Effects of Sustained Natural Apophyseal Glides with and without thoracic posture correction techniques on mechanical back pain: a randomized control trial.

OBJECTIVE: To determine effectiveness of sustained natural apophyseal glides with and without thoracic postural correction techniques on patients of chronic mechanical low back pain . METHODS: The randomized control trial was conducted at the National Institute of Rehabilitation Medicine, Islamabad, Pakistan, from November 1, 2015, to January 31, 2016, and comprised females aged 20-60 years experiencing mechanical low back pain for more than 03 months. They were randomly assigned to two equal groups. Group 1 was given Mulligan sustained natural apophyseal glides mobilization, while group2 was given the same along with thoracic postural correction techniques for 4 weeks, 3 sessions per week and one session per day. Outcome measures included Numeric Pain Rating Scale, Oswestry Disability Index and Goniometry of Lumbar Range of Motion. Data was analysed using SPSS 20. RESULTS: Of the 40 patients, there were 20(50%) in each of the groups. Mean age of patients in group 1 was 41.30±10.45years, while in group 2 it was 35.12±9.04 years. Compared to the baseline readings, pain, functional independence and range of motion showed significant improvement (p<0.0001) postintervention in both groups. Mean scores in group 2 showed more improvement than group 1 (p<0.0001) in all variables. CONCLUSIONS: The effectiveness of thoracic postural correction exercises along with sustained natural apophyseal glides was noted in patients with mechanical low back pain.

River food webs: an integrative approach to bottom-up flow webs, top-down impact webs, and trophic position.

The majority of food web studies are based on connectivity, top-down impacts, bottom-up flows, or trophic position (TP), and ecologists have argued for decades which is best. Rarely have any two been considered simultaneously. The present study uses a procedure that integrates the last three approaches based on taxon-specific secondary production and gut analyses. Ingestion flows are quantified to create a flow web and the same data are used to quantify TP for all taxa. An individual predator's impacts also are estimated using the ratio of its ingestion (I) of each prey to prey production (P) to create an I/P web. This procedure was applied to 41 invertebrate taxa inhabiting submerged woody habitat in a southeastern U.S. river. A complex flow web starting with five basal food resources had 462 flows >1 mg·m-2 ·yr-1 , providing far more information than a connectivity web. Total flows from basal resources to primary consumers/omnivores were dominated by allochthonous amorphous detritus and ranged from 1 to >50,000 mg·m-2 ·yr-1 . Most predator-prey flows were much lower (<50 mg·m-2 ·yr-1 ), but some were >1,000  mg·m-2 ·yr-1 . The I/P web showed that 83% of individual predator impacts were weak (<10%), whereas total predator impacts were often strong (e.g., 35% of prey sustained an impact >90%). Quantitative estimates of TP ranged from 2 to 3.7, contrasting sharply with seven integer-based trophic levels based on longest feeding chain. Traditional omnivores (TP = 2.4-2.9) played an important role by consuming more prey and exerting higher impacts on primary consumers than strict predators (TP ≥ 3). This study illustrates how simultaneous quantification of flow pathways, predator impacts, and TP together provide an integrated characterization of natural food webs.

Efficacy of Mulligan thoracic sustained natural apophyseal glides on sub-acromial pain in patients with sub-acromial impingement syndrome: a single-blinded randomized controlled trial.

PURPOSE: To investigate the effects of Mulligan thoracic sustained natural apophyseal glides (SNAGS) techniques and traditional exercises on pain, shoulder function, size of sub-acromial space, and shoulder joint range in patients with sub-acromial impingement syndrome. METHODS: Seventy-four patients with sub-acromial impingement syndrome (25 to 40 years) joined this research and were allocated randomly into two equal groups; experimental group A (Mulligan SNAGS and exercise) and control group B (exercise only). All patients were assessed by visual analogue scale (VAS) for pain intensity, Shoulder Pain and Disability Index (SPADI) for shoulder function, plain x-ray for the size of sub-acromial space, and goniometer for shoulder range of motion (ROM). The measurements were performed at two intervals (baseline and after four weeks of intervention). RESULTS: After 4 weeks of intervention, there were statistically significant differences between groups, in favor of Mulligan SNAGS, on sub acromial space size, pain intensity, shoulder function, and shoulder joint range of motion (p < 0.05). In within-group analysis, there were also statistically significant differences between pre- and post-treatment in all measured variables (p < 0.05). CONCLUSION: Mulligan thoracic spine (SNAGS) mobilization into extension and traditional exercises improve sub acromial space size, pain intensity, shoulder function, and shoulder joint range of motion in patients with sub acromial impingement syndrome. It is recommended to mobilize the thoracic spine by mulligan SNAGS in the treatment of sub-acromial impingement syndrome.

