Sensory training combined with motor training improves trunk proprioception in stroke patients: a single-blinded randomized controlled trial.

OBJECTIVES: Inadequate trunk function is the underlying cause of many problems such as impaired balance and mobility. Although there have been trunk-based physiotherapy approaches in recent years, almost all of these approaches focus on motor problems. This study aims to investigate the effects of sensory training combined with trunk-centered Bobath exercises on trunk control and proprioception, balance, gait, and the activity of daily living (ADL). MATERIALS AND METHODS: This study is a randomized controlled trial included with twenty-seven stroke patients. Participants were separated into two groups, Group 1; 'sensory training combined with trunk-centered Bobath exercises' and Group 2; 'trunk-centered Bobath exercises'. Trunk-centered Bobath exercises were used for motor training. Sensory training included transcutaneous electric nerve stimulation and a set of exercises that provide tactile and proprioceptive stimulation. Trunk Impairment Scale, Trunk Reposition Error, Berg Balance Scale, 2-minute walk test, and Barthel Index were used to assess trunk control, trunk proprioception, balance, gait, and ADL respectively. RESULTS: Intra-group analysis results showed that trunk control, trunk proprioception, balance, gait, and ADL improved in both groups after treatment (p < 0.05). The changes in the Trunk Reposition Error values of the participants in Group 1 before and after treatment was found to be significantly higher than Group 2 (p < 0.05). CONCLUSIONS: The findings indicated that the application of trunk-centered motor training is effective in improving trunk proprioception and trunk control, balance, gait, and ADL in stroke patients. Also, sensory training combined with trunk-centered motor training was found more effective in improving trunk proprioception than solely motor training.

Acute effects of thoracolumbar fascia release techniques on range of motion, proprioception, and muscular endurance in healthy young adults.

PURPOSE: This study investigates the acute effects of Graston and myofascial release on thoracolumbar fascia (TLF) on lumbar range of motion (ROM), lumbar and cervical proprioception, and trunk muscle endurance in healthy young adults. METHOD: Twenty-four healthy young individuals were included in the study. Individuals were randomly divided into two groups as Graston technique (GT) (n = 12) and myofascial release (MFR) (n = 12). GT group received a fascial treatment with a graston instrument and the MFR group (n = 12) received manual myofascial treatment. Both techniques were applied for 10 min and as a single session. Lumbar ROM (goniometer), lumbar proprioception (digital inclinometer), cervical proprioception (CROM device), and trunk muscle endurance (with McGill Endurance Test) were evaluated before and after treatment. RESULTS: Age, gender and body mass index of individuals in both groups were similar (p > 0.05). In both GT and MFR groups, an increase in ROM in the flexion direction (p < 0.05) and a decrease in the angle of deviation in proprioception in the flexion direction were determined (p < 0.05). Neither technique had a significant effect on cervical proprioception and trunk muscle endurance (p > 0.05). In addition, no difference was found between the effectiveness of Graston and myofascial release (p > 0.05). CONCLUSION: This study showed that Graston and myofascial release applied to TLF in healthy young adults effectively improve lumbar ROM and proprioception in the acute period. Considering these results, both Graston and myofascial release can be used to provide elasticity of TLF and improve proprioceptive return.

SUPPLEMENT INDIVIDUAL ARTICLES: "Vehicles Matter" in the Treatment of Truncal Acne.

Among the general population and arguably among most dermatologists, the word acne calls to mind images of a teenager with papules and pustules on the face. Yet, we know that acne is not just a disease of adolescence, and it is not limited to the face.

Effect of Motor Control Training on Trunk Muscle Morphometry, Pain, and Disability in People With Chronic Low Back Pain: A Systematic Review and Meta-Analysis.

