (Sweden)

    Pinar Doruk

    2011-02-01

    Full Text Available PURPOSE: The aim of this study is to evaluate the effects on the median nerve distal sensory latencies (dsl, first digit median vs. radial sensory latency difference, fourth digit median vs. ulnar sensory latency difference which are repeated after performing the provocative wrist flexion for about five minutes in the healhty voluntaries. MATERIALS-METHODS: In this study, 20 women, 5 men voluntaries (total 46 hands were investigated. The median nerve dsl, the first digit median vs. radial sensory latency differences, the fourth digit median vs. ulnar sensory latency differences were recorded. After performing the provocative wrist flexion (bilaterally 90 degree for about five minutes, above mentioned studies were repeated. RESULTS: The mean age of the voluntaries in the study was 32.8±8.4 years. Before and after provocation, the mean dsl of median nerve was 2.71±0.19 msc, and 2.73±0.17 msc, and the mean amplitude of median nerve was 35.8±21.8, and 40.2±22.2 microvolt, the mean of fourth digit median vs. ulnar sensory latency differences was 0.12±0.18 msc, and 0.15±0.19 msc, the mean of first digit median vs. radial sensory latency differences was 0.13±0.23 msc and 0.24±0.47 msc, respectively. Statistically, there were no significance between before and after the provocation at the mean value of amplitude and dsl, the median vs. radial first digit and the median vs. ulnar fourth digit sensory latency differences measurements (p>0.05. CONCLUSION: The provocative wrist flexion in the healthy voluntaries has no effect on the electrophysiological studies. [Cukurova Med J 2011; 36(1.000: 24-28

  18. Neural adaptations associated with interlimb transfer in a ballistic wrist flexion task.

    Directory of Open Access Journals (Sweden)

    Kathy L Ruddy

    2016-05-01

    Full Text Available Cross education is the process whereby training of one limb gives rise to increases in the subsequent performance of its opposite counterpart. The execution of many unilateral tasks is associated with increased excitability of corticospinal projections from primary motor cortex (M1 to the opposite limb. It has been proposed that these effects are causally related. Our aim was to establish whether changes in corticospinal excitability arising from prior training of the opposite limb determine levels of interlimb transfer. We used three vision conditions shown previously to modulate the excitability of corticospinal projections to the inactive (right limb during wrist flexion movements performed by the training (left limb. These were: mirrored visual feedback of the training limb; no visual feedback of either limb; and visual feedback of the inactive limb. Training comprised 300 discrete, ballistic wrist flexion movements executed as rapidly as possible. Performance of the right limb on the same task was assessed prior to, at the mid point of, and following left limb training. There was no evidence that variations in the excitability of corticospinal projections (assessed by transcranial magnetic stimulation (TMS to the inactive limb were associated with, or predictive of, the extent of interlimb transfer that was expressed. There were however associations between alterations in muscle activation dynamics observed for the untrained limb, and the degree of positive transfer that arose from training of the opposite limb. The results suggest that the acute adaptations that mediate the bilateral performance gains realised through unilateral practice of this ballistic wrist flexion task are mediated by neural elements other than those within M1 that are recruited at rest by single-pulse TMS.

  19. Age-related decreases in motor unit discharge rate and force control during isometric plantar flexion

    DEFF Research Database (Denmark)

    Kallio, J; Søgaard, Karen; Avela, J

    2012-01-01

    Aging is related to multiple changes in muscle physiology and function. Previous findings concerning the effects of aging on motor unit discharge rate (DR) and fluctuations in DR and force are somewhat contradictory. Eight YOUNG and nine OLD physically active males performed isometric ramp (RECR)......) and isotonic (ISO) plantar flexions at 10 and 20% of surface EMG at MVC. Motor unit (MU) action potentials were recorded with intramuscular fine-wire electrodes and decomposed with custom build software "Daisy". DR was lower in OLD in RECR-10% (17.9%, p...

  20. Variability of ischiofemoral space dimensions with changes in hip flexion: an MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Adam C.; Howe, Benjamin M. [Mayo Clinic College of Medicine, Department of Radiology, Rochester, MN (United States); Hollman, John H.; Finnoff, Jonathan T. [Mayo Clinic College of Medicine, Department of Physical Medicine and Rehabilitation, Rochester, MN (United States)

    2017-01-15

    The primary aim of this study was to determine if ischiofemoral space (IFS) dimensions vary with changes in hip flexion as a result of placing a bolster behind the knees during magnetic resonance imaging (MRI). A secondary aim was to determine if IFS dimensions vary between supine and prone hip neutral positions. The study employed a prospective design. Sports medicine center within a tertiary care institution. Five male and five female adult subjects (age mean = 29.2, range = 23-35; body mass index [BMI] mean = 23.5, range = 19.5-26.6) were recruited to participate in the study. An axial, T1-weighted MRI sequence of the pelvis was obtained of each subject in a supine position with their hips in neutral and flexed positions, and in a prone position with their hips in neutral position. Supine hip flexion was induced by placing a standard, 9-cm-diameter MRI knee bolster under the subject's knees. The order of image acquisition (supine hip neutral, supine hip flexed, prone hip neutral) was randomized. The IFS dimensions were then measured on a separate workstation. The investigator performing the IFS measurements was blinded to the subject position for each image. The main outcome measurements were the IFS dimensions acquired with MRI. The mean IFS dimensions in the prone position were 28.25 mm (SD 5.91 mm, standard error mean 1.32 mm). In the supine hip neutral position, the IFS dimensions were 25.1 (SD 5.6) mm. The mean difference between the two positions of 3.15 (3.6) mm was statistically significant (95 % CI of the difference = 1.4 to 4.8 mm, t{sub 19} = 3.911, p =.001). The mean IFS dimensions in the hip flexed position were 36.9 (SD 5.7) mm. The mean difference between the two supine positions of 11.8 (4.1) mm was statistically significant (95 % CI of the difference = 9.9 to 13.7 mm, t{sub 19} = 12.716, p <.001). Our findings demonstrate that the IFS measurements obtained with MRI are dependent upon patient positioning with respect to hip flexion and

  1. Neck pain: causes, diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    Aleksey Ivanovich Isaikin

    2011-01-01

    Full Text Available Neck pain is frequently encountered in clinical practice. In most cases, it is unassociated with a serious problem and ends with complete recovery. Nonspecific (mechanical, axial pain is most common; posttraumatic pain associated with whiplash injury is less frequently encountered; compression (radicular and myelopathic syndromes are much less frequent. Analysis of complaints and medical histories and neuroorthopedic and neurological examinations allow one to define the major source of pain. Additional studies are indicated in cases of suspected serious pathology, ineffective standard medical therapy, elective manual therapy or neurosurgery. Paracetamol, nonsteroidal anti-inflammatory agents, and myelorelaxants are the drugs of choice in treating acute pain. If these are ineffective, blocks with local anesthetics and glucocorticoids, including diprospan, are used. Early activation and manual therapy are effective. Psychotherapy, therapeutic exercises, manual therapy, and the use of antidepressants and anticonvulsants are indicated for chronic pain. Surgical treatment has limited indications.

  2. MALLASEZIA FOLLICULITIS ON THE NECK

    Directory of Open Access Journals (Sweden)

    Brzeziński Piotr

    2010-10-01

    Full Text Available Folliculitis caused by Malassezia spp. classified as yeasts in our climate (Poland is fairly rare disease . MF is most commonly found on the chest, back, upper arms, and less frequently on the face. Permanent symptom is persistent itching. The favorable external conditions, which are largely due to high temperature and humidity, and endogenous factors, such as immunosuppression, there is a lipophilic yeast multiplication in the hair follicles. The aim of this article is presentation of the patient with Malassezia Folliculitis on the neck. Patient age 33 with 1- to 2-mm monomorphic papules and pustules on chest. Skin lesions accompanied by itching. In the treatment used topical: ketoconazole containing shampoo, 1% clindamycin cream, 0,5% hydrocortisonum cream, fluconazole 400 mg once p.o.

  3. The effect of active recovery, cold water immersion and passive recovery on subsequent knee extension and flexion strength

    Directory of Open Access Journals (Sweden)

    Barbora Strejcová

    2012-09-01

    Full Text Available BACKGROUND: Recovery is an important aspect of every physical activity. Many athletes train hard without giving their body time to recover which can lead to overreaching, burnout or poor performance. Currently cold-water immersion recovery and active recovery have emerged as some of the most popular interventions enabling faster recovery. OBJECTIVE: To assess the effect of three kinds of recovery (active recovery, cold water immersion, passive recovery on medium-term knee strength in the extension and flexion. METHODS: Fourteen athletes at the age of 26.6 ± 4.4 years performed, in a random cross-over design, 3 sessions with 3 repeated medium-term isokinetic tests. The effect of active recovery, passive rest and cold water immersion were assessed by 3 × 3 (time × recovery repeated-measure ANOVA, respectively. The dependent variables were – peak torque, total work and average power. RESULTS: We found significantly lower absolute differences between the first and third trial in knee extension for peak torque after the active recovery (↑ 0.9 N × m than after the cold water immersion (↓ 14.6 N × m or the passive recovery (↓ 13.9 N × m. The decrease of the average power was significantly lower differences after the active recovery (↓ 5 W than after the cold water immersion (↓ 23.7 W or passive recovery (↓ 25.9 W. The changes in total work were not significant. We did not found any changes in the isokinetic strength for the knee flexors after different kinds of recovery. Maximal heart rate (HRmax was significantly higher during the active recovery than during the cold water immersion and the passive recovery (173 ± 14, 166 ± 14 and 167 ± 14 rpm. We have found significant differences in the average heart rates (HRavg during active recovery, cold water immersion and passive recovery (124 ± 8, 97 ± 9 and 107 ± 12 rpm. CONCLUSION: We found the positive effect of the active recovery on the subsequent medium-term performance for

  4. Direction-Specific Impairments in Cervical Range of Motion in Women with Chronic Neck Pain: Influence of Head Posture and Gravitationally Induced Torque

    Science.gov (United States)

    Björklund, Martin; Svedmark, Åsa; Srinivasan, Divya; Djupsjöbacka, Mats

    2017-01-01

    Background Cervical range of motion (ROM) is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension) or a movement strategy to avoid large gravitationally induced torques on the cervical spine. Methods Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition) and maximal protraction (low torque condition) in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM), from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure. Findings Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour. Interpretation The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments. PMID:28099504

  5. Management of patients with neck pain

    OpenAIRE

    E. A. Chechet; V. A. Parfenov

    2016-01-01

    Neck pain (cervicalgia) occupies one of the leading places among the reasons for outpatient visits, 75% of people have experienced neck pain at least once in their lives. In most cases, neck pain regresses; however, it recurs in almost one half of patients. The paper gives data on the risk factors, mechanisms, course, and prognosis of cervicalgia. It discusses the issues of differential diagnosis, examination, and approaches to treating this condition in these patients. Nonsteroidal anti-infl...

  6. Application of head flexion detection for enhancing eye gaze direction classification.

    Science.gov (United States)

    Al-Rahayfeh, Amer; Faezipour, Miad

    2014-01-01

    Extensive research has been conducted on the tracking and detection of the eye gaze and head movement detection as these aspects of technology can be applied as alternative approaches for various interfacing devices. This paper proposes enhancements to the classification of the eye gaze direction. Viola Jones face detector is applied to first declare the region of the eye. Circular Hough Transform is then used to detect the iris location. Support Vector Machine (SVM) is applied to classify the eye gaze direction. Accuracy of the system is enhanced by calculating the flexion angle of the head through the utilization of a microcontroller and flex sensors. In case of rotated face images, the face can be rotated back to zero degrees through the flexion angle calculation. This is while Viola Jones face detector is limited to face images with very little or no rotation angle. Accuracy is initiated by enhancing the effectiveness of the system in the overall procedure of classifying the direction of the eye gaze. Therefore, the head direction is a main determinant in enhancing the control method. Different control signals are enhanced by the eye gaze direction classification and the head direction detection.

  7. Human soleus sarcomere lengths measured using in vivo microendoscopy at two ankle flexion angles.

    Science.gov (United States)

    Chen, Xuefeng; Delp, Scott L

    2016-12-08

    The forces generated by the soleus muscle play an important role in standing and locomotion. The lengths of the sarcomeres of the soleus affect its force-generating capacity, yet it is unknown how sarcomere lengths in the soleus change as a function of ankle flexion angle. In this study, we used microendoscopy to measure resting sarcomere lengths at 10° plantarflexion and 20° dorsiflexion in 7 healthy individuals. Mean sarcomere lengths at 10° plantarflexion were 2.84±0.09µm (mean±S.E.M.), near the optimal length for sarcomere force generation. Sarcomere lengths were 3.43±0.09µm at 20° dorsiflexion, indicating that they were longer than optimal length when the ankle was in dorsiflexion and the muscle was inactive. Our results indicate a smaller sarcomere length difference between two ankle flexion angles compared to estimates from musculoskeletal models and suggest why these models frequently underestimate the force-generating capacity of the soleus.

  8. Peak triceps surae muscle activity is not specific to knee flexion angles during MVIC.

    Science.gov (United States)

    Hébert-Losier, Kim; Schneiders, Anthony G; García, José A; Sullivan, S John; Simoneau, Guy G

    2011-10-01

    There is limited research on peak activity of the separate triceps surae muscles in select knee flexion (KF) positions during a maximum voluntary isometric contraction (MVIC) used to normalize EMG signals. The aim of this study was to determine how frequent peak activity occurred during an MVIC for soleus (SOL), gastrocnemius medialis (GM), and gastrocnemius lateralis (GL) in select KF positions, and if these peaks were recorded in similar KF positions. Forty-eight healthy individuals performed unilateral plantar-flexion MVIC in standing with 0°KF and 45°KF, and in sitting with 90°KF. Surface EMG of SOL, GM, and GL were collected and processed in 250 ms epochs to determine peak root-mean-square amplitude. Peak activity was most frequently captured in standing and rarely in sitting, with no position selective to SOL, GM or GL activity. Peak GM and GL activity was more frequent in 0°KF than 45°KF, and more often in similar KF positions than not. Peak SOL activity was just as likely in 45°KF as 0°KF, and more in positions similar to GM, but not GL. The EMG amplitudes were at least 20% greater in positions that captured peak activity over those that did not. The overall findings support performing an MVIC in more than one KF position to normalize triceps surae EMG. It is emphasized that no KF position is selective to SOL, GM, or GL alone.

  9. The role of biceps brachii and brachioradialis for the control of elbow flexion and extension movements.

    Science.gov (United States)

    von Werder, Sylvie Charlotte Frieda Anneliese; Disselhorst-Klug, Catherine

    2016-06-01

    How do synergistic muscles interact, when their contraction aims at stabilizing and fine-tuning a movement, which is induced by the antagonistic muscle? The aim of the study was to analyze the interaction of biceps and brachioradialis during fine-tuning control tasks in comparison to load bearing ones. The surface electromyogram of biceps, brachioradialis and triceps were examined in 15 healthy subjects in dynamic flexion and extension movements with different combinations of contraction levels, joint angles and angular velocities. The measurements were conducted in two configurations, where the torque due to an external load opposes the rotational direction of the elbow flexion (load bearing tasks) or the elbow extension (fine-tuning tasks). Whereas during load bearing control tasks, similar muscular activation of biceps and brachioradialis was observed for all joint angles, angular velocities and external loads, during fine-tuning control tasks a significant difference of the muscular activation of both flexors was observed for 1kg, F(3.639,47.305)=2.864, p=0.037, and 5kg of external load, F(1.570,21.976)=6.834, p=0.008. The results confirm the synergistic muscular activation of both flexors during load bearing tasks, but suggest different control strategies for both flexors when they comprise a fine-tuning control task.

  10. Modulation of motor variability related to experimental muscle pain during elbow-flexion contractions.

    Science.gov (United States)

    Mista, Christian A; Christensen, Steffan W; Graven-Nielsen, Thomas

    2015-02-01

    Experimental muscle pain typically reorganizes the motor control. The pain effects may decrease when the three-dimensional force components are voluntarily adjusted, but it is not known if this could have negative consequences on other structures of the motor system. The present study assessed the effects of acute pain on the force variability during sustained elbow flexion when controlling task-related (one-dimensional) and all (three-dimensional) contraction force components via visual feedback. Experimental muscle pain was induced by bolus injection of hypertonic saline into m. biceps brachii, and isotonic saline was used as control. Twelve subjects performed sustained elbow flexion at different levels of the maximal voluntary contraction (5-30% MVC) before, during, and after the injections. Three-dimensional force components were measured simultaneously with surface electromyography (EMG) from elbow flexors and auxiliary muscles. Results showed that force variability was increased during pain compared to baseline for contractions using one-dimensional feedback (PEMG activity from m. trapezius was increased during contractions using both one-dimensional and three-dimensional feedback (PEMG from m. triceps brachii and m. deltoid was higher for the three-dimensional feedback (P<.05). In conclusion, the three-dimensional feedback reduced the pain-related functional distortion at the cost of a more complex control of synergistic muscles.

  11. Rites thérapeutiques : réflexion sur le terrain et les archives

    Directory of Open Access Journals (Sweden)

    Chantal Radimilahy

    2008-08-01

    Full Text Available Rites thérapeutiques : réflexion sur le terrain et les archives. En comparant la façon dont l’écrit sert à noter et à fixer des pratiques de guérissage, d’une part dans les archives de L. Vig et d’autre part dans les carnets d’un guérisseur malgache contemporain, l’auteur esquisse une réflexion sur la stabilité apparente des formes du langage et des pratiques rituelles dans un contexte social transformé.Therapeutic rituals: consideration on fieldwork and archives. By comparing the way in which writing is used to record and establish traditional healing practices, on the one hand in the archives of L. Vig and on the other, in the notes of a contemporary Madagascan traditional healer, the author outlines her reflections on the apparent stability of language forms and ritual practices in a transformed social context.

  12. flexions sur les fondements éthiques de l'acte clinique

    Directory of Open Access Journals (Sweden)

    Florence Gautier

    Full Text Available Dans le domaine de la prise en charge psychothérapeutique la réflexion éthique est aujourd’hui reléguée à un second plan par le discours de l’efficacité et de l’évaluation. Or cette réflexion reste essentielle même si on peut considérer qu’elle a parfois été réduite à une rhétorique. Partant de la description d’un suivi psychothérapeutique référé à la psychanalyse, les auteurs proposent une démarche de recherche susceptible de mettre en évidence de manière rigoureuse la dimension éthique des actes cliniques. Dans une situation d’inceste la catégorie éthique de l’intime apparaît comme une valeur fondant l’ensemble de l’attitude du clinicien, ce qui interroge la validité d’une approche strictement évaluatrice et qui donc ne prendrait pas en compte cette dimension de l’acte clinique.

  13. Analysis for Sit-to-Stand Performance According to the Angle of Knee Flexion in Individuals with Hemiparesis.

    Science.gov (United States)

    Lee, Mi Young; Lee, Hae Yong

    2013-12-01

    [Purpose] Sit-to-stand (STS) is one of the important functional tasks people perform throughout the day. This study investigated whether varying angles of knee flexion affect STS patterns in individuals with hemiparesis by using a foot plantar pressure measurement system. [Methods] Fifteen stroke patients with hemiparesis participated for this study. They performed sit-to-stand with three angles of knee flexion (70°, 90°, and 110°). We measured the trajectory of the center of pressure, peak plantar pressure, and symmetry index using a Mat-scan system (Tekscan, South Boston, MA, USA). [Results] As a result, we found that there were significant differences among the three angle conditions (trajectory of center of pressure, peak plantar pressure on the affected side, and symmetry index). However, there was no significant difference in peak pressure according to the knee flexion on the unaffected side. [Conclusion] In the current study, we found that stroke patients with hemiparesis had a compensated STS pattern according to knee flexion angles. This indicates that the peak value of plantar pressure increased and that the trajectory of the center of pressure widened as the angle of knee flexion increased. We also suggest that hemiparesis patients should be more concerned about proper knee angle for symmetrical STS pattern.

  14. Cervical flexion myelopathy in a patient showing apparent long tract signs: a severe form of Hirayama disease.

    Science.gov (United States)

    Sakai, Kenji; Ono, Kenjiro; Okamoto, Yoshiyuki; Murakami, Hideki; Yamada, Masahito

    2011-05-01

    We describe an 18-year-old male with cervical flexion myelopathy with Hirayama disease-like features who showed apparent long tract signs. He first experienced insidious-onset hand muscle weakness and atrophy at the age of 15. Subsequently, he developed sensory disturbance in his lower limb. Neurological examination revealed atrophy and weakness in the right hand and forearm, pyramidal signs in the right lower extremity, and disturbance of superficial sensation in the lower left half of the body. Cervical magnetic resonance images and computed tomographic myelography revealed anterior displacement with compression of the cervical cord in flexion that was more apparent in the right side. The right side of the cervical cord showed severe atrophy. The mechanisms of myelopathy in our patient appeared to be same as that of "tight dural canal in flexion," which has been reported to be the mechanism of juvenile muscular atrophy of the unilateral upper extremity (Hirayama disease). Patients with Hirayama disease generally show minimal sensory signs and no pyramidal signs. An autopsy case of Hirayama disease revealed confined necrosis of the cervical anterior horn without obvious changes in the white matter. Our patient's disease progression suggests that cervical flexion myelopathy patients with severe cervical cord compression in flexion may develop extensive cervical cord injury beyond the anterior horn.

