Search

Background: There is limited knowledge about the possible long‐term effects on jaw motor function after whiplash trauma. Objectives: The primary aim was to evaluate integrated jaw and head–neck movement amplitudes during jaw function in individuals 2 years after whiplash trauma, compared to controls. The secondary aim was to evaluate changes between the acute stage and a 2‐year follow‐up in terms of jaw and head–neck movement amplitudes during jaw function. Methods: This study included 28 cases exposed to a whiplash trauma 2 years earlier (13 women) and 28 controls (13 women) without previous neck trauma. Head and jaw movement amplitudes were recorded during maximal jaw opening–closing movements using an optoelectronic 3D recording system. For a subpopulation of 12 cases and 15 controls, recordings had also been performed in the acute stage after the whiplash trauma. Jaw and head movement amplitudes were analysed using linear regression with group and sex as independent variables. The subpopulation longitudinal analysis was adjusted for movement amplitudes at baseline. Results: Jaw movement amplitudes were significantly associated with group (coefficient: −0.359: 95% CI: −10.70 to −1.93, p =.006) with smaller amplitudes of jaw movements for whiplash cases. Head movement amplitudes were not associated with group (coefficient: −0.051, 95% CI: −4.81 to 3.20, p =.687). In the longitudinal analysis, both jaw and head movement amplitudes showed significant associations between baseline and the 2‐year follow‐up. Conclusion: The present findings indicate that the effects on jaw function in terms of jaw opening capacity in the acute stage after whiplash trauma do not spontaneously recover. [ABSTRACT FROM AUTHOR]

BACKGROUND: Proprioceptive neuromuscular facilitation (PNF) stretching exercises have been widely advocated for the management of patients with different musculoskeletal conditions. However, its effect on the treatment of temporomandibular dysfunction (TMD) in patients with forward head posture (FHP) has not been fully investigated. OBJECTIVE: To investigate the effect of PNF stretching exercises on the treatment of TMD in patients with FHP. METHODS: A prospective, randomized, double-blinded clinical trial. Twenty-four patients with TMD and FHP aged from 18–40 years were randomly assigned to PNF or control group. The PNF group composed of 12 patients received PNF stretching exercises of masticatory muscles in addition to routine physical therapy treatment (FHP correction exercises and ultrasound for the temporomandibular joint); the control group composed of 12 patients received routine physical therapy treatment only. Interventions were conducted twice a week for six weeks. Craniovertebral angle, pain threshold, pain intensity, temporomandibular joint ROM, and temporomandibular joint function were assessed for all participants before and after the intervention. The outcomes were analyzed using Two-way mixed MANOVA. For further multiple comparisons, post-hoc tests with the Bonferroni correction were performed. RESULTS: There was no significant difference between both groups pre-treatment (p > 0.05). Comparison between groups post-treatment revealed statistically significant differences in all outcome measures (p < 0.05) in favor of the PNF group. CONCLUSION: Adding PNF stretching exercises of masticatory muscles to routine physical therapy programs is an effective method for management of TMD in patients with FHP more than routine physical therapy programs alone. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to evaluate whether the application of an interfascial injection with dextrose water could result in reduced pain and improved shoulder function and range of motion. Design: This is a double-blind randomized controlled trial. Thirty-five patients with chronic shoulder pain were randomly assigned to receive either an interfascial injection of 10 mL of 10% dextrose water guided by ultrasound or a sham injection of 0.5 mL of 10% dextrose water into the subcutaneous layer. All patients received education on a home program of self-massage and self-stretching. Shoulder pain, shoulder range of motion, and neck and shoulder function were measured before injection and at 4 and 12 wks after injection. Results: Both groups showed significant improvements in visual analog scale scores at 12-wk follow-up. The interfascial injection group exhibited a significant pain reduction compared with the sham group at the 12-wks follow-up. No between-group differences were observed in shoulder range of motion, pain threshold, and neck and shoulder function. Conclusions: Interfascial injection is effective in decreasing pain in patients with myofascial pain syndrome. [ABSTRACT FROM AUTHOR]

BACKGROUND: People with forward head posture (FHP) and rounded shoulder posture (RSP) may experience shifts in scapular position and alterations in the strength of the muscles surrounding the scapula. Therefore, a reliable scapula position and scapula muscle strength test are required to identified scapula problem and provided appropriate intervention programs. OBJECTIVE: This study aimed to determine the reliability of scapular position measurements obtained using a modified digital inclinometer and palpation meter, as well as muscle strength using a hand-held dynamometer (HHD) in individuals with FHP and RSP. METHODS: Thirty healthy subjects underwent scapular position tests (upward rotation, anterior tilt, depression, and protraction) and strength tests of periscapular muscles (serratus anterior, upper trapezius, middle trapezius, and lower trapezius) on both the dominant and non-dominant sides. The reliability of the measurements was confirmed by computing the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID). Test and re-tests were conducted over a period of one week and actual values for each measurement were also obtained and assessed. RESULTS: The ICC ranged from 0.802 to 0.935 for the scapular position tests and from 0.808 to 0.949 for muscle strength tests on the dominant and non-dominant sides. For scapular position tests, SEM values ranged from 0.3 cm to 0.6 cm (protraction and depression), from 1.0∘ to 1.7∘ (upward rotation and anterior tilt) and MCID values ranged from 0.7 cm to 1.6 cm (protraction and depression), from 2.8∘ to 4.7∘ (upward rotation and anterior tilt). Regarding muscle strength tests, SEM and MCID values were in the range 14.4N–27.3N and 39.9N–75.7N, respectively. CONCLUSIONS: Scapular position and periscapular muscle strength can be reproducibly measured in healthy subjects individuals with FHP and RSP. These instruments can hence be recommended for evaluating these functional traits in subjects with FHP and RSP. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is a lack of information about the optimal setup of multiple screen configurations in virtual reality (VR) office work. OBJECTIVE: The objective of this study was to evaluate the effects of different screen configurations on neck flexion, rotation, neck muscle activity, and simulator sickness symptoms during Virtual Reality (VR) office work. METHODS: Twelve participants (7 males; 21 to 27 years old) performed copy-paste and drag-drop tasks in three different screen configurations (single screen, primary-secondary screen, and double screen) in a randomized order. Optical motion capture system, electromyography (EMG) device, and simulator sickness questionnaire (SSQ) were used to measure the users' responses. RESULTS: Neck rotation angles, muscle activities, and VR sickness were significantly affected by the screen configurations (p < 0.021). The primary-secondary screen showed the highest right rotation angle (median: -33.47°) and left sternocleidomastoid (SCM) muscle activities (median: 12.57% MVC). Both single (median: 22.42) and primary-secondary (median: 22.40) screen showed the highest value of SSQ. CONCLUSIONS: The screen configurations in VR could be an important design factor affecting the users' physical demands of the neck and VR sickness symptoms. Asymmetric neck rotations caused by the primary-secondary screen conditions should be avoided. [ABSTRACT FROM AUTHOR]

