Abstract Objective It is believed that systematic modulation of spinal manipulative therapy (SMT) parameters should yield varying levels of physiological responses and eventually a range of clinical ...responses. However, investigation of SMT dose–physiological response relationship is recent and has mostly been conducted using animal or cadaveric models. The main objective of the present study is to investigate SMT dose–physiological response relation in humans by determining how different levels of force can modify electromyographic (EMG) responses to spinal manipulation. Methods Twenty-six participants were subjected to 2 trials of 4 different SMT force-time profiles using a servo-controlled linear actuator motor. Normalized EMG activity of paraspinal muscles (left and right muscles at level T6 and T8) was recorded during and after SMT, and EMG values were compared across the varying levels of force. Results Increasing the level of force yielded an increase in paraspinal muscle EMG activity during the thrust phase of SMT but also in the two 250-millisecond time windows after the spinal manipulation impulse. These muscle activations quickly attenuated (500 milliseconds after spinal manipulation impulse). Conclusion The study confirmed the presence of a local paraspinal EMG response after SMT and highlighted the linear relationship between the SMT peak force and paraspinal muscle activation.
Abstract Objective Teaching spinal manipulation (SM) is a fundamental aspect of chiropractic training. Recent works have identified various biomechanical variables as indicators of SM performance and ...learning. However, only data from cross-sectional studies are available, limiting conclusions regarding the persistence of SM performance over the years. Therefore, the main objective of this investigation was to quantify the evolution of biomechanical parameters of SM over a 5-year learning period. Methods Thirty-three students enrolled in a chiropractic program participated in the present study. They were tested each year at the beginning of each fall semester by performing 10 SMs on an instrumented manikin while standing on a force plate. The procedure allowed us to measure various force-time parameters. Results Overall, significant time effects were noted for most dependent variables. The results indicated rapid improvement in the peak force applied and the rate of force production during the first 2 years. Time to peak force decreased drastically during the first year, whereas preload forces reached satisfactory levels during the third year. When various force-time requirements of bimanual task components were met, learners significantly reduced trial-to-trial variability of SM peak and preload forces, indicating automaticity of performance. Although global coordination improved in all learning processes, it was only in the later phase that learners reached values approaching those of experts. Conclusion Overall, these results highlighted the importance of considering learning principles in the development of didactic strategies related to SM motor skills.
Secondary analysis of a randomized controlled trial.
To identify preoperative physical variables associated with favorable postoperative outcome in individuals undergoing laminectomy or laminotomy ...for degenerative central lumbar spinal stenosis.
Clinical or condition specific variables have most commonly been studied as predictors of postoperative outcome in lumbar spinal stenosis. If associated to favorable postoperative outcome, modifiable physical variables would inform prehabilitation interventions for patients with degenerative central lumbar spinal stenosis.
Patients awaiting surgery for central lumbar spinal stenosis were recruited to participate in a randomized controlled trial. Following baseline data collection of demographics, clinical portrait and physical testing, participants were randomized to either 6-week active prehabilitation program or hospital standard care. Complete baseline and postoperative data were obtained from 58 participants which were included in the present analysis. Favorable postoperative outcome was determined based on two outcome measures. Favorable outcome was defined as a decrease of ≥30% on the Numerical Rating Scale for leg pain intensity and a decrease of ≥30% on the Oswestry Disability Index for low back disability. Baseline physical variables were used to conduct binary logistic regression.
Sixty percent of participants were determined as having a favorable postoperative outcome. None of the included physical variables were found to be predictors of a favorable postoperative outcome based on leg pain intensity and low back pain-associated disability trunk flexors muscle strength (OR = 0.73; 95%CI (0.02-27.12) lumbar extensors muscle endurance OR= 1.09; 95%CI (0.95-1.24) total ambulation time OR = 1.00 95%CI (0.99-1.01) lumbar active range of motion in extension OR = 1.08; 95%CI (0.95-1.23) and knee extensors muscle strength OR=1.02; 95%CI (0.98-1.06).
Results show that none of the investigated variables, all related to low back and lower limbs physical capacity, were predictors of postoperative recovery. Further testing in larger cohort is needed to assess the full potential of physical outcome measures as predictors of postoperative recovery.
ObjectiveThe objective of this scoping review is to investigate the possible links between the practice of video games and physical health. It seeks to answer the following question: What are the ...physical health consequences of playing video games in healthy video game player? and How is it currently investigated?.MethodsA scoping review was conducted to identify observational and experimental studies pertaining to our research question. Retrieved papers were screened using a two-phase method first involving a selection based on titles and abstracts. Then, potentially relevant studies were read and triaged. The final set of included studies was analysed, and data were subsequently extracted. Observational studies and experimental studies were assessed using the appropriate Cochrane Risk of Bias Tool and data were synthetised according to specific physical health and related health behaviours.ResultsTwelve peer-reviewed articles were retained for further analyses. Results of this scoping review suggest preliminary evidence that time spent gaming is associated with some health outcomes indicators. Our results indicate preliminary evidence that increased gaming time is associated with higher body mass index and lower self-reported general health status. There is insufficient evidence to conclude on a possible association between gaming time and physical activity or sedentary behaviours, sleep or fatigue, musculoskeletal pain or dietary behaviours.ConclusionThe results of this sopping review suggest an association between increased video game playing time and a deterioration in some physical health indicators but available evidence is scarce, precluding from any strong conclusion.