OBJECTIVE: The aim of this systematic review and meta-analysis was to study the effects of motor control training (MCT) on trunk muscle morphometry measured by ultrasound imaging and pain and disability in individuals with chronic low back pain. METHODS: PubMed, Web of Science, Scopus, and Cochrane Library databases were searched from study inception until January 2021. Randomized control trials evaluating both muscle morphometry and pain or disability in individuals with chronic low back pain were included. Study selection, data extraction, and quality assessment were performed by 2 reviewers independently. Modified Downs and Black tool and the Grading of Recommendations Assessment, Development and Evaluation approach were used to assess the risk of bias and quality of evidence, respectively. A meta-analysis was performed using a random effects model with mean difference or standardized mean difference (SMD). RESULTS: Of 3459 studies initially identified, 15 studies were included, and 13 studies were selected for meta-analysis. The results revealed no differences in the resting thickness of the transversus abdominis, internal and external oblique, and lumbar multifidus muscles in studies that compared MCT with other interventions. The transversus abdominis muscles contraction ratio was greater (SMD = 0.93; 95% confidence interval [CI], -0.0 to 1.85) and lower pain (weighted mean difference: -1.07 cm; 95% CI, -1.91 to -0.22 cm; P = .01) and disability (SMD = -0.86; 95% CI, -1.42 to -0. 29; P < .01) scores were found in the groups who underwent MCT compared with other interventions. CONCLUSION: This systematic review and meta-analysis found that motor control exercise training increased the transverse abdominis contraction ratio (muscle activation) and improved the level of pain and disability compared to other interventions in people with chronic low back pain. However, motor control exercise training was not superior to other interventions in increasing the resting thickness of deep abdominal and lumbar multifidus muscles in intervention times less than 12 weeks.

Analysis of Trunk Neuromuscular Activation During Equine-Assisted Therapy in Older Adults.

The three-dimensional movement of the horse in physical therapy is a valuable kinesio-therapeutic phenomenon that simultaneously affects several body systems, including particularly the neuromuscular system. However, the effects of equine-assisted services (EAS) on neuromuscular activation patterns in older adults have not been thoroughly investigated. In this study, we evaluated the impact of a 10-weeks EAS program on trunk muscles in older adults who used a saddle and placed their feet in stirrups for the first 15 minutes and out of stirrups for the remaining 15 minutes of 30-minute EAS sessions. We gathered electromyographic (EMG) data of the trunk muscles five times each on the first, fifth, and 10th sessions: pre-EAS and post-EAS on a stationary horse and at 1-minute, 15-minutes, and 30-minutes on a horse in motion. Participants were 20 adults, aged 60-79 years. We analyzed normalized EMG data with 5 (session time) by 3 (session number) analyses of variance (ANOVAs) with repeated measures and with Bonferroni's testing (p ≤ .05). There was a significant difference over the number of interventions for the right thoracic paravertebral muscle (p = .025) and session time effect for the left trapezius (p = .042), right thoracic paravertebral (p < .001), right and left multifidus (p < .001), and right and left rectus abdominis muscles (p < .001). Thus, trunk muscles in older adults showed complex neuromuscular activation synchronized with the horse's movement, which was influenced by session time and number of interventions. The practical implication of these findings is that EAS can reduce fall risk among elderly adults of both sexes.

Effects of dynamic lumbar motor control training on lumbar proprioception: A randomized controlled trial.

BACKGROUND: Dynamic lumbar motor control training (MCT) is frequently used in low back pain management; however, whether it affects lumbar proprioception remains unclear. Objectives The purpose of this study was to investigate the effect of dynamic lumbar MCT on lumbar proprioception and to determine the effectiveness of dynamic lumbar MCT in patients with low back pain. DESIGN: Randomized controlled trial. METHOD: The study included patients with chronic non-specific low back pain, who were randomized into two groups: general trunk-training group and dynamic lumbar MCT group. Training was conducted for 8 weeks, and measurements were recorded at the beginning and end of the intervention period. The outcomes were the Fremantle Back Awareness Questionnaire score (FreBAQ; subjective proprioception) and the active joint repositioning sense (AJRS; objective proprioception) in trunk-forward bending. RESULTS/FINDINGS: Nine participants in the general trunk-training group and 10 in the dynamic lumbar MCT group were included in the final analysis. In the pre- and post-intervention comparisons, FreBAQ score decreased in the dynamic lumbar MCT group only. AJRS was not significantly different between pre- and post-intervention in both groups. Between-group comparisons of pre- and post-intervention differences showed no significant differences in either FreBAQ or AJRS. CONCLUSIONS: Although the effect of dynamic lumbar MCT on lumbar proprioception is no different from that of general trunk training without moving the lower limbs, dynamic lumbar MCT is effective in training to improve subjective proprioception in patients with low back pain.

Correlation between lower limb and trunk muscle endurance with drop vertical jump in the special military forces.