Context: Neuromobilization exercises (NE) could be a useful therapeutic tool to induce analgesia and increase function and range of motion (ROM) in patients with musculoskeletal pathologies with neuropathic components; however, the effectiveness of this intervention in patients with cervical radiculopathy (CR) is unknown. Objective: To determine the effectiveness of NE in CR on pain, function, and ROM. Design: Systematic review and meta-analysis. Evidence acquisition: An electronic search was performed in the MEDLINE, Scopus, PEDro, and EBSCO databases from inception until June 2022. The authors included randomized clinical trials that evaluated the effectiveness of NE against control groups or other interventions that aimed to treat patients with CR. Evidence synthesis: Seven clinical trials met the eligibility criteria, and for the quantitative synthesis, 5 studies were included. For the studies that compared NE with a control group, the standardized mean difference for pain was -1.33/10 (95% confidence interval [CI], -1.80 to -0.86; P < .01; I2 = 0%), for function with the Neck Disability Index was -1.21/50 (95% CI, -1.67 to -0.75; P < .01; I2 = 0%), and for neck flexion and extensions was 0.66 (95% CI, 0.23 to 1.10; P < .01; I2 = 0%) and 0.47 (95% CI, 0.04 to 0.90; P < .01; I2 = 0%), respectively, with evidence of clinical effectiveness. These findings were based on moderate-quality evidence according to the Grading of Recommendation, Assessment, Development, and Evaluation rating. In studies that compared NE with other interventions, the meta-analysis failed to demonstrate the statistical or clinical superiority of NE. Conclusions: Moderate quality of evidence suggests that NE may be superior to no treatment for pain, function, and ROM in patients with CR. In contrast, NE are not superior to other interventions in the same outcomes, based on low- to very low-quality evidence. More high-quality research is needed to assess the consistency of these results. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the clinical efficacy of minimally invasive endoscopic treatment of children with congenital muscular torticollis (CMT). Methods: In total, 72 children (41 male, 31 female) with CMT who underwent endoscopic surgery at the Department of Orthopedics, Xi'an Children's Hospital, between January 2021 and January 2023 were included. Their mean age was 54 ± 36.1 (range, 12–141) months. Of these, 29 (40.3%) cases involved the left side while 43 (59.7%) involved the right side. Preoperative preparation involved precise body surface markings of the sternocleidomastoid muscle(SCM), clavicle, and important nerve and blood vessels, followed by the establishment of surgical channels through passive separation techniques. An arthroscope and a low-temperature plasma knife were utilized for accurate localization and surgical release of the clavicular and sternal heads of the SCM. The duration of surgery, blood loss, postoperative hospital stay, neck range of motion measurements, and any intraoperative or postoperative complications were analyzed using the rank sum test. Cervical and thoracic braces were applied for three months postoperatively, with follow-up assessments conducted using Cheng's scoring system. Results: All patients successfully underwent endoscopic surgery, without the need for conversion to open surgery. No intra- or postoperative complications were observed. The average surgical duration was 56.4 ± 15.7 min, with minimal intraoperative bleeding (1–5 mL) and no need for blood transfusion. The mean postoperative hospital stay was 2.7 ± 0.8 days. Over a mean follow-up period of 22.2 ± 5.5 (range, 14–32) months, significant improvements were observed in neck rotation (from 20.2° [17.7° to 25°] to only 3.6° [2° to 6.7°]) and lateral flexion (from 19° [17° to 22.6°] to only 3° [2° to 7.8°]) restrictions (p < 0.05). According to Cheng's scoring system, 70 (97.2%) patients achieved excellent or good clinical outcomes, while 2 (2.8%) had average outcomes. The torticollis deformity was corrected during the follow-up period, and all surgical incisions healed without noticeable scarring. Conclusion: Endoscopic release is a safe, effective, and minimally invasive treatment option for CMT in children. [ABSTRACT FROM AUTHOR]

Medical provider's ability to detect, diagnose, and treat sport-related concussion has greatly improved in recent years. Although more is known about the biomechanical forces involved in concussion, it is still uncertain whether there are preventative measures athletes can take to prevent a sport-related concussion from occurring. The objective of this review was to determine if either neck size or neck strength is related to a decreased risk of sustaining a sport-related concussion. A literature review was conducted on Google Scholar and Ovid MEDLINE for pertinent articles. Findings indicate that isometric neck strength, but not neck size, has been shown to be a predictor for sport-related concussion prevention. Formal neck strengthening programs are feasible and lead to decreased sport-related concussion risk. Additionally, there may be greater opportunity to increase neck strength in amateur athletes compared to professional. In conclusion, cervical strengthening programs have been shown to be feasible and beneficial for athletes to decrease their risk of sustaining a sport-related concussion, though the optimal duration, intensity, and frequency has yet to be determined. [ABSTRACT FROM AUTHOR]

A common cause of traumatic brain injuries (TBIs) is the head’s kinematic response to rapid movement, which can be reduced with dynamic neck strengthening. This study aimed to determine the most effective neck-strengthening program by comparing a traditional and nontraditional program. Isometric neck strength was assessed in 32 subjects randomly assigned to one of the traditional and nontraditional neck-strengthening programs. The nontraditional program used a novel neck-strengthening device. After weeks 6 and 10 of training, isometric neck strength was reassessed. With the collected data, linear mixed models were established to compare the changes in neck strength between the 2 groups during the 10-week training period. Statistical analysis results suggest that, for both cervical extension (CE) and cervical flexion (CF), subjects in the novel neck-strengthening device group had a significantly higher gain of strength during the 10 weeks than the traditional group. With test statistics of 22.691 and 23.203 and corresponding 2-sided p-value of 0.01289 and 0.003889, respectively, we conclude that there is a statistically significant difference in the linear slopes of increase for both CE and CF between the 2 groups. As to left cervical lateral flexion and right cervical lateral flexion, the novel neck strength group had increased strength gains compared with the traditional group. However, the increase was not enough to demonstrate significant findings. Results were considered significant at p, 0.05. The results of this study show that the novel neck-strengthening device may be an effective mechanism for preventing mild TBIs. [ABSTRACT FROM AUTHOR]

Background: Head-down tackling has been associated with higher rates of head and neck injuries and less successful tackles compared with head-up tackling in American football. In rugby, head and neck injuries have been associated with tackling, with the tackler's head positioned in front of the ball carrier. Purpose: To assess the success and risks of tackling techniques used in the English Rugby Premiership matches. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Three reviewers analyzed 1000 consecutive solo defensive tackling attempts during the 2022 to 2023 season in 6 English Rugby Premiership matches. Slow-motion replays were used to analyze the success of the tackling attempt in terms of head angulation (head up vs head down), head position relative to the offensive player's waist at point of contact, and tackling method (inside shoulder, arm, head across the bow, and head-to-head). The chi-square test or Fisher exact test was used to analyze categorical data, and the 2-tailed Student t test or the Mann-Whitney U test was used to analyze continuous data. Results: The mean interrater reliabilities for analyzing the tackles were good across all groups (κ = 0.715). Head-up and head-down tackling occurred in 848 tackle attempts (84.8%) and 152 tackle attempts (15.2%), respectively. Head-up tackles were successful in 80.7% of the tackle attempts compared with 71.1% of the head-down tackle attempts (P =.0072). Tackles made at or above the waist were successful in 80.7% of the tackle attempts compared with 73.1% of tackles below the waist (P =.0193). The inside-shoulder technique had the highest successful tackle rate at 90.8%, compared with 44.2% with the arm technique (P <.0001) and 72.4% with the head-across-the-bow technique (P <.0001). The inside-shoulder technique resulted in head-up tackling in 84.8% of players compared with 59.8% with the head-across-the-bow technique (P <.0001) and 94.9% with arm tackling (P =.0001). There were 4 recorded injuries to the tackler: 2 neck injuries, 1 shoulder injury, and 1 wrist/hand injury. Conclusion: Head-up tackling, tackles made at or above the level of the offensive player's waist, and inside-shoulder tackling were found to be more efficient in producing successful tackles. The head-down, tackling below the waist, and head-across-the-bow techniques were associated with poor tackling and lower success rates. [ABSTRACT FROM AUTHOR]

Background: A 19-month old male was presented for chiropractic care with his mother noting concerns about his emotional state. He was constantly agitated and emotional, and the mother also reported he had issues with moods and reactions, sleep, head shape (asymmetry), poor neck movement and position, difficulties with digestion and feeding, as well as some difficulties with crawling and walking. Intervention: The patient was placed on a course of chiropractic care during which he was adjusted using Diversified Technique, with hands-on adjusting using Manual adjusting and Activator methods. Tonal checks, Logan technique, and Cranial work were also utilised. Outcomes: Significant improvements in the patient's subluxation listings were noted alongside massive changes in his affect and ability to engage with life. His parents described him as "a completely different child." Spinal range of motion, digestion, head symmetry and other secondary concerns also improved significantly. Conclusion: This case report has significant linkages to supporting vagal tone in paediatric patients, and supporting neurodevelopment and co-regulation through subluxation-based care and supporting exercises. [ABSTRACT FROM AUTHOR]

