Slower but more accurate mental rotation performance in aphantasia linked to differences in cognitive strategies.

Mental rotation tasks are frequently used as standard measures of mental imagery. However, aphantasia research has brought such use into question. Here, we assessed a large group of individuals who lack visual imagery (aphantasia) on two mental rotation tasks: a three-dimensional block-shape, and a human manikin rotation task. In both tasks, those with aphantasia had slower, but more accurate responses than controls. Both groups demonstrated classic linear increases in response time and error-rate as functions of angular disparity. In the three-dimensional block-shape rotation task, a within-group speed-accuracy trade-off was found in controls, whereas faster individuals in the aphantasia group were also more accurate. Control participants generally favoured using object-based mental rotation strategies, whereas those with aphantasia favoured analytic strategies. These results suggest that visual imagery is not crucial for successful performance in classical mental rotation tasks, as alternative strategies can be effectively utilised in the absence of holistic mental representations.

The immediate effect of cervical rotation-traction manipulation on cervical paravertebral soft tissue: a study using soft tissue tension cloud chart technology.

BACKGROUND: To evaluate the reliability of the Soft Tissue Tension Cloud Chart (STTCC) technology, an original method combining multi-point Cervical Paravertebral Soft Tissue Test (CPSTT) with MATLAB software, we conducted a preliminary analysis on the immediate effects of Orthopaedic Manual Therapy (OMT) on cervical paravertebral soft tissue. METHODS: 30 patients with Cervical Spondylotic Radiculopathy (CSR) were included in this study. We analyzed the differences in CPSTT before and after treatment with Cervical Rotation-Traction Manipulation (CRTM), a representative OMT technique in Traditional Chinese Medicine, using the STTCC technology. RESULTS: The STTCC results demonstrated that post-treatment CPSTT levels in CSR patients were significantly lower than pre-treatment levels after application of CRTM, with a statistically significant difference (P < 0.001). Additionally, pre-treatment CPSTT levels on the symptomatic side (with radicular pain or numbness) were higher across the C5 to C7 vertebrae compared to the asymptomatic side (without symptoms) (P < 0.001). However, this difference disappeared after CRTM treatment (P = 0.231). CONCLUSIONS: The STTCC technology represents a reliable method for analyzing the immediate effects of OMT. CSR patients display uneven distribution of CPSTT characterized by higher tension on the symptomatic side. CRTM not only reduces overall cervical soft tissue tension in CSR patients, but can also balance the asymmetrical tension between the symptomatic and asymptomatic sides. TRIAL REGISTRATION: This study was approved by the Chinese Clinical Trials Registry (Website: . https://www.chictr.org.cn .) on 20/04/2021 and the Registration Number is ChiCTR2100045648.

Alteration in the callogenesis, tropane alkaloid formation, and gene expression in Hyoscyamus niger under clinorotation.

This study aimed to investigate the effects of clinorotation induced by 2-D clinostat on the growth, tropane alkaloid production, gene expression, antioxidant capacity, and cellular defense responses in the callus tissue of Hyoscyamus niger. Callus induction was conducted by putting hypocotyl explants in the MS culture medium supplemented with 1 mgL-1 2,4-D and 1 mgL-1 BAP growth regulators. The sub-cultured calli were placed on a clinostat for 0, 3, 7, and 10 days (2.24 × 10-5 g on the edge of the callus ring). Clinorotation significantly increased callus fresh weight, dry weight, protein, carbohydrate, and proline contents compared to the control, and their maximum contents were obtained after 7 and 10 days. H2O2 level enhanced under clinorotation with a 76.3% rise after 10 days compared to control and positively affected the atropine (77.1%) and scopolamine (69.2%) productions. Hyoscyamine 6-beta hydroxylase and putrescine N-methyltransferase gene expression involved in the tropane alkaloid biosynthesis were upregulated markedly with 14.2 and 17.1-folds increase after 10 days of clinorotation, respectively. The expressions of jasmonic acid, mitogen-activated protein kinase, and ethylene-responsive element-binding transcription factor were upregulated, and the activity of peroxidase and catalase showed a 72.7 and 80% rise after 10 days. These findings suggest that microgravity can enhance callogenesis by stimulating the ROS level, which can impact the antioxidant enzymes, tropane alkaloid formation, and gene expression.

Understanding calibration of deep neural networks for medical image classification.

