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Immediate Effects of Spinal Manipulative Therapy on the Performance of Elite Brazilian Soccer Players: A Pilot Randomized Controlled Trial With an Internally Validated Sham Treatment 脊柱推拿疗法对巴西优秀足球运动员表现的直接影响:一项内部验证假治疗的随机对照试验
Pub Date : 2022-12-01 DOI: 10.1016/j.jcm.2022.02.021
Marcelo B. Botelho DC, MD, PhD , Marcio A. Barbosa BPhEd, PhD , Celso S. Junior BPhEd, MSc , Jerusa P.R. Lara BPhEd, PhD , Alexandre Moreira BPhEd, PhD , Abrahão F. Baptista PT, PhD

Objective

The purpose of this study was to assess the feasibility of the procedures’ routine, the recruiting rate, the presence of any significant detrimental impact on the players’ training routine, and the sham efficacy in achieving blinding.

Methods

A parallel randomized controlled clinical trial was performed with 20 elite soccer players who were randomly assigned to 1 of 2 groups: spinal manipulative therapy (SMT) and sham SMT. All players were from the same team, were injury free, and were naive to SMT. Measured outcome tests (30-m sprint run with a 10-m split and change of direction [COD] test) were performed at the same time by all participants immediately before and after interventions. Photocell devices were used for data acquisition.

Results

Twenty participants were analyzed (10 in each group). There were no changes to the sprint (10 m and 30 m) and COD test results immediately after either of the interventions. All participants in both groups (SMT and sham SMT) answered “yes” to a question after the intervention asking if they were treated by SMT. No adverse effects or training routine impairment were reported.

Conclusion

This pilot study protocol showed it was an appropriate design for a confirmatory clinical trial. The study had minimal effect on the team training routine, and the recruitment rate was excellent. The proposed sham SMT strategy was successful in blinding the players. In this sample, SMT did not have any immediate effect on the performance of these elite soccer players, as measured by 10- and 30-m sprint times and COD sprint times.

目的评估程序常规的可行性,招募率,是否存在对球员训练常规的重大不利影响,以及实现盲化的假效果。方法对20名优秀足球运动员进行平行随机对照临床试验,随机分为脊椎推拿治疗组(SMT)和假SMT组。所有的选手都来自同一个队,没有受伤,对SMT很幼稚。在干预前后,所有参与者同时进行测量结果测试(30米冲刺跑加10米分裂和方向改变[COD]测试)。数据采集采用光电池装置。结果共分析受试者20例(每组10例)。在任何一种干预后,短跑(10米和30米)和COD测试结果都没有变化。两组(SMT和假SMT)的所有参与者在干预后都回答了“是”的问题,询问他们是否接受了SMT治疗。没有不良反应或常规训练损伤的报道。结论该初步研究方案是一种适合临床验证性试验的设计。该研究对团队日常训练的影响很小,并且招募率很高。提议的假SMT策略成功地蒙蔽了参与者。在这个样本中,SMT对这些精英足球运动员的表现没有任何直接影响,通过10米和30米冲刺时间和COD冲刺时间来衡量。
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引用次数: 0
Clinimetric Properties of the Applied Kinesiology Manual Muscle Test in Adults With and Without Pain: A Methodological Study 应用运动学手工肌肉测试在有和没有疼痛的成年人中的临床特性:一项方法学研究
Pub Date : 2022-12-01 DOI: 10.1016/j.jcm.2022.03.003
Décio G. Oliveira MS , Gabriel M. Oliveira BPT , Renata N. Kirkwood PhD

Objective

The purpose of this study was to determine the intra- and interexaminer reliability, concurrent validity, and responsiveness of the applied kinesiology manual muscle test (AK-MMT) to discriminate gluteus medius muscle strength and latency.

Methods

A cross-sectional and methodological study was conducted in 38 participants using electromyography, electrogoniometry, and hand-held dynamometry to measure latency, angular displacement, and muscle force during the assessment of the gluteus medius by AK-MMT. Inter- and intrarater reliability of 2 examiners with different levels of experience were obtained using the intraclass correlation coefficient. Muscle force, latency, and joint angular displacement were compared between groups (facilitated vs inhibited). Latency and angular displacement also were compared within groups by using the Wilcoxon paired test. For the concurrent validity of the AK-MMT in classifying an inhibited muscle as weak, the receiver operating characteristic curve was conducted.

Results

Intra- and interexaminer reliability for the facilitated vs inhibited classifications based on AK-MMT presented good results, with intraclass correlation coefficient > 0.86. For the inhibited group, force and peak force were significantly lower and joint displacement significantly greater. The receiver operating characteristic curve showed an area under the curve of 0.743, demonstrating that the test has concurrent validity (P = .001) to discriminate muscle force. The Wilcoxon paired test showed a significant delay in latency of the inhibited gluteus medius group (0.10 s vs 0.18 s, P = .007) when compared with the facilitated one.