  15. Effects of knee joint angle on the fascicle behavior of the gastrocnemius muscle during eccentric plantar flexions.

    Science.gov (United States)

    Wakahara, Taku; Kanehisa, Hiroaki; Kawakami, Yasuo; Fukunaga, Tetsuo

    2009-10-01

    The present study aimed to clarify the effects of knee joint angle on the behavior of the medial gastrocnemius muscle (MG) fascicles during eccentric plantar flexions. Eight male subjects performed maximal eccentric plantar flexions at two knee positions [fully extended (K0) and 90 degrees flexed (K90)]. The eccentric actions were preceded by static plantar flexion at a 30 degrees plantar flexed position and then the ankle joint was forcibly dorsiflexed to 15 degrees of dorsiflexion with an isokinetic dynamometer at 30 degrees /s and 150 degrees /s. Tendon force was calculated by dividing the plantar flexion torque by the estimated moment arm of the Achilles tendon. The MG fascicle length was determined with ultrasonography. The tendon forces during eccentric plantar flexions were influenced by the knee joint angle, but not by the angular velocity. The MG fascicle lengths were elongated as the ankle was dorsiflexed in K0, but in K90 they were almost constant despite the identical range of ankle joint motion. These results suggested that MG fascicle behavior during eccentric actions was markedly affected by the knee joint angle. The difference in the fascicle behavior between K0 and K90 could be attributed to the non-linear force-length relations and/or to the slackness of tendinous tissues.

  16. Neck ligament strength is decreased following whiplash trauma

    Directory of Open Access Journals (Sweden)

    Rubin Wolfgang

    2006-12-01

    Full Text Available Abstract Background Previous clinical studies have documented successful neck pain relief in whiplash patients using nerve block and radiofrequency ablation of facet joint afferents, including capsular ligament nerves. No previous study has documented injuries to the neck ligaments as determined by altered dynamic mechanical properties due to whiplash. The goal of the present study was to determine the dynamic mechanical properties of whiplash-exposed human cervical spine ligaments. Additionally, the present data were compared to previously reported control data. The ligaments included the anterior and posterior longitudinal, capsular, and interspinous and supraspinous ligaments, middle-third disc, and ligamentum flavum. Methods A total of 98 bone-ligament-bone specimens (C2–C3 to C7-T1 were prepared from six cervical spines following 3.5, 5, 6.5, and 8 g rear impacts and pre- and post-impact flexibility testing. The specimens were elongated to failure at a peak rate of 725 (SD 95 mm/s. Failure force, elongation, and energy absorbed, as well as stiffness were determined. The mechanical properties were statistically compared among ligaments, and to the control data (significance level: P Results For all whiplash-exposed ligaments, the average failure elongation exceeded the average physiological elongation. The highest average failure force of 204.6 N was observed in the ligamentum flavum, significantly greater than in middle-third disc and interspinous and supraspinous ligaments. The highest average failure elongation of 4.9 mm was observed in the interspinous and supraspinous ligaments, significantly greater than in the anterior longitudinal ligament, middle-third disc, and ligamentum flavum. The average energy absorbed ranged from 0.04 J by the middle-third disc to 0.44 J by the capsular ligament. The ligamentum flavum was the stiffest ligament, while the interspinous and supraspinous ligaments were most flexible. The whiplash

  17. Déficit bilateral nos movimentos de flexão e extensão de perna e flexão do cotovelo Déficit bilateral en los movimientos de flexion y extension de la pierna y flexion del codo Bilateral deficit in leg flexion and extension and elbow flexion movements

    Directory of Open Access Journals (Sweden)

    Christianne Pereira Giesbrecht Chaves

    2004-12-01

    áxima (CM en la flexión y extensión de pierna e flexión del de codo aisladamente y entre la suma de esos dos resultados con aquel desarrollado simultaneamente por las dos piernas y los dos brazos, respectivamente. Sometemos a 60 indivíduos al ejercicio de flexión y extensión de pierna y a flexión de codo a un test de 1RM. Los resultados para los movimientos de flexión y extensión de pierna y flexión de codo izquierdos y derechos en la CM fueron de 31,6 (± 7,9, 32,0 (± 8,0, 20,2 (± 9,2, 20,2 (± 9,8, 29,3 (± 13,9 e 29,8 (± 14,1 kg respectivamente, y se mostraron similares (p > 0,05 y fuertemente asociados (r = 0,96, 0,96 e 0,98. Comparando la suma de los valores unilaterales con los de ejecución bilateral, la CM presentó una diferencia significativa para los movimientos de extensión de pierna (p = 0,04 y flexión de codo (p = 0,03, el mismo no fué observado en el movimiento de flexión de pierna (p = 0,75. Este resultado puede ser explicado por el menor incremento de carga - dos kilos y medio en este último movimiento en relación a los dos movimientos anteriores - cinco kilos. A pesar de la mayoría de los sujetos sean diestros, no hubo diferencias unilaterales en la CM a pesar de no todos estar entrenados. La suma de los resultados unilaterales fué mayor en 9,8% y 4,0% para los movimientos de extensión de la pierna y flexión del codo, respectivamente, de aquel obtenido bilateralmente, mostrando, probablemente una limitación central en la coordenación motora de un movimiento complejo hecho en máxima velocidad y con carga elevada. Por otro lado, en el movimiento de flexión de pierna, la suma de los resultados unilaterales fué inferior a la bilateral (-0,6%, presentando un posible aprendizage del movimiento y adaptación al entrenamiento con pesos a partir de las doce semanas.Endurance exercises (EE may be performed unilaterally and bilaterally. The objective was to compare the maximum load (ML in leg flexion and extension and elbow flexion alone

  18. A Method to Develop Neck Injury Criteria to Aid Design and Test of Escape Systems Incorporating Helmet Mounted Displays

    Science.gov (United States)

    2014-09-01

    electromyography (EMG), neck strength (via Maximum Voluntary Contraction or MVC testing), neck endurance, neck discomfort surveys, and cognitive performance via...dependent variables; neck muscle fatigue via electromyography (EMG), neck strength (via Maximum Voluntary Contraction or MVC testing), neck endurance

  19. Elective Neck Dissection in Patients With Head and Neck Adenoid Cystic Carcinoma

    DEFF Research Database (Denmark)

    Amit, Moran; Na'ara, Shorook; Sharma, Kanika;

    2015-01-01

    BACKGROUND: Adenoid cystic carcinoma (ACC) accounts for 3-5 % of all head and neck malignancies. Investigations of outcomes from elective neck dissection (END) for patients with ACC are sparse. This study aimed to assess the impact of END on the survival of patients with ACC. METHODS: This retros......BACKGROUND: Adenoid cystic carcinoma (ACC) accounts for 3-5 % of all head and neck malignancies. Investigations of outcomes from elective neck dissection (END) for patients with ACC are sparse. This study aimed to assess the impact of END on the survival of patients with ACC. METHODS...

  20. Stiff Neck, Torticollis, and Pseudotumor Cerebri

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-05-01

    Full Text Available Three prepubertal children diagnosed with pseudotumor cerebri and presenting with stiff neck and torticollis are reported from Schneider Children’s Medical Center, Sackler School of Medicine, Tel Aviv, Israel.

  1. Drugs Approved for Head and Neck Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for head and neck cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  2. Cervical Spondylosis (Arthritis of the Neck)

    Science.gov (United States)

    ... and fingers • Trouble walking, loss of balance, or weakness in the hands or legs • Muscle spasms in the neck and shoulders Doctor Examination Physical Examination After discussing your medical ...

  3. Predicting Neck Abscess with Contrast-Enhanced Computed Tomography

    OpenAIRE

    2014-01-01

    Neck abscesses are difficult to diagnose and treat. Currently, contrast-enhanced computed tomography (CECT) is the imaging modality of choice. The study aims to determine the predictive value of CECT findings in diagnosing neck abscess, causes of neck abscess and the most common neck space involved in the local population. 84 consecutive patients clinically suspected to have neck abscess who underwent CECT and surgical confirmation of pus were included. Demographic and clinical data were reco...

  4. Prevalence of neck pain in computer operators

    OpenAIRE

    2015-01-01

    Abstract Introduction: Persisting neck pain is common in society, especially in office-workers. Although, neck pain is common source of disability, little is known about its prevalence and course. The bulk of literature available on this problem is in west with few studies done in an Indian setup. India is a middle-income developing country. The importance of this kind of studies becomes more obvious when it is considered that some reports indicate that...

  5. Schwannomas of the head and neck

    Directory of Open Access Journals (Sweden)

    Anastasios Kanatas

    2011-12-01

    Full Text Available Schwannomas are benign encapsulated nerve sheath tumors composed of Schwann cells. Malignant change in head and neck schwannomas is rare, with the incidence varying between 8 and 13.9%. In this review, we discuss the presentation and the management of head and neck schwannomas. The issues and difficulties based on our own experience as well as the experience of published reports from the literature are presented.

  6. Acupuncture for patients with chronic neck pain.

    Science.gov (United States)

    Witt, Claudia M; Jena, Susanne; Brinkhaus, Benno; Liecker, Bodo; Wegscheider, Karl; Willich, Stefan N

    2006-11-01

    Acupuncture is widely used by patients with neck pain, but there is a lack of information about its effectiveness in routine medical care. The aim was to investigate the effectiveness of acupuncture in addition to routine care in patients with chronic neck pain compared to treatment with routine care alone. We performed a randomized controlled multicentre trial plus non-randomized cohort in general practices in Germany. 14,161 patients with chronic neck pain (duration >6 months). Patients were randomly allocated to an acupuncture group or a control group receiving no acupuncture. Patients in the acupuncture group received up to 15 acupuncture sessions over three months. Patients who did not consent to randomization received acupuncture treatment. All subjects were allowed to receive usual medical care in addition to study treatment. Neck pain and disability (NPAD Scale by Wheeler) after three months. Of 14,161 patients (mean age 50.9+/-13.1 years, 68% female) 1880 were randomized to acupuncture and 1886 to control, and 10,395 included into the non-randomized acupuncture group. At three months, neck pain and disability improved by 16.2 (SE: 0.4) to 38.3 (SE: 0.4); and by 3.9 (SE: 0.4) to 50.5 (SE: 0.4), difference 12.3 (pacupuncture and control group, respectively. Treatment success was essentially maintained through six months. Non-randomized patients had more severe symptoms at baseline and showed higher neck pain and disability improvement compared to randomized patients. Treatment with acupuncture added to routine care in patients with chronic neck pain was associated with improvements in neck pain and disability compared to treatment with routine care alone.

  7. Rational radical neck dissection for oral cancer

    Institute of Scientific and Technical Information of China (English)

    李龙江; 温玉明; 王昌美; 王莉娟

    2003-01-01

    Lymphatic metastasis is the most commonly seen route for the spread of malignant epithelial tumors. Oral cancers derived from epithelial tissue occur more often in the head and neck regions with a high lymphatic metastasis rate. According to reports from Chinese researchers, the lymphatic metastasis rate of oral cancer could be as high as 40%, and clearing those involved lymph nodes in neck is one of the most important methods to treat the disease.

  8. Ipsilateral femoral neck and trochanter fracture

    Directory of Open Access Journals (Sweden)

    Devdatta S Neogi

    2011-01-01

    Full Text Available Ipsilateral fractures in the neck and trochanteric region of the femur are very rare and seen in elderly osteoporotic patients. We present a case of a young man who presented with ipsilateral fracture of the femoral neck and a reverse oblique fracture in the trochanteric region following a motor vehicle accident. A possible mechanism, diagnostic challenge, and awareness required for identifying this injury are discussed.

  9. Effect of a suspension seat support chair on the trunk flexion angle and gluteal pressure during computer work.

    Science.gov (United States)

    Yoo, Won-Gyu

    2015-09-01

    [Purpose] We assessed the effects of a suspension seat support chair on the trunk flexion angle and gluteal pressure during computer work. [Subjects] Ten males were recruited. [Methods] The suspension seat support was developed to prevent abnormal gluteal pressure and a slumped sitting posture during computer work. The gluteal pressure was measured with a TekScan system and the trunk flexion angle was measured with a video camera, to compare the differences between a general chair and the suspension seat support. [Results] The gluteal peak pressures were decreased significantly in the suspension seat support versus the general chair. The trunk flexion angle was also decreased significantly in the suspension seat support compared with the general chair. [Conclusions] This study suggests that the suspension seat support chair contributes to preventing abnormal gluteal pressure and a slumped sitting posture.

  10. Comparison of the Symmetry of Right and Left Lateral Cervical Flexion and Rotation and the Cervical FRR in Young Computer Workers.

    Science.gov (United States)

    Yoo, Won-Gyu

    2014-05-01

    [Purpose] This study compared the symmetry of right and left lateral cervical flexion and rotation, and the cervical flexion-relaxation ratio (FRR) in young computer workers in Korea. [Subjects and Methods] Twenty computer workers (14 males and 6 females) participated in this study. We measured their right and left lateral cervical flexion, rotation, and FRR. [Results] Right and left lateral flexion and right and left rotation showed no significant differences between the sides. The left cervical FRR was significantly lower than the right cervical FRR. [Conclusion] The cervical FRR, expressed as a numerical value, is a more sensitive marker for measuring neuromuscular changes associated with mild asymmetry than CROM.

  11. Prognostic factors for long-term sickness absence among employees with neck-shoulder and low-back pain

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Hansen, Jørgen V; Burr, Hermann;

    2010-01-01

    OBJECTIVE: The aim of this study was to identify prognostic factors for long-term sickness absence among employees with neck-shoulder or low-back pain. METHODS: In 2000, a representative sample of Danish employees (N=5036) rated their average pain intensity in the neck-shoulder and low-back during...... the last three months on a 10-point scale; using a questionnaire, they also reported on physical and psychosocial work factors, health behavior, work ability and self-efficacy. Employees reporting pain intensity of >or=4 were considered to have musculoskeletal pain. As a result, we defined two populations...... to be included in our analyses: people with pain in the neck-shoulder (N=848) and low-back (N=676) regions. Data on long-term sickness absence of >or=3 weeks for the period 2001-2002 were attained from the Danish national register of social transfer payments. RESULTS: One fifth of employees with neck...

  12. Effect of maitland mobilization in cervical and thoracic spine and therapeutic exercise on functional impairment in individuals with chronic neck pain

    Science.gov (United States)

    Lee, Keun-Su; Lee, Joon-Hee

    2017-01-01

    [Purpose] This study evaluated joint mobilization and therapeutic exercise applied to the cervical spine and upper thoracic spine for functional impairment caused by chronic neck pain. [Subjects and Methods] Eighteen study subjects were randomly assigned to two groups of nine people each. Therapeutic exercise only was applied to the cervical and upper thoracic spine for Group I, while both therapeutic exercise and joint mobilization were applied to Group II. The visual analog scale, neck disability index, active cervical range of motion, static balance capacity, and muscle tone were assessed with a pre-test. The intervention was carried out for 60 minutes a day, three times a week, for two weeks for each group, followed by a post-test using the same protocol as the pre-test. [Results] The visual analog scale, neck disability index, and active cervical range of motion improved significantly in both groups. Group II improved significantly more on right lateral flexion and rightward rotation. Muscle tone improved significantly in the upper trapezius in both groups. [Conclusion] The joint mobilization and therapeutic exercise for functional impairments caused by chronic neck pain had a significant effect on several types of functional impairment. PMID:28356648

  13. Modeling neck mobility in fossil turtles.

    Science.gov (United States)

    Werneburg, Ingmar; Hinz, Juliane K; Gumpenberger, Michaela; Volpato, Virginie; Natchev, Nikolay; Joyce, Walter G

    2015-05-01

    Turtles have the unparalleled ability to retract their heads and necks within their shell but little is known about the evolution of this trait. Extensive analysis of neck mobility in turtles using radiographs, CT scans, and morphometry reveals that basal turtles possessed less mobility in the neck relative to their extant relatives, although the anatomical prerequisites for modern mobility were already established. Many extant turtles are able to achieve hypermobility by dislocating the central articulations, which raises cautions about reconstructing the mobility of fossil vertebrates. A 3D-model of the Late Triassic turtle Proganochelys quenstedti reveals that this early stem turtle was able to retract its head by tucking it sideways below the shell. The simple ventrolateral bend seen in this stem turtle, however, contrasts with the complex double-bend of extant turtles. The initial evolution of neck retraction therefore occurred in a near-synchrony with the origin of the turtle shell as a place to hide the unprotected neck. In this early, simplified retraction mode, the conical osteoderms on the neck provided further protection.

  14. Chronic neck pain and masticatory dysfunction.

    Science.gov (United States)

    Catanzariti, Jean-François; Debuse, Thierry; Duquesnoy, Bernard

    2005-12-01

    Chronic nonspecific neck pain is a common problem in rheumatology and may resist conventional treatment. Pathophysiological links exist between the cervical spine and masticatory system. Occlusal disorders may cause neck pain and may respond to dental treatment. The estimated prevalence of occlusal disorders is about 45%, with half the cases being due to functional factors. Minor repeated masticatory dysfunction (MD) with craniocervical asymmetry is the most common clinical picture. The pain is usually located in the suboccipital region and refractory to conventional treatment. The time pattern may be suggestive, with nocturnal arousals or triggering by temporomandibular movements. MD should be strongly suspected in patients with at least two of the following: history of treated or untreated MD, unilateral temporomandibular joint pain and clicking, lateral deviation during mouth opening, and limitation of mouth opening (less than three fingerbreadths). Rheumatologists should consider MD among causes of neck pain, most notably in patients with abnormal craniocervical posture, signs linking the neck pain to mastication, and clinical manifestations of MD. Evidence suggesting that MD may cause neck pain has been published. However, studies are needed to determine whether treatment of MD can relieve neck pain.

  15. Larger plantar flexion torque variability implies less stable balance in the young: an association affected by knee position.

    Science.gov (United States)

    Mello, Emanuele Moraes; Magalhães, Fernando Henrique; Kohn, André Fabio

    2013-12-01

    The present study examined the association between plantar flexion torque variability during isolated isometric contractions and during quiet bipedal standing. For plantar flexion torque measurements in quiet stance (QS), subjects stood still over a force plate. The mean plantar flexion torque level exerted by each subject in QS (divided by 2 to give the torque due to a single leg) served as the target torque level for right leg force-matching tasks in extended knee (KE) and flexed knee (KF) conditions. Muscle activation levels (EMG amplitudes) of the triceps surae and mean, standard deviation and coefficient of variation of plantar flexion torque were computed from signals acquired during periods with and without visual feedback. No significant correlations were found between EMG amplitudes and torque variability, regardless of the condition and muscle being analyzed. A significant correlation was found between torque variability in QS and KE, whereas no significant correlation was found between torque variability in QS and KF, regardless of vision availability. Therefore, torque variability measured in a controlled extended knee plantar flexion contraction is a predictor of torque variability in the anterior-posterior direction when the subjects are in quiet standing. In other words, larger plantar flexion torque variability in KE (but not in KF) implies less stable balance. The mechanisms underlying the findings above are probably associated with the similar proprioceptive feedback from the triceps surae in QS and KE and poorer proprioceptive feedback from the triceps surae in KF due to the slackening of the gastrocnemii. An additional putative mechanism includes the different torque contributions of each component of the triceps surae in the two knee angles. From a clinical and research standpoint, it would be advantageous to be able to estimate changes in balance ability by means of simple measurements of torque variability in a force matching task.

  16. +GZ-induced neck injuries in Royal Australian Air Force fighter pilots.

    Science.gov (United States)

    Newman, D G

    1997-06-01

    +GZ-induced neck injuries are a relatively common occurrence in pilots of high performance fighter aircraft. We surveyed 52 fighter pilots from the Royal Australian Air Force Base at Williamtown via an anonymous questionnaire in order to determine the prevalence and operational significance of these injuries. The pilots flew either the F/A-18 Hornet or the MB326H Macchi. Of the respondents, 44 reported having had a neck injury under +GZ. A higher rate was reported in pilots of the F/A-18. Most of these injuries were simple muscle sprains. There were 20 pilots who reported their neck injury as having interfered with mission completion. Only 12 pilots reported doing any regular neck strengthening exercises, while 33 pilots reported doing preflight neck stretches immediately prior to high +GZ exposure. There were 14 pilots who sought medical attention for their injury, with 9 being taken off flight status for an average of 2 weeks. Air combat maneuvering sorties and the "check six" head position were identified as causal factors by most pilots. This study demonstrates the operational significance of these injuries, and highlights the need for more research into this important aerospace medicine issue.

  17. The influence of a semi-reclined seated posture on head and neck kinematics and muscle activity while reading a tablet computer.

    Science.gov (United States)

    Douglas, Ethan C; Gallagher, Kaitlin M

    2017-04-01

    Increased tablet computer usage calls for a proper understanding of potential injury risks from these devices. The purpose of this study was to assess the influence of tablet computer reading postures on head and neck flexion and muscle activity. Nineteen participants completed read a tablet computer in four different postures (standard computer monitor, tablet on a desk, tablet in the lap, semi-reclined with tablet in the lap). Reading the tablet in a semi-reclined trunk posture with the tablet in one's lap increased (p computer monitor (6.39%ROM). Head flexion in the semi-reclined posture (19.7%ROM) and muscle activity (8.88%MVC) were similar to when reading from a standard computer monitor. Despite potentially reducing the gravitational moment produced by the head, the semi-reclined position could still compromise the force capabilities of the neck extensor musculature and result in increased strain on the passive tissues of the spine. Future work should assess how the semi-reclined position influences cervical intervertebral angles and passive tissue properties of the cervical spine. Overall, more research needs to be conducted on thoracic spine kinematics while reading a tablet computer.

  18. [Necrotizing fasciitis of the neck].