Effectiveness of sustained natural apophyseal glides in females with cervicogenic headache: A randomized controlled trial.

BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal glides (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs. OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH. METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P< 0.05. RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p> 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p< 0.05) showed a significant difference in pain and level of disability at three and four weeks (p< 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p< 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p> 0.05). CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH.

Myofascial release versus Mulligan sustained natural apophyseal glides' immediate and short-term effects on pain, function, and mobility in non-specific low back pain.

BACKGROUND: Myofascial release (MFR) and Mulligan Sustained Natural Apophyseal Glides (SNAGs) are manual therapy techniques routinely practiced in the management of non-specific low back pain (NSLBP). As a solo intervention or along with other therapies, both methods have reported positive results for individuals with NSLBP. However, which technique improves NSLBP-related pain, restricted range of motion (ROM) and disability, warrants further research. OBJECTIVE: To study the comparative effects of MFR and SNAGs on pain, disability, functional ability, and lumbar ROM in NSLBP. METHOD: A parallel-group study was conducted at tertiary care hospitals. Sixty-five Sub-acute or chronic NSLBP patients were allocated to receive strengthening exercises along with either MFR (n = 33) or SNAGs (n = 32) for six treatment sessions over one week. An independent assessor evaluated outcome measures such as the Visual Analog Scale (VAS), Patient-Specific Function Scale (PSFS), and ROM at baseline, immediate (after 1st treatment), and short-term (post-sixth day of the intervention). The Modified Oswestry disability index (MODI) was assessed at baseline and short-term. RESULTS: Within-group analysis found clinically and statistically significant (p < 0.05) changes for VAS and PSFS at immediate and short-term for both the groups. The lumbar extension also showed improvement immediately and in the short-term. Improvement in Lumbar flexion was seen only in the SNAGs group over the short-term. A statistically significant improvement was seen for MODI in both the groups but was not clinically significant in the MFR group. The analysis observed no statistically significant difference (p < 0.05) between the groups at both the immediate and short-term. CONCLUSIONS: Pain and restricted function associated with NSLBP can be improved using SNAGs or MFR, along with strengthening exercises. For limited lumbar flexion ROM, Mulligan SNAGs have a better outcome than MFR over the short-term. Hence, both manual therapy techniques can be incorporated along with exercises for immediate and short-term management of sub-acute to chronic NSLBP.Clinical Trial Registration. CTRI/2018/12/016787 (http://ctri.nic.in/Clinicaltrials/).

Measurement data from sample plots characterizing three development stages of a subalpine spruce forest and describing the bird assemblages associated with them.

The paper presents data on tree stands located in a subalpine spruce forest in the Gorce National Park (Western Carpathians, Poland) as well as on the birds inhabiting them in the breeding and nonbreeding seasons. The authors conducted stand measurements on a total of twenty-four sample plots, with eight plots established in each of the three studied forest development stages (mature, break-up, and growing-up) representing successive phases of subalpine forest development. The study area designated for each stage was 30 ha. The development properties of each study area resulted from both biotic and abiotic factors. Tree stands were characterized in terms of the tree layer, saplings, and deadwood. The types of deadwood measured were: standing entire dead trees, snags, stumps, and downed deadwood. In the case of birds, the presented data include species composition and pair density in the breeding season and individual bird density in the nonbreeding season. The authors used these data in a paper [1] examining the relationship between forest structural indicators and bird diversity in the three forest development stages. Other researchers can also utilize these data for the purpose of comparison with other areas representing similar forest communities or for studies on stand dynamics, especially in the face of climate change which may substantially affect those phenomena. Furthermore, the presented data may be useful in studies concerning the abundance and dynamics of bird assemblages and other organisms associated with the subalpine zone as well as in research devoted to the diversity of ecological niches. Such investigations may lay foundations for developing conservation guidelines for the ecosystems in question.

The ecology, distribution, conservation and management of large old trees.