This study recruited 30 young participants (15 men and 15 women) to examine the smartphone usage patterns in three postures (standing, supported sitting, and unsupported sitting) and at five head angle (HA) positions (0°-40°). Cervical erector spinae (CES) and upper trapezius (UTZ) muscle activity, neck flexion (NF), gaze angle (GA), viewing distance (VD), and discomfort scores were collected. Results showed that HA and posture almost affected all responses, while CES muscle activity, NF, and VD differed between sexes. Strain in the neck and shoulder region increased with HA increase. Particularly, when the HA exceeded 20°, the discomfort scores considerably increased. Unsupported sitting should be avoided during smartphone use because of relatively poor responses in all variables. However, both standing and supported sitting have their respective benefits. Sex-related differences were typically observed in the standing position, with women tending to have lower NF but higher CES muscle activity compared with men. Practitioner summary: Although smartphones have become daily necessities, the overall quantitative neck and shoulder strain of using smartphones in different postures is rarely evaluated. We suggest that maintaining the HA within 20° is recommended because of relatively low load on the neck and shoulders. An unsupported sitting should be avoided during smartphone use. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to examine the associations of 24-h movement behaviors (moderate to vigorous physical activity [MVPA], light physical activity [LPA], sedentary behavior [SB], and sleep) with age-, sex-, and race-specific a real bone mineral density (aBMD) z-score parameters at clinical sites in young pediatric cancer survivors. Methods: This cross-sectional multicenter study was carried out within the iBoneFIT framework in which 116 young pediatric cancer survivors (12.1 ± 3.3 yr old; 42%female) were recruited. We obtained anthropometric and body composition data (i.e., body mass, stature, body mass index, and region-specific lean mass), time spent in movement behaviors over at least seven consecutive 24-h periods (wGT3x-BT accelerometer, ActiGraph), and aBMD z-score parameters (age-, sex-, and race-specific total at the body, total hip, femoral neck and lumbar spine). Survivors were classified according to somatic maturity (pre or peri/postpubertal depending on the estimated years from peak height velocity). The adjusted models' coefficients were used to predict the effect of reallocating time proportionally across behaviors on the outcomes. Results: In prepubertal young pediatric cancer survivors, reallocating time to MVPA from LPA, SB, and sleep was significantly associated with higher aBMD at total body (B = 1.765, P = 0.005), total hip (B = 1.709, P = 0.003), and lumbar spine (B = 2.093, P = 0.001). In peri/postpubertal survivors, reallocating time to LPA from MVPA, SB, and sleep was significantly associated with higher aBMD at all sites (B = 2.090 to 2.609, P = 0.003 to 0.038). Reallocating time to SB from MVPA or LPA was significantly associated with lower aBMD atmost sites in prepubertal and peri/postpubertal survivors, respectively. Finally, reallocating time to sleep from MVPA, LPA, and SB was significantly associated with lower aBMD at total body (B = -2.572, P = 0.036) and total hip (B = -3.371, P = 0.015). Conclusions: These findings suggest that every move counts and underline the benefits of increasing MVPA or LPA, when low MVPA levels are present, for bone regeneration after pediatric cancer treatment completion. [ABSTRACT FROM AUTHOR]

The neurocognitive health effects of repetitive head impacts have been examined in many sports. However, characterizations of head impacts for sliding-sport athletes are lacking. To describe head impact kinematics and injury epidemiology in elite athletes during the 2021–2022 Bobsleigh World Cup season. Cross-sectional study. On-track training and competitions during the Bobsleigh World Cup season. Twelve elite bobsleigh athletes (3 pilots [1 female], 9 push athletes [5 females]; age = 30 ± 5 years; female height and weight = 173 ± 8 cm and 75 ± 5 kg, respectively; male height and weight = 183 ± 5 cm and 101 ± 5 kg, respectively). Athletes wore an accelerometer-enabled mouthguard to quantify 6-degrees-of-freedom head impact kinematics. Isometric absolute and relative neck strength, number of head acceleration events (HAEs), workload (J), peak linear velocity (m·s−1), peak angular velocity (rad·s−1), peak linear acceleration (g), and peak angular acceleration (rad·s−2) were derived from mouthguard manufacturer algorithms. Linear mixed-effect models tested the effects of sex (male versus female), setting (training versus competition), and position (pilot versus push athlete) on the kinematic variables. A total of 1900 HAEs were recorded over 48 training and 53 competition days. No differences were found between the number of HAEs per run per athlete by sex (incidence rate ratio [IRR] = 0.82, P =.741), setting (IRR = 0.94, P =.325), or position (IRR = 1.64, P =.463). No sex differences were observed for workload (mean ± SD: males = 3.3 ± 2.2 J, females = 3.1 ± 1.9 J; P =.646), peak linear velocity (males = 1.1 ± 0.3 m·s−1, females = 1.1 ± 0.3 m·s−1; P =.706), peak angular velocity (males = 4.2 ± 2.1 rad·s−1, females = 4.7 ± 2.5 rad·s−1; P =.220), peak linear acceleration (male = 12.4 ± 3.9g, females = 11.9 ± 3.5g; P =.772), or peak angular acceleration (males = 610 ± 353 rad·s−2, females = 680 ± 423 rad·s−2; P =.547). Also, no effects of setting or position on any kinematic variables were seen. Male athletes had greater peak neck strength than female athletes for all neck movements, aside from right-side flexion (P =.085), but no sex differences were noted in relative neck strength. We provide a foundational understanding of the repetitive HAEs that occur in bobsleigh athletes. Future authors should determine the effects of repetitive head impacts on neurocognitive function and mental health. [ABSTRACT FROM AUTHOR]

BACKGROUND: Physical and psychosocial demands (e.g., serving, cleaning, fulfilling orders) can lead to work-related musculoskeletal pain (WRMSP). OBJECTIVE: To assess the prevalence of WRMSP in the upper quadrant and lower back among skilled male Arab waiters; to evaluate the disability related to WRMSP; to evaluate the association between work demands and WRMSP with related disability. METHODS: 100 skilled male Arab waiters working full-time, aged 18–60, participated in the cross-sectional study. Participants completed basic demographics and working conditions; the NDI; QuickDASH; the OswestryQ; workload, burnout, and job satisfaction at work; the adjusted NordicQ; and the TaskQ, compiled especially for this study. RESULTS: A 12-month pain prevalence, pain frequency, and work avoidance were high: neck- 42%, 60.5%, 89.5%; shoulders –53%, 78.2%, 94.4%; elbows- 46%, 78.6%, 83.3%; lower back- 45%, 44%, 78.7%, respectively. Pain prevalence in at least one site was 83%. The OswestryQ, QuickDASH, and NDI revealed mild-moderate pain and disability (14.85/50, 25.54/75, 13.74/50, respectively). Burnout score was positively associated with OswestryQ, QuickDASH, and NDI. Job satisfaction was negatively associated with 12 months of pain in the lower back, hands, arms, shoulders, and hands (NordicQ). TaskQ was positively associated with OswestryQ. CONCLUSION: Male Arab waiters who work in physically and psychologically challenging conditions report high levels of WRMSP with a high frequency and related work avoidance. Many of them must keep their jobs as they are their families' primary or sole providers. It is possible that they are trying to prevent more severe disabilities in the future by ensuring temporary rest and pain prevention. [ABSTRACT FROM AUTHOR]

Objectives: Schwannoma arising from cervical sympathetic chain (CSC) is a rare clinical entity. CSC is hard to preserve in CSC schwannoma (CSCS) surgeries, resulting in Horner's syndrome (HS) and first bite syndrome (FBS). This article aims to explore our experience in successful preservation of CSC in CSCS surgeries. Methods: This is a retrospective review of CSCS cases treated at our tertiary medical institution between Apr 2018 and March 2022. Only cases with successful intraoperative preservation of CSC were included. Results: In total, 3 cases were included. There were 2 male patients and 1 female patient. Their age was between 38 years old and 66 years old (average and median age was 52 and 51 years old, respectively). Presenting symptom was neck mass for all them, 2 of which were on the left side, while 1 was on the right. Intracapsular enucleation of the CSCS was attempted and achieved in all 3 cases. Hemorrhage from the inner surface of capsules was diffuse and heavy. Constant saline irrigation, suction, and bipolar coagulation were needed to achieve hemostasis. Postoperative HS presented between 4 hours and 14 hours after surgery for all 3 patients, which took 1 month to 3 months to recover, whereas FBS did not occur in any patient. Median duration of follow-up was 6 months. No recurrence was observed. Conclusions: Intracapsular enucleation should be attempted in CSCS surgeries, although hemorrhage might be diffuse and hard to control. When intracapsular enucleation was achieved, postoperative FBS can be avoided, while postoperative HS could occur, but its recovery was satisfactory. [ABSTRACT FROM AUTHOR]