    Science.gov (United States)

    Kovacić, Marijan; Kovacić, Ivan; Delalija, Boris

    2013-03-01

    Necrotizing fasciitis is a rare and rapidly progressive infection characterized by necrosis of the superficial fascia and spread on the surrounding skin or muscles, which can be fatal. It usually occurs in the limbs, abdominal wall and perineum. In this retrospective review, the authors present 15 patients with cervical necrotizing fasciitis. The patient mean age was 54.7 years and they had one or more comorbid health problems. Five of them had descending necrotizing mediastinitis and three had progressive sepsis with toxic shock syndrome. Broad-spectrum intravenous antibiotic therapy was administered to all patients immediately, and in three of them we used five-day intravenous immunoglobulin therapy for the signs of toxic shock syndrome. After positive computed tomography imaging for necrotizing fasciitis, we used surgical exploration and debridement of necrotic tissue. In five patients, the initial surgery also included mediastinal transcervical drainage. Preoperative tracheotomy was performed in six patients and delayed tracheotomy in one patient. Histopathologically, all cases showed extensive necrosis of debrided fascia and vascular thrombosis of the neck soft tissue. The mortality rate was 6.7% (1/15). The authors point to the importance of early diagnosis and timely surgical management, broad-spectrum antibiotics and intravenous immunoglobulin therapy when patients are too unstable to undergo surgery.

  19. Modular titanium alloy neck adapter failures in hip replacement - failure mode analysis and influence of implant material

    Directory of Open Access Journals (Sweden)

    Bloemer Wilhelm

    2010-01-01

    Full Text Available Abstract Background Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery. The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68 of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years and the average weight 102.3 kg (75 to 130 kg. The failures of neck adapters were divided into 66% with small CCD of 130° and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. Methods A series of adapter failures of titanium alloy modular neck adapters in combination with a titanium alloy modular short hip stem was investigated. For patients having received this particular implant combination risk factors were identified which were associated with the occurence of implant failure. A Kaplan-Meier survival-failure-analysis was conducted. The retrieved implants were analysed using microscopic and chemical methods. Modes of failure were simulated in biomechanical tests. Comparative tests included modular neck adapters made of titanium alloy and cobalt chrome alloy material. Results Retrieval examinations and biomechanical simulation revealed that primary micromotions initiated fretting within the modular tapered neck

  20. Quadriceps and patellar tendon pie-crusting as a treatment for limited flexion in total knee arthroplasty.

    Science.gov (United States)

    Burge, J Ross; Sanchez, Hugo B; Wagner, Russell A

    2014-04-01

    The pie-crusting method of ligament and tendon lengthening has been used successfully in various tissues but is not reported in the literature as an option for patellar or quadriceps tendons to address flexion limitation. Our case report discusses a patient with longstanding flexion limitation who underwent primary total knee arthroplasty. The report reviews the literature on intraoperative treatments, which primarily pertains to the condition of patella baja, and demonstrates that the pie-crusting technique should be included as a treatment option for a tight extensor mechanism while having some advantages over tibial tubercle osteotomy or Z-plasty.

  1. 3D motion analysis comparison of left handers’ wrist flexion and cutting accuracy according to scissors type

    OpenAIRE

    2015-01-01

    [Purpose] The purpose of this study was to research the difference in wrist flexion and accuracy of left-handers when using regular scissors made for right-handed persons versus scissors made for left-handers. [Subjects and Methods] Eighteen left-handers participated in the experiment. There were ten males and eight females subjects. The degree of wrist flexion of 18 left-handers was analyzed when using scissors designed for left-handers and when using scissors designed for right-handers. [Re...

  2. Comparative short-term effects of two thoracic spinal manipulation techniques in subjects with chronic mechanical neck pain: a randomized controlled trial.

    Science.gov (United States)

    Casanova-Méndez, Amaloha; Oliva-Pascual-Vaca, Angel; Rodriguez-Blanco, Cleofás; Heredia-Rizo, Alberto Marcos; Gogorza-Arroitaonandia, Kristobal; Almazán-Campos, Ginés

    2014-08-01

    Spinal Manipulation (SM) has been purported to decrease pain and improve function in subjects with non-specific neck pain. Previous research has investigated which individuals with non-specific neck pain will be more likely to benefit from SM. It has not yet been proven whether or not the effectiveness of thoracic SM depends on the specific technique being used. This double-blind randomized trial has compared the short-term effects of two thoracic SM maneuvers in subjects with chronic non-specific neck pain. Sixty participants were distributed randomly into two groups. One group received the Dog technique (n = 30), with the subject in supine position, and the other group underwent the Toggle-Recoil technique (n = 30), with the participant lying prone, T4 being the targeted area in both cases. Evaluations were made of self-reported neck pain (Visual Analogue Scale); neck mobility (Cervical Range of Motion); and pressure pain threshold at the cervical and thoracic levels (C4 and T4 spinous process) and over the site described for location of tense bands of the upper trapezius muscle. Measurements were taken before intervention, immediately afterward, and 20 min later. Both maneuvers improved neck mobility and mechanosensitivity and reduced pain in the short term. No major or clinical differences were found between the groups. In the between-groups comparison slightly better results were observed in the Toggle-Recoil group only for cervical extension (p = 0.009), right lateral flexion (p = 0.004) and left rotation (p < 0.05).

  3. Comparison of electromyographic activity and range of neck motion in violin students with and without neck pain during playing.

    Science.gov (United States)

    Park, Kyue-nam; Kwon, Oh-yun; Ha, Sung-min; Kim, Su-jung; Choi, Hyun-jung; Weon, Jong-hyuck

    2012-12-01

    Neck pain is common in violin students during a musical performance. The purpose of this study was to compare electromyographic (EMG) activity in superficial neck muscles with neck motion when playing the violin as well as neck range of motion (ROM) at rest, between violin students with and without neck pain. Nine violin students with neck pain and nine age- and gender-matched subjects without neck pain were recruited. Muscle activity of the bilateral upper trapezius, sternocleidomastoid, and superficial cervical extensor muscles was measured using surface EMG. Kinematic data on neck motion while playing and active neck ROM were also measured using a three-dimensional motion analysis system. Independent t-tests were used to compare EMG activity with kinematic data between groups. These analyses revealed that while playing, both the angle of left lateral bending and leftward rotation of the cervical spine were significantly greater in the neck pain group than among those without neck pain. Similarly, EMG activity of the left upper trapezius, both cervical extensors, and both sternocleidomastoid muscles were significantly greater in the neck pain group. The active ROM of left axial rotation was significantly lower in the neck pain group. These results suggest that an asymmetric playing posture and the associated increased muscle activity as well as decreased neck axial rotation may contribute to neck pain in violin students.

  4. flexion sur l’origine du processus de segmentation du marche du travail

    Directory of Open Access Journals (Sweden)

    Attia Nicole

    2006-01-01

    Full Text Available (francuski Ce travail propose une réflexion sur l'origine du processus de segmentation du marché du travail par rapport à l'entreprise. Se situe-t-elle au sein même de l'entreprise ou en amont, c'est à dire entre les entreprises? Cela revient à se demander si on peut avoir une approche microéconomique ou macroéconomique de la segmentation et, à s'interroger sur le rôle réel tenu par les firmes dans le processus. Déterminant pour la théorie, ce rôle est à repenser selon la réponse apportée à notre question.

  5. A restrained-torque-based motion instructor: forearm flexion/extension-driving exoskeleton

    Science.gov (United States)

    Nishimura, Takuya; Nomura, Yoshihiko; Sakamoto, Ryota

    2013-01-01

    When learning complicated movements by ourselves, we encounter such problems as a self-rightness. The self-rightness results in a lack of detail and objectivity, and it may cause to miss essences and even twist the essences. Thus, we sometimes fall into the habits of doing inappropriate motions. To solve these problems or to alleviate the problems as could as possible, we have been developed mechanical man-machine human interfaces to support us learning such motions as cultural gestures and sports form. One of the promising interfaces is a wearable exoskeleton mechanical system. As of the first try, we have made a prototype of a 2-link 1-DOF rotational elbow joint interface that is applied for teaching extension-flexion operations with forearms and have found its potential abilities for teaching the initiating and continuing flection motion of the elbow.

  6. Dynamic Finite Element Analysis of Mobile Bearing Type Knee Prosthesis under Deep Flexional Motion

    Directory of Open Access Journals (Sweden)

    Mohd Afzan Mohd Anuar

    2014-01-01

    Full Text Available The primary objective of this study is to distinguish between mobile bearing and fixed bearing posterior stabilized knee prostheses in the mechanics performance using the finite element simulation. Quantifying the relative mechanics attributes and survivorship between the mobile bearing and the fixed bearing prosthesis remains in investigation among researchers. In the present study, 3-dimensional computational model of a clinically used mobile bearing PS type knee prosthesis was utilized to develop a finite element and dynamic simulation model. Combination of displacement and force driven knee motion was adapted to simulate a flexion motion from 0° to 135° with neutral, 10°, and 20° internal tibial rotation to represent deep knee bending. Introduction of the secondary moving articulation in the mobile bearing knee prosthesis has been found to maintain relatively low shear stress during deep knee motion with tibial rotation.

  7. Evaluation experimentale et theorique du comportement a la flexion de nouveaux poteaux en materiaux composites

    Science.gov (United States)

    Metiche, Slimane

    La demande croissante en poteaux pour les differents reseaux d'electricite et de telecommunications a rendu necessaire l'utilisation de materiaux innovants, qui preservent l'environnement. La majorite des poteaux electriques existants au Canada ainsi qu'a travers le monde, sont fabriques a partir de materiaux traditionnels tel que le bois, le beton ou l'acier. Les motivations des industriels et des chercheurs a penser a d'autres solutions sont diverses, citons entre autre: La limitation en longueur des poteaux en bois ainsi que la vulnerabilite des poteaux fabriques en beton ou en acier aux agressions climatiques. Les nouveaux poteaux en materiaux composites se presentent comme de bons candidats a cet effet, cependant; leur comportement structural n'est pas connu et des etudes theoriques et experimentales approfondies sont necessaires avant leur mise en marche a grande echelle. Un programme de recherche intensif comportant plusieurs projets experimentaux, analytiques et numeriques est en cours a l'Universite de Sherbrooke afin d'evaluer le comportement a court et a long termes de ces nouveaux poteaux en Polymeres Renforces de Fibres (PRF). C'est dans ce contexte que s'inscrit la presente these, et notre recherche vise a evaluer le comportement a la flexion de nouveaux poteaux tubulaires coniques fabriques en materiaux composites par enroulement filamentaire et ce, a travers une etude theorique, ainsi qu'a travers une serie d'essais de flexion en "grandeur reelle" afin de comprendre le comportement structural de ces poteaux, d'optimiser la conception et de proposer une procedure de dimensionnement pour les utilisateurs. Les poteaux en Polymeres Renforces de Fibres (PRF) etudies dans cette these sont fabriques avec une resine epoxyde renforcee de fibres de verre type E. Chaque type poteaux est constitue principalement de trois zones ou les proprietes geometriques (epaisseur, diametre) et les proprietes mecaniques sont differentes d'une zone a l'autre. La difference

  8. Severe Bilateral Fixed Flexion Deformity-Simultaneous or Staged Total Knee Arthroplasty?

    Science.gov (United States)

    Lee, Wu Chean; Kwan, Yu Heng; Yeo, Seng Jin

    2016-01-01

    Outcomes of 29 simultaneous (SimBTKA) and 38 staged bilateral total knee arthroplasty (StaBTKA) subjects with severe (≥16°) bilateral fixed flexion deformity (FFD) were retrospectively investigated. SimBTKA patients were significantly younger (63 ± 8 vs 68 ± 7, P > .01). At 2 years, SimBTKA subjects had significantly better residual FFD (2.5° ± 5.1° vs 5.4° ± 6.6°, P = .02) and Knee Society function score (75.7 ± 25.7 vs 69.3 ± 24.1, P = .02). However, Knee Society knee scores, Oxford Knee Scores, and Short Form-36 scores were similar. These suggest no large clinical advantage of SimBTKA over StaBTKA. We feel that severe bilateral FFD is not an absolute indication for SimBTKA.

  9. The effect of image alterations on identification using palmar flexion creases.

    Science.gov (United States)

    Cook, Tom; Sutton, Raul; Buckley, Kevan

    2013-11-01

    Palmprints are identified using matching of minutia points, which can be time consuming for fingerprint experts and in database searches. This article analyzes the operational characteristics of a palmar flexion crease (PFC) identification software tool, using a dataset of 10 replicates of 100 palms, where the user can label and match palmar line features. Results show that 100 palmprint images modified 10 times each using rotation, translation, and additive noise, mimicking some of the characteristics found in crime scene palmar marks, can be identified with a 99.2% genuine acceptance rate and 0% false acceptance rate when labeled within 3.5 mm of the PFC. Partial palmprint images can also be identified using the same method to filter the dataset prior to traditional matching, while maintaining an effective genuine acceptance rate. The work shows that identification using PFCs can improve palmprint identification through integration with existing systems, and through dedicated palmprint identification applications.

  10. Treatment of knee flexion contracture in patients with chronic juvenile arthritis: A case report

    Directory of Open Access Journals (Sweden)

    Matijević Radmila

    2006-01-01

    Full Text Available Introduction. Knee flexion contractures are common after-effects of juvenile arthritis. Treatment is usually conservative and may include physical therapy and kinesitherapy. Surgical treatment, particularly of the soft parts, indicated for contractures resistant to conservative treatment, helps to correct the deformity, maintain movements, and relieves pain. Intensive postoperative physiotherapy is of special importance. Case report. A 23-year-old female patient with chronic juvenile arthritis since the age of one was admitted for treatment of flexion con­tractures in both knees, muscle hypotrophy, loss of strength and gait disability. The patient underwent arthroscopic synovectomy. The operation was first performed on the right and after 3 mouths on the left knee. The pre operative range of motion in the rigth knee was 30°-70° and in the left 40°-80°. The patient underwent intensive physical therapy to reduce postoperative swelling of knees and firstly passive and then active kinesitherapy. Nine months after the first surgery and six months after the second, the range of motion in the right knee was 0°-100° and in the left 0°-105°. The strength of tested muscles was increased and gait was improved. Conclusion. Management and rehabilitation of patients with chronic juvenile arthritis include maintenance or improvement in position and function of joints that is achieved with synovectomy. The results depend on combined interdisciplinary rehabilitation, well-experienced staff, and pre- and post-operative physiotherapy as well as kinesitherapy. Arthroscopic synovectomy has many advantages and we believe that it was a better solution than open capsulosynovectomy in this patient with chronic juvenile arthritis of the knee. .

  11. Unilateral static and dynamic hamstrings stretching increases contralateral hip flexion range of motion.

    Science.gov (United States)

    Chaouachi, Anis; Padulo, Johnny; Kasmi, Sofien; Othmen, Aymen Ben; Chatra, Moktar; Behm, David G

    2017-01-01

    Static (SS) and dynamic stretching (DS) can lead to subsequent performance impairments or enhancement with the stretched limb. Crossover or non-local muscle fatigue (NLMF) refers to unilateral fatigue-induced impairments in a contralateral or non-exercised muscle. Whereas there are conflicting findings in the NLMF literature, there are few studies examining the effect of an acute bout of SS or DS on contralateral flexibility, torque or power. Fourteen highly trained subjects (means ± standard deviations: 18 ± 2 years; 179·4 ± 4·6 cm; 70·5 ± 6·3 kg; %body fat: 10·7 ± 2·5%) were tested before and following separate sessions of eight repetitions of 30 s of unilateral hip flexion SS or DS. Pre- and postintervention testing at 1 and 10 min included hip flexor range of motion (ROM), isokinetic leg flexion torque and power at 60°.s(-1) and 300°.s(-1) of the stretched and contralateral limbs. The stretched limb had a 6·3% (P = 0·01; ES: 0·91) ROM increase with DS at 10 min. The contralateral non-stretched hip flexors experienced ROM increases with SS of 5·7% (P = 0·02; ES: 0·68) from pretest to 1 min post-test, whereas DS showed 7·1% (P<0·0001; ES: 1·09) and 8·4% (P = 0·005; ES: 0·89) increases, respectively. There were no relative differences in ROM changes between conditions or limbs nor any stretch-induced changes in isokinetic torque or power. In conclusion, unilateral SS and DS augment contralateral limb ROM likely through an increased stretch tolerance.

  12. The flexion synergy, mother of all synergies and father of new models of gait

    Directory of Open Access Journals (Sweden)

    Jacques eDuysens

    2013-03-01

    Full Text Available Recently there has been a growing interest in the modular organization of leg movements, in particular those related to locomotion. One of the basic modules involves the flexion of the leg during swing and it was shown that this module is already present in neonates (Dominici, et al. 2011. In this paper, we question how these finding build upon the original work by Sherrington, who proposed that the flexor reflex is the basic building block of the flexion during swing phase. Similarly, the relation between the flexor reflex and the withdrawal reflex modules of Schouenborg et al. (1994 will be discussed. It will be argued that there is large overlap between these notions on modules and the older concepts of reflexes. In addition, it will be shown that there is a great flexibility in the expression of some of these modules during gait, thereby allowing for a phase-dependent modulation of the appropriate responses. In particular, the end of the stance phase is a period when the flexor synergy is facilitated. It is proposed that this is linked to the activation of circuitry that is responsible for the generation of locomotor patterns (CPG, central pattern generator. More specifically, it is suggested that the responses in that period relate to the activation of a flexor burst generator. The latter structure forms the core of a new asymmetric model of the CPG. This activation is controlled by afferent input (facilitation by a broad range of afferents, suppression by load afferent input. Meanwhile, many of these physiologic features have found their way in the control of very flexible walking bipedal robots.

  13. Comparison of tibiofemoral joint space width measurements from standing CT and fixed flexion radiography.

    Science.gov (United States)

    Segal, Neil A; Frick, Eric; Duryea, Jeffrey; Nevitt, Michael C; Niu, Jingbo; Torner, James C; Felson, David T; Anderson, Donald D

    2016-08-09

    The objective of this project was to determine the relationship between medial tibiofemoral joint space width measured on fixed-flexion radiographs and the three-dimensional joint space width distribution on low-dose, standing CT (SCT) imaging. At the 84-month visit of the Multicenter Osteoarthritis Study, 20 participants were recruited. A commercial SCT scanner for the foot and ankle was modified to image knees while standing. Medial tibiofemoral joint space width was assessed on radiographs at fixed locations from 15-30% of compartment width using validated software and on SCT by mapping the distances between three-dimensional subchondral bone surfaces. Individual joint space width values from radiographs were compared with three-dimensional joint space width values from corresponding sagittal plane locations using paired t-tests and correlation coefficients. For the 4 medial-most tibiofemoral locations, radiographic joint space width values exceeded the minimal joint space width on SCT by a mean of 2.0mm and were approximately equal to the 61st percentile value of the joint space width distribution at each respective sagittal-plane location. Correlation coefficients at these locations were 0.91-0.97 and the offsets between joint space width values from radiographs and SCT measurements were consistent. There were greater offsets and variability in the offsets between modalities closer to the tibial spine. Joint space width measurements on fixed-flexion radiographs are highly correlated with three-dimensional joint space width from SCT. In addition to avoiding bony overlap obscuring the joint, a limitation of radiographs, the current study supports a role for SCT in the evaluation of tibiofemoral OA. This article is protected by copyright. All rights reserved.

  14. Identifying the Functional Flexion-extension Axis of the Knee: An In-Vivo Kinematics Study.

    Directory of Open Access Journals (Sweden)

    Li Yin

    Full Text Available This study aimed to calculate the flexion-extension axis (FEA of the knee through in-vivo knee kinematics data, and then compare it with two major anatomical axes of the femoral condyles: the transepicondylar axis (TEA defined by connecting the medial sulcus and lateral prominence, and the cylinder axis (CA defined by connecting the centers of posterior condyles.The knee kinematics data of 20 healthy subjects were acquired under weight-bearing condition using bi-planar x-ray imaging and 3D-2D registration techniques. By tracking the vertical coordinate change of all points on the surface of femur during knee flexion, the FEA was determined as the line connecting the points with the least vertical shift in the medial and lateral condyles respectively. Angular deviation and distance among the TEA, CA and FEA were measured.The TEA-FEA angular deviation was significantly larger than that of the CA-FEA in 3D and transverse plane (3.45° vs. 1.98°, p < 0.001; 2.72° vs. 1.19°, p = 0.002, but not in the coronal plane (1.61° vs. 0.83°, p = 0.076. The TEA-FEA distance was significantly greater than that of the CA-FEA in the medial side (6.7 mm vs. 1.9 mm, p < 0.001, but not in the lateral side (3.2 mm vs. 2.0 mm, p = 0.16.The CA is closer to the FEA compared with the TEA; it can better serve as an anatomical surrogate for the functional knee axis.

  15. Acute neck pain: cervical spine range of motion and position sense prior to and after joint mobilization.

    Science.gov (United States)

    McNair, Peter J; Portero, Pierre; Chiquet, Christophe; Mawston, Grant; Lavaste, Francois

    2007-11-01

    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.

  16. Neck Pain and Disability Scale and Neck Disability Index : validity of Dutch language versions

    NARCIS (Netherlands)

    Jorritsma, Wim; Dijkstra, Pieter U.; Geertzen, Jan H. B.; Knol-de Vries, Grietje; Reneman, Michiel F.