Background and Objective - In the field of medical image analysis, achieving high accuracy is not enough; ensuring well-calibrated predictions is also crucial. Confidence scores of a deep neural network play a pivotal role in explainability by providing insights into the model's certainty, identifying cases that require attention, and establishing trust in its predictions. Consequently, the significance of a well-calibrated model becomes paramount in the medical imaging domain, where accurate and reliable predictions are of utmost importance. While there has been a significant effort towards training modern deep neural networks to achieve high accuracy on medical imaging tasks, model calibration and factors that affect it remain under-explored. Methods - To address this, we conducted a comprehensive empirical study that explores model performance and calibration under different training regimes. We considered fully supervised training, which is the prevailing approach in the community, as well as rotation-based self-supervised method with and without transfer learning, across various datasets and architecture sizes. Multiple calibration metrics were employed to gain a holistic understanding of model calibration. Results - Our study reveals that factors such as weight distributions and the similarity of learned representations correlate with the calibration trends observed in the models. Notably, models trained using rotation-based self-supervised pretrained regime exhibit significantly better calibration while achieving comparable or even superior performance compared to fully supervised models across different medical imaging datasets. Conclusion - These findings shed light on the importance of model calibration in medical image analysis and highlight the benefits of incorporating self-supervised learning approach to improve both performance and calibration.

An efficient strategy for large-scale preparation of low polarity gingerols directly from ginger crude extract by high-speed countercurrent chromatography with different rotation mode.

This study presents an efficient strategy for large-scale preparation of low polarity gingerols directly from ginger crude extract by high-speed countercurrent chromatography with different rotation mode. The ultrasonic-assisted extraction conditions were optimized by response surface methodology and the results showed the major low polarity gingerols could be well enriched under the optimized extraction conditions. Then the crude extract without any pretreatment was directly separated by high-speed countercurrent chromatography with different rotation mode using n-hexane/ethyl acetate/methanol/water (6:4:6:4, v/v/v/v) as the solvent system. In about 400 min, five major gingerols including 150 mg of [6]-gingerol, 50 mg of [8]-gingerol, 20 mg of [6]-shogaol, 43 mg of [6]-dehydrogingerdione, and 40 mg of [10]-gingerol were obtained from 1.2 g of crude extract in a single run with repeated injection. Their structures were identified by 1 H-NMR spectroscopy.

Reliability of changes in neck pain and cervical rotation range following manual scapular repositioning.

BACKGROUND: Manual scapular repositioning may result in change in neck pain and cervical rotation range. However, the reliability of such changes performed by examiners remains unknown. OBJECTIVE: To evaluate the reliability of changes in neck pain and cervical rotation range following manual scapular repositioning performed by two examiners and the agreement between these measures and patients' perceptions of change. DESIGN: Cross-sectional study. METHODS: Sixty-nine participants with neck pain and altered scapular position were recruited. Two physiotherapists performed the manual scapular repositioning. Neck pain intensity was measured using a 0-10 numerical scale and cervical rotation range with a cervical range of motion (CROM) device at baseline and in the modified scapular position. Participants' perceptions of any change were rated on a five-item Likert scale. Clinically relevant changes in pain (>2/10) and range (≥7°) were defined as "improved" or "no change" for each measure. RESULTS: ICCs for changes in pain and range between examiners were 0.92 and 0.91. For clinically relevant changes, percent agreement and kappa values between examiners were 82.6%, 0.64 for pain and 84.1%, 0.64 for range. Percent agreement and kappa values between participants' perceptions and measured changes were 76.1%, 0.51 for pain and 77.5%, 0.52 for range. CONCLUSION: Changes in neck pain and rotation range following manual scapular repositioning demonstrated good reliability between examiners. There was moderate agreement between the measured changes and patients' perceptions.

Clinical teaching in dentistry: Evaluating a clinical oral pathology rotation while looking to the future of dental education.