The high levels of musculoskeletal pain, in conjunction with the low levels of functional capacity, may negatively affect workers' health, efficiency, and productivity. This randomized controlled study investigated the efficacy of a 6-month comprehensive workplace exercise program on musculoskeletal pain and functional capacity in office workers. Seventy male and female office workers with musculoskeletal pain in any body area were randomly assigned to either an intervention (IG; n = 35) or a control group (CG; n = 35). The IG participated every working day (during working hours) in a 6-month supervised combined (flexibility, strength, and balance) exercise program (120 training sessions; five times/week) for the total body. The CG did not participate in any intervention. Musculoskeletal pains in nine body areas and functional capacity (flexibility, balance, and strength) of the lower and upper body were measured before and following the intervention. The IG significantly reduced duration and intensity of pain (43.1–70%; p = 0.000) as well as days of work absenteeism (84.6%; p = 0.000), while improving work capacity (87.1%; p = 0.000). Furthermore, the IG significantly increased cervical, handgrip, back, and leg maximal strength (10.3–27.1%; p = 0.000) and flexibility and balance (12.3–73.7%; p = 0.000). In CG, all musculoskeletal pain and functional capacity indices remained unchanged. In conclusion, this program may be effectively used to reduce musculoskeletal pain and improve functional capacity. [ABSTRACT FROM AUTHOR]

Background: The main cause of anesthesia-related deaths is the failure to manage difficult airways. Difficult laryngoscopic exposure is a major cause of unsuccessful management of difficult airways. Inadequate preoperative airway assessment hinders the clinical management of difficult airways cases, emphasizing the critical need for accurate identification of difficult airways. Currently, no definitive and reliable indicators are available to predict a difficult airway. Our study aims to predict laryngoscope exposure risk factors by combining ultrasonically measured upper airway anatomic parameters with physical examination indicators. Methods: Patients aged 18 to 75 years, classified as American Standards Association (ASA) I-III, and scheduled for elective general anesthesia with endotracheal intubation were included. All patients received the upper airway and ultrasonographic measurements. After anesthesia induction, laryngoscope exposure was analyzed using the Cormack-Lehane grading system, with Grades III and IV as indicative of difficult laryngoscopy. Univariate and multivariate logistic regression analyses were performed to identify reliable indicators for predicting difficult laryngoscopy. Receiver Operating Characteristic (ROC) curve analysis was utilized to assess the predictive performance of each indicator. Results: A total of 1120 patients finished the study, with 710 cases found in Grade I laryngoscopic exposure group, 360 cases in Grade II group, and 50 cases in Grade III group. There was no case observed in Grade IV group, thereby resulting in an incidence of difficult laryngoscopy of 4.46%. Univariate logistic regression analysis revealed that several parameters including age, Body Mass Index (BMI), neck circumference, neck mobility, snoring intensity, as well as ultrasound measurements of the pre-epiglottic space and thyromental distance were identified as significant risk factors for difficult laryngoscopy (P < 0.05). Among these, BMI, and neck circumference exhibited notable predictive value, with Area Under The Curve (AUC) values of 0.746 (95%CI 0.649–0.842) and 0.732 (95%CI 0.638–0.827), respectively. Neck mobility was also identified as an independent risk factor for predicting difficult laryngoscopy (P = 0.009) in multivariate logistic regression analysis, with an AUC of 0.672 (0.562–0.782) in the ROC curve. Conclusions: Our findings revealed a direct correlation between difficult laryngoscopy and age, BMI, neck circumference, neck mobility, snoring intensity, as well as ultrasound measurements of the pre-epiglottic space and thyromental distance. Furthermore, neck mobility was identified as an independent predictive factor. Trial registration: The trial was registered prior to patient enrollment at clinicaltrials.gov (register no. ChiCTR2100053826, Date of registration: November 30, 2021). [ABSTRACT FROM AUTHOR]

Background: The relationship between different surgical treatments and quality of life remains uncertain for differentiated thyroid carcinoma (DTC). The aim of this study is to compare the gasless endoscopic thyroidectomy trans-axillary approach (ET) and traditional open thyroidectomy (OT) through a prospective cohort study focusing on the rate of the efficacy, and quality of life (QoL). Methods: This prospective observational longitudinal cohort study enrolled 134 female patients diagnosed with DTC from December 01/2021 to December 31/2022. Multiple scales were applicated to evaluate the differences in quality of life, effectiveness, safety, etc. between the two groups during preoperative and postoperative follow-up periods, including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, version 3.0 (QOL-C30), Symptom Checklist (SCL-90), Scar Cosmesis Assessment and Rating (SCAR-Q), voice impairment score (VIS), swallowing impairment score (SIS), and neck impairment score (NIS). Results: Among them, 68 accepted ET and 66 patients underwent OT. To enhance comparability between the two groups, the patients enrolled in this study are female. Compared with the OT group, the ET group performed significantly better postoperative physical quality of life, including sound (p = 0.036), swallowing (p < 0.001), and neck function (p = 0.010). The ET group was also associated with significantly better cosmetic satisfaction (p < 0.001), and relatively faster recovery in psychological and emotional situation. Conclusions: Gasless endoscopic thyroidectomy through an axillary approach leads to good cosmetic and psychological effects, improves postoperative QoL, and could be recommended for rapid postoperative recovery and involvement in daily and social activities. [ABSTRACT FROM AUTHOR]

Cervical muscle strength has been demonstrated to reduce concussion risk in high school athletes, and interventions to improve this in male rugby players have elicited strength improvements. However, the feasibility of introducing neck‐strengthening interventions into women's rugby has not been investigated. This study sought to pilot a neck‐strength intervention in university‐level women's rugby players. A fixed‐frame dynamometer was used to assess the multi‐directional isometric neck‐strength of 14 university women's rugby players (20.3 ± 1.0 years). Between baseline and end‐of‐season testing, a neck‐strengthening program was completed. Interviews were conducted with six players and two coaches to understand program engagement. Interviews were transcribed verbatim and processed via inductive content analysis. Increases in absolute neck‐strength post‐intervention in left and right lateral flexion (left 85.4 ± 29.7 N to 108.2 ± 41.6 N, p = 0.02, right 87.4 ± 33.3 N to 110.5 ± 40.3 N, p = 0.01) and flexion (128.4 ± 28.8 N to 147.9 ± 30.5 N, p = 0.01) were perceived positively by the players although there were suggestions that greater adaptability according to training age and more variety was required. Participants initially demonstrated limited awareness of neck‐strength training but engaged well with the exercises once the potential benefits were understood. This intervention shows promise as an effective, palatable strategy to improve neck‐strength in university women's rugby players. Further research is needed to establish whether such improvements in neck‐strength are associated with meaningful reductions in head impact occurrence. Highlights: Neck‐strength training has proved an effective strategy for reducing concussion incidence in high‐school and elite male populations but is yet to be investigated in females.A neck‐strengthening intervention was introduced in a team of university women's rugby players, who were later interviewed to understand their experiences of the intervention.Multi‐directional neck‐strength was tested via an Isometric Neck‐Strength Testing Apparatus, purpose‐built to mimic the scrum position associated with rugby.Improvements to neck‐strength reached significance in flexion and lateral flexion strength, and the intervention was received positively by players and coaches. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background The paucity in round-the-clock availability of advanced tools like flexible bronchoscopes and video laryngoscopes makes it preferable to have alternative easily available gadgets for securing the airway in patients with cervical spine injuries where head and neck movements must be strictly avoided. This study compared the paraglossal technique of Miller blade insertion with the McCoy and Macintosh laryngoscope blades on the Cormack and Lehane grading (CLG) in patients with simulated restricted neck mobility. Methods We randomized 90 patients undergoing general anesthesia to be intubated either using Miller blade (Group-Mill), McCoy blade (Group-McCoy), or Macintosh blade (Group-Mac) following neck restriction using a soft cervical collar. CLG grade, the number of intubation attempts, use of bougie, intubation time, and hemodynamic parameters were noted. Nonparametric data were compared using the chi-squared test and parametric data using one-way analysis of variance. Results Group-MILL had significantly higher patients with Grade-1 CLG compared to Group-Mac (p = 0.02). The number of attempts, use of bougie, and intubation time were, however, comparable among the three groups. The hemodynamic parameters at intubation were not significantly different among the groups. Conclusion In adult patients with simulated restricted neck, the Miller laryngoscope blade, despite providing a better laryngeal view, showed no benefit in decreasing the intubation time when compared to the McCoy or Macintosh blades. [ABSTRACT FROM AUTHOR]