    2012-01-01

    To investigate the validity of the Neck Pain and Disability Scale Dutch Language Version (NPAD-DLV) and the Neck Disability Index (NDI)-DLV. NPAD-DLV, NDI-DLV, Short-Form-36 Health Survey (SF-36)-DLV, visual analog scale (VAS)(pain) and VAS(disability) were administered to 112 patients with non-spec

  17. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    2004-01-01

    Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how th

  18. Neck Pain and Disability Scale and the Neck Disability Index : reproducibility of the Dutch Language Versions

    NARCIS (Netherlands)

    Jorritsma, W; Knol-de Vries, Grietje; Geertzen, J.H.B.; Dijkstra, P.U.; Reneman, M.F

    2010-01-01

    The first aim of this study was to translate the Neck Pain and Disability Scale (NPAD) from English into Dutch producing the NPAD-Dutch Language Version (DLV). The second aim was to analyze test-retest reliability and agreement of the NPAD-DLV and the Neck Disability Index (NDI)-DLV. The NPAD was tr

  19. Assessing the Level of Disability, Deep Cervical Flexor Endurance and Fear Avoidance Beliefs in Bankers with Neck Pain

    Directory of Open Access Journals (Sweden)

    Deptee Warikoo

    2013-08-01

    Full Text Available Objective: To assess the level of disability, the deep cervical flexor endurance and fear avoidance beliefs (FAB in bankers with neck pain and to find a correlation between disability and deep cervical muscle endurance, FAB and disability, FAB and deep flexor muscle endurance. Methods: It ws an observational study. The Subjects who had neck pain and minimum 5 years’ experience as a Banker participated in the study. Total 100 subjects were selected. All the subjects were assessed for their disability by the neck pain and disability score (NPDI, their deep cervical flexor endurance using Pressure Biofeedback using Cranio-Cervical flexion test (CCFT and Fear Avoidance Belief by using questionnaire( FABQ. Results: It was found that bankers have a moderate level of disability. The results showed an elevated fear avoidance belief with a mean value of FABQ-PA 21.61±4.42 and FABQ-W 37.81± 5.69. The results indicated that a negative correlation was found between NPDI and CCFT (r=0.855. A positive correlation was found between NPDI and FABQ-PA(r=0.337, FABQ-W(r=0.500. In the present study a negative correlation was found between CCFT and FABQ-W(r=0.553, FABQ-PA (0.348 and positive correlation (r=0.540 was found between FABQ-PA and FABQ-W. Conclusion: The present study concluded that there was a significant level of disability and significantly decreased endurance level and increased fear avoidance beliefs (both work and physical activity related among bankers with neck pain. In addition to that there was a significant correlation found between NPDI and CCFT, NPDI and FABQ, CCFT and FABQ, FABQ-W and FABQ-PA.

  20. 7 CFR 1209.12 - On average.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false On average. 1209.12 Section 1209.12 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS....12 On average. On average means a rolling average of production or imports during the last two...

  1. PET/MRI in head and neck cancer: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Platzek, Ivan; Laniado, Michael [Dresden University Hospital, Department of Radiology, Dresden (Germany); Beuthien-Baumann, Bettina [Dresden University Hospital, Department of Nuclear Medicine, Dresden (Germany); Schneider, Matthias [Dresden University Hospital, Oral and Maxillofacial Surgery, Dresden (Germany); Gudziol, Volker [Dresden University Hospital, Department of Otolaryngology, Dresden (Germany); Langner, Jens; Schramm, Georg; Hoff, Joerg van den [Institute of Bioinorganic and Radiopharmaceutical Chemistry, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Kotzerke, Joerg [Dresden University Hospital, Nuclear Medicine, Dresden (Germany)

    2013-01-15

    To evaluate the feasibility of PET/MRI (positron emission tomography/magnetic resonance imaging) with FDG ({sup 18}F-fluorodeoxyglucose) for initial staging of head and neck cancer. The study group comprised 20 patients (16 men, 4 women) aged between 52 and 81 years (median 64 years) with histologically proven squamous cell carcinoma of the head and neck region. The patients underwent a PET scan on a conventional scanner and a subsequent PET/MRI examination on a whole-body hybrid system. FDG was administered intravenously prior to the conventional PET scan (267-395 MBq FDG, 348 MBq on average). The maximum standardized uptake values (SUV{sub max}) of the tumour and of both cerebellar hemispheres were determined for both PET datasets. The numbers of lymph nodes with increased FDG uptake were compared between the two PET datasets. No MRI-induced artefacts where observed in the PET images. The tumour was detected by PET/MRI in 17 of the 20 patients, by PET in 16 and by MRI in 14. The PET/MRI examination yielded significantly higher SUV{sub max} than the conventional PET scanner for both the tumour (p < 0.0001) and the cerebellum (p = 0.0009). The number of lymph nodes with increased FDG uptake detected using the PET dataset from the PET/MRI system was significantly higher the number detected by the stand-alone PET system (64 vs. 39, p = 0.001). The current study demonstrated that PET/MRI of the whole head and neck region is feasible with a whole-body PET/MRI system without impairment of PET or MR image quality. (orig.)

  2. Effects of changing in the neck circumference during sleep on snoring sound characteristics.

    Science.gov (United States)

    Saha, Shumit; Taheri, Mahsa; Mossuavi, Zahra; Yadollahi, Azadeh

    2015-01-01

    Rostral fluid shift during sleep from the lower body part into the neck can increase neck circumference (NC) and narrow the upper airway. Such narrowing in the upper airway may increase turbulence of airflow passing through the upper airway; thus, induce snoring. The objective of this study was to investigate the effects of changes in NC during sleep on snoring sound characteristics. Fifteen non-obese men slept supine, and their sleep was monitored by a regular polysomnography. Snoring sounds were recorded with a microphone attached to the neck. NC was measured before and after sleep with a measuring tape. Snoring sounds' average power was calculated in different frequency ranges of 100 - 4000 Hz, 100 - 150 Hz, 150 - 450 Hz, 450 - 600 Hz, 600 - 1200 Hz, 1200 - 1800 Hz, 1800 - 2500 Hz and 2500 - 4000 Hz. Statistical analysis showed that increases in NC after sleep were strongly correlated with higher average power of the snoring sounds in the frequency ranges of 100-4000 Hz (r=0.74, P=0.004), 100-150 Hz (r=0.70, P=0.008), 150-450 Hz (r=0.73, P=0.005), and 450 - 600 Hz (r= 0.65, P=0.025). These results encourage the use of snoring sound analysis for monitoring the effects of fluid accumulation in the neck in relation to sleep apnea.

  3. Respiratory weakness in patients with chronic neck pain.

    Science.gov (United States)

    Dimitriadis, Zacharias; Kapreli, Eleni; Strimpakos, Nikolaos; Oldham, Jacqueline

    2013-06-01

    Respiratory muscle strength is one parameter that is currently proposed to be affected in patients with chronic neck pain. This study was aimed at examining whether patients with chronic neck pain have reduced respiratory strength and with which neck pain problems their respiratory strength is associated. In this controlled cross-sectional study, 45 patients with chronic neck pain and 45 healthy well-matched controls were recruited. Respiratory muscle strength was assessed through maximal mouth pressures. The subjects were additionally assessed for their pain intensity and disability, neck muscle strength, endurance of deep neck flexors, neck range of movement, forward head posture and psychological states. Paired t-tests showed that patients with chronic neck pain have reduced Maximal Inspiratory (MIP) (r = 0.35) and Maximal Expiratory Pressures (MEP) (r = 0.39) (P Neck muscle strength (r > 0.5), kinesiophobia (r neck pain and disability (r Neck muscle strength was the only predictor that remained as significant into the prediction models of MIP and MEP. It can be concluded that patients with chronic neck pain present weakness of their respiratory muscles. This weakness seems to be a result of the impaired global and local muscle system of neck pain patients, and psychological states also appear to have an additional contribution. Clinicians are advised to consider the respiratory system of patients with chronic neck pain during their usual assessment and appropriately address their treatment.

  4. Transfracture abduction osteotomy: A solution for nonunion of femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Jairamchander Pingle

    2014-01-01

    femur with or without bone graft, valgus osteotomy or hip arthroplasty. We conducted a retrospective analysis of cases of nonunion of femoral neck fracture treated by transfracture abduction osteotomy (TFAO. Materials and Methods: Over a period of 35 years (1974-2008, 30 patients with nonunion of femoral neck fractures were treated with TFAO over a period of 35 years (1974-2008, All patients were less than 50 years of age. Absence of clinical and radiological signs of union after four months was considered as nonunion. Patients more than 50 years of age were excluded from the study. Union was assessed at 6 months radiologically. Limb length was measured at six months. The mean duration of femoral neck fracture was 19 months (range 4 months 10 years. Results were analyzed in terms of radiological union at six months. Average followup was five years and six months. Results: Consistent union was noted at the followup after six months in 29 cases. One case was lost to followup after five and one-half months postoperatively. However, the fracture had united in this case at the last followup. Average shortening of the limb at six months was 1.9 cm. Average neck shaft angle was 127° (range 120-145°. Five cases went into AVN but were asymptomatic. Two cases required reoperation due to back out of Moore′s pins. These were reopened and cancellous screws were inserted in the same tracks. Conclusions: Consistent union of nonunion femoral neck fracture was noted at the followup after six months in 29 cases. The major drawback of the procedure is immobilization of the patient in the hip spica for eight weeks.

  5. PRESSURE CHANGE OF CUBITAL TUNNEL AT DIFFERENT ELBOW FLEXION ANGLES IN PATIENTS WITH CUBITAL TUNNEL SYNDROME%肘管综合征患者不同屈肘角度的肘管内压力变化

    Institute of Scientific and Technical Information of China (English)

    孟纬; 潘昊鹏; 朱伟

    2013-01-01

    Objective To investigate the relationship between the elbow flexion angle and the cubital tunnel pressure in patients with cubital tunnel syndrome.Methods Between June 2010 and June 2011,63 patients with cubital tunnel syndrome were treated.There were 47 males and 16 females with an average age of 59 years (range,31-80 years).The lesion was at left side in 18 cases and at right side in 45 cases.During anterior transposition of ulnar nerve,the cubital tunnel pressure values were measured at full elbow extension,elbow flexion of 30,60,and 90°,and full elbow flexion with microsensor.The elbow flexion angle-cubital tunnel pressure curve was drawn.Results The cubital tunnel pressure increased smoothly with increased elbow flexion angle when the elbow flexed less than 60°,and the pressure increased sharply when the elbow flexed more than 90°.The cubital tunnel pressure values were (0.13 ± 0.15),(1.75 ± 0.30),(2.62 ± 0.34),(5.78 ± 0.47),and (11.40 ±0.62) kPa,respectively at full elbow extension,elbow flexion of 30,60,and 90°,and full elbow flexion,showing significant differences among different angles (P < 0.05).Conclusion The cubital tunnel pressure will increase sharply when the elbow flexes more than 90°,which leads to the chronic ischemic damage to ulnar nerve.Long-term ischemic damage will induce cubital tunnel syndrome.%目的 通过测定肘管综合征患者不同屈肘角度时肘管内压力,探讨肘管内压力与屈肘角度间的关系.方法 2010年6月-2011年6月,收治63例单侧肘管综合征患者.男47例,女16例;年龄31~80岁,平均59岁.左侧18例,右侧45例.于尺神经前移术中,采用颅内微型传感器测量最大伸肘位,屈肘30、60、90°和最大屈肘位时肘管内压力,绘制屈肘角度-压力曲线.结果 肘管内压力随屈肘角度增加而增大,屈肘超过90°时显著增大.最大伸肘位,屈肘30、60、90°和最大屈肘位时肘管内压力分别为(0.13±0.15)、(1.75±0.30)、(2.62±0.34)、(5

  6. 平山病患者屈颈位F波的变化%Cervical flexion F-waves in the patients with Hirayama diseases

    Institute of Scientific and Technical Information of China (English)

    郑超君; 吕飞舟; 马晓生; 夏新雷; 金翔; 殷骏; 姜建元; 朱愈

    2015-01-01

    Objective To identify whether there is significant changes between the cervical neutral F-waves and cervical flexion F-waves in the patients with Hirayama disease.Methods This study was performed on 25 normal subjects and 22 male patients with identified Hirayama disease (age:15 to 44 years; height:165 to 183 cm; duration:6 to 240 months) between May 2010 and March 2014.Both cervical flexion F-wave (cervical flexion 45 °,30 minutes) and conventional F-waves to median nerve stimulation and to ulnar nerve stimulation were performed in all subjects bilaterally.Results were analyzed by t-test or Fisher exact probability.Results In the normal subjects,all measurements of the bilateral F-waves didn't have any difference between the cervical flexion position and the cervical neutral position.On the cervical neutral position,the persistence (t =5.209,P =0.000),average latencies (t =4.731,P =0.022) and minimal latencies (t =23.843,P =0.006) of ulnar F-wave on the symptomatic heavier side from the patients with identified Hirayama disease were significantly lower or longer than those from the normal subjects,and the repeat F-waves were found in 3 patients (13.6%).On the symptomatic lighter side,the ulnar F-waves only had lower persistence (t =22.306,P =0.001) along with 5 repeat F-waves.Only lower persistence were found in the median F-wave on the both side (higher side t =23.696,P =0.000 ; lighter side t =23.998,P =0.000),along with 5 (22.7%) repeat F-waves on the symptomatic heavier side and 6 (27.3%) ones on the symptomatic lighter side.After cervical flexion maintaining 30 minutes,the increased maximal amplitudes (t =-2.552,P =0.019),average amplitudes (t =-3.322,P =0.003),duration (t =-3.323,P =0.00),persistence (t =-2.604,P =0.017) and frequency of repeat F-waves (9/22,41%) (P =0.044) were found on the symptomatic heavier side of ulnar F-wave,and 5 of 10 absent ulnar F-wave on the cervical neutral position were also recover.The median F-wave on the symptomatic

  7. EMG activities of the quadratus lumborum and erector spinae muscles during flexion-relaxation and other motor tasks.

    Science.gov (United States)

    Andersson, E A; Oddsson, L I E; Grundström, H; Nilsson, J; Thorstensson, A

    1996-10-01

    OBJECTIVE: The aim of this study was to provide new information on the myoelectrical activation of the quadratus lumborum, the deep lateral and the superficial medial lumbar erector spinae, the psoas, and the iliacus muscles in various motor tasks. DESIGN: An intramuscular electromyographic study was performed. BACKGROUND: The contribution of individual deep trunk muscles to the stability of the lumbar spine is relatively unknown in different tasks, including the flexion-relaxation phenomenon. METHODS: Seven healthy subjects participated. Fine-wire electrodes were inserted with a needle guided by ultrasound. RESULTS: The highest activity observed for quadratus lumborum and deep lateral erector spinae occurred in ipsilateral trunk flexion in a side-lying position and for superficial medial erector spinae during bilateral leg lift in a prone position. Quadratus lumborum and deep lateral erector spinae were activated when the flexion-relaxation phenomenon was present for superficial medial erector spinae, i.e. when its activity ceased in the latter part of full forward flexion of the trunk, held relaxed and kyphotic. CONCLUSIONS: In general, the activation of the investigated muscles showed a high degree of task specificity, where activation of a certain muscle was not always predictable from its anatomical arrangement and mechanical advantage.

  8. Measurement of angular and linear segmental lumbar spine flexion-extension motion by means of image registration

    NARCIS (Netherlands)

    Penning, L; Irwan, R; Oudkerk, M

    2005-01-01

    Background The presently available method of measuring segmental lumbar spine mobility by means of superimposition of lumbar spine radiographs in flexion and extension lacks precision due to differences in the cortical outline of the vertebral bodies in flexed and extended position. The introduction

  9. Obliteration of Intercondylar Notch Mimicking Flexion-Extension Gap Imbalance in a Cruciate Retaining Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Harun Resit Gungor

    2015-01-01

    Full Text Available Following total knee arthroplasty (TKA, the most frequent cause of extension deficit and limitation of range of motion in early postoperative period is related to improper tensioning of soft tissues and failure to balance extension and flexion gaps. If a cruciate retaining (CR prosthesis is the planned implant, then attention should be given to balancing the posterior cruciate ligament (PCL, and any factor that alters this balance may also cause deterioration of knee balance in postoperative period. Here, we report on an unusual case referred from another hospital because of continuous pain and restriction of knee motion in early postoperative period following CR-designed TKA that was initially thought to be due to flexion-extension imbalance. However, during the revision procedure, extruded cement to the intercondylar notch was found to be both mechanically blocking terminal extension and limiting flexion by possible mechanism of irritation of the synovial nerve endings around the stretched anterior fibers of PCL during flexion. This case was successfully treated by removal of extruded cement from intercondylar notch to decompress PCL, polyethylene exchange, and secondary patellar resurfacing.

  10. Flexion Relaxation Ratio Not Responsive to Acutely Induced Low Back Pain from a Delayed Onset Muscle Soreness Protocol

    Science.gov (United States)

    Horn, Maggie E.; Bishop, Mark D.

    2013-01-01

    Background. The flexion relaxation ratio (FRR) has been suggested as a measure of muscular performance in patients with low back pain (LBP). The purpose of this study was to investigate whether the FRR was responsive to acute LBP produced from a delayed onset muscle soreness (DOMS) protocol. Methods. Fifty-one pain-free volunteers performed DOMS to induce LBP. Current pain intensity, trunk flexion range of motion (ROM), and passive straight leg raise (SLR) were measured at baseline, 24 and 48 hours after DOMS. Participants were categorized into pain groups based on reported current pain intensity. Changes in FRR, trunk flexion ROM, and SLR ROM were examined using two-way repeated measures analysis of variance. Results. Pain group was not found to have a significant effect on FRR (F1,29 = 0.054, P = 0.818), nor were there any two-way interactions for changes in FRR. The pain group had decreased trunk flexion ROM compared to the minimal pain group (F1,38 = 7.21, P = 0.011), but no decreases in SLR ROM (F1,38 = 3.51, P = 0.057) over time. Interpretation. There were no differences in FRR based on reported pain intensity of LBP from a DOMS protocol. The responsiveness of FRR might be limited in patients with acute onset LBP of muscular origin. PMID:27335879

  11. The effect of increasing resistance on trunk muscle activity during extension and flexion exercises on training devices.

    Science.gov (United States)

    Stevens, Veerle K; Parlevliet, Thierry G; Coorevits, Pascal L; Mahieu, Nele N; Bouche, Katie G; Vanderstraeten, Guy G; Danneels, Lieven A

    2008-06-01

    Although progressive resistance training of trunk muscles on devices is very common, today, the effects of increasing resistance on trunk muscle activity during dynamic extension and flexion movements on training devices have not been reported yet. Thirty healthy subjects participated in maximal isometric and submaximal dynamic (at 30%, 50% and 70% of maximum mean torque (MMT)) extension and flexion exercises on Tergumed lumbar training devices. The normalized (as a percentage of maximal voluntary isometric contractions (MVIC)) electromyographic activity of 16 abdominal and back muscles was investigated. The results of the present study indicated that in general, with increasing resistance from 30% MMT to 50% MMT and 70% MMT, the activity of all back muscles during the extension exercises and the activity of all abdominal muscles during the flexion exercises increased significantly. To train strength (>60% of MVIC), low intensities (30% and 50% MMT) appeared sufficient to affect the back muscles, but for the abdominals higher resistance (70% MMT) was required. In contrast to the other back muscles, the lumbar multifidus demonstrated high activity levels during both the extension and the flexion exercises. As the lumbar multifidus is demonstrated to be an important muscle in segmental stabilization of the lumbar spine, this finding may help in understanding the efficacy of rehabilitation programs using specific training devices.

  12. Defining the knee joint flexion-extension axis for purposes of quantitative gait analysis: an evaluation of methods.

    Science.gov (United States)

    Schache, Anthony G; Baker, Richard; Lamoreux, Larry W

    2006-08-01

    Minimising measurement variability associated with hip axial rotation and avoiding knee joint angle cross-talk are two fundamental objectives of any method used to define the knee joint flexion-extension axis for purposes of quantitative gait analysis. The aim of this experiment was to compare three different methods of defining this axis: the knee alignment device (KAD) method, a method based on the transepicondylar axis (TEA) and an alternative numerical method (Dynamic). The former two methods are common approaches that have been applied clinically in many quantitative gait analysis laboratories; the latter is an optimisation procedure. A cohort of 20 subjects performed three different functional tasks (normal gait; squat; non-weight bearing knee flexion) on repeated occasions. Three-dimensional hip and knee angles were computed using the three alternative methods of defining the knee joint flexion-extension axis. The repeatability of hip axial rotation measurements during normal gait was found to be significantly better for the Dynamic method (pknee varus-valgus kinematic profile and the degree of knee joint angle cross-talk were smallest for the Dynamic method across all functional tasks. The Dynamic method therefore provided superior results in comparison to the KAD and TEA-based methods and thus represents an attractive solution for orientating the knee joint flexion-extension axis for purposes of quantitative gait analysis.

  13. Prevalence of neck pain in computer operators

    Directory of Open Access Journals (Sweden)

    S A Shah

    2015-01-01

    Full Text Available Abstract Introduction: Persisting neck pain is common in society, especially in office-workers. Although, neck pain is common source of disability, little is known about its prevalence and course. The bulk of literature available on this problem is in west with few studies done in an Indian setup. India is a middle-income developing country. The importance of this kind of studies becomes more obvious when it is considered that some reports indicate that the greatest increase in the prevalence of musculo-skeletal disorders in the next decade will be in middle-/low-income countries. Aims & objectives: The Primary aim of this research was to study the prevalence of neck pain in computer operators. Methodology: Study design: Cross Sectional Study. Sampling technique: Simple Random Sampling. Study subject: They should be working on computer for at least 3 hours / day or 15 hours/week, in current job for at least past 6 months & should be willing to participate in the study. Technique: Study was approved from the Institutional Ethics Committee. Informed consent was taken prior to data collection. Data were collected from 700 subjects via structured mailed questionnaire which included individual variables & work related variables. Conclusions: Prevalence of neck pain was found to be 47%. The study shows that neck pain is affected by individual variables and work related variables.