Conclusion

In this study, we found good intra- and interexaminer reliability and concurrent validity for the AK-MMT to determine differences in gluteus medius muscle force. Although the paired data showed a different latency time between groups, the hypothesis of prolonged latency in muscles classified as inhibited by AK-MMT still needs further investigation.

目的本研究的目的是确定应用运动学手工肌肉测试(AK-MMT)鉴别臀中肌力量和潜伏期的内部和内部的信度、并发效度和反应性。方法对38名参与者进行横断面和方法学研究,采用肌电图、角电测量和手持式测力仪测量AK-MMT评估臀中肌时的潜伏期、角位移和肌肉力。采用类内相关系数对两名不同经验水平的审查员的内部信度和内部信度进行分析。肌肉力量、潜伏期和关节角位移在两组之间进行比较(促进组与抑制组)。潜伏期和角位移也通过Wilcoxon配对检验在组内进行比较。为了验证AK-MMT对被抑制肌肉分类为弱肌的同时有效性,我们绘制了受试者工作特征曲线。结果基于AK-MMT的促进与抑制分类的内、间信度均较好,类内相关系数为>0.86. 抑制组的力和峰值力显著降低,关节位移显著增大。受试者工作特征曲线下面积为0.743,说明该测试对肌力鉴别具有并发效度(P = 0.001)。Wilcoxon配对检验显示,与促进组相比,抑制臀中肌组的潜伏期明显延迟(0.10 s vs 0.18 s, P = .007)。结论在本研究中,我们发现AK-MMT在测定臀中肌肌力差异时具有良好的内部和内部信度和并发效度。虽然配对数据显示各组之间的潜伏期不同,但AK-MMT抑制肌肉潜伏期延长的假设仍需进一步研究。
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引用次数: 0
COVID-19 Infectious Disease Prevention and Mitigation Practices by Chiropractic Physicians and Licensed Massage Therapists in Mississippi: A Needs Assessment to Inform Health Education and Promotion 密西西比州脊骨按摩医生和持牌按摩治疗师的COVID-19传染病预防和缓解实践:为健康教育和促进提供信息的需求评估
Pub Date : 2022-12-01 DOI: 10.1016/j.jcm.2022.02.016
Robert A. Leach DC, MS , Harrison Ndetan MPH, MD, PhD , Jeffrey A. King DC, MS , Marion W. Evans Jr DC, PhD

Objective

The purpose of this study was to assess self-reported infection prevention processes and their effect on businesses of chiropractic doctors (DCs) and licensed massage therapists (LMTs) in Mississippi during the COVID-19 pandemic.

Methods

We developed a survey that was electronically delivered to all licensed DCs and LMTs in Mississippi between August and September 2020. Assessments were made using Qualtrics software, with data management and subsequent analysis including Pearson's χ2 test.

Results

Responses were based on 32 of 323 DCs and 69 of 934 LMTs that were still seeing patients through the pandemic (n = 101, response rate 8%). The DC and LMT practitioners (94%) used treatment table and/or surface sanitizing (91.8%) and hand washing and/or sanitizing (89.8%) between all patients. Female practitioners reported practicing handwashing for at least 20 seconds, whereas male practitioners reported practicing handwashing for at least 15 seconds (P < .001). DCs were more likely to report using gloves for personal protective equipment, and LMTs were more likely to report using face masks (P < .001). Other COVID-19 procedures included limiting practice to acute care (82.5%), checking all patient temperatures (62.9%), sign-in and wait in the car (53.2% LMT vs 6.5% DC, P < .001), and prohibiting all nonpatient visitors (87.7% LMTs vs 9.4% DCs, P < .001). DCs (96.9%) and LMTs (89.9%) reported making referrals for COVID-19 testing or treatment when indicated. LMTs (82.3%) reported seeing fewer patients (P = .03), and older practitioners reported the most economic impact (P = .003) by the pandemic. Patient concerns and LMTs needing more time to perform infection control (P = .04) were reasons cited by practitioners for the reduced number of visits seen.

Conclusion

Most respondents had moderate to high compliance with guidelines on recommended infection prevention processes during fall 2020 of the COVID-19 pandemic. This assessment of compliance may be used to help guide future health education and promotion research of disease prevention and mitigation as well as physical and economic burdens faced by DCs and LMTs in Mississippi during a pandemic.

