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ObjectiveMethodsResultsConclusionNeck pain is a prevalent global health concern often accompanied by musculoskeletal symptoms. This randomized controlled trial attempted to contrast the impacts of non-thrust Maitland mobilization and Autogenic inhibition muscle energy technique on chronic mechanical neck pain associated with cervico-thoracic junction hypo-mobility.Sixty participants (24 males and 36 females, aged 18–45 years) were allocated randomly into three equally sized groups (A, B, C). Group A: Maitland mobilization plus conventional treatment, Group B: Autogenic Muscle energy technique plus conventional treatment, while; Group C solely received conventional treatment. Treatment was administered for four weeks, three times a week. Outcome measures: neck pain (The primary outcome measure) assessed by Visual Analog Scale (VAS), disability evaluated through Neck Disability Index (NDI), active range of motion (AROM), and joint position error (JPE) as an indicator of cervical proprioception. All measures were assessed both at baseline and after four weeks of intervention.Results showed significant improvements in VAS, NDI, and increased ROM across all groups post-treatment (p < 0.001). While Groups A and B demonstrated superior outcomes compared to Group C, differences between Groups A and B were not statistically significant (p > 0.05). For VAS and NDI, Cohen-d between Groups A and B was 0.31 and 0.31, and for ROM, Cohen-d was 0.37, 0.16, 0.07, 0.29, 0.36, and 0.53 for flexion, extension, right rotation, left rotation, right bending, and left bending, respectively. Furthermore, all groups experienced a significant decrease in JPE, with Groups A and B showing greater improvement than Group C (p < 0.01). Group B exhibited significantly greater improvement in reducing JPE related to specific motions compared to Group A (p < 0.05).Cervico-thoracic junction mobilization and the Autogenic muscle energy technique offer enhanced management for mechanical neck pain by improving pain, function, ROM, and cervical proprioception. [ABSTRACT FROM AUTHOR]

Introduction: Osteoarthritis (OA) is a chronic degenerative disabling worldwide disorder in which the knee osteoarthritis range of motion (ROM) is particularly reduced. Mobilization with Movement (MWM) has shown rapid improvements in pain and functions. The muscle energy technique (MET) is claimed to be effective in muscle lengthening, strengthening, and increasing joint ROM. Materials and Methods: A clinical trial was conducted to compare knee Mulligan (lateral, medial, and rotational glides) techniques (n=15), and post-isometric relaxation muscle energy techniques (quadriceps, hamstring, and tensor fascia latae) (n=15) on pain and function in OA. Results: Twenty-two subjects (73.3%) were grade-II of knee OA and 8 subjects (26.7%) with grade III. The visual analogue scale (VAS) showed significant changes in the reduction of pain. In the VAS, the main effect of time of treatment shows that the mean value of the VAS score was statistically significant between at least two assessment stages (before the first session, after the third session, and after a month) (P<0.001) in each group. In knee osteoarthritis outcome score (KOOS), the main effect of time of treatment shows that the mean value of KOOS score is statistically significant in increasing KOOS between at least two assessment stages (before the first session, after the third session, and after a month) (P<0.001) in each group. KOOS showed significant changes for increasing function. Timed up and go (TUG) score showed decremental significant changes in time. In the TUG score, the main effect of time of the treatment shows that the mean value of the TUG score was statistically significant between at least two assessment stages (before the first session, after the third session, and after a month) (P<0.008). In ROM score, the main effect of time of the treatment shows that the mean value of ROM score was statistically significant in increasing ROM between at least two assessment stages (before the first session, after the third session, and after a month) (P<0.002, observed power= 0.927). Conclusion: Applying MWM is more functionally effective than applying the post-isometric relaxation muscle energy technique, both interventions increase functional performance in the short term in patients with chronic knee osteoarthritis, but they are not functionally effective from a single session. Applying both techniques has effects on reducing pain immediately and in the short term. [ABSTRACT FROM AUTHOR]