  14. Epidemiology, diagnosis, and treatment of neck pain.

    Science.gov (United States)

    Cohen, Steven P

    2015-02-01

    Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%. Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of individuals will continue to experience some degree of pain or frequent occurrences. History and physical examination can provide important clues as to whether the pain is neuropathic or mechanical and can also be used to identify "red flags" that may signify serious pathology, such as myelopathy, atlantoaxial subluxation, and metastases. Magnetic resonance imaging is characterized by a high prevalence of abnormal findings in asymptomatic individuals but should be considered for cases involving focal neurologic symptoms, pain refractory to conventional treatment, and when referring a patient for interventional treatment. Few clinical trials have evaluated treatments for neck pain. Exercise treatment appears to be beneficial in patients with neck pain. There is some evidence to support muscle relaxants in acute neck pain associated with muscle spasm, conflicting evidence for epidural corticosteroid injections for radiculopathy, and weak positive evidence for cervical facet joint radiofrequency denervation. In patients with radiculopathy or myelopathy, surgery appears to be more effective than nonsurgical therapy in the short term but not in the long term for most people.

  15. Kinematic Analysis of the Neck and Upper Extremities During Walking in Healthy Young Adults

    Institute of Scientific and Technical Information of China (English)

    Kwon Son; Junghong Park; Seonghun Park

    2011-01-01

    The objective of this paper is to quantify the local stabilities of the neck and upper extremities (right/left shoulders and right/left elbows), and investigate differences between linear and nonlinear measurements of the associated joint motions and differences in the local stability between the upper and lower extremities. This attempt involves the calculation of a nonlinear parameter, Lyapunov Exponent (LE), and a linear parameter, Range of Motion (ROM), during treadmill walking in conjunction with a large population of healthy subjects. Joint motions of subjects were captured using a three-dimensional motion-capture system. Then mathematical chaos theory and the Rosenstein algorithm were employed to calculate LE of joints as the extent of logarithmic divergence between the neighboring state-space trajectories of flexion-extension angles. LEs computed over twenty males and twenty females were 0.037±0.023 for the neck, 0.043±0.021 for the right shoulder, 0.045±0.030 for the left shoulder, 0.032±0.021 for the right elbow, and 0.034±0.026 for the left elbow. Although statistically significant difference in the ROM was observed between all pairs of the neck and upper extremity joints, differences in the LE between all pairs of the joints as well as between males and females were not statistically significant. Between the upper and lower extremities, LEs of the neck, shoulder, and elbow were significantly smaller than those of the hip (~0.064) and the knee (~0.062). These results indicate that a statistical difference in the local stability between the upper extremity joints is not significant. However, the different result between the ROM and LE gives a strong rationale for applying both linear and nonlinear tools together to the evaluation of joint movement. The LEs of the joints calculated from a large population of healthy subjects could provide normative values for the associated joints and can be used to evaluate the recovery progress of patients with

  16. Lumbar spine side bending is reduced in end range extension compared to neutral and end range flexion postures.

    Science.gov (United States)

    Ebert, Ryan; Campbell, Amity; Kemp-Smith, Kevin; O'Sullivan, Peter

    2014-04-01

    Lumbar side bending movements coupled with extension or flexion is a known low back pain (LBP) risk factor in certain groups, for example, athletes participating in sports such as hockey, tennis, gymnastics, rowing and cricket. Previous research has shown that sagittal spinal postures influence the degree of spinal rotation, with less rotation demonstrated at end of range extension and flexion. To date it is unknown whether sagittal spinal postures influence side bending. The aim of this study was to determine whether side bend range of motion (ROM) of the lumbar spine is decreased in end-range flexion and extension postures compared to a neutral spine. Twenty subjects between 18 and 55 years of age [mean age = 22.8 yrs (6.8)] with no history of LBP were recruited for this study. Upper (L1-L3) and lower (L3-L5) lumbar side bend, were measured utilising a 14 camera system (Vicon, Oxford metrics, inc.) in end-range flexion, extension and neutral postures, in both sitting and standing positions. The results revealed no statistically significant difference in upper and lower lumbar side bend ROM in an end-range flexion posture compared to a neutral spinal posture. A reduction was found in the range of upper and lower lumbar side bend ROM in an end-range extended posture (p postures. This ROM reduction was found in sitting and standing. These findings allow clinicians to better interpret combined movements involving side bending of the lumbar spine in clinical and real life settings.

  17. Loading the limb during rhythmic leg movements lengthens the duration of both flexion and extension in human infants.

    Science.gov (United States)

    Musselman, Kristin E; Yang, Jaynie F

    2007-02-01

    Sensory input is critical for adapting motor outputs to meet environmental conditions. A ubiquitous force on all terrestrial animals is gravity. It is possible that when performing rhythmic movements, animals respond to load-related feedback in the same way by prolonging the muscle activity resisting the load. We hypothesized that for rhythmic leg movements, the period (extension or flexion) experiencing the higher load will be longer and vary more strongly with cycle period. Six rhythmic movements were studied in human infants (aged 3-10 mo), each providing different degrees of load-related feedback to the legs during flexion and extension of the limb. Kicking in supine provided similar loads (inertial) during flexion and extension. Stepping on a treadmill, kicking in supine against a foot-plate, and kicking in sitting loaded the legs during extension more than flexion, whereas air-stepping and air-stepping with ankle weights did the opposite. Video, electrogoniometry, surface electromyography, and contact forces were recorded. We showed that load-related feedback could make either the duration of flexion or extension longer. Within the tasks of stepping and kicking against a plate, infants who exerted lower forces showed shorter extensor durations than those who exerted higher forces. Because older babies tend to step with greater force, we wished to rule out the contribution of age. Eight babies (>8 mo old) were studied during stepping, in which we manipulated the amount of weight-bearing. The same effect of load was seen. Hence, the degree of loading directly affects the duration of extension in an incremental way.

  18. TO COMPARE THE EFFECTS OF DEEP NECK FLEXORS STRENGHTNING EXERCISE AND McKENZIE NECK EXERCISE IN SUBJECTS WITH FORWARD NECK POSTURE: A RANDOMISED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    Vijay Kage

    2016-04-01

    Full Text Available Background: Forward Neck Posture also called as Protracted neck, is one in which the head is positioned anteriorly and the normal anterior cervical convexity is increased with the apex of the lordotic cervical curve at a considerable distance from the LOG in comparison with optimal posture.Nowadays texting may play a significant role in forward neck posture. According to Wellness Centre “It is the repetition of forward head movements combined with poor ergonomic postures and/or trauma that causes the body to adapt to forward head posture. Purpose: To compare effects of deep flexor strengthening exercises and McKenzie neck exercises in subjects with forward neck posture. Materials and Methods: 30 Subjects clinically diagnosed with FNP meeting the inclusion criteria were randomly assigned into three groups. Group A received McKenzie neck exercises, Group B received Deep Neck Flexor Strengthening Exercises and both the groups commonly went for pectoralis minor stretching respectively for once daily for a total of 6 sessions. Results: The results suggested that all the outcome measure i.e Forward Neck Posture, flexibility of pectoralis minor and CROM values showed significant differences among both the groups. Conclusion: The present study concluded that the comparison of McKenzie neck Exercises and Deep Neck Flexor Strengthening Exercises revealed no statistically significant differences, However each group showed improvement in cervical range of motion and forward neck posture with increase in the pectoralis minor flexibility.

  19. The Danish Head and Neck Cancer database

    DEFF Research Database (Denmark)

    Overgaard, Jens; Jovanovic, Aleksandar; Godballe, Christian

    2016-01-01

    ) of cancer in the nasal sinuses, salivary glands, or thyroid gland (corresponding to the International Classification of Diseases, tenth revision, classifications C.01-C.11, C.30-C.32, C.73, and C.80). MAIN VARIABLES: The main variables used in the study were symptoms and the duration of the symptoms......AIM OF THE DATABASE: The Danish Head and Neck Cancer database is a nationwide clinical quality database that contains prospective data collected since the early 1960s. The overall aim of this study was to describe the outcome of the national strategy for multidisciplinary treatment of head and neck...... cancer in Denmark and to create a basis for clinical trials. STUDY POPULATION: The study population consisted of all Danish patients referred for treatment of squamous cell carcinoma of the larynx, pharynx, oral cavity, or neck nodes from unknown primary or any histopathological type (except lymphoma...

  20. Perfusion CT of head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Razek, Ahmed Abdel Khalek Abdel, E-mail: arazek@mans.edu.eg; Tawfik, Ahmed Mohamed, E-mail: ahm_m_tawfik@hotmail.com; Elsorogy, Lamiaa Galal Ali, E-mail: lamia2elsorogy@hotmail.com; Soliman, Nermin Yehia, E-mail: nermin_eid@hotmail.com

    2014-03-15

    We aim to review the technique and clinical applications of perfusion CT (PCT) of head and neck cancer. The clinical value of PCT in the head and neck includes detection of head and neck squamous cell carcinoma (HNSCC) as it allows differentiation of HNSCC from normal muscles, demarcation of tumor boundaries and tumor local extension, evaluation of metastatic cervical lymph nodes as well as determination of the viable tumor portions as target for imaging-guided biopsy. PCT has been used for prediction of treatment outcome, differentiation between post-therapeutic changes and tumor recurrence as well as monitoring patient after radiotherapy and/or chemotherapy. PCT has a role in cervical lymphoma as it may help in detection of response to chemotherapy and early diagnosis of relapsing tumors.

  1. Management of patients with neck pain

    Directory of Open Access Journals (Sweden)

    E. A. Chechet

    2016-01-01

    Full Text Available Neck pain (cervicalgia occupies one of the leading places among the reasons for outpatient visits, 75% of people have experienced neck pain at least once in their lives. In most cases, neck pain regresses; however, it recurs in almost one half of patients. The paper gives data on the risk factors, mechanisms, course, and prognosis of cervicalgia. It discusses the issues of differential diagnosis, examination, and approaches to treating this condition in these patients. Nonsteroidal anti-inflammatory drugs are most effective in treating patients with acute cervicalgia. Therapeutic exercises and manual therapy are indicated in patients with chronic cervicalgia. There is evidence on the efficacy and safety of meloxicam for the management of acute and chronic cervicalgia.

  2. DEEP NECK INFECTION AFTER THIRD MOLAR EXTRACTION*

    Directory of Open Access Journals (Sweden)

    Seda YILMAZ

    2015-04-01

    Full Text Available Odontogenic and oropharyngeal infections are relatively common in the cervicofacial region. In rare cases, odontogenic or peritonsillar abscesses may spread through the deep fascial cervical spaces and cause life-threatening complications. Odontogenic infection is the most common cause of deep neck infections and it accounts for 43% of the cases. Early diagnosis, immediate antibiotic treatment, and surgical drainage are the basis of therapeutic success. Deep neck infections are potentially life threatening complications if they are not diagnosed in time and treated quickly. This case report presents clinical, radiological features and treatment of the spread of abscesses through cervical spaces of an unusual case of deep neck infection that was caused by the secondary infection of the root remnants after extraction.

  3. Psychometric properties of the Neck OutcOme Score (NOOS), Neck Disability Index (NDI) and Short form-36 (SF-36) were evaluated in patients with neck pain

    DEFF Research Database (Denmark)

    Sørensen, Tina Juul; Søgaard, Karen; Davis, Aileen M;

    2016-01-01

    OBJECTIVE: To assess reliability, construct validity, responsiveness and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI) and Short-form-36 (SF-36) in neck pain patients. STUDY DESIGN AND SETTING: Internal consistency was assessed by Cronbach's alpha. Test-retest reliab......OBJECTIVE: To assess reliability, construct validity, responsiveness and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI) and Short-form-36 (SF-36) in neck pain patients. STUDY DESIGN AND SETTING: Internal consistency was assessed by Cronbach's alpha. Test......, valid and responsive measure of self-reported disability in neck pain patients, performing at least as well or better than the commonly used SF-36 and NDI....

  4. Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head-and-Neck Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Thariat, Juliette [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Department of Radiation Oncology/IBDC CNRS UMR, Cancer Center Antoine-Lacassagne, University Nice Sophia-Antipolis, Nice, Cedex 2 (France); Ang, K. Kian; Allen, Pamela K. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Ahamad, Anesa [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); University of the West Indies, St. Augustine (Trinidad and Tobago); Williams, Michelle D. [Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Myers, Jeffrey N. [Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Department of Cancer Biology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); El-Naggar, Adel K. [Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Ginsberg, Lawrence E. [Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Rosenthal, David I. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Glisson, Bonnie S. [Department of Thoracic/Head and Neck Medicine, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Morrison, William H. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Weber, Randal S. [Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Garden, Adam S., E-mail: agarden@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

    2012-03-01

    Background: This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation and to determine the benefit of a neck dissection in those with less than CR by tumor site. Methods: Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx, or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log-rank test and prognostic factors by Cox's proportional hazard model. Results: Nodal CR occurred in 377 (43%) patients, of whom 365 patients did not undergo nodal dissection. The 5-year actuarial regional control rate of patients with CR was 92%. Two hundred sixty-eight of the remaining patients (53%) underwent neck dissections. The 5-year actuarial regional control rate for patients without a CR was 84%. Those who had a neck dissection fared better with 5-year actuarial regional control rates of 90% and 76% for those operated and those not operated (p < 0.001). Variables associated with poorer regional control rates included higher T and N stage, non-oropharynx cancers, non-CR, both clinical and pathological. Conclusions: With 92% 5-year neck control rate without neck dissection after CR, there is little justification for systematic neck dissection. The addition of a neck dissection resulted in higher neck control after partial response though patients with viable tumor on pathology specimens had poorer outcomes. The identification of that subgroup that benefits from additional treatment remains a challenge.

  5. Penetrating wounds of the head and neck.

    Science.gov (United States)

    Jahrsdoerfer, R A; Johns, M E; Cantrell, R W

    1979-12-01

    Wounding capability of bullets is primarily releated to velocity. Bullet mass and shape, and specific gravity of body tissues being struck by the missile, are lesser factors. Seventy cases of penetrating wounds of the head and neck were treated during a six-year period. Vascular injuries were more common with neck wounds, while face and head injuries (extracranial) were similar to maxillofacial trauma. It is recognized that hemorrhage at the base of the skull is difficult to treat, and contemporary training in temporal bone and base of skull surgery is mandatory for the critical management of these wounds.

  6. Electrochemotherapy of mucosal head and neck tumors

    DEFF Research Database (Denmark)

    Plaschke, Christina Caroline; Gothelf, Anita; Gehl, Julie

    2016-01-01

    with head and neck cancer treated across the mucosal surface with electrochemotherapy. The search resulted in 11 studies with a total of 72 patients. RESULTS: Overall complete response was reported as good, especially in primary small tumors. Side effects were minor in primary tumors whereas large......, recurrent tumors displayed more frequent side effects and some serious adverse events. Design and structure of the studies differed considerably, making general comparisons difficult. CONCLUSION: Few studies concerning electrochemotherapy on mucosal head and neck tumors are available and they are not easily...

  7. INTRAOPERATIVE NEUROMONITORING DURING HEAD AND NECK SURGERY

    Directory of Open Access Journals (Sweden)

    P. O. Rumyantsev

    2012-01-01

    Full Text Available This clinical trial comparatively analyzed the frequency of postoperative neurological complications due to damage to motor (facial, recurrent, laryngeal, and accessory nerves after head and neck operations using the traditional procedure or intraoperative neuromonitoring. Neuromonitoring made during operations on the thyroid and level VI central neck could reduce the rate of recurrent laryngeal nerve paralysis by more than twice (OR = 0.32; 95 % CI 0.11–0.86; p = 0.028. The author considers the absolute indication for intraoperative neuromonitoring to be high-risk surgery for nondeliberate damage to the motor nerves and impossibility of their visual detection.

  8. [Unilateral atypical neck pain in Eagle syndrome].

    Science.gov (United States)

    Lonka, Matilde Mia; Schousboe, Lars Peter

    2012-04-30

    This article is an introduction to Eagle syndrome as a differential diagnosis in patients with lateral neck pain, a symptom, which is often difficult to diagnose and where the accepted treatment covers a variety of forms. This was the case for a 51 year-old man with lateral neck pain and a crunchy sensation/sound when he turned his head. After years of pain, the right examination and a computed tomography finally suggested Eagle syndrome. The patient had severe symptoms and was treated with an operation by which part of the ossificated stylohyoid ligament was removed. The operation relieved him of all his symptoms.

  9. Acute Neck Pain in General Practice

    OpenAIRE

    2006-01-01

    textabstractWe performed a prospective cohort study with one-year follow-up of patients with acute neck pain in general practice. Patients above 18 years of age consulting their GP for non-specific acute neck pain lasting no longer than six weeks were invited to participate. Self-administered questionnaires were collected from patients at baseline and after 6, 12, 26 and 52 weeks. 187 patients were included and we have follow-up data of 138 patients (74%). After one-year 47% still reported ne...

  10. Congenital neck masses: embryological and anatomical perspectives

    Directory of Open Access Journals (Sweden)

    Zahida Rasool

    2013-08-01

    Full Text Available Neck masses are a common problem in paediatric age group. They tend to occur frequently and pose a diagnostic dilemma to the ENT surgeons. Although the midline and lateral neck masses differ considerably in their texture and presentation but the embryological perspective of these masses is not mostly understood along with the fundamental anatomical knowledge. The article tries to correlate the embryological, anatomical and clinical perspectives for the same. [Int J Res Med Sci 2013; 1(4.000: 329-332

  11. Accurate Switched-Voltage voltage averaging circuit

    OpenAIRE

    金光, 一幸; 松本, 寛樹

    2006-01-01

    Abstract ###This paper proposes an accurate Switched-Voltage (SV) voltage averaging circuit. It is presented ###to compensated for NMOS missmatch error at MOS differential type voltage averaging circuit. ###The proposed circuit consists of a voltage averaging and a SV sample/hold (S/H) circuit. It can ###operate using nonoverlapping three phase clocks. Performance of this circuit is verified by PSpice ###simulations.

  12. Spectral averaging techniques for Jacobi matrices

    CERN Document Server

    del Rio, Rafael; Schulz-Baldes, Hermann

    2008-01-01

    Spectral averaging techniques for one-dimensional discrete Schroedinger operators are revisited and extended. In particular, simultaneous averaging over several parameters is discussed. Special focus is put on proving lower bounds on the density of the averaged spectral measures. These Wegner type estimates are used to analyze stability properties for the spectral types of Jacobi matrices under local perturbations.

  13. Facilitation of a nociceptive flexion reflex in man by nonnoxious radiant heat produced by a laser.

    Science.gov (United States)

    Plaghki, L; Bragard, D; Le Bars, D; Willer, J C; Godfraind, J M

    1998-05-01

    Electromyographic recordings were made in healthy volunteers from the knee-flexor biceps femoris muscle of the nociceptive RIII reflex elicited by electrical stimulation of the cutaneous sural nerve. The stimulus intensity was adjusted to produce a moderate pricking-pain sensation. The test responses were conditioned by a nonnoxious thermal (CO2 laser stimulator and consisted of a 100-ms pulse of heat with a beam diameter of 20 mm. Its power was 22.7 +/- 4.2 W (7.2 mJ/mm2), and it produced a sensation of warmth. The maximum surface temperature reached at the end of the period of stimulation was calculated to be 7 degrees C above the actual reference temperature of the skin (32 degrees C). The interval between the laser (conditioning) and electrical (test) stimuli was varied from 50 to 3, 000 ms in steps of 50 ms. It was found that the nociceptive flexion reflex was facilitated by the thermal stimulus; this modulation occurred with particular conditioning-test intervals, which peaked at 500 and 1,100 ms with an additional late, long-lasting phase between 1,600 and 2,300 ms. It was calculated that the conduction velocities of the cutaneous afferent fibers responsible for facilitating the RIII reflex, fell into three ranges: one corresponding to A delta fibers (3.2 m/s) and two in the C fiber range (1.3 and 0.7 m/s). It is concluded that information emanating from warm receptors and nociceptors converges. In this respect, the present data show, for the first time, that in man, conditioning nonnociceptive warm thermoreceptive A delta and C fibers results in an interaction at the spinal level with a nociceptive reflex. This interaction may constitute a useful means whereby signals add together to trigger flexion reflexes in defensive reactions and other basic motor behaviors. It also may contribute to hyperalgesia in inflammatory processes. The methodology used in this study appears to be a useful noninvasive tool for exploring the thermoalgesic mechanisms in both

  14. PET-CT–Guided Surveillance of Head and Neck Cancers

    Science.gov (United States)

    Patients with advanced squamous cell carcinoma of the head and neck who underwent PET-CT–guided surveillance had fewer operations but similar overall survival rates to those of patients who underwent planned neck dissection.

  15. PREVALENCE OF NECK DISABILITY AMONG DENTAL PROFESSIONALS IN NORTH INDIA

    Directory of Open Access Journals (Sweden)

    Anshul

    2013-11-01

    Full Text Available ABSTRACT: AIM: (The aim of this study was to determine the prevalence and severity of neck pain in dentists of north India [h1]. MATERIALS AND METHODS : Following ethical approval, a cross sectional study was conducted on 74 randomly selected dentists. Questionnaires were used to collect personal and occupational characteristics as well as the prevalence and risk factors of neck pain. Subjects were assessed by visual analogue scale and neck disability questionnaires for pain intensity and functional disability of neck, respectively. RESULTS : Point and last 12 months prevalence of neck pain were 27% and 76%, respect ively. Mean VAS for neck pain is 2.48. CONCLUSION : Results indicated that the prevalence of neck pain and neck disability in dentists appears to be high

  16. Physiotherapy for Chronic Neck Pain: Evaluation of a biopsychosocial approach

    OpenAIRE

    2010-01-01

    markdownabstract__Abstract__ Neck pain is a common complaint that causes substantial morbidity in western countries. Reported prevalence in the general population ranges from 9.5% to 22%, and the 12-month (point) prevalence estimates ranges from 30% to 50%. It is suggested that two thirds of individuals may at least once in their lifetime experience neck pain; it is more often reported by women than men. Patients with neck complaints generally also complain of neck stiffness and reduced mobil...