OBJECTIVE: Police officers, particularly the ones who are trained to be on "special forces", perform a wide range of hazardous and physically demanding activities when aiming to protect and serve. The purpose of this study was to investigate the association between lower limb and trunk muscle endurance with drop vertical jump (DVJ) height in a special military police force. METHODS: One hundred and three male military men (age: 36 ± 5.0 years; height: 1.76 ± 0.05 m; weight: 81.8 ± 9.7 kg) volunteered to take part in this study. SIX TESTS WERE PERFORMED: DVJ, McGill core battery (trunk flexion, trunk extension, and side bridge test-right and left), and single-leg squat repetitions. Correlations were analyzed using the Pearson correlation coefficient (r). The level of significance for all analyses was set at p ≤ 0.05. RESULTS: Single-leg squat repetitions were positively associated with DVJ height, contact time and flight time (p = 0.00093∗∗, p = 0.00085∗∗, and p = 0.00098∗∗ respectively). No correlation was observed between trunk muscle endurance and DVJ. CONCLUSION: Therefore, it was concluded that greater endurance of the lower limb muscles, as demonstrated by the single leg squat, was associated with better performance in a DVJ. Individuals should consider incorporating single leg squats into their fitness program to develop muscular endurance and possibly perform better in the DVJ.

A Systematic Review on the Biomechanics of Breakfall Technique (Ukemi) in Relation to Injury in Judo within the Adult Judoka Population.

OBJECTIVES: To investigate the biomechanics of Ukemi in relation to head and neck injury in adult judokas with varying skill sets. DESIGN: Narrative systematic review. METHODS: An extensive literature search was performed using PubMed, Google Scholar, Science direct and EMBASE from inception to April 2021. Studies were included if they: (1) reported biomechanical analysis of judo throws and Ukemi; (2) were on adult judoka populations; (3) discussed injury related to judo technique. The included studies were assessed for risk of bias using a five-part modified STROBE checklist. A narrative synthesis was performed due to the heterogeneity of included studies. RESULTS: 173 titles and abstracts were screened with 16 studies (158 judokas, 9 of which were female) included. All studies used 3D biomechanical analysis to assess Ukemi. Ukemi implementation produced reduced kinematic data in comparison to direct occipital contact, which was always below the injury threshold. Analysis of lower limb and trunk kinematics revealed variances in Ukemi between novice and experienced judoka. Whilst no significant differences were seen in neck flexion angles, hip, knee and trunk angle time plots revealed greater extension angles in experienced judokas. CONCLUSIONS: Ukemi is essential in preventing head and neck injuries; however, technique differs between experienced and novice judoka. Larger flexion angles of the hip, knee and trunk are seen in novice judoka, which correlate with increased kinematic data. The association of greater neck muscle strength with improved Ukemi is weak. However, a negative correlation was established between fatigue and breakfall skill by one study.

Effect of myofascial release, stretching, and strengthening on upper torso posture, spinal curvatures, range of motion, strength, shoulder pain and disability, and quality of life in breast cancer survivors.

BACKGROUND AND PURPOSE: Breast cancer survivors are known to develop upper torso pain and stiffness including shoulder elevation and ipsilateral inclination of the trunk within a short period of time as a result of cancer adjuvant therapies correlating with the type and side of surgery. Hence, the study. METHODS: Twenty-two breast cancer survivors at a tertiary care hospital, Belgaum, Karnataka, have participated in this pre-post experimental study which included myofascial release (MFR), stretching, and strengthening for four sessions per week for 3 weeks that is, a total of 12 sessions. The participants were assessed at baseline and post-intervention using photogrammetry for Posture and shoulder range of motion (ROM), flexicurve for spinal curvatures, digital inclinometer for cervical ROM, manual muscle testing and hand dynamometer for strength of the upper back, shoulder muscles and hand grip, Shoulder Pain and Disability Index (SPADI) for shoulder impairment and Functional Assessment of Cancer Therapy-Breast (FACT-B) for quality of life. RESULTS: The outcomes were analyzed with a p-value set at ≤0.05. The results of the study demonstrated a substantial improvement in the posture alignment (p = 0.001), shoulder and cervical ROM (p = 0.001), upper back and shoulder muscle and hand grip strength (p = 0.001), SPADI (p = 0.001), and FACT-B (p = 0.001) values. DISCUSSION: The upper torso malalignment and muscular imbalance is seen in patients who has undergone surgeries involving the chest wall and early physiotherapy intervention can benefit the patients overall physical performance and quality of life. Hence, MFR, stretching and strengthening has shown to be beneficial in improving upper torso malalignment in breast cancer survivors. IMPLICATIONS OF PHYSIOTHERAPY PRACTICE: The suggested techniques can be applied at a larger scale which can involve patients with head and neck cancer since the areas of intervention are identical. CTRI (Clinical Trial Registry- India) Registration No.: CTRI/2021/01/030453.