目的本研究旨在评估2019冠状病毒病大流行期间密西西比州脊椎病医生(dc)和执业按摩治疗师(LMTs)自我报告的感染预防流程及其对业务的影响。方法:我们开发了一项调查,该调查于2020年8月至9月期间以电子方式交付给密西西比州的所有有执照的dc和LMTs。采用Qualtrics软件进行评估,数据管理及后续分析包括Pearson χ2检验。结果323个dc中的32个和934个lmt中的69个在大流行期间仍在治疗患者(n = 101,有效率为8%)。DC和LMT从业者(94%)在所有患者之间使用治疗台和/或表面消毒(91.8%)和洗手和/或消毒(89.8%)。据报告,女学员至少练习洗手20秒,而男学员至少练习洗手15秒(P <措施)。DCs更有可能报告使用手套作为个人防护装备,而ltts更有可能报告使用口罩(P <措施)。其他COVID-19程序包括将实践限制在急性护理(82.5%),检查所有患者体温(62.9%),签到并在车内等待(LMT 53.2% vs DC 6.5%)。.001),并禁止所有非患者探视(87.7%的LMTs vs 9.4%的DCs, P <措施)。dc(96.9%)和LMTs(89.9%)报告在需要时转诊进行COVID-19检测或治疗。lmt(82.3%)报告患者较少(P = .03),老年从业者报告受疫情影响最大(P = .003)。患者的担忧和LMTs需要更多的时间来进行感染控制(P = .04)是医生认为就诊次数减少的原因。结论大多数受访者对2020年秋季COVID-19大流行期间推荐的感染预防流程指南的依从性中等至高度。这种依从性评估可用于帮助指导未来的健康教育和促进疾病预防和减轻的研究,以及流行病期间密西西比州dc和LMTs面临的身体和经济负担。
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引用次数: 0
Early Activation of Quadriceps With Pressure Biofeedback for the Prevention of Arthrogenic Muscle Inhibition Following Lower Limb Orthopedic Surgeries: A Proof of Concept Clinical Trial 用压力生物反馈早期激活股四头肌预防下肢骨科手术后关节源性肌肉抑制:一项概念验证临床试验
Pub Date : 2022-12-01 DOI: 10.1016/j.jcm.2022.05.005
Jeslin T. Achens MPT, Vijay S. Raj Victor MPT, Jakson K. Joseph MPT

Objective

The purpose of this study was to explore the possible role of pressure biofeedback in the early activation of quadriceps following lower limb orthopedic surgeries.

Methods

This was a proof of concept clinical trial. A single-blinded randomized controlled study was conducted on 24 patients who underwent lower limb surgeries. The experimental group received standardized physiotherapy treatment in addition to pressure biofeedback for quadriceps retraining. The control group received a standardized physiotherapy treatment developed for an inpatient orthopedic setting. The motor unit action potential (MUAP) duration and amplitude were measured using electromyography on the second and sixth postoperative days.

Results

Twenty-four participants, with a mean age for the control group of 58.67 ± 17.21 and the experimental group of 40.1 ± 6.96, were enrolled. No statistical significance in MUAP amplitude for within the groups (F[5,85] = 1.735, P = .135) was found. However, there was a statistical significance between the control and experimental groups in amplitude measured by electromyography (F[1,17] = 49.09, P < .01). There was no statistical significance in MUAP duration for within the groups (F[5,85] = 1.303, P = .270). However, there was a statistical significance in duration (F[1,17] = 71.84, P < .01).

Conclusion

Pressure biofeedback was more effective in the early activation of quadriceps muscle when coupled with conventional exercises compared with conventional exercises alone following lower limb orthopedic surgeries. Early activation of quadriceps could be a contributing factor to preventing arthrogenic muscle inhibition.

目的探讨压力生物反馈在下肢骨科手术后股四头肌早期激活中的可能作用。方法采用概念验证型临床试验。对24例下肢手术患者进行单盲随机对照研究。实验组在压力生物反馈的基础上接受标准化的物理治疗进行股四头肌再训练。对照组接受为住院骨科患者制定的标准化物理治疗。术后第2天和第6天采用肌电图测量运动单位动作电位(MUAP)持续时间和振幅。结果共纳入24例患者,对照组平均年龄58.67±17.21岁,试验组平均年龄40.1±6.96岁。各组间MUAP振幅差异无统计学意义(F[5,85] = 1.735, P = 0.135)。但对照组与实验组肌电测幅值差异有统计学意义(F[1,17] = 49.09, P <. 01)。各组间MUAP持续时间差异无统计学意义(F[5,85] = 1.303, P = 0.270)。但持续时间差异有统计学意义(F[1,17] = 71.84, P <. 01)。结论下肢骨科术后,压力生物反馈联合常规运动对股四头肌早期激活的效果优于单纯常规运动。股四头肌的早期激活可能是预防关节源性肌肉抑制的一个因素。
{"title":"Early Activation of Quadriceps With Pressure Biofeedback for the Prevention of Arthrogenic Muscle Inhibition Following Lower Limb Orthopedic Surgeries: A Proof of Concept Clinical Trial","authors":"Jeslin T. Achens MPT,&nbsp;Vijay S. Raj Victor MPT,&nbsp;Jakson K. Joseph MPT","doi":"10.1016/j.jcm.2022.05.005","DOIUrl":"10.1016/j.jcm.2022.05.005","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this study was to explore the possible role of pressure biofeedback in the early activation of quadriceps following </span>lower limb orthopedic surgeries.</p></div><div><h3>Methods</h3><p>This was a proof of concept clinical trial<span><span>. A single-blinded randomized controlled study was conducted on 24 patients who underwent lower limb surgeries. The experimental group received standardized physiotherapy treatment<span> in addition to pressure biofeedback for quadriceps retraining. The control group received a standardized physiotherapy treatment developed for an inpatient orthopedic setting. The motor unit action potential (MUAP) duration and amplitude were measured using </span></span>electromyography on the second and sixth postoperative days.</span></p></div><div><h3>Results</h3><p>Twenty-four participants, with a mean age for the control group of 58.67 ± 17.21 and the experimental group of 40.1 ± 6.96, were enrolled. No statistical significance in MUAP amplitude for within the groups (F[5,85] = 1.735, <em>P</em> = .135) was found. However, there was a statistical significance between the control and experimental groups in amplitude measured by electromyography (F[1,17] = 49.09, <em>P</em><span> &lt; .01). There was no statistical significance in MUAP duration for within the groups (F[5,85] = 1.303, </span><em>P</em> = .270). However, there was a statistical significance in duration (F[1,17] = 71.84, <em>P</em> &lt; .01).</p></div><div><h3>Conclusion</h3><p>Pressure biofeedback was more effective in the early activation of quadriceps muscle when coupled with conventional exercises compared with conventional exercises alone following lower limb orthopedic surgeries. Early activation of quadriceps could be a contributing factor to preventing arthrogenic muscle inhibition.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 4","pages":"Pages 296-304"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9556235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of Telemedicine in the Diagnosis of Cervical Spondylotic Myelopathy in a US Veteran During the COVID-19 Pandemic: A Case Report 在COVID-19大流行期间使用远程医疗诊断美国退伍军人的脊髓型颈椎病:病例报告
Pub Date : 2022-09-01 DOI: 10.1016/j.jcm.2022.03.004
Alyssa Troutner DC, MS, Michael Barbato DC