  17. Average-Time Games on Timed Automata

    OpenAIRE

    Jurdzinski, Marcin; Trivedi, Ashutosh

    2009-01-01

    An average-time game is played on the infinite graph of configurations of a finite timed automaton. The two players, Min and Max, construct an infinite run of the automaton by taking turns to perform a timed transition. Player Min wants to minimise the average time per transition and player Max wants to maximise it. A solution of average-time games is presented using a reduction to average-price game on a finite graph. A direct consequence is an elementary proof of determinacy for average-tim...

  18. Grassmann Averages for Scalable Robust PCA

    DEFF Research Database (Denmark)

    Hauberg, Søren; Feragen, Aasa; Black, Michael J.

    2014-01-01

    arbitrarily corrupt the results. Unfortunately, state-of-the-art approaches for robust PCA do not scale beyond small-to-medium sized datasets. To address this, we introduce the Grassmann Average (GA), which expresses dimensionality reduction as an average of the subspaces spanned by the data. Because averages...... to vectors (subspaces) or elements of vectors; we focus on the latter and use a trimmed average. The resulting Trimmed Grassmann Average (TGA) is particularly appropriate for computer vision because it is robust to pixel outliers. The algorithm has low computational complexity and minimal memory requirements...

  19. Prevention of flight-related neck pain in military aircrew

    NARCIS (Netherlands)

    van den Oord, M.H.A.H.

    2012-01-01

    Military pilots and rear aircrew members are occupations with several occupational exposures that might cause neck pain. In addition to the negative impact of neck pain on health, safety is one of the main concerns for the military aviation, because neck pain may interfere with flying performance. I

  20. Neck sprain after motor vehicle accidents in drivers and passengers

    NARCIS (Netherlands)

    Versteegen, GJ; Kingma, J; Meijler, WJ; ten Duis, HJ

    2000-01-01

    Neck sprain is a general term denoting a soft tissue injury of the neck, which seldom causes major disability but is considered a modem epidemic. The purpose of the present study was to determine the prevalence of sprain of the neck injury due to motor vehicle accidents (MVAs) in both drivers and pa

  1. A 66-year-old man with neck pain.

    Science.gov (United States)

    Jaynstein, Dayna

    2017-03-01

    Neck pain is a fairly common complaint among patients in the ED. The differential diagnosis is broad, from musculoskeletal causes to potentially life-threatening causes. Providers need to have a good understanding of when the complaint of neck pain requires more diagnostic investigation, even in a patient with chronic neck pain.

  2. A new methodology for biofidelic head-neck postural control

    NARCIS (Netherlands)

    Nemirovsky, N.; Rooij, L. van

    2010-01-01

    Active safety systems require accurate modelling of human behaviour. The effect of bracing, together with an appropriate human head/neck stability control are essential in the study of pre-crash behaviour and neck injury, since they can account for changes in apparent joint stiffness in the neck. In

  3. Postural Correction in Persons with Neck Pain (II. Integrated Electromyography of the Upper Trapezius in Three Simulated Neck Positions).

    Science.gov (United States)

    Enwemeka, C S; Bonet, I M; Ingle, J A; Prudhithumrong, S; Ogbahon, F E; Gbenedio, N A

    1986-01-01

    In the previous paper (Enwemeka, Bonet, Ingle, et al. 8:235-239, 1986) we showed that patients with neck pain and spasm of the upper trapezius often assume a forward head position, and that two neck positions, axial extension, and neutral neck position are frequently used by physical therapists to correct this faulty neck posture. Because there is no scientific basis for recommending either of the two corrective neck positions, we simulated the three neck positions in 10 normal adults and compared the integrated electromyography (IEMG) of the upper trapezius to determine if the muscle shows less activity in any of the two corrective positions. The results showed significantly less IEMG of the upper trapezius in each of the two corrective neck positions than in the faulty neck position (p 0.10). The implications and limitations of these findings are discussed along with suggestions for future studies. J Orthop Sports Phys Ther 1986;8(5):240-242.

  4. Motion as motivation: using repetitive flexion movements to stimulate the approach system.

    Science.gov (United States)

    Haeffel, Gerald J

    2011-12-01

    Research suggests that having a healthy approach system is critical for adaptive emotional functioning. The goal of the current study (n=186 undergraduates) was to determine the efficacy of an easy-to-disseminate and cost-efficient strategy for stimulating this system. The experiment tested the effects of repeated flexion movements (rFM) on approach system activation as measured by both self-report (BAS scales) and behavior. The results showed that rFM increased approach system motivation in men but not women. Men who completed the rFM task reported significantly greater levels of fun-seeking motivation than men in the control task. Moreover, the rFM task led to changes in actual behavior. Men who completed the rFM task exhibited significantly greater persistence on a difficult laboratory task than men in the control task. In contrast, women who completed the rFM task reported significantly lower levels of fun seeking and tended to exhibit less persistence on a difficult laboratory task than women in the control task. These results provide support for embodied theories of emotion as well as additional evidence for a gender difference in approach-avoidance tendencies.

  5. Analysis of right anterolateral impacts: the effect of trunk flexion on the cervical muscle whiplash response

    Directory of Open Access Journals (Sweden)

    Narayan Yogesh

    2006-05-01

    Full Text Available Abstract Background The cervical muscles are considered a potential site of whiplash injury, and there is a need to understand the cervical muscle response under non-conventional whiplash impact scenarios, including variable body position and impact direction. There is no data, however, on the effect of occupant position on the muscle response to frontal impacts. Therefore, the objective of the study was to measure cervical muscle response to graded right anterolateral impacts. Methods Twenty volunteers were subjected to right anterolateral impacts of 4.3, 7.8, 10.6, and 12.8 m/s2 acceleration with their trunk flexed forward 45 degrees and laterally flexed right or left by 45 degrees. Bilateral EMG of the sternocleidomastoids, trapezii, and splenii capitis and acceleration of the sled, torso, and head were measured. Results and discussion With either direction of trunk flexion at impact, the trapezius EMGs increased with increasing acceleration (p Conclusion When the subject sits with trunk flexed out of neutral posture at the time of anterolateral impact, the cervical muscle response is dramatically reduced compared to frontal impacts with the trunk in neutral posture. In the absence of bodily impact, the flexed trunk posture appears to produce a biomechanical response that would decrease the likelihood of cervical muscle injury in low velocity impacts.

  6. Effects of lumbar stabilization exercises on the flexion-relaxation phenomenon of the erector spinae.

    Science.gov (United States)

    Park, San-Seong; Choi, Bo-Ram

    2016-06-01

    [Purpose] This study evaluated the differences in the flexion-relaxation phenomenon (FRP) of the right and left erector spinae muscles in asymptomatic subjects and the effect of lumbar stabilization exercises on these differences. [Subjects and Methods] Twenty-six participants (12 in the exercise group and 14 in the control group) with a difference in the FRP in the right and left erector spinae muscles were recruited from among healthy students attending Silla University. The exercise group performed two lumbar stabilization exercises (back bridge exercise and hand-knee exercise) for 4 weeks. The control group did not exercise. [Results] No significant group-by-exercise interaction was found. The right and left erector spinae muscles did show a difference in FRP between the control and exercise groups (119.2 ± 69.2 and 131.1 ± 85.2 ms, respectively). In addition, the exercise group showed a significant decrease in post-exercise (50.0 ± 27.0 ms) compared to pre-exercise (112.3 ± 41.5 ms) differences in the right and left FRP. [Conclusion] These results suggest that lumbar stabilization exercises may counter asymmetry of the FRP in the erector spinae muscles, possibly preventing low back pain in the general population.

  7. Prototype of a mechanical assistance device for the wrists' flexion-extension movement

    Energy Technology Data Exchange (ETDEWEB)

    Politti, Julio C; Puglisi, Lisandro J; Farfan, Fernando D [Departamento de BioingenierIa - FaCEyT - UNT (Argentina)

    2007-11-15

    Using CMU actuators, a Prototype of Mechanical Assistance Device for the Wrist's Flexion Movement (PMA) was developed and probed in a mechanical model, in order to be implemented in a future as a dynamic powered orthosis or as a rehabilitation assistant instrument. Two Mayor Actuators conformed by three CMU actuators arranged in a series configuration, allows to an artificial hand to be placed in four predefined positions: 0{sup 0}, 20{sup 0}, 40{sup 0} and 60{sup 0}. The synchronism and control of the actuators is achieved with the Programmable Control Module (PCM). It is capable to drive up to six CMU actuators, and possess two different modes of execution: a Manual mode and an Exercise mode. In the Manual Mode, the position of the hand responds directly to the commands of the keyboard of the front panel, and in the Exercise mode, the hand realizes a repetitive and programmed movement. The prototype was tested in 100 positions in the Manual Mode and for 225 works cycles in the Exercise Mode. The relative repetition error was less than 5% for both test. This prototype only consumes 4,15W, which makes it possible to be powered by small rechargeable batteries, allowing its use as a portable device.

  8. Peak activation of lower limb musculature during high flexion kneeling and transitional movements.

    Science.gov (United States)

    Kingston, David C; Tennant, Liana M; Chong, Helen C; Acker, Stacey M

    2016-09-01

    Few studies have measured lower limb muscle activation during high knee flexion or investigated the effects of occupational safety footwear. Therefore, our understanding of injury and disease mechanisms, such as knee osteoarthritis, is limited for these high-risk postures. Peak activation was assessed in eight bilateral lower limb muscles for twelve male participants, while shod or barefoot. Transitions between standing and kneeling had peak quadriceps and tibialis anterior (TA) activations above 50% MVC. Static kneeling and simulated tasks performed when kneeling had peak TA activity above 15% MVC but below 10% MVC for remaining muscles. In three cases, peak muscle activity was significantly higher (mean 8.9% MVC) when shod. However, net compressive knee joint forces may not be significantly increased when shod. EMG should be used as a modelling input when estimating joint contact forces for these postures, considering the activation levels in the hamstrings and quadriceps muscles during transitions. Practitioner Summary: Kneeling transitional movements are used in activities of daily living and work but are linked to increased knee osteoarthritis risk. We found peak EMG activity of some lower limb muscles to be over 70% MVC during transitions and minimal influence of wearing safety footwear.

  9. Change in EMG with skin friction at different frequencies during elbow flexion.

    Science.gov (United States)

    Sugawara, Hitoshi; Shimose, Ryota; Tadano, Chigaya; Ushigome, Nobuyuki; Muro, Masuo

    2013-06-01

    Modulation of muscle activation in superficial and deeper regions may be induced by tactile stimulation. The purpose of this study was to examine changes in muscle activation with skin friction. Subjects performed an isometric elbow flexion at 30% maximal voluntary cotraction (MVC) with skin friction at different frequencies (0.5-2.7 Hz). Surface electromyography (S-EMG) and intramuscular EMG were obtained from the elbow flexor muscles (BBS: short head of biceps brachii, BBL: long head of biceps brachii, BRA: brachialis). S-EMG activity decreased at a higher frequency of 2.7 Hz and increased linearly with an increase in skin friction frequency (0.5-2.7 Hz) in BBS. A decrease in high-threshold motor unit (HT-MU) firing rate in superficial regions and an increase in low-threshold motor unit (LT-MU) firing rate in deeper regions were observed with skin friction (2.7 Hz) in BBS. The actions of inhibitory interneurons may be influenced by cutaneous afferent input with skin friction. Muscle activation of BBS depended on the intensity of the stimulus. Skin friction over BBS results in an inhibitory response in superficial regions of BBS, most likely due to the increase in firing rate of low-threshold cutaneous mechanoreceptors.

  10. Systematic review of flexion/extension radiography of the cervical spine in trauma patients

    Energy Technology Data Exchange (ETDEWEB)

    Sierink, J.C., E-mail: j.c.sierink@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Lieshout, W.A.M. van, E-mail: w.a.vanlieshout@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Beenen, L.F.M., E-mail: l.f.beenen@amc.nl [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Schep, N.W.L., E-mail: n.w.schep@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Vandertop, W.P., E-mail: w.p.vandertop@amc.nl [Neurosurgical Center Amsterdam, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Goslings, J.C., E-mail: j.c.goslings@amc.nl [Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2013-06-15

    Introduction: The aim of this review was to investigate whether Flexion/Extension (F/E) radiography adds diagnostic value to CT or MRI in the detection of cervical spine ligamentous injury and/or clinically significant cervical spine instability of blunt trauma patients. Methods: A systematic search of literature was done in Pubmed, Embase and Cochrane Library databases. Primary outcome was sensitivity and specificity of F/E radiography. Secondary outcomes were the positive predicting value (PPV) and negative predicting value (NPV) (with CT or MRI as reference tests due to the heterogeneity of the included studies) of each modality and the quality of F/E radiography. Results: F/E radiography was overall regarded to be inferior to CT or MRI in the detection of ligamentous injury. This was reflected by the high specificity and NPV for CT with F/E as reference test (ranging from 97 to 100% and 99 to 100% respectively) and the ambiguous results for F/E radiography with MRI as its reference test (0–98% and 0–83% for specificity and NPV respectively). Image quality of F/E radiography was reported to have 31 to 70% adequacy, except in two studies which reported an adequacy of respectively 4 and 97%. Conclusion: This systematic review of the literature shows that F/E radiography adds little diagnostic value to the evaluation of blunt trauma patients compared to CT and MRI, especially in those cases where CT or MRI show no indication of ligamentous injury.

  11. Primary afferent depolarization and flexion reflexes produced by radiant heat stimulation of the skin.

    Science.gov (United States)

    Burke, R E; Rudomin, P; Vyklický, L; Zajac, F E

    1971-02-01

    1. The reflex effects of pulses of intense radiant heat applied to the skin of the central plantar pad have been studied in unanaesthetized (decerebrate) spinal cats.2. Pad heat pulses produced flexion of the ipsilateral hind limb and increased ipsilateral flexor monosynaptic reflexes, due to post-synaptic excitation of flexor alpha motoneurones. These effects were accompanied by reduction of extensor monosynaptic reflexes and post-synaptic inhibition of extensor motoneurones.3. Ipsilateral (and contralateral) pad heat pulses consistently evoked negative dorsal root potentials (DRPs) as well as increased excitability of both cutaneous and group Ib muscle afferent terminals. The excitability of group Ia afferents was sometimes also increased during pad heat pulses, but to a lesser extent.4. Pad heat pulses produced negative DRPs in preparations in which positive DRP components could be demonstrated following electrical stimulation of both skin and muscle nerves.5. The motor and primary afferent effects of heat pulses always accompanied one another, beginning after the pad surface temperature had reached rather high levels (usually 48-55 degrees C).6. Negative DRPs increased excitability of cutaneous and group Ib afferents, and motoneurone activation produced by pad heat pulses was essentially unmodified when conduction in large myelinated afferents from the central plantar pad was blocked by cooling the posterior tibial nerve trunk.7. It is concluded that adequate noxious activation of cutaneous afferents of small diameter produces primary afferent depolarization in a variety of large diameter afferent fibres, as well as post-synaptic effects in alpha motoneurones.

  12. Recurrence and survival after neck dissections in cutaneous head and neck melanoma

    DEFF Research Database (Denmark)

    Andersen, Peter Stemann; Chakera, Annette Hougaard; Thamsborg, Andreas Key Milan;

    2014-01-01

    INTRODUCTION: An important prognostic factor in head and neck melanoma is the status of the regional lymph nodes since the presence of metastatic disease in the nodes greatly aggravates the prognosis. There is no consensus on the surgical treatment algorithm for this group. Our aim was to study...... if there is a difference in nodal recurrence and survival after radical, modified or selective neck dissection. METHODS: A total of 57 patients treated for regional meta-stases of head and neck melanoma were analysed retrospectively with respect to type of neck dissection, use of sentinel node biopsy, nodal recurrence...... benefit for patients who undergo completion lymph node dissection following a positive sentinel node biopsy. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  13. Are People With Whiplash-Associated Neck Pain Different from People With Nonspecific Neck Pain?

    DEFF Research Database (Denmark)

    Anstey, Ricci; Kongsted, Alice; Kamper, Steven

    2016-01-01

    Study Design Secondary analysis of a prospective cohort study with cross sectional and longitudinal analyses. Background The clinical importance of a history of whiplash associated disorder (WAD) in people with neck pain remains uncertain. Objective To compare people with WAD to people with non......-specific neck pain, in terms of their baseline characteristics, and pain and disability outcomes over 1 year. Methods Consecutive patients with neck pain presenting to a secondary care spine centre answered a comprehensive self-report questionnaire and underwent a physical examination. Patients were classified...... into either WAD or non-specific neck pain groups. We compared the outcomes of baseline characteristics of the 2 groups, as well as pain intensity and activity limitation at 6 and 12-month follow-up. Results 2578 participants were included in the study. Of these 488 (19%) were classified as having WAD...

  14. Neck pain and disability due to neck pain: what is the relation?

    DEFF Research Database (Denmark)

    Fejer, René; Hartvigsen, Jan

    2008-01-01

    Pain and disability are interrelated, but the relationship between pain and disability is not straightforward. The objective of this study was to investigate the relationship between neck pain (NP) intensity, NP duration, and disability based on the population-based 'Funen Neck and Chest Pain......' study. Pain intensity was measured using 11-box numerical rating scales, pain duration was measured using the Standardized Nordic Questionnaire, and disability was measured by the Copenhagen Neck Functional Disability Scale. Spearman rank correlation coefficients and logistic regression analyses were...... used to measure correlations and strength of associations between pain intensity, pain duration, and disability given domain specific characteristics (socioeconomic, health and physical, comorbidity, and variables related to consequences of NP). Neck pain was very common, but mainly mild and did...

  15. Malignant neoplasms of the head and neck.

    Science.gov (United States)

    Dickson, Paxton V; Davidoff, Andrew M

    2006-05-01

    Head and neck masses represent a common clinical entity in children. In general, these masses are classified as developmental, inflammatory, or neoplastic. Having a working knowledge of lesions within this region and conducting a thorough history and physical examination generally enables the clinician to facilitate an appropriate workup and establish a diagnosis. The differential diagnosis is broad, and expeditiously distinguishing benign from malignant masses is critical for instituting a timely multidisciplinary approach to the management of malignant lesions. Neoplasms of the head and neck account for approximately 5% of all childhood malignancies. A diagnosis of malignancy may represent a primary tumor or metastatic foci to cervical nodes. In this review, we discuss the general approach to evaluating suspicious masses and adenopathy in the head and neck region and summarize the most common malignant neoplasms of the head and neck with regard to their incidence, clinical presentation, diagnostic evaluation, staging, and management. Thyroid, parathyroid, and salivary gland tumors are discussed elsewhere in this issue of Seminars in Pediatric Surgery.

  16. Anatomy of lithosphere necking during orthogonal rifting

    Science.gov (United States)

    Nestola, Yago; Cavozzi, Cristian; Storti, Fabrizio

    2013-04-01

    The evolution of lithosphere necking is a fundamental parameter controlling the structural architecture and thermal-state of rifted margin. The necking shape depends on several parameters, including the extensional strain-rate and thermal layering of the lithosphere. Despite a large number of analogue and numerical modelling studies on lithosphere extension, a quantitative description of the evolution of necking through time is still lacking. We used analogue modelling to simulate in three-dimension the progression of lithosphere thinning and necking during orthogonal rifting. In our models we simulated a typical "cold and young" 4-layer lithosphere stratigraphy: brittle upper crust (loose quartz sand), ductile lower crust (silicon-barite mixture), brittle upper mantle (loose quartz sand), and ductile lower mantle (silicon-barite mixture). The experimental lithosphere rested on a glucose syrup asthenosphere. We monitored model evolution by periodic and coeval laser scanning of both the surface topography and the lithosphere base. After model completion, each of the four layers was removed and the top of the underlying layer was scanned. This technical approach allowed us to quantify the evolution in space and time of the thinning factors for both the whole lithosphere (βz) and the crust (γ). The area of incremental effective stretching (βy) parallel to the extensional direction was obtained from the βz maps.

  17. Anatomy of neck configuration in fission decay

    CERN Document Server

    Patra, S K; Satpathy, L

    2010-01-01

    The anatomy of neck configuration in the fission decay of Uranium and Thorium isotopes is investigated in a microscopic study using Relativistic mean field theory. The study includes $^{236}U$ and $^{232}Th$ in the valley of stability and exotic neutron rich isotopes $^{250}U$, $^{256}U$, $^{260}U$, $^{240}Th$, $^{250}Th$, $^{256}Th$ likely to play important role in the r-process nucleosynthesis in stellar evolution. Following the static fission path, the neck configurations are generated and their composition in terms of the number of neutrons and protons are obtained showing the progressive rise in the neutron component with the increase of mass number. Strong correlation between the neutron multiplicity in the fission decay and the number of neutrons in the neck is seen. The maximum neutron-proton ratio is about 5 for $^{260}$U and $^{256}$Th suggestive of the break down of liquid-drop picture and inhibition of the fission decay in still heavier isotopes. Neck as precursor of a new mode of fission decay li...