Cultural adaptation to Henry Ford Hospital Headache Disability Inventory (HDI) and investigating the validity and reliability of this inventory. International standards were followed in conducting the cultural adaption of Henry Ford Hospital Headache Disability Inventory Turkish version (HDI-T). Test-Retest reliability (intraclass correlation coefficient, ICC) and internal consistency (Cronbach's alpha) were included in the psychometric assessments; Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the structural validity; and construct validity was performed by examining relationship the HDI-T between the Headache Impact Test-6 (HIT- 6), Neck Disability Index (NDI), Perceived Stress Scale-14 (PSS-14), and Nottingham Health Profile (NHP). HDI-T showed excellent test-retest reliability (ICC =0.901), excellent internal consistency (Cronbach's a = 0.935), and low to high correlation with Headache Impact Test-6 (HIT-6), Neck Disability Index (NDI), Perceived Stress Scale-14 (PSS-14) and Nottingham Health Profile (NHP). Following EFA, two factors (emotional and functional) were extracted, accounting for 50.734% of the total variation. The dimensional structure of the HDI-T obtained in the EFA was confirmed by CFA. The HDI-T is a reliable and valid instrument to determine the symptoms and disability in the Turkish population with cervicogenic headaches. Henry Ford Hospital Headache Disability Inventory Turkish version (HDI-T) is an outcome measure with high validity and reliability to obtain objective data in the determination of disability due to cervicogenic headache. HDI-T is recommended for all rehabilitation professionals to evaluate both the disability levels before rehabilitation and the changes during the rehabilitation process in patients with cervicogenic headaches in the Turkish population. Physiotherapists, orthopedists and neurosurgeons can also use HDI-T to objectively evaluate the secondary effects of their treatment for neck problems. [ABSTRACT FROM AUTHOR]

Background: Prevention of pitching-related elbow pain in youth baseball players is important. Overhead pitching involves a whole-body motion, including head-neck rotation. A limited range of motion of head-neck rotation may cause inefficient pitching motion; however, this association is unclear. Purpose: To determine whether the range of motion of head-neck rotation is associated with the history of pitching-related elbow pain in youth baseball players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 311 youth baseball players were selected and asked to complete a questionnaire survey about their age, weight, height, sex, baseball experience, main position, pitching side, and previous/current elbow pain during pitching. The range of motion of the upper and lower limb joints, head-neck rotation, and thoracic kyphosis angle were measured. Binomial logistic regression analysis was used to identify factors associated with the history of elbow pain related to pitching. Results: There were 101 players with a history of pitching-related elbow pain (history group) and 142 players with no pitching-related elbow pain (no-history group). The history group had significantly lower values than the no-history group regarding the range of motion of head-neck rotation on the nondominant side (74.9°± 9° vs 77.7°± 9.6°; P =.02) and overall head-neck rotation (150.6°± 14.7° vs 154.9°± 18.4°; P =.04). Binomial logistic regression analysis identified head-neck rotation on the nondominant side (odds ratio [OR], 0.97 [95% CI, 0.94-1.00]), shoulder horizontal adduction on the dominant side (OR, 0.98 [95% CI, 0.96-1.00]), height (OR, 1.04 [95% CI, 1.00-1.08]), and playing position (pitcher) (OR, 0.40 [95% CI, 0.21-0.76]) as factors associated with a history of pitching-related elbow pain. Conclusion: Our cross-sectional analysis demonstrated that youth baseball players with a history of pitching-related elbow pain had limited head-neck rotation range of motion on the nondominant side, and this was a significant factor associated with the history of pitching-related elbow pain. [ABSTRACT FROM AUTHOR]

Background: The development of osteophytes and the involvement of adjacent soft tissue structures are the initial indications of degenerative changes in the intervertebral discs in cervical spondylitis. Forward head posture also has an effect on the muscles at the head and shoulders, which aggravates postural deformity. Purpose: The purpose is to determine Efficacy of cervical thoracic spine correction exercises in reducing pain and improving neck posture in people with cervical spondylitis. Methods: This experimental study has been conducted from December 2022 to April 2023. Patients willing to participate in the study were screened for inclusion and exclusion criteria. The total number of subjects (30) were taken from Sai charan physio clinic and they are divided into 15 subjects for the experimental group, they are given cervical thoracic spine correction exercises with ultrasound. The control group consisting of 15 subjects, are isometric exercises with ultrasound. NPRS and Neck disability index are used as outcome measures. The treatments were given for 5 days per week and continued for 2 weeks. Results: From statistical analysis made with the quantitative data revealed statistically significant differences between the Group A and Group B, with the P value of <0.0001. Thus, the experimental group has higher statistical differences than the conventional group. Conclusion: According to the findings of this study, Cervical thoracic spine correction exercises in the experimental group were found to be more beneficial than isometric exercises in conventional groups in lowering pain and leading to faster recovery in participants with forward neck posture. [ABSTRACT FROM AUTHOR]

Background: This study was designed to inspect the effectiveness of Dry needling and interferential therapy on cervical radiculopathy patients. Purpose: To compare the effectiveness of dry needling and interferential therapy in patients with cervical radiculopathy. Materials and methods: It is an experimental study from November 2022 to April 2023. In this study, 30 subjects were allocated randomly using a randomization method (computer-generated random numbers) according to inclusion and exclusion criteria. Group A was allocated for interferential therapy with neck exercise (n=15) and Group B was allocated for dry needling with neck exercise (n =15). Outcome measures are NPRS (Numerical pain rating scale), Goniometer. Informed consent was obtained from the patient. Result: From the statistical analysis, both groups showed extremely satisfied statistical significance between their pre- and post-test values (p<0.0001) Also, there is a significant difference in the post-test values of both groups (p<0.0001) which denotes that dry needling therapy with neck exercises values are higher than the IFT with neck exercises values for reducing pain and increasing ROM of cervical joint for cervical radiculopathy. Conclusion: In this study, Dry needling with Neck exercise activities was found to be more beneficial than IFT with neck exercise in reducing cervical pain and increasing ROM. [ABSTRACT FROM AUTHOR]

Background: In the pediatric population, tracheostomy is most common to provide good ventilator support, and that too is most commonly performed in the infant population. Tracheostomy is frequently associated with devices such as ventilators, which can further interrupt the neck motion and this in turn, may also affect the gross motor development. Purpose: To determine the effectiveness of early intervention in post-tracheostomy infants with developmental delays. Materials and Methods: A randomized control trial was conducted with a total of 20 tracheostomy infants with a mean age of 2 months. Subjects were randomized into the early intervention group (n = 10) and the conventional group (n = 10). Both groups were treated with routine chest care in the Pediatric Intensive Care Unit. In addition, the early intervention group included neck postural and movement activities for 20 minutes per day for 5 days for 4 weeks. Results: One outcome concentrated on neck control by using a clinical rating scale for head control (HCS), and another outcome concentrated on gross motor milestones (lying and rolling components) by using the Gross Motor Functional Measure (GMFM-88). Both groups were similar at baseline, with a p-value of 0.8493 in HCS and 0.56866 in GMFM. Following improvement in head control, the GMFM score improves from 29% to 74% in the conventional group. Early intervention groups progressed from 25% to 89%. Conclusion: Early intervention programs concentrated on post-tracheostomy infants showed significant improvement in the development of neck control and rolling. And organized head movement in space was noted when compared to conventional groups. [ABSTRACT FROM AUTHOR]

Background: Chronic neck pain is known to be caused by the weakness of the deep neck flexors and disturbances in the mechanoreceptors and the proprioceptors of the cervical spine. Proprioceptive neuromuscular facilitation (PNF) is hypothesized to balance the relative stiffness and weakness of the muscles and activate the mechanoreceptors and proprioceptors. Objective: To investigate PNF techniques and the craniocervical flexor training (CCFT) techniques for pain and function in chronic neck pain. Methods: A randomized clinical trial was conducted on 66 chronic mechanical neck pain patients randomly assigned to either the PNF or CCFT groups using block randomization for a duration of 4 weeks. Numerical Pain Rating Scale (NPRS), Neck disability Index (NDI) and Active cervical range of motion (ACROM) were measured at baseline and after 4 weeks of intervention. Data were analysed using independent t test and MANOVA. Results: The mean difference scores for NPRS and NDI were 2.18 and 15.72 in PNF group and 2.26 and 15.76 in the CCFT groups, respectively. Both the groups showed a change that was statistically significant. Also, the mean differences for the ACROM in all the planes in both the groups were statistically significant. However, the between group changes did not reveal any statistical significance in this study except for the right rotation in the CCFT group (p = 0.01). Conclusions: This study concluded that the PNF treatment is also beneficial to pain and function in treating chronic mechanical neck pain patients as its results stand similar to the CCFT treatment, which is already established to be a reliable tool to treat this condition. [ABSTRACT FROM AUTHOR]

The objective was to examine the efficacy of the Get aHEAD Safely in Soccer™ intervention on head impact kinematics and neck strength in female youth soccer players. The control group (CG) consisted of 13 players (age: 11.0 ± 0.4 yrs), while the experimental group (EG) consisted of 14 players (age: 10.6 ± 0.5 yrs). Head impact kinematics included peak linear acceleration (PLA), peak rotational acceleration (PRA), and peak rotational velocity (PRV). Pre- and post-season measures included strength measures of neck/torso flexion (NF/TF) and extension (NE/TE). Data were analysed using a multilevel linear model and ANOVA techniques. No differences in PLA, PRA, or PRV were observed between groups. The EG showed significant improvement in NF strength while the CG showed significant improvement in NE strength. Both groups significantly improved in TF pre- to post-season. The foundational strength components of the Get aHEAD Safely in Soccer program appear to show a benefit in youth soccer players beginning to learn the skill of purposeful heading. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to determine the restoration of hip biomechanics through lateral offset, leg length, and acetabular component position when comparing non-arthroplasty surgeons (NAS) to elective arthroplasty surgeons (EAS). Methods: 131 patients, with a femoral neck fracture treated with a THA by 7 EAS and 20 NAS, were retrospectively reviewed. 2 blinded observers measured leg-length discrepancy, femoral offset, and acetabular component position. Multivariate logistic regression models examined the association between the surgeon groups and restoration of lateral femoral, acetabular offset, leg length discrepancy, acetabular anteversion, acetabular position, and component size, while adjusting for surgical approach and spinal pathology. Results: NAS under-restored 4.8 mm of lateral femoral offset (43.9 ± 8.7 mm) after THA when compared to the uninjured side (48.7 ± 7.1 mm, p = 0.044). NAS were at risk for under-restoring lateral femoral offset when compared to EAS (p = 0.040). There was no association between lateral acetabular offset, leg length, acetabular position, or component size and surgeon type. Conclusions: Lateral femoral offset is at risk for under-restoration after THA for femoral neck fractures, when performed by surgeons that do not regularly perform elective THA. This indicates that lateral femoral offset is an under-appreciated contributor to hip instability when performing THA for a femoral neck fracture. Lateral femoral offset deserves as much attention and awareness as acetabular component position since a secondary analysis of our data reveal that preoperative templating and intraoperative imaging did not prevent under-restoration. [ABSTRACT FROM AUTHOR]

Background: The neck has been implicated as a potential generator of symptoms such as dizziness and headache in individuals with persistent symptoms post concussion. Anatomically, the neck could also be a potential trigger for autonomic or cranial nerve symptoms. The glossopharyngeal nerve which innervates the upper pharynx is one possible autonomic trigger that might be affected by the upper cervical spine. Case Description: This is a case series of three individuals with persistent post-traumatic headache (PPTH) and symptoms of autonomic dysregulation who also had signs of intermittent glossopharyngeal nerve irritation associated with certain neck positions or movements. Biomechanical principles were applied to anatomical research on the path of the glossopharyngeal nerve, in relation to the upper cervical spine and the dura mater, to alleviate these intermittent symptoms. The patients were provided techniques to be used as tools to immediately alleviate the intermittent dysphagia, which also alleviated the constant headache at the same time. As part of the overall long-term management program, patients were also taught daily exercises to improve upper cervical and dural stability and mobility. Outcome: The result was a decrease in intermittent dysphagia, headache, and autonomic symptoms in the long term in persons with PPTH following concussion. Discussion: Autonomic and dysphagia symptoms may provide clues as to the origin of symptoms in a subgroup of individuals with PPTH. [ABSTRACT FROM AUTHOR]

The habit of using smartphones while walking has become widespread among modern individuals, particularly when pedestrians are in a hurry. However, there has been little exploration into the differences between standing and walking at various speeds in terms of smartphone use. In this study, we examined 60 young participants (30 men and 30 women) who engaged in smartphone tasks such as one-handed browsing or two-handed texting while standing, walking slowly, and walking normally. The measured variables included neck flexion (NF), head flexion (HF), gaze angle (GA), and viewing distance (VD). The study findings indicate that using smartphones while walking may cause a more pronounced kyphotic curve in the cervical spine compared to when standing, leading to increased strain in the neck region. The heightened neck load can be attributed to the concurrent dynamic nature of both walking and smartphone usage. Moreover, two-handed texting had a more detrimental impact on NF, HF, and GA when contrasted with one-handed browsing. The interplay among hand operation, posture, and maintaining arm position displayed an uncertain correlation with VD. While women typically exhibited smaller NF, HF, and GA than men, it is important to explore whether their shorter VD might contribute to increased eyestrain. [ABSTRACT FROM AUTHOR]