Objective

The purpose of this case study was to describe the diagnosis of cervical spondylotic myelopathy through telemedicine during the COVID-19 pandemic.

Clinical Features

A 57-year-old male patient was evaluated at a Veterans Affairs chiropractic clinic via video telemedicine for evaluation regarding neck pain and bilateral arm paresthesia.

Intervention and Outcome

During the initial evaluation performed by video telemedicine, the doctor of chiropractic was concerned about the possibility of cervical spondylotic myelopathy. This prompted a face-to-face consultation with the patient for further evaluation. The face-to-face evaluation revealed correlating objective findings, including brisk reflexes and transient clonus. Noncontrast magnetic resonance imaging of the cervical spine was performed, which showed evidence of cord compression with associated myelomalacia in the cervical spine at the C4-C5 level. After a neurosurgical consultation, the patient underwent successful anterior cervical decompression and fusion at the C4-C5 level.

Conclusion

Chiropractic services through live video telemedicine in conjunction with face-to-face evaluation resulted in a timely neurosurgical consultation and successful decompression of the affected region. In this case, telemedicine facilitated a positive outcome for a patient with cervical spondylotic myelopathy.

目的探讨COVID-19大流行期间远程医疗对脊髓型颈椎病的诊断。临床特征:一名57岁男性患者在退伍军人事务部整脊诊所通过视频远程医疗评估其颈部疼痛和双侧手臂感觉异常。干预措施和结果在通过视频远程医疗进行的初步评估中,整脊医生担心出现脊髓型颈椎病的可能性。这促使与患者进行面对面的会诊以进一步评估。面对面的评估揭示了相关的客观发现,包括快速反射和短暂的结膜炎。对颈椎进行非对比磁共振成像,显示颈椎C4-C5水平有脊髓受压伴髓鞘软化的证据。神经外科会诊后,患者成功行颈椎前路减压和C4-C5节段融合术。结论通过实时视频远程医疗结合面对面评估的捏脊服务可以及时进行神经外科会诊,并成功地对患区进行减压。在本例中,远程医疗促进了脊髓型颈椎病患者的积极结果。
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引用次数: 1
Comparison of Blood Pressure and Pulse Adaptations Between Younger and Older Patients During Balneotherapy With Physiotherapy balnetherapy与physical therapy对年轻与年老患者血压与脉搏适应的比较
Pub Date : 2022-09-01 DOI: 10.1016/j.jcm.2022.02.012
Senem Sas MD , Derya Ozer Kaya PT, PhD , Seyda Toprak Celenay PT, PhD

Objective

This study aimed to investigate the blood pressure and pulse adaptation characteristics between younger and older patients with musculoskeletal disorders during acute and recovery responses at the first and 10th sessions of balneotherapy added to physiotherapy.

Methods

Forty-six participants (n = 22, between 18 and 35 years of age as young adults; n = 24, more than 65 years of age as older adults) with musculoskeletal disorders admitted to physiotherapy therapy sessions with balneotherapy were enrolled. The participants’ immersion time was 20 minutes each during 10 sessions occurring over the course of 2 weeks. Blood pressure and pulse were measured at the baseline and the 5th minute as acute responses, and at the baseline and the 30th minute as recovery responses during the first and 10th sessions.