  18. Nodular Fasciitis of Neck in Childhood.

    Directory of Open Access Journals (Sweden)

    Saurabh Varshney

    2013-01-01

    Full Text Available Nodular fasciitis, is a benign, pseudo sarcomatous proliferative lesion of the soft tissue, which is frequently misinterpreted as sarcoma, both clinically and microscopically. It is a reactive lesion composed of fibroblasts/myofibroblasts and most commonly found in extremities and trunk. NF has been described in the head and neck region in 10-20% of cases. Many pathologists do not consider NF in the differential diagnosis of soft tissue masses arising in the Head neck region. NF that occurs in otherwise healthy individuals usually presents with a history of rapid growth, and is commonly found in the upper extremities and on the chest and trunk. The importance of otolaryngologists being aware of the existence of this entity in this area of the body is stressed. It has a confirmed perfectly benign clinical course, and simple excision, as tissue-sparing as possible, is the treatment of choice. A case of NF over the neck in a 05-year-old female not associated with trauma who presented with a localized mass over her left neck is presented.

  19. Malignant triton tumor (MTT) of the neck

    DEFF Research Database (Denmark)

    Sørensen, Kristine Bjørndal; Godballe, Christian; Krogdahl, Annelise

    2006-01-01

    Malignant Triton Tumor (MTT) is a rare, malignant periphere nerve sheath tumor with rhabdomyoblastic differentiation. One third of described MTT's were located at the head and neck region. One third of these are associated with neurofibromatosis type 1. MTT most often appears in the third decade...

  20. Chronic calcific tendinitis of the neck

    Energy Technology Data Exchange (ETDEWEB)

    Newmark, H.; Zee, C.S.; Frankel, P.; Robinson, A.; Blau, L.; Gans, D.C.

    1981-12-01

    The authors present the first three cases of chronic calcific tendinits of the neck. This condition is diagnosed radiologically by the presence of calcification located just inferior to the anterior tubercle of C1. The calcification is at the insertion of the longus colli muscle. No soft tissue swelling is present and the patients are asymptomatic.

  1. Sex differences in heritability of neck Pain

    DEFF Research Database (Denmark)

    Fejer, René; Hartvigsen, Jan; Kyvik, Kirsten Ohm

    2006-01-01

    Experimental studies have suggested biological factors as a possible explanation for gender disparities in perception of pain. Recently, heritability of liability to neck pain (NP) has been found to be statistically significantly larger in women compared to men. However, no studies have been...

  2. The Funen Neck and Chest Pain study

    DEFF Research Database (Denmark)

    Fejer, René; Hartvigsen, Jan; Kyvik, Kirsten Ohm

    2006-01-01

    OBJECTIVE: To describe the Funen Neck and Chest Pain (FNCP) study and carry out a comprehensive non-response analysis of the quality of the survey. METHODS: The FNCP questionnaire was sent out to 7000 randomly selected individuals aged 20-71 years living in Funen County, Denmark. A full description...

  3. Manipulation or Mobilisation for Neck Pain

    NARCIS (Netherlands)

    A. Gross; J. Miller; J. D'Sylva; S.J. Burnie; C.H. Goldsmith; N. Graham; T. Haines; G. Brønfort; J.L. Hoving

    2010-01-01

    Background Manipulation and mobilisation are often used, either alone or combined with other treatment approaches, to treat neck pain. Objectives To assess if manipulation or mobilisation improves pain, function/disability, patient satisfaction, quality of life, and global perceived effect in adults

  4. Neck muscle fatigue alters upper limb proprioception.

    Science.gov (United States)

    Zabihhosseinian, Mahboobeh; Holmes, Michael W R; Murphy, Bernadette

    2015-05-01

    Limb proprioception is an awareness by the central nervous system (CNS) of the location of a limb in three-dimensional space and is essential for movement and postural control. The CNS uses the position of the head and neck when interpreting the position of the upper limb, and altered input from neck muscles may affect the sensory inputs to the CNS and consequently may impair the awareness of upper limb joint position. The purpose of this study was to determine whether fatigue of the cervical extensors muscles (CEM) using a submaximal fatigue protocol alters the ability to recreate a previously presented elbow angle with the head in a neutral position. Twelve healthy individuals participated. CEM activity was examined bilaterally using surface electromyography, and kinematics of the elbow joint was measured. The fatigue protocol included an isometric neck extension task at 70 % of maximum until failure. Joint position error increased following fatigue, demonstrating a significant main effect of time (F 2, 18 = 19.41, p ≤ 0.0001) for absolute error. No significant differences were found for variable error (F 2, 18 = 0.27, p = 0.76) or constant error (F 2, 18 = 1.16 of time, p ≤ 0.33). This study confirms that fatigue of the CEM can reduce the accuracy of elbow joint position matching. This suggests that altered afferent input from the neck subsequent to fatigue may impair upper limb proprioception.

  5. Investigation of Cervical Fleksor and Extensor Muscle Activation During Isometric Neck Extension Applied by Therraband

    Science.gov (United States)

    Önal, Sercan; Can, Filiz; Yakut, Yavuz; Baltacı, Gül

    2014-01-01

    Objectives: Therrabands are commonly used for resistive exercises, streching and stabilization exercises and also isometric exercises. However, principles of practice of therrabands are mostly focused on exercise variety. Likewise it is only given point to exercise variety during therrabands’ usage at cervical region. Nevertheless, for effective usage of therrabands and for proper assessment of effectiveness response, it is necessary to know the amount of resistance being given or muscle activation response against the resistance given. The aim of this study was to compare activations of cervical flexor and extensor muscles during isometric extension exercise against the resistance of therraband in healthy individuals. Methods: 14 healthy subjects (8 female,6 male)aged between 19-32 have been included in the study. Subjects with neck problems, systemic diseases, history of trauma or operation were excluded. Neck isometric exercises with therraband was 2 sets with 2 minutes’ intervals and EMG records have been taken during exercises. After preparation of the skin, surface electrodes placed on the motor points of sternocleidomastoideus(SCM) and erector spinae(ES) muscles. After taking the average of 3 measures, the first 10 seconds of muscular activations were recorded. The average of integrated EMG(iEMG) values of each records was used for statistical data. Independent T test and Mann Whitney U test were used for the analysis of findings. Results: There was no significant difference between the right ES and left ES’s mean iEMG during isometric neck extension against therraband (p=0.06). Although there was no difference between right SCM and right ES muscles action potentials(t=-0.895; p=0.379), there was a significant difference between left SCM and left ES muscles’ action potentials (z= -2.435; p=0.01). When all the right and left SCM and ES muscle activations were compared, a significant difference was detected in favour of ES muscles ( t= -2.133; p= 0

  6. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

    OpenAIRE

    2004-01-01

    Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how these outcomes compared between patients who had undergone surgery and a control group. Methods. We analyzed physical symptoms, psychological symptoms, and social and functional well-being at least 1...

  7. Differences between two subgroups of low back pain patients in lumbopelvic rotation and symmetry in the erector spinae and hamstring muscles during trunk flexion when standing.

    Science.gov (United States)

    Kim, Min-hee; Yoo, Won-gyu; Choi, Bo-ram

    2013-04-01

    The present study was performed to examine lumbopelvic rotation and to identify asymmetry of the erector spinae and hamstring muscles in people with and without low back pain (LBP). The control group included 16 healthy subjects, the lumbar-flexion-rotation syndrome LBP group included 17 subjects, and the lumbar-extension-rotation syndrome LBP group included 14 subjects. Kinematic parameters were recorded using a 3D motion-capture system, and electromyography parameters were measured using a Noraxon TeleMyo 2400T. The two LBP subgroups showed significantly more lumbopelvic rotation during trunk flexion in standing than did the control group. The muscle activity and flexion-relaxation ratio asymmetries of the erector spinae muscles in the lumbar-flexion-rotation syndrome LBP group were significantly greater than those in the control group, and the muscle activity and flexion-relaxation ratio asymmetry of the hamstring muscles in the lumbar-extension-rotation syndrome LBP group were significantly greater than those in the control group. Imbalance or asymmetry of passive tissue could lead to asymmetry of muscular activation. Muscle imbalance can cause asymmetrical alignment or movements such as unexpected rotation. The results showed a greater increase in lumbopelvic rotation during trunk flexion in standing among the lumbar-flexion-rotation syndrome and lumbar-extension-rotation syndrome LBP groups compared with the control group. The differences between the two LBP subgroups may be a result of imbalance and asymmetry in erector spinae and hamstring muscle properties.

  8. Does a combination of physical training, specific exercises and pain education improve health-related quality of life in patients with chronic neck pain? A randomised control trial with a 4-month follow up

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Søgaard, Karen; Gram, Bibi;

    2016-01-01

    anterior and cervical spine, Cranio-cervical Flexion, Cervical Extension muscle function, and oculomotion) were recorded at baseline and after 4 months. Results The exercise group showed statistically significant improvement in physical HR-QoL, mental HR-QoL, depression, cervical pressure pain threshold......Qol-5D, Beck Depression Inventory-II, Neck Disability Index, Pain Bothersomeness, Patient-Specific Functioning Scale, Tampa Scale of Kinesiophobia, Global Perceived Effect) and clinical tests (Aastrand Physical Fitness, cervical Range of Motion, Pressure Pain Threshold at infraspinatus, tibialis......, cervical extension movement, muscle function, and oculomotion. Per protocol analyses confirmed these results with additional significant improvements in the exercise group compared with controls. Conclusions This multimodal intervention may be an effective intervention for chronic neck pain patients...

  9. Malignant Peripheral Nerve Sheath Tumors of the Head and Neck: A Case Series and Literature Review

    Directory of Open Access Journals (Sweden)

    Brandon T. Mullins

    2014-01-01

    Full Text Available Background. Malignant peripheral nerve sheath tumors (MPNSTs of the head and neck are rare aggressive neoplasms with a poor prognosis. This study describes the management and outcomes of 3 of our patients with MPNSTs of the head and neck. Methods. We identified 3 patients presenting with MPNST of the head and neck and treated at the University of North Carolina. We compared our results to the literature from 1963 to 2014. Results. Mean follow-up was 31 months. Average age at diagnosis was 44.7 years of age. All patients received wide-local excision and adjuvant radiotherapy. No patients recurred during the series. Recurrence-free survival time for the patients was 45, 37, and 3 months, respectively. Conclusions. Our data series confirms that a combined-modality approach with complete surgical resection and adjuvant radiotherapy leads to improved outcomes in MPNSTs of the head and neck. Nonetheless, due to historically poor outcomes, continued research into newer therapies needs to be explored.

  10. Deep neck abscesses: the Singapore experience.

    Science.gov (United States)

    Lee, Yan Qing; Kanagalingam, Jeevendra

    2011-04-01

    This study aims to review our experience with deep neck abscesses, identify key trends, and improve the management of this condition. This is a retrospective chart review of patients diagnosed with deep neck abscesses in the Department of ENT (Otorhinolaryngology) at Tan Tock Seng Hospital, Singapore between 2004 and 2009. Patient demographics, etiology, bacteriology, systemic disease, radiology, treatment, complications, duration of hospitalization, and outcomes were reviewed. 131 patients were included (64.9% male, 35.1% female) with a median age of 51.0 years. 54 (41.2%) patients had diabetes mellitus. The parapharyngeal space (23.7%) was the most commonly involved space. Odontogenic and upper airway infections were the leading causes of deep neck abscesses (28.0% each). Klebsiella pneumoniae (27.1%) was the most commonly cultured organism in this study and among the diabetic patients (50.0%). 108 (82.4%) patients underwent surgical drainage. 42 patients suffered complications. All 19 patients, who had upper airway obstruction, had either a tracheostomy or intubation. Patients with multi-space abscesses, diabetes mellitus, and complications had prolonged hospitalizations. Old age and diabetes are risk factors for developing deep neck abscesses and their sequelae. The empiric choice of antibiotics should recognize that a dental source is likely, and that Klebsiella is most common in diabetics. Surgical drainage and adequate antibiotic coverage remains the cornerstone of treatment of deep neck abscesses. Therapeutic needle aspiration may successfully replace surgical drainage, if the abscesses are small and no complications are imminent. Airway obstruction should be anticipated in multi-space and floor of mouth abscesses.

  11. WIDTHS AND AVERAGE WIDTHS OF SOBOLEV CLASSES

    Institute of Scientific and Technical Information of China (English)

    刘永平; 许贵桥

    2003-01-01

    This paper concerns the problem of the Kolmogorov n-width, the linear n-width, the Gel'fand n-width and the Bernstein n-width of Sobolev classes of the periodicmultivariate functions in the space Lp(Td) and the average Bernstein σ-width, averageKolmogorov σ-widths, the average linear σ-widths of Sobolev classes of the multivariatequantities.

  12. The effects of stabilization exercises using a sling and stretching on the range of motion and cervical alignment of straight neck patients.

    Science.gov (United States)

    Oh, Seung-Hyean; Yoo, Kyung-Tae

    2016-01-01

    [Purpose] The purpose of this study was to assess how stretching exercise training and sling exercise training for stabilization influences the cervical spine angles and cervical range of motion of straight neck patients. [Subjects and Methods] Twenty straight neck patients were selected as subjects and they were randomly divided into two groups, the stretching and sling stabilization exercise groups which 60 minutes of exercise three times a week for 6weeks. All the subjects in each of the two respective study groups received an X-ray and had their cervical range of motion measured, both before and after the exercise. [Results] When differences in the cervical spine angle between the pre- and the post-test were checked, it was found that only the stretching exercise group showed statistically significant decreases in the craniovertebral angle and the cranial rotation angle. When differences in the range of motion between pre- and post-test were checked, the sling stabilization exercise group showed a significant change in flexion, right rotation, left lateral bending, right lateral bending, and the stretching exercise group showed a significant change in left rotation, left lateral bending, and right lateral bending. [Conclusion] These results indicate that both types of exercises are effective at improving the cervical range of motion of straight neck patients, and that the stretching exercise was more effective than the sling stabilization exercise at improving cervical spine angles.

  13. A Multibody Knee Model Corroborates Subject-Specific Experimental Measurements of Low Ligament Forces and Kinematic Coupling During Passive Flexion.

    Science.gov (United States)

    Kia, Mohammad; Schafer, Kevin; Lipman, Joseph; Cross, Michael; Mayman, David; Pearle, Andrew; Wickiewicz, Thomas; Imhauser, Carl

    2016-05-01

    A multibody model of the knee was developed and the predicted ligament forces and kinematics during passive flexion corroborated subject-specific measurements obtained from a human cadaveric knee that was tested using a robotic manipulator. The model incorporated a novel strategy to estimate the slack length of ligament fibers based on experimentally measured ligament forces at full extension and included multifiber representations for the cruciates. The model captured experimentally measured ligament forces (≤ 5.7 N root mean square (RMS) difference), coupled internal rotation (≤ 1.6 deg RMS difference), and coupled anterior translation (≤ 0.4 mm RMS difference) through 130 deg of passive flexion. This integrated framework of model and experiment improves our understanding of how passive structures, such as ligaments and articular geometries, interact to generate knee kinematics and ligament forces.

  14. Effect of elbow flexion, forearm rotation and upper arm abduction on MVC grip and grip endurance time.

    Science.gov (United States)

    Farooq, Mohd; Khan, Abid Ali

    2012-01-01

    This experiment was designed to know the effect of upper limb postural deviations on grip strength and grip endurance time. A full factorial design of experiment, i.e., 3 (0°, 45°, 90° abduction angles of upper arm) × 3 (45°, 90°, 135° angles of elbow flexion) × 3 (0°, -60° prone, +60° supine angles of forearm rotation) was used to find the effect of 27 combinations of postures on maximum voluntary contraction (MVC) grip strength and grip endurance time. The results showed that none of the main factors were significant on MVC grip, although there was a change in MVC grip. Grip endurance time significantly decreased with an increase in upper arm abduction. Also, grip endurance significantly increased with the elbow flexion angle and decreased with forearm rotation from neutral. These data will help designers and engineers to improve the workplace and tools to reduce the risk of injuries.

  15. Real-time force feedback during flexion-distraction procedure for low back pain: A pilot study.

    Science.gov (United States)

    Gudavalli, Maruti Ram; Cox, James M

    2014-06-01

    A form of chiropractic procedure known as Cox flexion-distraction is used by chiropractors to treat low back pain. Patient lies face down on a specially designed table having a stationery thoracic support and a moveable caudal support for the legs. The Doctor of Chiropractic (DC) holds a manual contact applying forces over the posterior lumbar spine and press down on the moving leg support to create traction effects in the lumbar spine. This paper reports on the development of real-time feedback on the applied forces during the application of the flexion-distraction procedure. In this pilot study we measured the forces applied by experienced DCs as well as novice DCs in using this procedure. After a brief training with real-time feedback novice DCs have improved on the magnitude of the applied forces. This real-time feedback technology is promising to do systematic studies in training DCs during the application of this procedure.

  16. Position of arm and forearm, and elbow flexion during performance of the sculling technique: Technical recommendation versus actual performance

    Directory of Open Access Journals (Sweden)

    Lara Elena Gomes

    2014-03-01

    Full Text Available Sculling motion is a swimming technique executed in a vertical position with the head above the water's surface and, based on the technical recommendation, should be performed maintaining an elbow flexion angle of 90°, arms kept stationary while the forearms move. In order to verify if this recommendation is indeed realistic, the aim of this study was to describe the elbow flexion angle ant its angular velocity, linear speed and range of motion of the shoulder, elbow and wrist during the sculling motion. Data were calculated using three-dimensional kinematic process from underwater video images of ten athletes of synchronized swimming. The results indicate that the arm is relatively stationary and the forearm moves, which agrees with the technical recommendation. However, the elbow flexes and extends, which contradicts the technical recommendation. These findings should be considered when this action is practiced, especially in synchronized swimming, in which sculling motion is a fundamental technique.

  17. Amount of health care and self-care following a randomized clinical trial comparing flexion-distraction with exercise program for chronic low back pain

    Directory of Open Access Journals (Sweden)

    Keenum Michael

    2006-08-01

    Full Text Available Abstract Background Previous clinical trials have assessed the percentage of participants who utilized further health care after a period of conservative care for low back pain, however no chiropractic clinical trial has determined the total amount of care during this time and any differences based on assigned treatment group. The objective of this clinical trial follow-up was to assess if there was a difference in the total number of office visits for low back pain over one year after a four week clinical trial of either a form of physical therapy (Exercise Program or a form of chiropractic care (Flexion Distraction for chronic low back pain. Methods In this randomized clinical trial follow up study, 195 participants were followed for one year after a four-week period of either a form of chiropractic care (FD or a form of physical therapy (EP. Weekly structured telephone interview questions regarded visitation of various health care practitioners and the practice of self-care for low back pain. Results Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p Conclusion During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care.

  18. NOAA Average Annual Salinity (3-Zone)

    Data.gov (United States)

    California Department of Resources — The 3-Zone Average Annual Salinity Digital Geography is a digital spatial framework developed using geographic information system (GIS) technology. These salinity...

  19. Stochastic averaging of quasi-Hamiltonian systems

    Institute of Scientific and Technical Information of China (English)

    朱位秋

    1996-01-01

    A stochastic averaging method is proposed for quasi-Hamiltonian systems (Hamiltonian systems with light dampings subject to weakly stochastic excitations). Various versions of the method, depending on whether the associated Hamiltonian systems are integrable or nonintegrable, resonant or nonresonant, are discussed. It is pointed out that the standard stochastic averaging method and the stochastic averaging method of energy envelope are special cases of the stochastic averaging method of quasi-Hamiltonian systems and that the results obtained by this method for several examples prove its effectiveness.

  20. Study of the influence of degenerative intervertebral disc changes on the deformation behavior of the cervical spine segment in flexion

    Science.gov (United States)

    Kolmakova, Tatyana V.

    2016-11-01

    The paper describes the model of the cervical spine segment (C3-C4) and the calculation results of the deformation behavior of the segment under degenerative changes of the intervertebral disc. The segment model was built based on the experimental literature data taking into account the presence of the cortical and cancellous bone tissue of vertebral bodies. The calculation results show that degenerative changes of the intervertebral disc cause the immobility of the C3 vertebra at flexion.

  1. Cervical flexion myelopathy in a patient showing apparent long tract signs: A severe form of Hirayama disease

    OpenAIRE

    Sakai, Kenji; Ono, Kenjiro; Okamoto, Yoshiyuki; MURAKAMI, Hideki; Yamada, Masahito

    2011-01-01

    We describe an 18-year-old male with cervical flexion myelopathy with Hirayama disease-like features who showed apparent long tract signs. He first experienced insidious-onset hand muscle weakness and atrophy at the age of 15. Subsequently, he developed sensory disturbance in his lower limb. Neurological examination revealed atrophy and weakness in the right hand and forearm, pyramidal signs in the right lower extremity, and disturbance of superficial sensation in the lower left half of the b...

  2. Restricted neck mobility in children with chronic tension type headache: a blinded, controlled study.

    Science.gov (United States)

    Fernández-Mayoralas, Daniel M; Fernández-de-las-Peñas, César; Palacios-Ceña, Domingo; Cantarero-Villanueva, Irene; Fernández-Lao, Carolina; Pareja, Juan A

    2010-10-01

    The main purpose of this study was to analyze the differences in neck mobility between children with chronic tension type headache (CTTH) and healthy children, and to determine the influence of cervical mobility on headache intensity, frequency and duration. Fifty children, 13 boys and 37 girls (mean age 8.5 ± 1.6 years) with CTTH associated to peri-cranial tenderness (IHS 2.3.1) and 50 age- and sex matched children without headache (13 boys, 37 girls, mean age 8.5 ± 1.8 years, P = 0.955) participated. Cervical range of motion (CROM) was objectively assessed with a cervical goniometer by an assessor blinded to the children's condition. Children completed a headache diary for 4 weeks to confirm the diagnosis. Children with CTTH showed decreased CROM as compared to children without headache for flexion (z = -6.170; P 0.125) or gender (P > 0.250) did not influence CROM in either children with CTTH or without headache. Current results support the hypothesis that the cervical spine should be explored in children with headache. Further research is also needed to clearly define the potential role of the cervical spine in the genesis or maintenance of CTTH.