Large old trees are some of the most iconic biota on earth and are integral parts of many terrestrial ecosystems including those in tropical, temperate and boreal forests, deserts, savannas, agro-ecological areas, and urban environments. In this review, we provide new insights into the ecology, function, evolution and management of large old trees through broad cross-disciplinary perspectives from literatures in plant physiology, growth and development, evolution, habitat value for fauna and flora, and conservation management. Our review reveals that the diameter, height and longevity of large old trees varies greatly on an inter-specific basis, thereby creating serious challenges in defining large old trees and demanding an ecosystem- and species-specific definition that will only rarely be readily transferable to other species or ecosystems. Such variation is also manifested by marked inter-specific differences in the key attributes of large old trees (beyond diameter and height) such as the extent of buttressing, canopy architecture, the extent of bark micro-environments and the prevalence of cavities. We found that large old trees play an extraordinary range of critical ecological roles including in hydrological regimes, nutrient cycles and numerous ecosystem processes. Large old trees strongly influence the spatial and temporal distribution and abundance of individuals of the same species and populations of numerous other plant and animal species. We suggest many key characteristics of large old trees such as extreme height, prolonged lifespans, and the presence of cavities - which confer competitive and evolutionary advantages in undisturbed environments - can render such trees highly susceptible to a range of human influences. Large old trees are vulnerable to threats ranging from droughts, fire, pests and pathogens, to logging, land clearing, landscape fragmentation and climate change. Tackling such diverse threats is challenging because they often interact and manifest in different ways in different ecosystems, demanding targeted species- or ecosystem-specific responses. We argue that novel management actions will often be required to protect existing large old trees and ensure the recruitment of new cohorts of such trees. For example, fine-scale tree-level conservation such as buffering individual stems will be required in many environments such as in agricultural areas and urban environments. Landscape-level approaches like protecting places where large old trees are most likely to occur will be needed. However, this brings challenges associated with likely changes in tree distributions associated with climate change, because long-lived trees may presently exist in places unsuitable for the development of new cohorts of the same species. Appropriate future environmental domains for a species could exist in new locations where it has never previously occurred. The future distribution and persistence of large old trees may require controversial responses including assisted migration via seed or seedling establishment in new locales. However, the effectiveness of such approaches may be limited where key ecological features of large old trees (such as cavity presence) depend on other species such as termites, fungi and bacteria. Unless other species with similar ecological roles are present to fulfil these functions, these taxa might need to be moved concurrently with the target tree species.

Evaluating noninvasive genetic sampling techniques to estimate large carnivore abundance.

Monitoring large carnivores is difficult because of intrinsically low densities and can be dangerous if physical capture is required. Noninvasive genetic sampling (NGS) is a safe and cost-effective alternative to physical capture. We evaluated the utility of two NGS methods (scat detection dogs and hair sampling) to obtain genetic samples for abundance estimation of coyotes, black bears and Canada lynx in three areas of Newfoundland, Canada. We calculated abundance estimates using program capwire, compared sampling costs, and the cost/sample for each method relative to species and study site, and performed simulations to determine the sampling intensity necessary to achieve abundance estimates with coefficients of variation (CV) of <10%. Scat sampling was effective for both coyotes and bears and hair snags effectively sampled bears in two of three study sites. Rub pads were ineffective in sampling coyotes and lynx. The precision of abundance estimates was dependent upon the number of captures/individual. Our simulations suggested that ~3.4 captures/individual will result in a < 10% CV for abundance estimates when populations are small (23-39), but fewer captures/individual may be sufficient for larger populations. We found scat sampling was more cost-effective for sampling multiple species, but suggest that hair sampling may be less expensive at study sites with limited road access for bears. Given the dependence of sampling scheme on species and study site, the optimal sampling scheme is likely to be study-specific warranting pilot studies in most circumstances.

The effect of sustained natural apophyseal glides on headache, duration and cervical function in women with cervicogenic headache.

The objective of this study is to investigate the effect of sustained natural apophyseal glides (SNAGs) on pain and headache duration in women with cervicogenic headache. The method of this study is a single blind and randomized controlled trial. Forty patients with headache were divided randomly into the SNAGs group (n= 20), and control group (n= 20). The expectation of this study was that the SNAGs group, with facilitatory glide, has full range of movement without pain. Sustained end range holds or overpressure can be applied to the physiological movement and subjects in the control group received just light contact to the occipital area for the same amount of time as the SNAGs group, which is three times per week for a period of four weeks. Visual Analogue Scale (VAS), Headache Duration and Neck Disability Index (NDI) were evaluated by patients before and after the intervention. NDI in the SNAGs group showed significantly greater improvement, compared to the control group, in which only the SNAGS placebo technique was applied. In addition, a significantly greater improvement on the visual analogue scale was also observed in the SNAGs group compared with the control group (P< 0.05). In conclusion, the SNAGs technique can help middle aged female patients suffering from cervicogenic headache for relief of cervical pain and headache. It can also be used in physiotherapy on headache.