Results

First, the group and session effect was examined. There was no significance in this part. Then, session main effect and group main effect were examined. The group main effect was significant, that is, a difference was found between groups independent of the session in terms of only pulse values (P < .001). There was no difference in sessions. The acute and recovery responses of the pulse at the first and 10th sessions of balneotherapy showed higher alterations in the young people compared with the older people (P < .008).

Conclusion

Greater pulse alterations at the acute and recovery phases of the first and 10th sessions were observed in young adults.

目的探讨老年和老年肌肉骨骼疾病患者在第1次和第10次按摩加物理治疗急性期和恢复期的血压和脉搏适应特征。方法46名参与者(n = 22名,年龄在18 - 35岁之间;N = 24例,年龄大于65岁的老年人)患有肌肉骨骼疾病,接受理疗治疗。参与者的沉浸时间为20分钟,在为期两周的10次会议中进行。在第一次和第10次疗程中,在基线和第5分钟测量血压和脉搏作为急性反应,在基线和第30分钟测量血压和脉搏作为恢复反应。结果首先检验了群体效应和会话效应。这部分没有什么意义。然后对分组主效应和分组主效应进行检验。组主效应是显著的,也就是说,独立于会话的组之间仅在脉冲值方面存在差异(P <措施)。疗程没有差异。在第一次和第10次按摩治疗中,脉搏的急性和恢复反应在年轻人中显示出比老年人更高的变化(P <.008)。结论青壮年第1、10期急性期和恢复期脉搏变化较大。
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引用次数: 1
Influence of a Sacroiliac Belt on Pain and Functional Impairment in Patients With Low Back Pain: A Randomized Trial 骶髂带对腰痛患者疼痛和功能损害的影响:一项随机试验
Pub Date : 2022-09-01 DOI: 10.1016/j.jcm.2022.06.001
John S. Ward DC, MA, MS

Objective

The purpose of this study was to assess the protective influence of the Serola Sacroiliac Belt on pain and functional impairment in individuals with low back pain (LBP) during 5 days of strenuous manual labor.

Methods

Thirty-three participants (mean ± standard deviation: age, 43.2 ± 11.4 years; height, 1.74 ± 0.11 m; body mass index, 88.3 ± 16.7 kg) with LBP were randomized to either condition A (wearing the Serola Sacroiliac Belt during a 10-minute daily repeated strenuous lifting task) during week 1 or condition B (not wearing a Serola Sacroiliac Belt during the same lifting task) in week 2 or vice versa. All 33 participants completed 1 week under condition A and 1 week under condition B for comparison. At the beginning and end of each week, the following dependent variables were measured: lumbar spine pain on a 0 to 10 Numeric Rating Scale (NRS), spine and thigh discomfort on a Nordic Musculoskeletal Questionnaire, and completion of a toe-touch surface electromyography flexion relaxation phenomenon test.

Results

During the week that participants used the Serola Sacroiliac Belt, spine pain increased 0.2 compared with 0.9 on the NRS for those who did not use the belt. No statistically significant difference was observed for Nordic Musculoskeletal Questionnaire data or the flexion relaxation phenomenon test in this study.

Conclusion

The findings of this preliminary study suggest participants using the Serola Sacroiliac Belt while performing a daily repeated lifting task had less progression of their LBP. However, this protective value did not meet the recommended NRS for minimally clinically important difference, and there was no effect on functional impairment.

目的本研究的目的是评估骶髂血清带对腰痛(LBP)患者在5天的剧烈体力劳动中疼痛和功能损害的保护作用。方法33例受试者(平均±标准差:年龄43.2±11.4岁;高度:1.74±0.11 m;体重指数为88.3±16.7 kg)的腰痛患者在第1周随机分为A组(每天10分钟重复剧烈举重任务中佩戴骶髂带),或B组(在相同的举重任务中不佩戴骶髂带),反之亦然。所有33名参与者在条件A和条件B下完成了1周的比较。在每周开始和结束时,测量以下因变量:腰椎疼痛(0 - 10数值评定量表(NRS)),脊柱和大腿不适(北欧肌肉骨骼问卷),完成脚趾接触表面肌电图屈曲松弛现象测试。结果在使用骶髂带的一周内,受试者的脊柱疼痛增加了0.2,而未使用骶髂带的受试者的NRS疼痛增加了0.9。北欧肌肉骨骼问卷数据和屈曲松弛现象测试在本研究中无统计学差异。结论:本初步研究的结果表明,在进行每日重复举重任务时使用骶髂带的参与者的腰痛进展较少。然而,这一保护价值没有达到推荐的NRS的最低临床重要差异,并且对功能损害没有影响。
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引用次数: 0
Visualizing Anatomic Variants of the Sciatic Nerve Using Diagnostic Ultrasound During Piriformis Muscle Injection: An Example of 4 Cases 梨状肌注射过程中坐骨神经解剖变异的超声诊断观察(附4例)
Pub Date : 2022-09-01 DOI: 10.1016/j.jcm.2022.02.017
Gamze Gül Güleç MD , Kübra Neslihan Kurt Oktay MD , İlknur Aktaş MD , Barış Yılmaz MD

Objective

The aim of this article is to present examples of patients in whom piriformis muscle (PM) and sciatic nerve (SN) variations were detected by a diagnostic ultrasound (US)–guided examination and were successfully diagnosed and treated for piriformis syndrome (PS) by US-guided injections.

Clinical Features

This series includes 4 cases. In case 1, a 30-year-old woman with a 7 numeric rating scale (NRS) score for pain (on a 0-10 scale) was evaluated for complaints of left gluteal pain radiating to the thigh for 5 years and right gluteal pain for 2 years. Case 2 involves a 32-year-old man with a 7 NRS score presenting with left gluteal pain radiating to his leg for 1 year. The third case presents a 37-year-old man who had pain (6 NRS score), numbness, and discomfort radiating from the right hip to the leg that lasted for 7 years. Finally, in case 4, a 23-year-old male patient was examined with deep gluteal paresthesia and discomfort on the left side for 1 year.

Intervention and Outcome

Diagnostic US evaluation of the gluteal region for each patient revealed anatomical variations of the SN. In 3 of the cases, corresponding contralateral US images demonstrated similar anatomic variations. Diagnosis of PS in each patient was made by US-guided injection. After the injection of 4 cm3 of lidocaine 2% into the PM, the patients’ complaints resolved almost fully.

Conclusion

The anatomical variations of the SN and PM might be a facilitating factor for myofascial pain syndrome in PS. These cases demonstrate that SN variations could be visualized with the help of diagnostic US.

目的通过超声诊断检查发现梨状肌(PM)和坐骨神经(SN)变异,并通过超声引导注射成功诊断和治疗梨状肌综合征(PS)的病例。临床特点本系列包括4例。在病例1中,一名30岁的女性用7数值评定量表(NRS)对疼痛进行评分(0-10分),评估她的左臀痛放射至大腿5年,右臀痛2年。病例2涉及一名32岁男性,NRS评分为7分,表现为左臀痛放射至腿部1年。第三例患者为37岁男性,疼痛(NRS评分6分)、麻木和从右髋向腿部放射的不适持续了7年。最后,病例4,一名23岁男性患者因深臀感觉异常和左侧不适检查了1年。干预和结果每位患者臀区诊断性美国评估显示了SN的解剖差异。在3例中,相应的对侧US图像显示类似的解剖变化。每例患者均经us引导注射诊断为PS。在PM中注射2%利多卡因4 cm3后,患者的症状几乎完全消失。结论骶椎弓根和脊膜弓根的解剖变异可能是诱发骶椎弓根肌筋膜疼痛综合征的一个因素。这些病例表明,在超声诊断的帮助下,骶椎弓根弓根的变异是可以可视化的。
{"title":"Visualizing Anatomic Variants of the Sciatic Nerve Using Diagnostic Ultrasound During Piriformis Muscle Injection: An Example of 4 Cases","authors":"Gamze Gül Güleç MD ,&nbsp;Kübra Neslihan Kurt Oktay MD ,&nbsp;İlknur Aktaş MD ,&nbsp;Barış Yılmaz MD","doi":"10.1016/j.jcm.2022.02.017","DOIUrl":"10.1016/j.jcm.2022.02.017","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this article is to present examples of patients in whom piriformis muscle (PM) and sciatic nerve<span> (SN) variations were detected by a diagnostic ultrasound (US)–guided examination and were successfully diagnosed and treated for piriformis syndrome (PS) by US-guided injections.</span></p></div><div><h3>Clinical Features</h3><p>This series includes 4 cases. In case 1, a 30-year-old woman with a 7 numeric rating scale (NRS) score for pain (on a 0-10 scale) was evaluated for complaints of left gluteal pain radiating to the thigh for 5 years and right gluteal pain for 2 years. Case 2 involves a 32-year-old man with a 7 NRS score presenting with left gluteal pain radiating to his leg for 1 year. The third case presents a 37-year-old man who had pain (6 NRS score), numbness, and discomfort radiating from the right hip to the leg that lasted for 7 years. Finally, in case 4, a 23-year-old male patient was examined with deep gluteal paresthesia and discomfort on the left side for 1 year.</p></div><div><h3>Intervention and Outcome</h3><p><span><span>Diagnostic US evaluation of the gluteal region for each patient revealed anatomical variations of the SN. In 3 of the cases, corresponding </span>contralateral US images demonstrated similar anatomic variations. Diagnosis of PS in each patient was made by US-guided injection. After the injection of 4 cm</span><sup>3</sup> of lidocaine 2% into the PM, the patients’ complaints resolved almost fully.</p></div><div><h3>Conclusion</h3><p>The anatomical variations of the SN and PM might be a facilitating factor for myofascial pain syndrome in PS. These cases demonstrate that SN variations could be visualized with the help of diagnostic US.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 3","pages":"Pages 213-219"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10801401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Within-Subject Changes in Shoulder Girdle Muscle Activation After Soft Tissue Mobilization of the Upper Trapezius 上斜方肌软组织活动后肩带肌激活的受试者内变化
Pub Date : 2022-09-01 DOI: 10.1016/j.jcm.2022.04.003
Tanmay Sathe MPT, Anupama Prabhu MPT, Kavitha Vishal MPT

Objective

The purpose of this study was to investigate the effect of the integrated neuromuscular inhibition technique (INIT) of the upper trapezius (UT) on shoulder muscle activity in chronic shoulder pain.

Methods

Twenty-two patients (mean age 42.5 ± 16.07) with chronic unilateral shoulder pain with UT myofascial trigger points (MTrPs) (n = 27) and scapular dyskinesis received a single session of INIT (∼15 minutes for each MTrP). The pain on the visual analog scale, along with surface electromyographic activity, maximum voluntary contraction in % (in arm raising and lowering in scapular plane), and pressure pain threshold (PPT) of 5 girdle muscles UT, lower trapezius, serratus anterior, middle deltoid, and infraspinatus were measured before and immediately after treatment. Wilcoxon signed-rank test was used for analysis (at α ≤ 0.05).

Results

Muscle activity of all the muscles, especially the lower trapezius, was reduced during arm raising in the scapular plane (76.69%-71.14% [p = 0.003]). UT activity decreased during arm lowering also (56.70%-45.99% [p ˂ 0.001]). The intensity of shoulder pain reduced (50.50 mm to 22 mm, [p ˂ 0.001]), and PPT values of all 5 muscles improved post-treatment.

Conclusion

The findings of this study provide preliminary evidence for the application of a single session of INIT on UT MTrPs in reducing activity in the scapular muscles, improving shoulder pain, and PPT in chronic unilateral shoulder pain.

目的探讨斜方肌上段综合神经肌肉抑制技术(INIT)对慢性肩痛患者肩肌活动的影响。方法22例(平均年龄42.5±16.07)伴有肌筋膜触发点(MTrPs)的慢性单侧肩痛患者(n = 27)和肩胛骨运动障碍患者接受单次INIT治疗(每次MTrP治疗~ 15分钟)。测量治疗前后5块腰肌UT、下斜方肌、前锯肌、中三角肌、冈下肌的视觉模拟疼痛、体表肌电活动、最大自主收缩%(肩胛平面上的上臂和下臂)和压痛阈值(PPT)。采用Wilcoxon符号秩检验进行分析(α≤0.05)。结果在抬臂过程中,肩胛骨平面各肌肉活动度均降低(76.69% ~ 71.14% [p = 0.003]),尤其是下斜方肌活动度降低。UT活性在手臂降低时也降低(56.70% ~ 45.99% [p小于0.001])。肩部疼痛强度降低(50.50 mm至22 mm, [p小于0.001]),治疗后5块肌肉的PPT值均有所改善。结论本研究结果为单次INIT应用于UT MTrPs降低肩胛骨肌肉活动,改善肩部疼痛和PPT治疗慢性单侧肩部疼痛提供了初步证据。
{"title":"Within-Subject Changes in Shoulder Girdle Muscle Activation After Soft Tissue Mobilization of the Upper Trapezius","authors":"Tanmay Sathe MPT,&nbsp;Anupama Prabhu MPT,&nbsp;Kavitha Vishal MPT","doi":"10.1016/j.jcm.2022.04.003","DOIUrl":"10.1016/j.jcm.2022.04.003","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to investigate the effect of the integrated neuromuscular inhibition technique (INIT) of the upper trapezius (UT) on shoulder muscle activity in chronic shoulder pain.</p></div><div><h3>Methods</h3><p><span>Twenty-two patients (mean age 42.5 ± 16.07) with chronic unilateral shoulder pain with UT myofascial trigger points (MTrPs) (n = 27) and scapular dyskinesis received a single session of INIT (∼15 minutes for each MTrP). The pain on the visual analog scale, along with surface electromyographic activity, maximum voluntary contraction in % (in arm raising and lowering in scapular plane), and </span>pressure pain threshold<span> (PPT) of 5 girdle muscles UT, lower trapezius, serratus anterior, middle deltoid, and infraspinatus were measured before and immediately after treatment. Wilcoxon signed-rank test was used for analysis (at α ≤ 0.05).</span></p></div><div><h3>Results</h3><p>Muscle activity of all the muscles, especially the lower trapezius, was reduced during arm raising in the scapular plane (76.69%-71.14% [p = 0.003]). UT activity decreased during arm lowering also (56.70%-45.99% [p ˂ 0.001]). The intensity of shoulder pain reduced (50.50 mm to 22 mm, [p ˂ 0.001]), and PPT values of all 5 muscles improved post-treatment.</p></div><div><h3>Conclusion</h3><p>The findings of this study provide preliminary evidence for the application of a single session of INIT on UT MTrPs in reducing activity in the scapular muscles, improving shoulder pain, and PPT in chronic unilateral shoulder pain.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 3","pages":"Pages 149-156"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10801405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Demographic Factors Associated With Public Awareness of Chiropractic in Klang Valley, Malaysia: A Cross-sectional Study 在马来西亚巴生谷,人口统计学因素与公众对脊骨疗法的认识相关:一项横断面研究
Pub Date : 2022-09-01 DOI: 10.1016/j.jcm.2022.02.020
Yi Kai Wong BSc(Chiro), MPH , Kok Leong Tan MPH , Michael Thomas Haneline DC, MPH

Objective

The purposes of this study were to determine the public awareness of chiropractic in Klang Valley and to identify sociodemographic factors associated with this awareness.

Methods

A cross-sectional study with a total of 440 respondents was conducted in medical, chiropractic, pharmacy, and dental health care facilities in Klang Valley. A self-administrated questionnaire was enclosed in an envelope and handed to the participants by the health care facilities’ staff. Tables and figures were used to present the descriptive data. Data collected were also analyzed using inferential statistics such as binary logistic regression, odds ratio, and 95% confidence interval. The variables in this study were age, ethnicity, sex, education level, marital status, nationality, employment status, and health status along with awareness of chiropractic.

Results

The respondents’ ages ranged from 18 to 81 years, and the mean age was 33.1 years. The majority of respondents were single (52.1%), and 43.1% of respondents were married. Most of the respondents were employed (64.4%), followed by students (14.8%). Among the respondents, 40.2% perceived to have a good health status. Good awareness of chiropractic was 50.2%, whereas the poor awareness of chiropractic was 49.8%. Two sociodemographic factors that were statistically significantly associated with the awareness of chiropractic were ethnicity and employment status, with a P value of <.001 and .006, respectively.

Conclusion

The level of public awareness of chiropractic was 50.2%, with ethnicity and employment status as statistically significant associated factors.

目的本研究的目的是确定巴生谷公众对脊椎指压疗法的认识,并确定与这种认识相关的社会人口因素。方法在巴生谷的医疗、脊椎指压、药房和牙科保健机构对440名受访者进行了横断面研究。保健机构的工作人员将一份自行填写的调查表装入信封,交给参与者。描述性数据采用表格和图表。收集的数据还使用二元逻辑回归、优势比和95%置信区间等推理统计进行分析。研究变量包括年龄、种族、性别、教育程度、婚姻状况、国籍、就业状况、健康状况以及对捏脊疗法的认识。结果调查对象年龄18 ~ 81岁,平均年龄33.1岁。大多数受访者为单身(52.1%),43.1%的受访者已婚。受访者中就业人数最多(64.4%),其次是学生(14.8%)。在受访者中,40.2%的人认为自己的健康状况良好。捏脊意识良好的占50.2%,捏脊意识不佳的占49.8%。与捏脊意识有统计学显著相关的两个社会人口因素是种族和就业状况,P值为<分别为0.001和0.006。结论公众捏脊知识知知率为50.2%,种族和就业状况是有统计学意义的相关因素。
{"title":"Demographic Factors Associated With Public Awareness of Chiropractic in Klang Valley, Malaysia: A Cross-sectional Study","authors":"Yi Kai Wong BSc(Chiro), MPH ,&nbsp;Kok Leong Tan MPH ,&nbsp;Michael Thomas Haneline DC, MPH","doi":"10.1016/j.jcm.2022.02.020","DOIUrl":"10.1016/j.jcm.2022.02.020","url":null,"abstract":"<div><h3>Objective</h3><p>The purposes of this study were to determine the public awareness of chiropractic in Klang Valley and to identify sociodemographic factors associated with this awareness.</p></div><div><h3>Methods</h3><p><span><span>A cross-sectional study with a total of 440 respondents was conducted in medical, chiropractic, pharmacy, and dental health care facilities in Klang Valley. A self-administrated questionnaire was enclosed in an envelope and handed to the participants by the health care facilities’ staff. Tables and figures were used to present the descriptive data. Data collected were also analyzed using </span>inferential statistics such as binary </span>logistic regression, odds ratio, and 95% confidence interval. The variables in this study were age, ethnicity, sex, education level, marital status, nationality, employment status, and health status along with awareness of chiropractic.</p></div><div><h3>Results</h3><p>The respondents’ ages ranged from 18 to 81 years, and the mean age was 33.1 years. The majority of respondents were single (52.1%), and 43.1% of respondents were married. Most of the respondents were employed (64.4%), followed by students (14.8%). Among the respondents, 40.2% perceived to have a good health status. Good awareness of chiropractic was 50.2%, whereas the poor awareness of chiropractic was 49.8%. Two sociodemographic factors that were statistically significantly associated with the awareness of chiropractic were ethnicity and employment status, with a <em>P</em> value of &lt;.001 and .006, respectively.</p></div><div><h3>Conclusion</h3><p>The level of public awareness of chiropractic was 50.2%, with ethnicity and employment status as statistically significant associated factors.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 3","pages":"Pages 187-196"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10814875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of chiropractic medicine
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