PURPOSE/OBJECTIVES: Clinical teaching in dentistry has cycled through specialty-based "departmental" teaching to group practice scenarios. The aims of this study were to ascertain third-year dental students' perceptions of a specialty-based rotation supplemented by online educational tools and to compare their Objective Structured Clinical Exam (OSCE) scores to those of the students in the previous year. METHODS: This retrospective research design included the analysis of OSCE scores, and student responses to survey questions regarding their perceptions of the clinical oral pathology (COP) rotation. This study was completed in 2022. It included data from 2020 to 2021 and 2021 to 2022 corresponding to input from the Classes of 2022 and 2023, respectively. The response rate was 100%. RESULTS: The students evaluated the focused COP rotation and the online teaching modules as a positive experience. The results of the OSCE were similar to those of the previous class and showed a high average score. CONCLUSIONS: This study shows that students had a positive perception to specialty-based learning with online educational tools and that it enhanced the education they received in the comprehensive care clinic. The OSCE scores were similar to those of the previous class. These findings suggest a method of maintaining high-quality dental education through challenges as it continues evolving.

Population dynamics of head-direction neurons during drift and reorientation.

The head direction (HD) system functions as the brain's internal compass1,2, classically formalized as a one-dimensional ring attractor network3,4. In contrast to a globally consistent magnetic compass, the HD system does not have a universal reference frame. Instead, it anchors to local cues, maintaining a stable offset when cues rotate5-8 and drifting in the absence of referents5,8-10. However, questions about the mechanisms that underlie anchoring and drift remain unresolved and are best addressed at the population level. For example, the extent to which the one-dimensional description of population activity holds under conditions of reorientation and drift is unclear. Here we performed population recordings of thalamic HD cells using calcium imaging during controlled rotations of a visual landmark. Across experiments, population activity varied along a second dimension, which we refer to as network gain, especially under circumstances of cue conflict and ambiguity. Activity along this dimension predicted realignment and drift dynamics, including the speed of network realignment. In the dark, network gain maintained a 'memory trace' of the previously displayed landmark. Further experiments demonstrated that the HD network returned to its baseline orientation after brief, but not longer, exposures to a rotated cue. This experience dependence suggests that memory of previous associations between HD neurons and allocentric cues is maintained and influences the internal HD representation. Building on these results, we show that continuous rotation of a visual landmark induced rotation of the HD representation that persisted in darkness, demonstrating experience-dependent recalibration of the HD system. Finally, we propose a computational model to formalize how the neural compass flexibly adapts to changing environmental cues to maintain a reliable representation of HD. These results challenge classical one-dimensional interpretations of the HD system and provide insights into the interactions between this system and the cues to which it anchors.

Reliability of the Joint Position Sense Error Test for Women With Neck Pain and Asymptomatic Men and Women.

OBJECTIVE: The purpose of this study was to evaluate the intra-rater between-days reliability of the joint position sense error (JPSE) test in asymptomatic men and women, as well as in women with neck pain. METHODS: Fourteen asymptomatic men and 27 women (14 asymptomatic and 13 with neck pain) participated. The JPSE test was performed during right and left cervical rotation (10 trials for each side) in 2 sessions, with at least 7 days between them. The head repositioning error during the JPSE test (in degrees) was measured and used to calculate the intra-rater between-days reliability of the test, evaluated through the intraclass correlation coefficient and Bland-Altman analyses. Independent t tests were calculated to compare the head repositioning errors of asymptomatic women and men. The minimal detectable change was also calculated. RESULTS: The neck pain group showed higher intraclass correlation coefficient values (0.866 and 0.773, good reliability) compared to the asymptomatic men (0.478 and 0.403, poor reliability) and to the asymptomatic women (-0.161 and 0.504, poor and moderate reliability, respectively) for both right and left cervical rotation, respectively. Considering Bland-Altman analyses, the neck pain group showed better agreement between the measurements for right cervical rotation than the asymptomatic groups. CONCLUSION: The results indicate that the methodology used to perform the JPSE test in this study may be a reliable way to assess the proprioception of women with neck pain in clinical settings.

An action recognition method for manual acupuncture techniques using a tactile array finger cot.