Background: A therapeutic recommendation for restoring function in individuals with chronic low back pain (CLBP) is manual therapy through manipulative spinal or muscle energy techniques. Objectives: To compare the effectiveness of two osteopathic manipulative techniques on clinical low back symptoms and trunk neuromuscular postural control in male workers with CLBP. Method: Ten male workers with CLBP were randomly allocated to two groups: high-velocity low-amplitude (HVLA) manipulation or muscle energy techniques (MET). Each group received one therapy per week for both techniques during 7 weeks of treatment. Pain and function were measured by using the Numeric Pain-Rating Scale, the McGill Pain Questionnaire and the Roland Morris Disability Questionnaire. The lumbar flexibility was assessed by Modified Schober Test. Electromyography (EMG) and force platform measurements were used for evaluation of trunk muscular activation and postural balance, respectively at three different times: baseline, post intervention, and 15 days later. Results: Both techniques were effective (p < 0.01) in reducing pain with large clinical differences (-1.8 to -2.8) across immediate and after 15 days. However, no significant effect between groups and times was found for other variables, namely neuromuscular activation and postural balance measures. Conclusion: Both techniques (HVLA thrust manipulation and MET) were effective in reducing back pain immediately and 15 days later. Neither technique changed the trunk neuromuscular activation patterns nor postural balance in male workers with LBP. Clinical implications: These results may facilitate clinical decision-making for CLBP management in physiotherapy programs. [ABSTRACT FROM AUTHOR]

Background Low back pain (LBP) is one of the most common reasons for seeking medical care. Manipulative therapies are a common treatment for LBP. Few studies have compared the effectiveness of different types of manipulative therapies. Moreover, the physiologic mechanisms underlying these treatments are not fully understood. Herein, we present the study protocol for The R esearching the E ffectiveness of L umbar I nterventions for E nhancing F unction Study (The RELIEF Study). Methods and study design The RELIEF Study is a Phase II RCT with a nested mechanistic design. It is a single-blinded, sham-controlled study to test the mechanisms and effectiveness of two manual therapy techniques applied to individuals (n = 162; 18–45 years of age) with chronic LBP. The clinical outcome data from the mechanistic component will be pooled across experiments to permit an exploratory Phase II RCT investigating the effectiveness. Participants will be randomized into one of three separate experiments that constitute the mechanistic component to determine the muscular, spinal, and cortical effects of manual therapies. Within each of these experimental groups study participants will be randomly assigned to one of the three treatment arms: 1) spinal manipulation, 2) spinal mobilization, or 3) sham laser therapy. Treatments will be delivered twice per week for 3-weeks. Discussion This data from this will shed light on the mechanisms underlying popular treatments for LBP. Additionally, the coupling of this basic science work in the context of a clinical trial will also permit examination of the clinical efficacy of two different types of manipulative therapies. [ABSTRACT FROM AUTHOR]

How gravity influences neural control of arm movements remains under debate. We tested three alternative interpretations suggested by previous research: (1) that muscular control includes two components, tonic which compensates for gravity and phasic which produces the movement; (2) that there is a tendency to exploit gravity to reduce muscle effort; and (3) that there is a tendency to use a trailing pattern of joint control during which either the shoulder or elbow is rotated actively and the other joint rotates predominantly passively, and to exploit gravity for control of the passively rotated joint. A free-stroke drawing task was performed that required production of center-out strokes within a circle while selecting stroke directions randomly. The circle was positioned in the horizontal, sagittal, and frontal plane. The arm joints freely rotated in space. In each plane, the distribution of the strokes across directions was non-uniform. Directional histograms were built and their peaks were used to identify preferred movement directions. The directional preferences were especially pronounced in the two vertical planes. The upward directions were most preferred. To test the three interpretations, we used a kinetic analysis that determined the role of gravitational torque in the production of movement in the preferred directions. The results supported the third interpretation and provided evidence against the first and second interpretation. The trailing pattern has been associated with reduced neural effort for joint coordination, and therefore, we conclude that the major tendency with respect to gravity is to exploit it for simplification of joint coordination. [ABSTRACT FROM AUTHOR]

It is currently unclear whether the brain plans movement kinematics explicitly or whether movement paths arise implicitly through optimization of a cost function that takes into account control and/or dynamic variables. Several cost functions are proposed in the literature that are very different in nature (e.g., control effort, torque change, and jerk), yet each can predict common movement characteristics. We set out to disentangle predictions of the different variables using a combination of modeling and empirical studies. Subjects performed goal-directed arm movements in a force field (FF) in combination with visual perturbations of seen hand position. This FF was designed to have distinct optimal movements for muscle-input and dynamic costs while leaving kinematic cost unchanged. Visual perturbations in turn changed the kinematic cost but left the dynamic and muscle-input costs unchanged. An optimally controlled, physiologically realistic arm model was used to predict movements under the various cost variables. Experimental results were not consistent with a cost function containing any of the control and dynamic costs investigated. Movement patterns of all experimental conditions were adequately predicted by a kinematic cost function comprising both visually and somatosensory perceived jerk. The present study provides clear behavioral evidence that the brain solves kinematic and mechanical redundancy in separate steps: in a first step, movement kinematics are planned; and in a second, separate step, muscle activation patterns are generated. [ABSTRACT FROM AUTHOR]

