Assessing validity of thoracic spine rotation range of motion measurement methods: comparison of magnetic resonance imaging and clinical measurements.

[Purpose] This work was designed to establish criteria for assessing common clinical measurement methods for thoracic spinal rotation angles by comparing their results with magnetic resonance imaging measurements. [Participants and Methods] Twenty-six healthy participants underwent thoracic rotation angle assessments using an electronic goniometer in three positions: lumbar-locked, seated, and half-kneeling. We compared these results with measurements obtained by magnetic resonance imaging. [Results] A moderate but significant positive correlation was observed between the thoracic rotation angle measured by magnetic resonance imaging and the lumbar-locked rotation test. The respective 95% confidence intervals of these correlation coefficients were 0.09 and 0.72. Bland-Altman analysis revealed a fixed error in the lumbar-locked rotation test, suggesting that the test tended to overestimate thoracic rotation compared with magnetic resonance imaging, but proportional errors could not be definitively identified. [Conclusions] Thoracic spine rotation angles measured using magnetic resonance imaging aligned closely with previously reported results. Notably, although measurements obtained by the lumbar-locked rotation test correlated with magnetic resonance imaging results, they exhibited fixation errors. Functional tests (seated and half-kneeling) showed limited correlations with magnetic resonance imaging results. The influence of adjacent joints on clinical measurements should be considered.

Effect of thoracic manipulation on neck pain in the mobility group: A randomized controlled trial.

Background and aims: Thoracic spine manipulation (TSM) increases the thoracic spine's range of motion (ROM), effectively reducing pain intensity and disability in patients with mechanical neck pain. We aimed to determine the effect of TSM on neck pain intensity and functional impairment in patients classified under the "mobility" category in Childs' classification. Methods: In this randomized controlled trial, patients with mechanical neck pain who met the inclusion criteria were randomly assigned to either the TSM (n = 21) or sham manipulation (n = 20) group. The primary outcomes were pain during neck rotation and subjective improvement assessed using the Numerical Pain Rating Scale (NPRS) and Global Rating of Change (GROC), respectively. The secondary outcomes were NPRS at rest, disability (assessed using the Neck Disability Index [NDI]), and ROM of the cervical and thoracic spine rotation. Outcome measurements were performed at baseline, immediately after treatment, 1 week after treatment, and at the 4-week follow-up. Linear mixed models were used to analyze the NPRS, NDI, and ROM. The GROC was analyzed using a chi-square test for the percentage recording ≥+4; the means of each group were compared using an unpaired t-test. Results: The NPRS with neck rotation, neck and thoracic ROM, and NDI showed significant interactions between the groups. The NPRS with neck rotation was significantly lower in the TSM group than in the sham group at all time points after the treatment (p < 0.001). There was no difference between the groups in the proportion showing moderate (≥+4) improvement according to the GROC; however, there was a significant difference in the mean values (p = 0.013). Conclusion: Incorporating TSM into treatment protocols may improve clinical outcomes in patients with neck pain, potentially leading to better pain management and functional recovery. Therefore, physiotherapists should consider TSM as a viable and effective intervention to improve patient outcomes in neck pain rehabilitation.

Pelvis/lower extremity alignment and range of motion in knee osteoarthritis: A case-control study in elderly Japanese women.

BACKGROUND: The prevalence of radiographic knee osteoarthritis (OA) in Japan is high, with an estimated 25,300,000 affected individuals. OBJECTIVE: The purpose of this study was to clarify the characteristics of knee osteoarthritis by comparing differences between patients with knee osteoarthritis and healthy elderly individuals with respect to alignment of the pelvis and lower extremities and range of motion. METHODS: Twenty-six women (13 with medial knee osteoarthritis and 13 healthy elderly) participated in this study. Pelvic tilt, knee extension angle, femoro-tibial angle, quadriceps angle, navicular drop, and leg-heel alignment were measured. In addition, the range of motion was measured at the hip, knee, and ankle joints. RESULTS: Patients with knee osteoarthritis showed a posterior pelvic tilt, knee flexion, varus, and foot pronation alignment compared to healthy subjects. The range of motion for hip extension, adduction, knee flexion, extension, and ankle dorsiflexion was significantly smaller while the range of motion for eversion was significantly larger in the knee osteoarthritis group. CONCLUSION: People with medial knee OA have different static alignment and ROM compared to those without knee OA. The results clarify the comprehensive characteristics of the pelvis and lower extremities in knee osteoarthritis.

A Maximum Muscle Strength Prediction Formula Using Theoretical Grade 3 Muscle Strength Value in Daniels et al.'s Manual Muscle Test, in Consideration of Age: An Investigation of Hip and Knee Joint Flexion and Extension.

This study attempted to develop a formula for predicting maximum muscle strength value for young, middle-aged, and elderly adults using theoretical Grade 3 muscle strength value (moment fair: Mf )-the static muscular moment to support a limb segment against gravity-from the manual muscle test by Daniels et al. A total of 130 healthy Japanese individuals divided by age group performed isometric muscle contractions at maximum effort for various movements of hip joint flexion and extension and knee joint flexion and extension, and the accompanying resisting force was measured and maximum muscle strength value (moment max, Mm ) was calculated. Body weight and limb segment length (thigh and lower leg length) were measured, and Mf was calculated using anthropometric measures and theoretical calculation. There was a linear correlation between Mf and Mm in each of the four movement types in all groups, excepting knee flexion in elderly. However, the formula for predicting maximum muscle strength was not sufficiently compatible in middle-aged and elderly adults, suggesting that the formula obtained in this study is applicable in young adults only.

Comparative analysis of ultrasound changes in the vastus lateralis muscle following myofascial release and thermotherapy: a pilot study.

OBJECTIVES: This study aimed to compare the effects of myofascial release (MFR) and hot pack therapy (HPT) on fascial gliding and flexibility of the vastus lateralis muscle. METHODS: Three treatments were applied to the left vastus lateralis muscles of each participant (12 healthy males): MFR for 4 min, superficial HPT for 10 min, and superficial HPT for 20 min. Deep fascial motion was measured by B-mode ultrasound, whereas muscle stiffness was measured by real-time elastography (RTE) and a durometer before and after the interventions. RESULTS: Only MFR resulted in changes in both deep fascial motion and muscle stiffness measured by RTE. Durometer-measured muscle stiffness revealed changes following both MFR and 20-min HPT but not 10-min HPT. CONCLUSIONS: HPT may produce only superficial effects. Because MFR improved all measured parameters, continuous stretching and pressure are probably important for improving fascial gliding and flexibility of the vastus lateralis muscle.