The current measurement systems for the physical parameters (rotation frequency, and amplitude) of Traditional Chinese Medicine (TCM) manual acupuncture tend to cause disturbance and inconvenience in clinical application and do not accurately capture the tactile signals from the physician's finger during manual acupuncture operations. In addition, the literature rarely discusses classification of the four basic manual acupuncture techniques (reinforcing by twirling and rotating (RFTR), reducing by twirling and rotating (RDTR), reinforcing by lifting and thrusting (RFLT), and reducing by lifting and thrusting (RDLT)). To address this problem, we developed a multi-PVDF film-based tactile array finger cot to collect piezoelectric signals from the acupuncturist's finger-needle contact during manual acupuncture operations. In order to recognize the four typical TCM manual acupuncture techniques, we developed a method to capture piezoelectric signals in related "windows" and subsequently extract features to model acupuncture techniques. Next, we created an ensemble learning-based action classifier for manual acupuncture technique recognition. Finally, the proposed classifier was employed to recognize the four types of manual acupuncture techniques performed by 15 TCM physicians based on the piezoelectric signals collected using the tactile array finger cot. Among all the approaches, our proposed feature-based CatBoost ensemble learning model achieved the highest validation accuracy of 99.63% and the highest test accuracy of 92.45%. Moreover, we provide the efficiency and limitations of using this action recognition method.

Mental rotation of hands and objects in ageing and Parkinson's disease: differentiating motor imagery and visuospatial ability.

Motor imagery supports motor learning and performance and has the potential to be a useful strategy for neurorehabilitation. However, motor imagery ability may be impacted by ageing and neurodegeneration, which could limit its therapeutic effectiveness. Motor imagery can be assessed implicitly using a hand laterality task (HLT), whereby laterality judgements are slower for stimuli corresponding to physically more difficult postures, as indicated by a "biomechanical constraint" effect. Performance is also found to differ between back and palm views of the hand, which may differentially recruit visual and sensorimotor processes. Older adults and individuals with Parkinson's disease (PD) have shown altered performance on the HLT; however, the effects of both ageing and PD on laterality judgements for the different hand views (back and palm) have not been directly examined. The present study compared healthy younger, healthy older, and PD groups on the HLT, an object-based mental rotation task, and an explicit motor imagery measure. The older and PD groups were slower than the younger group on the HLT, particularly when judging laterality from the back view, and exhibited increased biomechanical constraint effects for the palm. While response times were generally similar between older and PD groups, the PD group showed reduced accuracy for the back view. Letter rotation was slower and less accurate only in the PD group, while explicit motor imagery ratings did not differ significantly between groups. These results suggest that motor imagery may be slowed but relatively preserved in both typical ageing and neurodegeneration, while a PD-specific impairment in visuospatial processing may influence task performance. The findings have implications for the use of motor imagery in rehabilitation protocols.

Normal Range of Movement During Rotation Stress Testing for the Alar Ligaments: An Observational Study.

OBJECTIVE: The purpose of this study was to determine the normal range of rotation occurring during rotation stress testing for alar ligament integrity and to ascertain whether rotation range on testing is affected by an individual's age. METHOD: In this observational study, 88 people aged 18 to 86 years old with no current neck problems or known risk factors for craniocervical instability underwent rotation stress testing for the alar ligaments. The test was performed in each direction in neutral, flexion, and extension, with the participant both sitting and supine. Rotation range was recorded using an electromagnetic movement tracking system. Range was assessed overall and then compared by 10-year age groups using analysis of variance. Reliability of measurements was assessed by intraclass correlation coefficient(2,1) and standard error of measurement. RESULTS: Mean angles of upper cervical rotation ranged between 10.91° (standard deviation 3.38°) to 16.12° (standard deviation 5.13°). Overall measured rotation ranged from 1.37° to 33.22°. Participants in older age groups generally displayed reduced rotation; however, the reduction was less than 4°. Reliability of rotation measurements was good to excellent, with the intraclass correlation coefficient ranging from 0.80 to 0.99. CONCLUSIONS: Normal range of rotation measured during stress testing for the alar ligament varied widely but did not exceed 33o. All values measured in this study fell below recommendations for ligament integrity. Age-related change was not clinically significant in the interpretation of this test in this asymptomatic population.

¿Efectividad de la técnica de liberación miofacial en el aumento del rango articular en restricción glenohumeral? Una comparación con la kinesioterapia tradicional / Effectiveness of the myofascial release technique in increasing joint range in glenohumeral restriction? A comparison with traditional kinesiotherapy

OBJETIVO: comparar la kinesioterapia tradicional con la técnica miofacial en pacientes con restricción articular interna glenohumeral. MÉTODO: estudio comparativo de 8 pacientes en un grupo de intervención (GI) y kinésico (GC), durante 8 semanas. Se comparó el pre y post test del ROM interno glenohumeral en ambos grupos mediante t de student. RESULTADOS: el grupo de la técnica miofascial demostró una amento significativo de ROM interno glenohumeral de 15,2º (p < 0,001), mientras que el grupo control no fue significativo (p > 0,05) sólo de de 6,4º. CONCLUSIONES:Un tratamiento de terapia con la Técnicas Liberación Miofascial en pacientes con déficit rotacional interno de hombro es más eficaz para aumentar el rango de movimiento articular de rotación interna glenohumeral que una técnica tradicional y conservadora.