Relatively few biomechanical models exist aimed at quantifying the mechanical risk factors associated with neck pain. In addition, there is a need to validate spinal-rhythm techniques for inverse dynamics spine models. Therefore, the present investigation was 3- fold: (1) the development of a cervical spine model in OpenSim, (2) a test of a novel spinal-rhythm technique based on minimizing the potential energy in the passive tissues, and (3) comparison of an electromyographically driven approach to estimating compression and shear to other cervical spine models. The authors developed ligament force--deflection and intervertebral joint moment--angle curves from published data. The 218 Hill-type muscle elements, representing 58 muscles, were included and their passive forces validated against in vivo data. Our novel spinal-rhythm technique, based on minimizing the potential energy in the passive tissues, disproportionately assigned motion to the upper cervical spine that was not physiological. Finally, using kinematics and electromyography collected from 8 healthy male volunteers, the authors calculated the compression at C7--T1 as a function of the head--trunk Euler angles. Differences from other models varied from 25.5 to 368.1 N. These differences in forces may result in differences in model geometry, passive components, number of degrees of freedom, or objective functions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Some interrelationships among fibromyalgia (FM), loss of cervical lordosis (LCL), and headache have been reported. Thus, it is sensible to examine LCL as a factor underlying FM and headache. OBJECTIVE: In this study we aimed to assess LCL in chronic neck pain patients (CNPP) with FM and its association with headache features and FM severity. METHODS: CNPP with (n = 55; mean age 40.0 ± 8.5; range 20 to 55 years) and without FM (n = 55; mean age 38.5 ± 8.9; range 20 to 55 years) were included in the study. Cervical lordosis was assessed by measuring the Cobb angle on the lateral cervical radiographs. The patients were asked about headache features within the last month. In addition, the CNPP with FM were evaluated by the Turkish version of the Revised Fibromyalgia Impact Questionnaire. RESULTS: There were no statistically significant differences between the groups in terms of age, weight, height, body mass index, working status, and neck pain duration (p > 0.05 for each). The CNPP with FM had significantly reduced cervical lordosis angle compared with those without. The CNPP with FM had significantly higher headache frequency than those without (p = 0.008). There was statistically significant negative correlation between cervical lordosis angle and headache frequency in the CNPP with FM (r: - 0.336; p = 0.012). CONCLUSION: According to the results of this study, LCL may be associated with FM and headache frequency in the CNPP with FM. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Quick Exposure Check (QEC) assesses four major body parts and engages users in assessing some physical interactions relevant to design in task analysis. OBJECTIVE: In this paper, we investigated the application of QEC as the ergonomic intervention to detect pre-production ergonomic design faults in the apple sorting machine by applying physical and virtual prototyping for three different tasks analysis divided into two phases (Task 1: Apple harvesting and preparation for sorting; Task 2: Sorting control and separation of waste fruits; Task 3: Transfer of separated apples). METHOD: First, the QEC questionnaire was administered while Iranian participants interacted with the machine to detect abnormal posture. Second, we redesigned a concept of the machine and assessed it with QEC by a focus group. RESULTS: Before design, the high pressure in Task 1 is on the back (dynamic), shoulder/arm, and very high pressure in Task 2, and in Task 3 on the back (static), arm/shoulder/neck, making an uncomfortable situation for posture. After redesign, we observed decreased pressures on the back/shoulder/arm in Task 1 from high to medium, in Task 3 from very high to low, and also in Task 2, this was detectable decreasing from very high pressures on the back/shoulder/arm and the high pressures on the neck to medium. CONCLUSION: Prototyping with QEC demonstrated that accurate redesigning of the machine with concentration on shifting from static tasks to dynamic or conversely, and ease of access by adjusting dimensions according to anthropometry and auxiliary products, could reduce musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the moderating role of baseline depressive symptoms on the association between baseline pain severity and time to recovery in individuals with acute grade I-II whiplash-associated disorders. Design: This is a secondary analysis of a randomized controlled trial investigating the effectiveness of a government-regulated rehabilitation guideline for the management of grade I-II whiplash-associated disorders. Participants who completed baseline questionnaires for neck pain intensity and depressive symptoms and follow-up questionnaire on self-reported recovery were included in the analysis. Cox proportional hazards models were built, and hazard rate ratios were reported to describe the association between baseline neck pain intensity and time to self-reported recovery and to assess the effect modification of baseline depressive symptoms. Results: Three hundred three participants provided data for this study. Despite baseline level of depressive symptoms and neck pain intensity being independently associated with delayed recovery, the association between baseline neck pain intensity and time to recovery was not stronger for individuals with significant postcollision depressive symptoms (hazard rate ratio = 0.91; 95% confidence interval = 0.79-1.04) than for those without depressive symptoms (hazard rate ratio = 0.92; 95% confidence interval = 0.83-1.02). Conclusions: Baseline depressive symptoms are not an effect modifier of the association between baseline neck pain intensity and time to self-reported recovery in acute whiplash-associated disorders. [ABSTRACT FROM AUTHOR]

Background: The functional integration of the jaw and neck motor systems, of great importance to everyday oral activities, is established in early childhood. Detailed characterisation of this developmental progress is largely unknown. Objective: To establish developmental changes in jaw–neck motor function in children over the ages 6–13 years compared to adults. Methods: Jaw and head movement kinematics during jaw opening–closing and chewing were longitudinally recorded in 20 Swedish children (8 girls) at 6 (6.3 ± 0.4), 10 (10.3 ± 0.3) and 13 (13.5 ± 0.7) years of age and 20 adults (9 women, 28.2 ± 6.7). Movement amplitudes, jaw movement cycle time (CT), coefficient of variation (CV) and head/jaw ratio for amplitudes were analysed. Linear mixed effect analysis and Welch's t‐test were used. Results: Children showed pronounced movement variability and longer CT at 6 and 10 years old during opening and chewing (p <.001). Compared to adults, 6‐year‐olds showed higher head/jaw ratios (p <.02) and longer CT (p <.001) during opening and chewing, and higher CV‐head (p <.001) during chewing. Whereas 10‐year‐olds showed larger jaw and head amplitudes (p <.02) and longer CT (p <.001) during opening, and longer CT (p <.001) and higher CV‐head (p <.001) during chewing. For 13‐year‐olds, longer CT (p <.001) during chewing was found. Conclusion: Children showed pronounced movement variability and longer movement cycle time at 6–10 years and developmental progress in jaw–neck integration from 6 to 13 years, with 13‐year‐olds displaying adult‐like movements. These results add new detailed understanding to the typical development of integrated jaw–neck motor function. [ABSTRACT FROM AUTHOR]

Patau syndrome (trisomy 13) is a severe disorder associated with multiple systemic defects. Patau syndrome is commonly associated with ocular abnormalities but rarely associated with congenital glaucoma. To obtain a better surgical view, palatoplasty requires neck extension during surgery. The intraocular pressure (IOP) of patients with Patau syndrome can increase owing to the neck extension position while undergoing palatoplasty, particularly in those with congenital glaucoma. Here, we describe a case with increased IOP measured using a rebound tonometer during palatoplasty in a pediatric patient with Patau syndrome and congenital glaucoma. This case shows that it may be important to reduce the degree of neck extension and shorten the operation time to minimize any increase in the IOP during palatoplasty in pediatric patients with Patau syndrome accompanied by congenital glaucoma. [ABSTRACT FROM AUTHOR]

Background: This study was designed to find the Correlation between the Simple Reaction Time and Cervical Proprioception in asymptomatic young adults with Forward Head Posture (FHP). Purpose: To find the correlation between the Simple Reaction Time and Cervical Proprioception in asymptomatic young adults with Forward Head Posture (FHP). Materials and Methods: Materials required for this study were Body markers, Tripod stand, Laptop, ON Protractor mobile application, Headband with laser beam device, Target with concentric circles, Deary-Liewald reaction time software. It was a cross-sectional observational study design. The sampling method used was Purposive sampling. One Sixty subjects with Forward head posture (CVA= <49º) were included in this study. The written informed consent was taken. Informed consent document was signed, retained by the principal investigator and a copy was given to the participant. Deary-Liewald Time task and Cervicocephalic Relocation test was used to study the Simple Reaction Time and Cervical Proprioception respectively. All the data obtained was statistically analysed using proper tests. Results: The results showed no significant (p value > 0.05) correlation of SRT with Cervical Rotation Proprioception, as the participants in our study were asymptomatic young adults with mean of 22.24±1.783years, had mild FHP and their scores on both the Simple Reaction Time and Cervical Proprioception tests were slightly above the normal range. Conclusion: Our study concluded that there is no significant correlation of Cervical Proprioception with Simple Reaction Time in Asymptomatic Young Adults with Forward Head Posture. [ABSTRACT FROM AUTHOR]

Due primarily to the excellent soft tissue contrast depictions provided by MRI, the widespread application of head and neck MRI in clinical practice serves to assess various diseases. Artificial intelligence (AI)-based methodologies, particularly deep learning analyses using convolutional neural networks, have recently gained global recognition and have been extensively investigated in clinical research for their applicability across a range of categories within medical imaging, including head and neck MRI. Analytical approaches using AI have shown potential for addressing the clinical limitations associated with head and neck MRI. In this review, we focus primarily on the technical advancements in deep-learning-based methodologies and their clinical utility within the field of head and neck MRI, encompassing aspects such as image acquisition and reconstruction, lesion segmentation, disease classification and diagnosis, and prognostic prediction for patients presenting with head and neck diseases. We then discuss the limitations of current deep-learning-based approaches and offer insights regarding future challenges in this field. [ABSTRACT FROM AUTHOR]

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Parry--Romberg syndrome (PRS) is a rare disorder characterised by progressive hemifacial atrophy, along with various neurological and ophthalmological manifestations. Patients with PRS may undergo reconstructive procedures such as fat grafting to address the facial contour deformities. Anaesthesiologists may face significant challenges due to the asymmetric craniofacial structures and the potential presence of neurological deficits, including hemiparesis. We report a case of an 18-year-old male with left-sided hemifacial atrophy and PRS with wasting of one side of the lobe of the thyroid gland who underwent fat grafting under general anaesthesia. The challenges faced during the anaesthetic management of this patient are airway management, positioning and monitoring of neurological deficits. PRS has been reported to coexist with other autoimmune diseases, including thyroid disorders. However, thyroid involvement in PRS is rare. This case used ultrasound to evaluate the airway and assess PRS impact. This case highlights the importance of ultrasound airway, which can serve as an effective tool for identifying associated conditions (like thyroid atrophy) in patients with PRS and can assist in the diagnosis and management of this rare and complex disease. [ABSTRACT FROM AUTHOR]