The content and effects of trunk rehabilitation on trunk and upper limb performance in people with multiple sclerosis: a systematic review.

INTRODUCTION: Persons with multiple sclerosis (pwMS) could have an impaired trunk and reduced postural control, which negatively impacts activities of daily living. Evidence is growing to consider the positive effects of trunk training on fall incidence and balance problems. Effects on trunk and upper limb performance is unknown. This systematic review provides an overview of trunk training programs and their effects in MS, specifically focusing on the content of training modalities and the effects on trunk and upper limb performance. EVIDENCE ACQUISITION: Two electronic databases were used: PubMed and Web Of Science (WOS). Intervention studies (with- and without control group) published in English, investigating the effects of active trunk training on trunk and upper limb performance in pwMS, were included. EVIDENCE SYNTHESIS: Sixteen studies met the criteria, investigating different rehabilitation modalities. The included interventions in the review varied between more generic postural interventions such as Pilates (N.=8) and Ai Chi (N.=1), with a focus on abdominal muscle activation, breathing, neutral position and lower extremity movements. Further, specifically developed trunk training programs like GroupCoreDIST/ SIT / CoDuSe (N.=6) and Bobath based trunk training (N.=1) are detected, with the main focus on trunk strengthening and dynamic movements. An overall improvement in trunk performance was reported in several tests on trunk strength, stability and coordination. While the majority of the programs integrated the upper limb, only half of them used upper limb outcome measures to evaluate the effect. Here, overall significant improvements were found for the upper limb. CONCLUSIONS: This systematic review showed that different types of trunk training programs can improve trunk and upper limb function in PwMS. The findings of this review suggest that a focus on trunk training to achieve effects on upper limb is reasonable. Future research is needed to further explore relations and the effect sizes.

Immediate Effects of Vibrotactile Biofeedback Instructions on Human Postural Control.

Vibrotactile biofeedback can improve balance and consequently be helpful in fall prevention. However, it remains unclear how different types of stimulus presentations affect not only trunk tilt, but also Center of Pressure (CoP) displacements, and whether an instruction on how to move contributes to a better understanding of vibrotactile feedback.Based on lower back tilt angles (L5), we applied individualized multi-directional vibrotactile feedback to the upper torso by a haptic vest in 30 healthy young adults. Subjects were equally distributed to three instruction groups (attractive - move in the direction of feedback, repulsive - move in the opposite direction of feedback & no instruction - with attractive stimuli). We conducted four conditions with eyes closed (feedback on/off, Narrow Stance with head extended, Semi-Tandem stance), with seven trials of 45s each. For CoP and L5, we computed Root Mean Square (RMS) of position/angle and standard deviation (SD) of velocity, and for L5 additionally, the percentage in time above threshold. The analysis consisted of mixed model ANOVAs and t-tests (α-level: 0.05).In the attractive and repulsive groups feedback significantly decreased the percentage above threshold (p<0.05). Feedback decreased RMS of L5, whereas RMS of CoP and SD of velocity in L5 and COP increased (p<0.05). Finally, an instruction on how to move contributed to a better understanding of the vibrotactile biofeedback.

Effects of a posture shirt with back active correction keeper on static and dynamic balance in Parkinson's disease.

BACKGROUND: Patients with Parkinson's disease (PD) suffer from postural disorders. This study aims at investigating the short- and medium-term effects of a shirt with appropriate tie-rods that allows to correct the posture of the trunk. METHODS: This is a longitudinal clinical study in which a pressure platform was used to assess the static and dynamic baropodometry and the static stabilometry of 20 patients with PD (70.95 ± 8.39 years old; 13 males, time from the onset of symptoms: 6.95 ± 4.04 years, Unified Parkinson's Disease Rating Scale score: UPDRS = 7.25 ± 6.26) without and with a shirt, specifically designed for improving posture, at baseline and after one month of wearing. RESULTS: The results showed a significant improvement in symmetry of loads (p = 0.015) and an enlargement of the foot contact surface (p = 0.038). A significant correlation was found between the change in forefoot load and time spent daily in wearing the shirt (R = 0.575, p = 0.008), with an optimal value identified at 8 h per day. CONCLUSION: The use of a postural shirt in patients with PD symmetrized the postural load and enlarged the foot contact surface improving their balance.

Trunk muscle function and anterior and posterior limits of stability in community-dwelling older adults.