OBJETIVE: to compare traditional kinesiotherapy with myofacial technique in patients with glenohumeral internal joint restriction. METHODS: comparative study of 8 patients in an intervention (IG) and kinesiotherapy (CG) group for 8 weeks. The pre- and post-test of glenohumeral internal ROM in both groups was compared using Student's t-test. RESULTS: the myofascial technique group showed a significant increase in glenohumeral internal ROM of 15.2º (p < 0.001), while the control group was not significant (p > 0.05) only 6.4º. CONCLUSIONS: A therapy treatment with Myofascial Release Techniques in patients with shoulder internal rotational deficit is more effective in increasing glenohumeral internal rotational joint range of motion than a traditional, conservative technique.

Therapeutic Effect of Tendon Bone Setting Technique and Sports Training on Joint Injury.

Purpose: In this study, we observe the therapeutic influence on tendon and bone setting technique, combined with sports training on joint injury. Methods: Using the random number method, 50 research objects with joint injuries were divided into two groups: treatment group and control group, and each group had 25 cases. The treatment group was combined with sports training with tendon and bone setting technique, and the control group was given intermediate frequency electrotherapy combined with forearm brace fixation. The scores of visual analogue scale (VAS), forearm pronation and postrotation activity, integral electromyogram (iEMG), and research object-rated wrist evaluation (PRWE) were evaluated and compared before and after treatment, and the curative effect observation (blind method was used in the evaluation process) and research object satisfaction were evaluated. Results: After the treatment, the VAS score of two groups decreased, forearm pronation and pronation activity increased, iEMG value increased, and PRWE scale score decreased (p < 0.05), and compared with the control group, the treatment group's curative effect was better (p < 0.05), and compared with the control group, treatment group's total effective rate was higher (p < 0.05). Conclusion: The method of tendon and bone setting combined with sports training could effectively reduce the pain of research objects with joint injury, improve the rotation range of the forearm, increase the recruitment of the pronator muscles, and improve the wrist function of the research objects, and the curative effect was better than that of medium frequency electrotherapy combined with forearm brace fixation.

The impact of force, time, and rotation on the transfer of ammonium nitrate: A reductionist approach to understanding evidence dynamics.

Empirical studies evaluating the conditions under which the transfer of forensic materials occurs can provide contextual information and offer insight into how that material may have been transferred in a given scenario. Here, a reductionist approach was taken to assess the impact of force, time, and rotation on the transfer of an explosive compound. An Instron ElectroPuls E3000 material testing instrument was used to bring porous and non-porous surfaces adulterated with an ammonium nitrate into direct contact with a human skin analogue, controlling for the force of contact, duration of contact, and rotation applied during contact. Quantifiable amounts of ammonium nitrate were recovered from all of the recipient surfaces demonstrating that ammonium nitrate is readily transferred from one surface to another, even when contact occurs for a short duration with a relatively low force. More particulates were transferred from non-porous surfaces onto the human skin analogue, but the amount of ammonium nitrate transferred did not depend upon the force of contact, duration of contact, or the amount of rotation applied. However, when contact occurred and involved rotation, a greater transfer of ammonium nitrate was observed, compared to those contacts occurring without rotation being applied. This approach complements more commonly-used holistic experiments that test multiple interacting variables in a realistic setting by isolating these variables, allowing them to be examined individually. This can be utilised to better understand the individual impact that specific variables have on the transfer of trace evidence in relevant crime reconstruction contexts.

Angular Kinematics of Chiropractic Supine Cervical Spine Manipulation: Rotational Measures and Comparisons to Doctor and Recipient Perceptions.