  3. Short Term Effects of Mobilization Techniques on Neck Pain and Deep Neck Flexor Muscle Endurance in Patients with Mechanical Chronic Neck Pain

    Science.gov (United States)

    Kılınç, Hasan Erkan; Harput, Gülcan; Baltacı, Gül; İnce, Deniz İnal

    2014-01-01

    Objectives: The aim of the study was to investigate short term effects of cervical and scapular mobilization techniques on neck pain and deep cervical muscles endurance in chronical mechanical neck pain patients. Methods: 22 chronical mechanic neck pain patients four male 18 female (mean age: mean±sd 35.59± 15.85) were included. Before treatment, neck pain level (visual analog scale) and deep neck flexor muscles endurance (in supine position with digital chronometer) of all patients were evaluated. Cyriax cervical mobilization for 10 minutes and scapular mobilization for 10 repetition 10 sets were performed to patients as treatment protocol. After treatment, 24 hours after and a week after evaluations of neck pain and deep cervical muscles endurance were repeated. Results: Before treatment Neck pain Visual Analog Scale scores was 5.78±1.43 point, 2.80±1.99 point after treatment, 24 hours later 3.36±2.12 point, one week later 3.91±2.24 point. This alteration was found significant statistically (p<0.01). Before treatment deep cervical flexor muscle endurance score was 27.25±17.74 sec, after treatment 39.46±25.20 sec, 24 hours later 38.67±28.43 and one week later 40.11±27.82 sec. This alteration was also found significant statistically (p=0.01). Conclusion: Initially neck pain scores in our subjects decreased quickly, after 24 hours these scores increased but last scores were below first neck pain level in a week follow-up. Deep neck cervical flexor muscles test scores also increased quickly, after 24 hours later this scores were stable along a week. Mobilization techniques are effective methods on neck pain and endurance in chronical mechanic neck pain patients.

  4. Flexion-extension gap in cruciate-retaining versus posterior-stabilized total knee arthroplasty: a cadaveric study.

    Science.gov (United States)

    Matthews, Joshua; Chong, Alexander; McQueen, David; O'Guinn, Justin; Wooley, Paul

    2014-05-01

    We re-examined experimental model results using half-body specimens with intact extensor mechanisms and navigation to evaluate cruciate-retaining (CR) and posterior stabilized (PS) total knee arthroplasty (TKA) component gaps through an entire range of motion. Six sequential testing regimens were conducted with the knee intact, with a CR TKA in place, and with a PS TKA in place, with and without 22 N traction in place at each stage. Each of 10 knees was taken through six full ranges of motion from 0° to 120° at every stage using a navigated knee system to record component gapping. No significant difference was found between loaded and unloaded component gaps, and no significant differences were found in component gapping between CR and PS TKAs throughout a full range of motion. Flexion-extension gap measurements were significantly different from previously published data (at 90° flexion). No difference was found in kinematics when comparing CR and PS TKA component designs. Our results suggest that intact extensor mechanisms may be required to perform proper kinematic studies of TKA. Our findings provide evidence that the extensor mechanism may play a major role in the flexion-extension gaps in cadaveric knees.

  5. [Manubriosternal dislocation caused by indirect flexion-compression trauma. A case report and review of the literature].

    Science.gov (United States)

    Kälicke, T; Feil, E; Steuer, K; Hansis, M

    2001-03-01

    Manubriosternal dislocation caused by indirect flexion-compression trauma is an extremely rare condition. Two forms of manubriosternal luxation are distinguished: in type I the sternum is dislocated posterior and in type II anterior to the manubrium. Direct or indirect trauma may cause manubriosternal dislocation. Mode of injury in direct trauma is mostly a head-on collition in a motor accident resulting either in type I or type II luxation. The unusual origin of manubriosternal dislocation by indirect trauma is put down to flexion-compression injuries of the thoracic spine and results in a type II dislocation. Predisposition to manubriosternal dislocation by indirect trauma consists in rheumatoid arthritis or extreme forms of kyphosis. Outcome of many patients treated conservatively after initial reposition with adhesive tape, symptomatic pain therapy, cryotherapy and prohibition of any physical training over several weeks is subluxation or complete luxation of the manubriosternal joint. This condition may lead to chronic pain, periarticular calcification with ankylosis and progredient deformation. Lacking a controlled study for treatment of manubriosternal dislocation a standard therapeutic regime could not be established yet. In the literature only a few case-reports of patients undergoing operative therapy are published. We report a type II dislocation of the manubriosternal joint caused by indirect flexion-compression trauma. We achieved a very good long-term result using a 8-hole 1/3 tubular plate for fixation of the manubriosternal joint after reposition.

  6. Flexion bonding transfer of multilayered graphene as a top electrode in transparent organic light-emitting diodes

    Science.gov (United States)

    Tae Lim, Jong; Lee, Hyunkoo; Cho, Hyunsu; Kwon, Byoung-Hwa; Sung Cho, Nam; Kuk Lee, Bong; Park, Jonghyurk; Kim, Jaesu; Han, Jun-Han; Yang, Jong-Heon; Yu, Byoung-Gon; Hwang, Chi-Sun; Chu Lim, Seong; Lee, Jeong-Ik

    2015-12-01

    Graphene has attracted considerable attention as a next-generation transparent conducting electrode, because of its high electrical conductivity and optical transparency. Various optoelectronic devices comprising graphene as a bottom electrode, such as organic light-emitting diodes (OLEDs), organic photovoltaics, quantum-dot LEDs, and light-emitting electrochemical cells, have recently been reported. However, performance of optoelectronic devices using graphene as top electrodes is limited, because the lamination process through which graphene is positioned as the top layer of these conventional OLEDs is a lack of control in the surface roughness, the gapless contact, and the flexion bonding between graphene and organic layer of the device. Here, a multilayered graphene (MLG) as a top electrode is successfully implanted, via dry bonding, onto the top organic layer of transparent OLED (TOLED) with flexion patterns. The performance of the TOLED with MLG electrode is comparable to that of a conventional TOLED with a semi-transparent thin-Ag top electrode, because the MLG electrode makes a contact with the TOLED with no residue. In addition, we successfully fabricate a large-size transparent segment panel using the developed MLG electrode. Therefore, we believe that the flexion bonding technology presented in this work is applicable to various optoelectronic devices.

  7. Dynamic Multiscale Averaging (DMA) of Turbulent Flow

    Energy Technology Data Exchange (ETDEWEB)

    Richard W. Johnson

    2012-09-01

    A new approach called dynamic multiscale averaging (DMA) for computing the effects of turbulent flow is described. The new method encompasses multiple applications of temporal and spatial averaging, that is, multiscale operations. Initially, a direct numerical simulation (DNS) is performed for a relatively short time; it is envisioned that this short time should be long enough to capture several fluctuating time periods of the smallest scales. The flow field variables are subject to running time averaging during the DNS. After the relatively short time, the time-averaged variables are volume averaged onto a coarser grid. Both time and volume averaging of the describing equations generate correlations in the averaged equations. These correlations are computed from the flow field and added as source terms to the computation on the next coarser mesh. They represent coupling between the two adjacent scales. Since they are computed directly from first principles, there is no modeling involved. However, there is approximation involved in the coupling correlations as the flow field has been computed for only a relatively short time. After the time and spatial averaging operations are applied at a given stage, new computations are performed on the next coarser mesh using a larger time step. The process continues until the coarsest scale needed is reached. New correlations are created for each averaging procedure. The number of averaging operations needed is expected to be problem dependent. The new DMA approach is applied to a relatively low Reynolds number flow in a square duct segment. Time-averaged stream-wise velocity and vorticity contours from the DMA approach appear to be very similar to a full DNS for a similar flow reported in the literature. Expected symmetry for the final results is produced for the DMA method. The results obtained indicate that DMA holds significant potential in being able to accurately compute turbulent flow without modeling for practical

  8. In vivo maximal fascicle-shortening velocity during plantar flexion in humans.

    Science.gov (United States)

    Hauraix, Hugo; Nordez, Antoine; Guilhem, Gaël; Rabita, Giuseppe; Dorel, Sylvain

    2015-12-01

    Interindividual variability in performance of fast movements is commonly explained by a difference in maximal muscle-shortening velocity due to differences in the proportion of fast-twitch fibers. To provide a better understanding of the capacity to generate fast motion, this study aimed to 1) measure for the first time in vivo the maximal fascicle-shortening velocity of human muscle; 2) evaluate the relationship between angular velocity and fascicle-shortening velocity from low to maximal angular velocities; and 3) investigate the influence of musculo-articular features (moment arm, tendinous tissues stiffness, and muscle architecture) on maximal angular velocity. Ultrafast ultrasound images of the gastrocnemius medialis were obtained from 31 participants during maximal isokinetic and light-loaded plantar flexions. A strong linear relationship between fascicle-shortening velocity and angular velocity was reported for all subjects (mean R(2) = 0.97). The maximal shortening velocity (V(Fmax)) obtained during the no-load condition (NLc) ranged between 18.8 and 43.3 cm/s. V(Fmax) values were very close to those of the maximal shortening velocity (V(max)), which was extrapolated from the F-V curve (the Hill model). Angular velocity reached during the NLc was significantly correlated with this V(Fmax) (r = 0.57; P < 0.001). This finding was in agreement with assumptions about the role of muscle fiber type, whereas interindividual comparisons clearly support the fact that other parameters may also contribute to performance during fast movements. Nevertheless, none of the biomechanical features considered in the present study were found to be directly related to the highest angular velocity, highlighting the complexity of the upstream mechanics that lead to maximal-velocity muscle contraction.

  9. Shortening behavior of the different components of muscle-tendon unit during isokinetic plantar flexions.

    Science.gov (United States)

    Hauraix, Hugo; Nordez, Antoine; Dorel, Sylvain

    2013-10-01

    The torque-velocity relationship has been widely considered as reflecting the mechanical properties of the contractile apparatus, and the influence of tendinous tissues on this relationship obtained during in vivo experiments remains to be determined. This study describes the pattern of shortening of various muscle-tendon unit elements of the triceps surae at different constant angular velocities and quantifies the contributions of fascicles, tendon, and aponeurosis to the global muscle-tendon unit shortening. Ten subjects performed isokinetic plantar flexions at different preset angular velocities (i.e., 30, 90, 150, 210, 270, and 330°/s). Ultrafast ultrasound measurements were performed on the muscle belly and on the myotendinous junction of the medial and lateral gastrocnemius muscles. The contributions of fascicles, tendon, and aponeurosis to global muscle-tendon unit shortening velocity were calculated for velocity conditions for four parts of the total range of motion. For both muscles, the fascicles' contribution decreased throughout the motion (73.5 ± 21.5% for 100-90° angular range to 33.7 ± 20.2% for 80-70°), whereas the tendon contribution increased (25.8 ± 15.4 to 55.6 ± 16.8%). In conclusion, the tendon contribution to the global muscle-tendon unit shortening is significant even during a concentric contraction. However, this contribution depends on the range of motion analyzed. The intersubject variability found in the maximal fascicle shortening velocity, for a given angular velocity, suggests that some subjects might possess a more efficient musculoarticular complex to produce the movement velocity. These findings are of great interest for understanding the ability of muscle-tendon shortening velocity.

  10. The use of forced flexion/extension views in the obtunded trauma patient

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, Harry J.; Wagner, Jason; Anglen, Jeff; Bunn, Paul; Metzler, Michael [Department of Radiology, Departments of Radiology/Orthopaedics and Surgery, University of Missouri-Columbia, One Hospital Drive - DC069.10, Columbia, MO 65212 (United States)

    2002-10-01

    To determine whether forced flexion/extension (F/E) films for ''clearing'' the cervical spine in unconscious or semiconscious patients are useful or actually dangerous.Design and patients. Of 810 patients admitted for blunt trauma over a 5-year period, 479 patients whose films and charts were available received passive F/E film views of the cervical spine. Of these, 447 were reviewed retrospectively in masked fashion for any exacerbation of neurological changes subsequent to the procedure and with respect to the final neurological status at discharge.Results. Twenty-nine patients (6%) had various abnormalities including fractures and ligamentous injuries seen on the initial films. Following forced F/E films no change was made in the diagnosis of 23 patients. Of the remaining six patients, two required no treatment, two only required the use of a collar but two did have surgical intervention, this decision being based on the findings seen in the initial films. However, 285 films (59%) were judged inadequate due either to inadequate F/E (150 patients, 31%) or poor visualization (194 patients, 40%). There were three false positives all subsequently cleared by other studies and there were no false negatives. From the chart review, there were no complications or deaths attributable to the procedure.Conclusion. Although we were unable to find any complication or deaths directly attributable to the procedure, the clinicians abandoned passive F/E views in obtunded patients on the grounds of expense. Our present method of ''clearing'' a cervical spine in an obtunded patient is a cross-table lateral radiograph followed by a high-resolution thin-slice CT scan with sagittal and coronal reconstruction. We are against the use of routine MRI studies and of a forced F/E view in these patients. (orig.)

  11. Three-dimensional bending, torsion and axial compression of the femoropopliteal artery during limb flexion.

    Science.gov (United States)

    MacTaggart, Jason N; Phillips, Nicholas Y; Lomneth, Carol S; Pipinos, Iraklis I; Bowen, Robert; Baxter, B Timothy; Johanning, Jason; Longo, G Matthew; Desyatova, Anastasia S; Moulton, Michael J; Dzenis, Yuris A; Kamenskiy, Alexey V

    2014-07-18

    High failure rates of femoropopliteal artery reconstruction are commonly attributed to complex 3D arterial deformations that occur with limb movement. The purpose of this study was to develop a method for accurate assessment of these deformations. Custom-made stainless-steel markers were deployed into 5 in situ cadaveric femoropopliteal arteries using fluoroscopy. Thin-section CT images were acquired with each limb in the straight and acutely bent states. Image segmentation and 3D reconstruction allowed comparison of the relative locations of each intra-arterial marker position for determination of the artery's bending, torsion and axial compression. After imaging, each artery was excised for histological analysis using Verhoeff-Van Gieson staining. Femoropopliteal arteries deformed non-uniformly with highly localized deformations in the proximal superficial femoral artery, and between the adductor hiatus and distal popliteal artery. The largest bending (11±3-6±1 mm radius of curvature), twisting (28±9-77±27°/cm) and axial compression (19±10-30±8%) were registered at the adductor hiatus and the below knee popliteal artery. These deformations were 3.7, 19 and 2.5 fold more severe than values currently reported in the literature. Histology demonstrated a distinct sub-adventitial layer of longitudinally oriented elastin fibers with intimal thickening in the segments with the largest deformations. This endovascular intra-arterial marker technique can quantify the non-uniform 3D deformations of the femoropopliteal artery during knee flexion without disturbing surrounding structures. We demonstrate that 3D arterial bending, torsion and compression in the flexed lower limb are highly localized and are substantially more severe than previously reported.

  12. Average sampling theorems for shift invariant subspaces

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The sampling theorem is one of the most powerful results in signal analysis. In this paper, we study the average sampling on shift invariant subspaces, e.g. wavelet subspaces. We show that if a subspace satisfies certain conditions, then every function in the subspace is uniquely determined and can be reconstructed by its local averages near certain sampling points. Examples are given.

  13. Testing linearity against nonlinear moving average models

    NARCIS (Netherlands)

    de Gooijer, J.G.; Brännäs, K.; Teräsvirta, T.

    1998-01-01

    Lagrange multiplier (LM) test statistics are derived for testing a linear moving average model against an additive smooth transition moving average model. The latter model is introduced in the paper. The small sample performance of the proposed tests are evaluated in a Monte Carlo study and compared

  14. Averaging Einstein's equations : The linearized case

    NARCIS (Netherlands)

    Stoeger, William R.; Helmi, Amina; Torres, Diego F.

    2007-01-01

    We introduce a simple and straightforward averaging procedure, which is a generalization of one which is commonly used in electrodynamics, and show that it possesses all the characteristics we require for linearized averaging in general relativity and cosmology for weak-field and perturbed FLRW situ

  15. Average Transmission Probability of a Random Stack

    Science.gov (United States)

    Lu, Yin; Miniatura, Christian; Englert, Berthold-Georg

    2010-01-01

    The transmission through a stack of identical slabs that are separated by gaps with random widths is usually treated by calculating the average of the logarithm of the transmission probability. We show how to calculate the average of the transmission probability itself with the aid of a recurrence relation and derive analytical upper and lower…

  16. Average excitation potentials of air and aluminium

    NARCIS (Netherlands)

    Bogaardt, M.; Koudijs, B.

    1951-01-01

    By means of a graphical method the average excitation potential I may be derived from experimental data. Average values for Iair and IAl have been obtained. It is shown that in representing range/energy relations by means of Bethe's well known formula, I has to be taken as a continuously changing fu

  17. New results on averaging theory and applications

    Science.gov (United States)

    Cândido, Murilo R.; Llibre, Jaume

    2016-08-01

    The usual averaging theory reduces the computation of some periodic solutions of a system of ordinary differential equations, to find the simple zeros of an associated averaged function. When one of these zeros is not simple, i.e., the Jacobian of the averaged function in it is zero, the classical averaging theory does not provide information about the periodic solution associated to a non-simple zero. Here we provide sufficient conditions in order that the averaging theory can be applied also to non-simple zeros for studying their associated periodic solutions. Additionally, we do two applications of this new result for studying the zero-Hopf bifurcation in the Lorenz system and in the Fitzhugh-Nagumo system.

  18. How common is hypothyroidism after external radiotherapy to neck in head and neck cancer patients?

    Directory of Open Access Journals (Sweden)

    Nirmala Srikantia

    2011-01-01

    Full Text Available Purpose: To identify the occurrence of clinical and subclinical hypothyroidism among head and neck cancer patients receiving radiation to the neck and to justify routine performing of thyroid function tests during follow-up. Materials and Methods: This is a prospective nonrandomized study of 45 patients of head and neck cancer, receiving radiotherapy (RT. Thyroid stimulating hormone and T4 estimations were done at baseline and at 4 months and 9 months following RT. Results: Of the 45 patients, 37(82.2 % were males and eight (17.8 % were females. All patients received radiation to the neck to a dose of >40Gy. 35.6% received concurrent chemotherapy. Two patients underwent prior neck dissection. Fourteen patients (31.1% were found to have clinical hypothyroidism (P value of 0.01. Five (11.1% patients were found to have subclinical hypothyroidism with a total 19 of 45 (42.2% patients developing radiation-induced hypothyroidism. Nine of 14 patients with clinical hypothyroidism were in the age group of 51 to 60 years (P=0.0522. Five of 16 patients who received chemoradiation and nine of 29 who received RT alone developed clinical hypothyroidism. Above 40 Gy radiation dose was not a relevant risk factor for hypothyroidism. Conclusion: Hypothyroidism (clinical or subclinical is an under-recognized morbidity of external radiation to the neck which is seen following a minimum dose of 40 Gy to neck. Recognizing hypothyroidism (clinical or subclinical early and treating it prevents associated complications. Hence, thyroid function tests should be made routine during follow-up.

  19. Effect of interfractional shoulder motion on low neck nodal targets for patients treated using volume modulated arc therapy (VMAT

    Directory of Open Access Journals (Sweden)

    Kevin Casey

    2014-03-01

    Full Text Available Purpose: To quantify the dosimetric impact of interfractional shoulder motion on targets in the low neck for head and neck patients treated with volume modulated arc therapy (VMAT.Methods: Three patients with head and neck cancer were selected. All three required treatment to nodal regions in the low neck in addition to the primary tumor site. The patients were immobilized during simulation and treatment with a custom thermoplastic mask covering the head and shoulders. One VMAT plan was created for each patient utilizing two full 360° arcs and a second plan was created consisting of two superior VMAT arcs matched to an inferior static AP supraclavicular field. A CT-on-rails alignment verification was performed weekly during each patient’s treatment course. The weekly CT images were registered to the simulation CT and the target contours were deformed and applied to the weekly CT. The two VMAT plans were copied to the weekly CT datasets and recalculated to obtain the dose to the deformed low neck contours.Results: The average observed shoulder position shift in any single dimension relative to simulation was 2.5 mm. The maximum shoulder shift observed in a single dimension was 25.7 mm. Low neck target mean doses, normalized to simulation and averaged across all weekly recalculations were 0.996, 0.991, and 1.033 (Full VMAT plan and 0.986, 0.995, and 0.990 (Half-Beam VMAT plan for the three patients, respectively. The maximum observed deviation in target mean dose for any individual weekly recalculation was 6.5%, occurring with the Full VMAT plan for Patient 3.Conclusion: Interfractional variation in dose to low neck nodal regions was quantified for three head and neck patients treated with VMAT. Mean dose was 3.3% higher than planned for one patient using a Full VMAT plan. A Half-Beam technique is likely a safer choice when treating the supraclavicular region with VMAT.-------------------------------------------Cite this article as: Casey K

  20. Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jinu; Shin, Eun Seow; Kim, Jeong Eon; Yoon, Sang Pil [Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Young Suk [Dept. of Radiation Oncology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2015-12-15

    Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered.