scholarly journals Immediate and Short-Term Effects of Upper Cervical High-Velocity, Low-Amplitude Manipulation on Standing Postural Control and Cervical Mobility in Chronic Nonspecific Neck Pain: A Randomized Controlled Trial

2020 ◽  
Vol 9 (8) ◽  
pp. 2580
Author(s):  
Francisco Gómez ◽  
Pablo Escribá ◽  
Jesús Oliva-Pascual-Vaca ◽  
Roberto Méndez-Sánchez ◽  
Ana Silvia Puente-González

This study aimed to determine the immediate and short-term effects of a single upper cervical high-velocity, low-amplitude (HVLA) manipulation on standing postural control and cervical mobility in chronic nonspecific neck pain (CNSNP). A double-blinded, randomized placebo-controlled trial was performed. Forty-four patients with CNSNP were allocated to the experimental group (n = 22) or control group (n = 22). All participants were assessed before and immediately after the intervention, with a follow-up on the 7th and 15th days. In each evaluation, we assessed global and specific stabilometric parameters to analyze standing postural balance and performed the cervical flexion-rotation test (CFRT) to analyze upper cervical mobility. We obtained statistically significant differences, with a large effect size, in the limited cervical rotation and global stabilometric parameters. Upper cervical HVLA manipulation produced an improvement in the global stabilometric parameters, significantly decreasing the mean values of velocity, surface, path length, and pressure in all assessments (p < 0.001; ƞ 2 p = 0.323–0.856), as well as significantly decreasing the surface length ratio (L/S) on the 7th (−0.219 1/mm; p = 0.008; 95% confidence interval (CI): 0.042–0.395) and 15th days (−0.447 1/mm; p < 0.001; 95% CI: 0.265–0.629). Limited cervical rotation values increased significantly immediately after manipulation (7.409°; p < 0.001; 95% CI: 6.131–8.687) and were maintained during follow-up (p < 0.001). These results show that a single upper cervical HVLA manipulation produces an improvement in standing postural control and increases the rotational range of motion (ROM) in the upper cervical spine in patients with CNSNP.

Author(s):  
Raúl Romero del Rey ◽  
Manuel Saavedra Hernández ◽  
Cleofás Rodríguez Blanco ◽  
Luis Palomeque del Cerro ◽  
Raquel Alarcón Rodríguez

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Huihao Wang ◽  
Enyu Jiang ◽  
Kuan Wang ◽  
Zhen Deng ◽  
Hongsheng Zhan ◽  
...  

Objective. To compare the immediate and short term effectiveness of Shi’s Daoyin therapy (DT) rather than the Melbourne Protocol (MP) in terms of pain, mobility, and isometric strength of cervical muscles in nonacute nonspecific neck pain patients. Material and Methods. A total of 114 nonacute nonspecific neck pain patients aged 20~50 years were recruited and randomly assigned to be treated by either Shi’s DT or the MP. 56 cases and 54 cases received treatment for 3 weeks and were evaluated before and after intervention and at 3-week follow-up in Shi’s DT group and MP group, respectively. The outcome measures were Chinese version of the Neck Disability Index (NDI), cervical range of motion (ROM), maximal voluntary isometric force (MVIF), and pain intensity (Numeric Pain Rating Scale, NPRS). Results. All outcomes of both groups showed statistically significant improvements after the intervention and at 3-week follow-up (P < 0.05), while no statistically significant difference was found in NDI between groups. When followed up after 3 weeks, the ROM in axial rotation was significantly greater in the Shi’s DT group (P < 0.05), and the NPRS in the Shi’s DT group was significantly lower than the MP group (P < 0.05). At the end of the treatment period, the MVIF in lateral bending in the Shi’s DT group had a lower value (P = 0.044) than in the MP group, but there was no significant difference in flexion and extension between the two groups. Conclusions. Both Shi’s DT and MP groups demonstrated an obvious reduction in pain intensity and improvements in neck mobility after a short term follow-up period. The improvement of Shi’s DT in disability and pain during functional activities is generally similar to that of the MP for the treatment of nonacute nonspecific neck pain.


2014 ◽  
Vol 19 (4) ◽  
pp. 331-337 ◽  
Author(s):  
Amaloha Casanova-Méndez ◽  
Ángel Oliva-Pascual-Vaca ◽  
Cleofás Rodriguez-Blanco ◽  
Alberto Marcos Heredia-Rizo ◽  
Kristobal Gogorza-Arroitaonandia ◽  
...  

2019 ◽  
Vol 28 (3) ◽  
pp. 1039-1052
Author(s):  
Reva M. Zimmerman ◽  
JoAnn P. Silkes ◽  
Diane L. Kendall ◽  
Irene Minkina

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.


Diabetes ◽  
1984 ◽  
Vol 33 (10) ◽  
pp. 995-1001 ◽  
Author(s):  
K. Perlman ◽  
R. M. Ehrlich ◽  
R. M. Filler ◽  
A. M. Albisser

2021 ◽  
pp. 036354652199190
Author(s):  
Nikolaj M. Malmgaard-Clausen ◽  
Oscar H. Jørgensen ◽  
Rikke Høffner ◽  
Peter E.B. Andersen ◽  
Rene B. Svensson ◽  
...  

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used in the treatment of Achilles tendinopathy, but whether they have any additive clinical effect on physical rehabilitation in the early phase of tendinopathy remains unknown. Purpose/Hypothesis: To investigate whether an initial short-term NSAID treatment added to a physical rehabilitation program in the early phase of Achilles tendinopathy would have an additive effect. We hypothesized that the combination of NSAID and rehabilitation would be superior to rehabilitation alone. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 69 patients with early phase Achilles tendinopathy (lasting <3 months) were randomly assigned to either a naproxen group (7 days of treatment; 500 mg twice daily; n = 34) or a placebo group (7 days of placebo treatment; n = 35). Both groups received an identical 12-week physical rehabilitation program. The clinical outcome of the study was evaluated using the Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaire and a numerical rating scale (NRS), and the physiological outcome was evaluated using ultrasonography, magnetic resonance imaging (MRI), and ultra-short time to echo T2* mapping MRI (UTE T2* MRI). Follow-up was performed at 1 week, 3 months, and 1 year. Time effects are presented as mean difference ± SEM. Results: No significant differences were found between the 2 treatment groups for any of the outcome measures at any time point ( P > .05). For the VISA-A score, a significant time effect was observed between baseline and 3-month follow-up (14.9 ± 2.3; P < .0001), and at 1-year follow-up, additional improvements were observed (6.1 ± 2.3; P < .01). Furthermore, the change in VISA-A score between baseline and 3-month follow-up was greater in patients with very short symptom duration (<1 month) at baseline compared with patients who had longer symptom duration (>2 months) (interaction between groups, 11.7 ± 4.2; P < .01). Despite clinical improvements, total weekly physical activity remained lower compared with preinjury levels at 3 months (–2.7 ± 0.5 h/wk; P < .0001) and 1 year (–3.0 ± 0.5 h/wk; P < .0001). At baseline, ultrasonography showed increased thickness (0.12 ± 0.03 cm; P < .0001) and vascularity (0.3 ± 0.1 cm2; P < .005) on the tendinopathic side compared with the contralateral side, but no changes over time were observed for ultrasonography, MRI, or UTE T2* MRI results. Conclusion: Clinical symptoms in early tendinopathy improved with physical rehabilitation, but this improvement was not augmented with the addition of NSAID treatment. Furthermore, this clinical recovery occurred in the absence of any measurable structural alterations. Finally, clinical improvements after a physical rehabilitation program were greater in patients with very short symptom duration compared with patients who had longer symptom duration. Registration: NCT03401177 (ClinicalTrials.gov identifier) and BFH-2016-019 (Danish Data Protection Agency)


Author(s):  
Ferdows Atiq ◽  
Jens van de Wouw ◽  
Oana Sorop ◽  
Ilkka Heinonen ◽  
Moniek P. M. de Maat ◽  
...  

AbstractIt is well known that high von Willebrand factor (VWF) and factor VIII (FVIII) levels are associated with an increased risk of cardiovascular disease. It is still debated whether VWF and FVIII are biomarkers of endothelial dysfunction and atherosclerosis or whether they have a direct causative role. Therefore, we aimed to unravel the pathophysiological pathways of increased VWF and FVIII levels associated with cardiovascular risk factors. First, we performed a randomized controlled trial in 34 Göttingen miniswine. Diabetes mellitus (DM) was induced with streptozotocin and hypercholesterolemia (HC) via a high-fat diet in 18 swine (DM + HC), while 16 healthy swine served as controls. After 5 months of follow-up, FVIII activity (FVIII:C) was significantly higher in DM + HC swine (5.85 IU/mL [5.00–6.81]) compared with controls (4.57 [3.76–5.40], p = 0.010), whereas VWF antigen (VWF:Ag) was similar (respectively 0.34 IU/mL [0.28–0.39] vs. 0.34 [0.31–0.38], p = 0.644). DM + HC swine had no endothelial dysfunction or atherosclerosis during this short-term follow-up. Subsequently, we performed a long-term (15 months) longitudinal cohort study in 10 Landrace–Yorkshire swine, in five of which HC and in five combined DM + HC were induced. VWF:Ag was higher at 15 months compared with 9 months in HC (0.37 [0.32–0.42] vs. 0.27 [0.23–0.40], p = 0.042) and DM + HC (0.33 [0.32–0.37] vs. 0.25 [0.24–0.33], p = 0.042). Both long-term groups had endothelial dysfunction compared with controls and atherosclerosis after 15 months. In conclusion, short-term hyperglycemia and dyslipidemia increase FVIII, independent of VWF. Long-term DM and HC increase VWF via endothelial dysfunction and atherosclerosis. Therefore, VWF seems to be a biomarker for advanced cardiovascular disease.


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