OBJECTIVES: The primary purposes of this study were to measure axial rotation during supine cervical spinal manipulative therapy (cSMT) and to record recipients' and doctors' perceptions of rotational magnitudes. METHODS: Experienced doctors of chiropractic (DCs) provided supine cSMT and acted as recipients of cSMT. Participants who received SMT wore inertial measurement units attached to the forehead and sternum for motion capture. Afterward, recipients and DCs completed questionnaires asking about their perceptions of motion. Data were analyzed for magnitudes of axial rotation at peak thrust and correlations with patient and doctor perceptions. Secondary analyses included angular velocity, angular acceleration, and other kinematic variables. RESULTS: We recorded 23 SMT events with 14 DCs. Rotation at thrust peaks averaged 32.4° (17.4°). Doctors' and recipients' perceptions of rotation were higher than measured values 45% and 50% of the time, respectively. Maximum angular velocity and acceleration averaged 221.9°/s (124.9) and 4786.5°/s2 (2456.6), respectively. We found no correlation between perceptions and velocity or acceleration; doctors' perceptions had an inverse correlation with measurements. CONCLUSION: On average, we found rotation during supine cSMT to be 32°. Both DCs and SMT recipients overestimated rotation compared with actual measurements. These factors should be considered in discussions of rotation and SMT.

Application of HPTLC Multiwavelength Imaging and Color Scale Fingerprinting Approach Combined with Multivariate Chemometric Methods for Medicinal Plant Clustering According to Their Species.

In the current study, multiwavelength detection combined with color scales HPTLC fingerprinting procedure and chemometric approach were applied for direct clustering of a set of medicinal plants with different geographical growing areas. The fingerprints profiles of the hydroalcoholic extracts obtained after single and double development and detection under 254 nm and 365 nm, before and after selective spraying with specific derivatization reagents were evaluated by chemometric approaches. Principal component analysis (PCA) with factor analysis (FA) methods were used to reveal the contribution of red (R), green (G), blue (B) and, respectively, gray (K) color scale fingerprints to HPTLC classification of the analyzed samples. Hierarchical cluster analysis (HCA) was used to classify the medicinal plants based on measure of similarity of color scale fingerprint patterns. The 1-Pearson distance measurement with Ward's amalgamation procedure proved to be the most convenient approach for the correct clustering of samples. Data from color scale fingerprints obtained for double development procedure and multiple visualization modes combined with appropriate chemometric methods proved to detect the similar medicinal plant extracts even though they are from different geographical regions, have different storage conditions and no specific markers are individually extracted. This approach could be proposed as a promising tool for authentication and identification studies of plant materials based on HPTLC fingerprinting analysis.

Mental imagery rotation and graph comprehension of IS-LM macroeconomic models.

The aim of this study was to determine if the ability to rotate mental imagery influenced the comprehension of graphs in economics. A sample of 140 Business Administration undergraduates familiar with economic analysis using graphs were administered the Measure of the Ability to Rotate Mental Images (MARMI). Moreover, participants completed an ad hoc graph comprehension test consisting of six exercises of increasing difficulty with graphs developing the IS-LM model described in conventional macroeconomic textbooks. Both the ability to rotate mental imagery and graph complexity (the number of quadrants in each graph) were found to significantly influence the number of correct graph comprehension responses.

Localised manual therapy treatment has a preferential effect on the kinematics of the targeted motion segment.

AIM: An observational cohort study to determine whether localised manual therapy results in a preferential increase in mobility of the targeted motion segment. METHOD: Eighteen participants with mechanical neck pain had three MRIs of their cervical spine. The first two were taken prior to treatment in neutral and at the end of active rotation in their more limited rotation. Participants received localised manual therapy targeting a motion segment deemed to be relevant to their presentation until either their range increased by > 10° or 8 min, whichever came first. A third MRI was performed immediately after treatment with their head in the same rotated position as pre-treatment. In the images, each vertebra was segmented using a semi-automated process. Movement between neutral and rotated positions was calculated as Euler angles and distance of facet translations for each motion segment. RESULTS: Rotation and lateral flexion at the targeted location increased by 40% (mean 0.86° (CI: 0.24-1.48) and 15% (mean 0.52° (CI: 0.17-1.21) respectively with only the CIs for rotation not containing zero. The mean changes for the non-targeted locations were less than 0.1° for each axis and all CIs contained zero. Facet translations at the targeted location increased by 25% (0.419 mm) and decreased by >4% (>0.01 mm) at the untreated locations but the wide CIs both contained zero. CONCLUSION: Localised manual therapy seems to have a preferential effect on mobility of the targeted motion segment. The findings support considering segmental dysfunction in clinical reasoning and the use of specifically targeted manual therapy interventions.