Changes in nesting sites abundance and their use by woodpeckers along an urban gradient: a ten-year comparison

Woodpeckers nesting substrate abundance may be reduced by urban expansion, negatively affecting their reproduction. Long-term studies in the tropics are rare but valuable to estimate how urban development has affected ecological communities. We present a ten-year comparison on nesting substrate abundance and their use by Melanerpes rubricapillus and M. chrysauchen woodpeckers along an urban gradient in Golfito, Costa Rica; which include three habitats and three substrates (snags, palms, and posts). Conditions remained unchanged in non-urban areas. In semi-urban areas, snag, posts, and nests on them, have decreased. In urban areas, despite snags and posts remaining constant, their use also decreased. In semi-urban and urban areas, palms and palm nests increased. This long term comparison indicates that woodpeckers took advantage of the increased presence of ornamental palms in gardens.

La abundancia de sustratos para anidación de pájaras carpinteros puede reducirse debido a la expansión urbana, afectando negativamente su reproducción. Los estudios a largo plazo en los trópicos son escazos, pero valiosos para estimar cómo el desarrollo urbano ha afectado las comunidades ecológicas. Presentamos una comparación de diez años sobre la abundancia y uso de sustratos de anidación de los carpinteros Melanerpes rubricapillus y M. chrysauchen en un gradiente urbano en Golfito, Costa Rica; que incluye tres hábitats y tres sustratos (tocones, palmas y postes). Las condiciones permanecieron similares en áreas no urbanas. En las áreas semi urbanas, los postes y tocones, así como los nidos en ellos disminuyeron. En áreas urbanas, a pesar de que los postes permanecieron constantes, su uso disminuyó. En las áreas semi urbanas y urbanas, la cantidad de palmas y de nidos en estas aumentó. Esta comparación a largo plazo indica que los carpinteros tomaron ventaja del aumento en la presencia de palmas ornamentales en los jardines.

Using dynamic N-mixture models to test cavity limitation on northern flying squirrel demographic parameters using experimental nest box supplementation.

Dynamic N-mixture models have been recently developed to estimate demographic parameters of unmarked individuals while accounting for imperfect detection. We propose an application of the Dail and Madsen (2011: Biometrics, 67, 577-587) dynamic N-mixture model in a manipulative experiment using a before-after control-impact design (BACI). Specifically, we tested the hypothesis of cavity limitation of a cavity specialist species, the northern flying squirrel, using nest box supplementation on half of 56 trapping sites. Our main purpose was to evaluate the impact of an increase in cavity availability on flying squirrel population dynamics in deciduous stands in northwestern Québec with the dynamic N-mixture model. We compared abundance estimates from this recent approach with those from classic capture-mark-recapture models and generalized linear models. We compared apparent survival estimates with those from Cormack-Jolly-Seber (CJS) models. Average recruitment rate was 6 individuals per site after 4 years. Nevertheless, we found no effect of cavity supplementation on apparent survival and recruitment rates of flying squirrels. Contrary to our expectations, initial abundance was not affected by conifer basal area (food availability) and was negatively affected by snag basal area (cavity availability). Northern flying squirrel population dynamics are not influenced by cavity availability at our deciduous sites. Consequently, we suggest that this species should not be considered an indicator of old forest attributes in our study area, especially in view of apparent wide population fluctuations across years. Abundance estimates from N-mixture models were similar to those from capture-mark-recapture models, although the latter had greater precision. Generalized linear mixed models produced lower abundance estimates, but revealed the same relationship between abundance and snag basal area. Apparent survival estimates from N-mixture models were higher and less precise than those from CJS models. However, N-mixture models can be particularly useful to evaluate management effects on animal populations, especially for species that are difficult to detect in situations where individuals cannot be uniquely identified. They also allow investigating the effects of covariates at the site level, when low recapture rates would require restricting classic CMR analyses to a subset of sites with the most captures.