In patients with fibromyalgia, exercise and education are recommended to decrease pain level and improve pain management. The latest scientific evidence recommends to focus interventions on the upper ...limb. The aim of this pilot study was to compare the immediate effect of physical activity education vs. a control group on pain and muscle capacity in fibromyalgia patients.
Fifty-six participants with fibromyalgia were randomized into an experimental group and a control group. The intervention consisted in watching a five-minute video that provided information about fibromyalgia, pain, kinesiophobia and physical activity. The control group watched a neutral five-minute video about beavers in Quebec. Following the video, participants performed a muscular fatigue task consisting of a repeated unilateral shoulder abduction task. At baseline and following the muscular fatigue task, maximal voluntary contraction (MVC) in shoulder abduction was assessed as well as pain level and pressure pain threshold (PPT) in the upper limb. Electromyographic activity was also assessed for upper trapezius and middle deltoid muscles. Two-way repeated measures analysis of variance was used to compare the MVC, PPT, and pain level before and after the muscular fatigue task between groups.
The experimental group showed a significantly lower increase in pain than the control group in the middle deltoid muscle (
= 0.002) when assessed by verbal pain rating scale. No significant interaction or main effect of Group and Time were observed for the pain level at the upper trapezius and elbow extensor muscles nor for any of the PPT measures. According to electromyographic data, the median frequency values indicate that neither group experienced muscle fatigue during the repeated contraction task.
The preliminary results suggest that a short physical activity education video positively influenced middle deltoid pain following repeated abduction in participants with fibromyalgia. Electromyographic analysis showed no evidence of objective muscle fatigue, suggesting that there might be a partial disconnection between the perception of muscle fatigue and the physiological biomarkers associated with muscle fatigue.
Abstract Objective The aim of this clinical trial was to evaluate the effect of 15 myofascial therapy treatments using ischemic compression on shoulder trigger points in patients with chronic ...shoulder pain. Methods Forty-one patients received 15 experimental treatments, which consisted of ischemic compressions on trigger points located in the supraspinatus muscle, the infraspinatus muscle, the deltoid muscle, and the biceps tendon. Eighteen patients received the control treatment involving 15 ischemic compression treatments of trigger points located in cervical and upper thoracic areas. Of the 18 patients forming the control group, 16 went on to receive 15 experimental treatments after having received their initial control treatments. Outcome measures included a validated 13-question questionnaire measuring shoulder pain and functional impairment. A second questionnaire was used to assess patients' perceived amelioration, using a scale from 0% to 100%. Outcome measure evaluation was completed for both groups at baseline after 15 treatments, 30 days after the last treatment, and finally for the experimental group only, 6 months later. Results A significant group × time interval interaction was observed after the first 15 treatments, indicating that the experimental group had a significant reduction in their Shoulder Pain and Disability Index (SPADI) score compared with the control group (62% vs 18% amelioration). Moreover, the patients perceived percentages of amelioration were higher in the experimental group after 15 treatments (75% vs 29%). Finally, the control group subjects significantly reduced their SPADI scores after crossover (55%). Conclusion The results of this study suggest that myofascial therapy using ischemic compression on shoulder trigger points may reduce the symptoms of patients experiencing chronic shoulder pain.
The objectives were (1) to describe and compare headache-related clinical features between teleworkers with migraine and those with tension-type headache (TTH) and (2) to determine the association ...between coping strategies and headache frequency, and intensity in the context of the COVID-19 pandemic.
This cross-sectional online survey was conducted with 284 teleworkers (127 with migraine and 157 with TTH). Sociodemographic data, information related to work factors, headache clinical features, coping strategies used during the COVID-19 pandemic, and headache-related clinical features were compared between headache profiles. Bivariate logistic regression analyses were used to determine the association between coping strategies and headache frequency, and intensity.
Results showed that teleworkers with migraine had longer and more painful headache episodes than teleworkers with TTH (
< 0.001). Higher migraine frequency was associated with the use of the denial coping strategy (
= 0.006) while lower migraine intensity was associated with planning (
= 0.046) and the use of positive reframing (
= 0.025). Higher TTH frequency was associated with the use of venting, self-blame, and behavioral disengagement (
< 0.007) while higher TTH intensity was associated with substance use and behavioral disengagement (
s < 0.030). All associations remained significant after adjusting for BMI as a covariate.