Scleredema Diabeticorum (SD) is a rare condition characterized by diffuse, symmetrical induration along with non-pitted swelling mostly on the upper back as a result of mucin being deposited in the dermis. It can also involve posterior neck, shoulders, and scalp. We report a case of 48 years old female patient from Pakistan, with uncontrolled diabetes mellites type 2 for the last 15 years, presenting with thickened skin at the back of the neck resulting in difficulty in neck and shoulder movements. This led to decreased functional class from I to II causing her to develop insomnia and depression. Scleredema diabeticorum is a difficult disease to manage as it runs a long and debilitating course with little propensity of remission with available treatments. [ABSTRACT FROM AUTHOR]

Background: Forward head posture (FHP) is a common condition where the head appears to be positioned in front of the vertical midline of the body. FHP is associated with shortening of the neck extensors and pectoral muscles, and the deep neck flexors and shoulder retractors are weakened. FHP is also found to cause decreases in respiratory function. Few clinical trials have investigated the effects of combination treatments to alleviate these problems. The aim of this study was to examine the effects of combination of traditional Thai massage, scapular stabilization exercise, and chest mobilization on forward head angle (FHA), forced vital capacity (FVC), and cervical flexion in subjects with FHP. Methods: Forty-eight subjects with FHP were randomly allocated to a treatment group receiving a Combination of Traditional Thai massage, Scapular stabilization exercise, and Chest mobilization (CTSC group) (n = 24) and a control group (relaxed by lying supine) (n = 24). FHA, FVC, and cervical flexion were measured before and after the four-week intervention (Week 4) and one month after the intervention period (Week 8). Results: The CTSC group showed statistically significantly greater improvement in FHA and cervical flexion than the control group at Week 4 (FHA, mean difference − 6.05; 95% CI − 8.03, − 4.07; cervical flexion, mean difference 6.84; 95% CI 3.14, 10.55) and Week 8 (FHA, mean difference − 4.64; 95% CI (− 6.71, − 2.58); cervical flexion, mean difference 5.21; 95% CI 0.84, 9.58). There were no significant between-group differences in FVC at week 4 (mean difference 0.09; 95% CI − 0.06, 0.23) and week 8 (mean difference 0.04; 95% CI − 0.11, 0.19). Conclusion: This study showed that CTSC had a positive effect on FHA and cervical flexion in subjects with FHP. Trial registration: Thai Clinical Trials Registry (TCTR) (Identification number: TCTR20211119001), registered 19 November 2021; https://www.thaiclinicaltrials.org/show/TCTR20211119001. [ABSTRACT FROM AUTHOR]

Emergency nurse practitioners are expected to assess and manage a variety of patients. These patients may present with urgent care-type complaints to severe life-threatening illnesses or injuries. For some, dermatological problems can sometimes be just as challenging as a critically ill patient. Atopic dermatitis (AD) is one, if not, the most common chronic inflammatory disease. Its presentation can vary depending on the age of the patient, the patient's skin tone, and other comorbidities. Patients often seek emergency care related to the condition itself or associated complications. This article includes a review of the pathophysiology, clinical manifestations, and standard management of AD. Finally, the potential complications of AD are discussed. A better understanding of AD will allow emergency nurse practitioners to properly identify and treat this chronic condition, as well as its complications. [ABSTRACT FROM AUTHOR]

Reference anthropometric and physical performance qualities can improve understanding of sporting needs and streamline preparation and rehabilitation programs. However, these data and their relationships with competitive success are absent in rodeo athletes. We hypothesized that riding performance would be most correlated with hip adductor, neck, and grip strength, whereas jump, reactive strength index (RSI), and change of direction abilities would best predict bull-fighting performance. Forty-three amateur (n = 9), professional (n = 23), or internationally ranked (n = 11) male rodeo athletes (bareback = 9, bull riders = 16, saddle bronc = 7, bullfighters = 11) (26.8 ± 5.6 years) volunteered for this study. Anthropometrics included body mass, height, and body fat percentage. Performance measures included isometric hip adduction and abduction, neck flexion and extension, handgrip strength, squat and countermovement jump heights, eccentric utilization ratio, reactive strength index, change of direction, bike sprints, and several pneumatic power measures. Bullfighters were taller and heavier than bull riders (effect size [ES] = 0.84-0.87, p = 0.008-0.017). Bull riders were leaner than bullfighters (ES = 0.74, p = 0.012). Fighters had greater RSI than riders (ES = 0.73-1.47, p < 0.001-0.030). Competitive level of rodeo riders (n = 32) correlated with age, rodeo experience (ρ = 0.37-0.43, p = 0.013-0.049), bent-leg abduction (ρ = 0.43, p = 0.014), straight-leg hip adduction and abduction (ρ = 0.49-0.56, p < 0.001-0.005), neck flexion force (ρ = 0.43, p = 0.016), and rotational power (ρ = 0.50, p = 0.004). The competitive level of the fighters correlated with age (ρ = 0.64, p = 0.036) and time trial performance (ρ = -0.76, p = 0.006). This is the first study providing normative and correlational strength and power performance data in a rodeo population. These data highlight the need for more event-specific physical preparation. Riders should focus their physical preparation on hip and neck strength and rotational power. Bullfighters should prioritize stiffness and anaerobic power. [ABSTRACT FROM AUTHOR]

Objective. To investigate the prevalence of sarcopenia and its association with myoelectric activity of the SH region in post-COVID-19 patients, stratified by disease severity and gender. Methods. A cross-sectional study conducted in the post-COVID-19 Outpatient Clinic of a University Hospital. The following outcomes were assessed: swallowing (Dysphagia Risk Evaluation Protocol), electromyography of the SH region, muscle strength and muscle mass (dynamometry, ultrasound, and bioimpedance analysis). Results. The sample consisted of 50 patients (50.4 ± 13.35 years), who were admitted to the COVID-19 ICU and referred to the Outpatient Clinic. Critical-COVID group (n = 19) had a loss of muscle strength, without loss of muscle mass, no altered myoelectric activity of the SH region. Deglutition was classified as normal. Female patients showed low strength and male patients presented loss of muscle mass, in both groups. In the Severe-COVID group (n = 31), female patients had higher myoelectric activity in the SH region at rest, when deglutition pasty and when swallowing liquids, and at the clinical evaluation of swallowing, multiple deglutition in the pasty consistency and coughing in the liquid consistency. The correlations were significant only in the Severe- COVID group. Conclusions. Male Critical-COVID patients showed sarcopenia, while female patients demonstrated pre-sarcopenia. The correlation observed in the Severe-COVID group, suggests that COVID-19 may compromise the muscles involved in swallowing even in non-critical patients. It is noteworthy the evaluation of these outcomes in post- COVID-19 patients to focus on individualized rehabilitation plan to provide functional recovery after hospital discharge. [ABSTRACT FROM AUTHOR]

Many jobs have health risks caused by unergonomic posture while working for a long time. One of the disorders that often occurs is myofascial pain syndrome. If ignored, there will be a disruption in neck function. Contract-relax stretching can reduce the pain and spasm in neck muscles, while the McKenzie neck exercise can restore the cervical intervertebral disc to its normal position and reduce neck disability. This research aimed to determine the difference in the effect of contract-relax stretching and the McKenzie neck exercise on the neck's function in onion peelers with myofascial pain syndrome. The study was quasi-experimental with two groups: pre-test and post-test design. The population was onion peelers at CV. Anita Jaya Sukses, Sidoarjo. The sample was 18 respondents who met the inclusion criteria. Data weres analyzed using the Independent Sample T-test. Based on the test, contract-relax stretching and McKenzie neck exercise obtained a significant value of 0.011(p< 0.05), so H0 is rejected and H1 is accepted. The study concluded that there was a difference in the effect of contract-relax stretching and McKenzie neck exercise on neck function in onion peelers with myofascial pain syndrome. [ABSTRACT FROM AUTHOR]