Background: Directional preferences during center-out horizontal shoulder-elbow movements were previously established for both the dominant and non-dominant arm with the use of a free-stroke drawing task that required random selection of movement directions. While the preferred directions were mirror-symmetrical in both arms, they were attributed to a tendency specific for the dominant arm to simplify control of interaction torque by actively accelerating one joint and producing largely passive motion at the other joint. No conclusive evidence has been obtained in support of muscle effort minimization as a contributing factor to the directional preferences. Here, we tested whether distal load changes directional preferences, making the influence of muscle effort minimization on the selection of movement direction more apparent. Methods: The free-stroke drawing task was performed by the dominant and non-dominant arm with no load and with 0.454 kg load at the wrist. Motion of each arm was limited to rotation of the shoulder and elbow in the horizontal plane. Directional histograms of strokes produced by the fingertip were calculated to assess directional preferences in each arm and load condition. Possible causes for directional preferences were further investigated by studying optimization across directions of a number of cost functions. Results: Preferences in both arms to move in the diagonal directions were revealed. The previously suggested tendency to actively accelerate one joint and produce passive motion at the other joint was supported in both arms and load conditions. However, the load increased the tendency to produce strokes in the transverse diagonal directions (perpendicular to the forearm orientation) in both arms. Increases in required muscle effort caused by the load suggested that the higher frequency of movements in the transverse directions represented increased influence of muscle effort minimization on the selection of movement direction. This interpretation was supported by cost function optimization results. Conclusions: While without load, the contribution of muscle effort minimization was minor, and therefore, not apparent, the load revealed this contribution by enhancing it. Unlike control of interaction torque, the revealed tendency to minimize muscle effort was independent of arm dominance. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To evaluate plasma amino acid (AA) concentrations in patients affected by fibromyalgia (FM) and to study the relationships between their levels and FM clinical parameters. Design and methods: 20 AAs were assessed in 34 FM patients and in 18 healthy volunteers by means of a modified version of the Waters picotag method. Results: Significant lower plasma taurine, alanine, tyrosine (Tyr), valine, methionine, phenylalanine and threonine concentrations, and the sum of essential AAs were observed in FM patients vs healthy controls (P <0.05). Tyr CAA'' ratio and the sum of AAs competing with tryptophan for brain uptake were significantly reduced in FM (P <0.05). A significant correlation was found between FM clinical parameters and certain AAs. Conclusions: Our results suggest probable defects of gut malabsorption of certain AAs in FM patients. Moreover, given the reduced Tyr CAA'' ratio in FM patients, a possible impairment of the cathecolaminergic system in the FM syndrome may be suggested. [Copyright &y& Elsevier]

The increasingly frequent use of electric drives is a new direction of development in personal transport. Sometimes these drives take over the work of human muscles, and sometimes they only support them. This is particularly evident in means of transport such as bicycles and scooters, but also in transporting people with disabilities. This study questions whether this is the only right development direction, and explores the possibility of developing means of transport for the more effective use of human muscles by proposing new structural solutions. We identified that such an action favors the minimization of the environmental load generated by technical facilities and, at the same time, may be a response to social needs resulting from the principles of sustainable development. This paper presents the operation principle of the innovative Wheelchair Cam-thread Drive (WCD), followed by field tests, laboratory measurements and biomechanical analyses of the WCD, comparing it with a typical Wheelchair Push-rim Drive (WPD). We found that the WCD allows efficient driving on flat and level surfaces, but its propulsion method can adversely alter the location of the center of gravity on the human-wheelchair system. A brake is also required to control the driving speed. Ultimately, the WCD was found to put less strain on the human movement system, so it could be used for rehabilitation exercises. The WCD appears to be a promising design, deserving further research into the drive biomechanics and the optimization of the mechanism operation. Such an innovative manual drive presents an interesting alternative to electric drives. [ABSTRACT FROM AUTHOR]