Teleworkers with migraine had more intense and longer headache episodes than teleworkers with TTH. This could be explained by the fact that a greater proportion of individuals suffering from migraine experienced headaches prior to the beginning of the pandemic compared with teleworkers suffering from TTH. Regarding coping strategies, both primary headache profiles were associated with different types of coping strategies. Most of the coping strategies associated with headache frequency or intensity were maladaptive except for planning and positive reframing that were found to be inversely associated with migraine intensity.
Abstract Objective The purpose of this study was to develop evidence-based treatment recommendations for the treatment of nonspecific (mechanical) neck pain in adults. Methods Systematic literature ...searches of controlled clinical trials published through December 2011 relevant to chiropractic practice were conducted using the databases MEDLINE, EMBASE, EMCARE, Index to Chiropractic Literature, and the Cochrane Library. The number, quality, and consistency of findings were considered to assign an overall strength of evidence (strong, moderate, weak, or conflicting) and to formulate treatment recommendations. Results Forty-one randomized controlled trials meeting the inclusion criteria and scoring a low risk of bias were used to develop 11 treatment recommendations. Strong recommendations were made for the treatment of chronic neck pain with manipulation, manual therapy, and exercise in combination with other modalities. Strong recommendations were also made for the treatment of chronic neck pain with stretching, strengthening, and endurance exercises alone. Moderate recommendations were made for the treatment of acute neck pain with manipulation and mobilization in combination with other modalities. Moderate recommendations were made for the treatment of chronic neck pain with mobilization as well as massage in combination with other therapies. A weak recommendation was made for the treatment of acute neck pain with exercise alone and the treatment of chronic neck pain with manipulation alone. Thoracic manipulation and trigger point therapy could not be recommended for the treatment of acute neck pain. Transcutaneous nerve stimulation, thoracic manipulation, laser, and traction could not be recommended for the treatment of chronic neck pain. Conclusions Interventions commonly used in chiropractic care improve outcomes for the treatment of acute and chronic neck pain. Increased benefit has been shown in several instances where a multimodal approach to neck pain has been used.
BackgroundBall velocity, accuracy and game statistics represent three methods used to measure pitching performance. However, individual determinants of pitching performance are more ...elusive.ObjectivesThe aims of this study were to classify the performance factors associated with baseball pitchers, to identify the methods used to quantify their abilities through all features of the game and to document relationships between performance factors and indicators.DesignScoping review.Data sourcesElectronic searches of MEDLINE, Academic Search Complete, CINAHL, SportDiscus, PubMed, PsycINFO, Cochrane and of grey literature were undertaken from inception to January 2019.Eligibility criteria for selecting studiesCross-sectional studies that investigated the relationship between performance indicators and individual performance factors in healthy baseball pitchers were selected.ResultsThirty-four cross-sectional studies investigating individual potential factors of pitching performance met the inclusion criteria. The primary performance factors investigated were kinematic, kinetic, timing outcomes, personal characteristics, physical tests and range of motion. Shoulder horizontal adduction (SHA), upper torso forward flexion, maximal shoulder external rotation, upper torso rotation angle, upper torso lateral flexion, lead knee flexion (LKF) and forward trunk tilt (FTT) were identified as key kinematic features associated with increased ball velocity. Shoulder proximal force and peak elbow proximal forces were associated with greater ball velocity. Individual performances in jumping tests and body weight (BW) are also associated with pitching performance.Summary/conclusionBased on studies presenting low and moderate risk of bias, we conclude that BW, age and kinematics, such as FTT, LKF, SHA and lateral trunk tilt, are associated with pitching performance.
The purpose of this study was to investigate the combined effect of augmented feedback and expertise on the performance and retention of basic motor learning spinal manipulation skills.
A total of ...103 chiropractic students with various training expertise were recruited for the study. Participants were evaluated at baseline, immediately after trials of augmented feedback practice and 1 week later. During all 3 assessments, students were asked to perform several trials of the same spinal manipulation, for which the maximum preload force, onset of thrust, thrust duration, force and peak force, thrust duration, rate of force application, and any drop in preload force were calculated. The constant error, absolute error, and variable error were calculated for the 3 experimental blocks of trials.
Results confirmed that augmented feedback training modified several biomechanical parameters such as the rate of force application, the preload force, and the drop in preload force. The study also confirmed that many biomechanical parameters, including thrust duration and rate of force application, are modified with expertise but failed to identify any interaction effect between expertise and augmented feedback training effects.
The study determined that expertise did not influence how students performed after a session of augmented feedback training. The study also determined that augmented feedback related to the global performance can yield improvements in several basic components of the spinal manipulation task. These results should be interpreted considering basic motor learning principles and specific learning environments.
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