Abstract
Objective
To compare the effects of dry needling or manual pressure release on an active trigger point in the upper trapezius on craniocervical flexion test performance, pressure pain ...thresholds, and cervical range of motion in chronic neck pain.
Design
A parallel randomized clinical trial.
Setting
Physical therapy service.
Subjects
Individuals with chronic neck pain.
Methods
Subjects were randomized to receive dry needling (n = 25) or manual trigger point pressure release (n = 25) on upper trapezius active trigger points. Surface electromyography from the upper trapezius, splenius capitis, sternocleidomastoid, and scalene muscles during performance of the craniocervical flexion test was assessed before and immediately after the intervention as the primary outcome. Neck pain intensity, range of motion, and pressure pain thresholds were the secondary outcomes.
Results
A decrease in sternocleidomastoid activity at all stages of the craniocervical flexion test (time effect, P < 0.001) was found in both groups after the interventions, with no significant between-group difference. Pressure pain thresholds measured over the cervical spine and second metacarpal increased after dry needling when compared with manual trigger point pressure release (P < 0.05). Pain intensity decreased immediately after both treatments with moderate to large effect sizes, whereas cervical range of motion increased for both groups but with small effect sizes.
Conclusion
A single session of dry needling or manual pressure release over upper trapezius active trigger points promotes limited effects on muscle performance during the craniocervical flexion test, pressure pain thresholds, and cervical range of motion in patients with chronic neck pain.
The coronavirus disease‑2019 (COVID‑19) has caused a worldwide pandemic. Approximately 5% of victims develop severe acute respiratory distress syndrome (ARDS), and some require extracorporeal ...membrane oxygenation (ECMO). However, weaning patients with COVID‑19‑related ARDS from ECMO are challenging. Here, we report a COVID‑19 case with severe ARDS that received venovenous ECMO to maintain adequate gas exchange for more than 4 weeks. We performed prolonged prone position ventilation and airway pressure release ventilation, and the patient was successfully weaned off ECMO.
Continuous positive airway pressure treatment aggravates airway obstruction in patients with epiglottis collapse. In these patients, partial epiglottectomy can resolve epiglottis collapse by partial ...excision of the obstructed epiglottis. However, patients with epiglottic collapse usually have simultaneous obstructions on multiple levels, such as the soft palate, base of the tongue, etc. Therefore, sleep apnea cannot be controlled merely by resolving epiglottis collapse. The use of additional continuous positive airway pressure treatment after partial epiglottectomy is considered essential. However, no studies have yet evaluated the effect of partial epiglottectomy on continuous positive airway pressure treatment. In this study, we report on 2 patients with obstructive sleep apnea who underwent partial epiglottectomy. These 2 patients used autotitrating positive airway pressure treatment pre- and postoperatively. The present case report will provide insight into the effects of partial epiglottectomy on the use of positive-pressure devices.
Terrorist attacks do not just cause devastation and casualties, but also constitute a symbolic battlefield. Drawing on Bourdieu's field analytical framework, this article suggests that a terrorist ...attack puts pressure on the symbolic underpinnings of the established social order. It irritates the taken-for-granted reality, and through the use of violence, brings a competing possible into the universe of discourse. Therefore, the counterterrorist response has a twofold reality. It serves not only to restore physical safety, but also to release symbolic pressure and thus, reinforce the symbolic underpinnings of the social order. Using the example of press conferences in the aftermath of the Vienna terrorist attack in 2020, this article examines the discursive moves through which state actors strive to release symbolic pressure imposed by the attack. Thus, the article lays bare the symbolic dimension of counterterrorism and contributes to its more nuanced understanding.
To study the influence of the mined-out area in the nearby upper section of a coal seam on the mining of the working face of the lower seam, in this study, the mining of the 18–4 working face using ...the 110 mining method in the Dongrong No. 2 Mine, Jixian County, Heilongjiang Province, China, was taken as the engineering background. The 3DEC discrete element numerical simulation method was used to simulate the mining conditions close to the upper coal seam. The seam spacing was set as 5, 10, 15, and 35 m, and the influence of the pressure on the working face of the lower coal seam was investigated based on comprehensive analysis of field measured data. According to the results, as the distance between the coal seams decreased, the stress and displacement of the roof of the surrounding rock increased and the stability distance of the roadway decreased. During roadway reuse process, as the coal seam spacing decreased, and displacement of the surrounding rock increased and the leading influence range of the roadway decreased. Under the influence of slit, the roof pressure on the side near the slit is lower than that on the side near the coal wall.
This article introduces a new non-pillar coal mining technology (i.e., Gob-side Entry Retaining by Roof Cutting (GERRC)) under the condition of thick and hard roofs. First, we theoretically analyzed ...the solution to the large suspension span of the thick and hard roof in coal mining. Three-Zone pre-split blasting design in non-pillar coal mining for thick and hard roofs was proposed, based on the principles of rock mechanics. After field experiments, the technology was successfully applied to the non-pillar coal mining of a huge thick conglomerate roof. This research supplements the non-pillar mining technology system. The proposed technologies and methods have strong applicability and have certain guiding significance for the safe and efficient mining of related coal mines.
This study aimed to investigate the effects of deep-stripping and trigger-point pressure release massage on the Pittsburgh Sleep Quality Index (PSQI), jaw mobility, and pressure pain threshold (PPT) ...of masticatory muscles in patients with sleep bruxism. A randomized controlled trial was conducted among 45 patients diagnosed with sleep bruxism. The patients were randomly assigned to three groups. Group I was the control group and included five men and 10 women; Group II was the deep-stripping massage group, which included two men and 13 women; and Group III was the pressure release group, which involved four men and 11 women. Patients were tested two times, before and after 6 weeks. Group I received transcutaneous electrical nerve stimulation and passive stretching; Group II received a deep-stripping massage; and Group III received a trigger-point pressure release massage. Findings revealed significant improvements in PSQI (
= 0.0001), jaw opening (
= 0.0001), jaw protrusion (
= 0.0001), jaw left lateral movement (
= 0.004), jaw retraction (
= 0.0001), right temporalis PPT (
= 0.0001), left temporalis PPT (
= 0.0001), right master PPT (
= 0.001), left master PPT (
= 0.001), right lateral pterygoid PPT (
= 0.001), left lateral pterygoid PPT (
= 0.001), right digastric muscle PPT (
= 0.001), and left digastric muscle PPT (
= 0.001) in the post-test condition in Group II compared with Group I and Group III. Deep-stripping massage improved PSQI, jaw mobility, or PPT of the masticatory muscles compared with trigger-point pressure release massage and traditional treatment techniques in patients with sleep bruxism.
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