BACKGROUND: Understanding of the influence of trunk muscles on the older adult's limit of stability (LOS) is important for clinical practice. OBJECTIVE: To compare the anterior and posterior LOS and the flexor and extensor trunk muscle function; verify the association of trunk muscles and LOS, and the association of LOS and the previous falls of community-dwelling older adults. METHODS: Sample characterization data, trunk muscle function (peak torque - PT and torque steadiness - TS), LOS and previous falls (6 months) were collected from 79 older people. Comparisons were made between the variables of the anterior/posterior LOS (Reaction time, Movement velocity, Maximum excursion, Directional control), between trunk extensors/flexors muscle function and between TS at 10% and at 50%. Associations were made between the anterior/posterior LOS and the number of previous falls and between LOS and trunk muscle function. RESULTS: The posterior LOS was worse than the anterior LOS, except for the reaction time. The flexor muscles obtained a lower PT, but better performance in TS. The TS at 10% of the trunk extensor was associated with the posterior directional control (p = 0.032). There was no association between trunk muscle function and the anterior LOS, or between previous falls and LOS. CONCLUSIONS: The older adults presented worse performance in the posterior LOS and worse TS in the trunk extensor muscles, although the trunk extensor muscles presented a higher PT. Although no association between LOS and previous falls, the better the TS at 10% of the trunk extensors, better posterior directional control.

Effects of core stability training program on trunk muscle endurance in deaf children: A preliminary study.

INTRODUCTION: Sport participation is an important for deaf children as participants experience physical, psychological and social benefits; however, the beneficial effect of core stability training on core muscle endurance is unclear. The present study aimed to examine the effects of an 8-week core stability exercise training program on endurance of trunk muscles in deaf children. METHODS: Twenty male deaf students (age, 16.5 ± 0.65 y; body mass, 62.08 ± 5.39 kg; BMI, 22.33 ± 2.24 kg/m2) volunteered to participate in this study and were randomly assigned to experimental (EXP, n = 10) and control (CON, n = 10) groups. The subjects in the EXP group performed 3 times a week for 8 weeks period of core stability training program and tested trunk muscle endurance including prone bridge, supine bridge and flexor endurance tests at pre and post 8 weeks intervention. RESULTS: The CON group did not show any significant change after training period (p > 0.05). The EXP group showed significantly changes in core stability muscle endurance tests following the 8-week core stability training program (p < 0.05). In addition, the EXP group indicated statistically significant changes than the CON group in truck muscle endurance (p < 0.05). CONCLUSIONS: The results indicated that core stability training program improved trunk muscle endurance. Therefore, this training approach can be recommended in deaf rehabilitation programs to improve trunk muscle endurance.

[Experimental research on characteristics of temperature field distribution of mild moxibustion and sparrow-pecking moxibustion].

OBJECTIVE: To explore the temperature field distribution and variation rules during treatment with mild moxibustion and sparrow-pecking moxibustion of TCM. METHODS: Six healthy subjects were selected. Mild moxibustion and sparrow-pecking moxibustion were exerted at Zusanli (ST 36) respectively, for 25 min. Using infrared thermal imaging instrument, the temperature field distribution was measured during moxibustion at Zusanli (ST 36). The simulated thermometer was adopted to measure the temperature field distribution during moxibustion at the imitated cortex. At 20 min of mild moxibustion and sparrow-pecking moxibustion, the temperature field distribution generated by moxibustion was observed at the imitated cortex and Zusanli (ST 36) separately. The temperature values were collected at the sites 0.7, 2.1 and 3.5 cm far from the center of the moxibustion-exerted places successively, and then the characteristics of temperature field distribution and variation rules were compared between different moxibustion methods at the imitated cortex and Zusanli (ST 36). RESULTS: At 20 min of mild moxibustion and sparrow-pecking moxibustion at Zusanli (ST 36), the temperature field distribution focused on the center of moxibustion-exerted site and the temperature was reduced to all directions and illustrated as a curved surface graph, whereas, the temperature field distribution at the imitated cortex was consistent with that at Zusanli (ST 36). With mild moxibustion, the temperature field was distributed uniformly along the longitudinal temperature gradient; whereas, with sparrow-pecking moxibustion, the longitudinal temperature of the temperature field was greatly different, in which, the maximum temperature and the average temperature were higher than those with mild moxibustion respectively and the first time up to the peak value of sparrow-pecking moxibustion was shorter than that with mild moxibustion. The thermal transfer was presented at the non-moxibustion exerted areas during the moxibustion experiment at Zusanli (ST 36). CONCLUSION: A distance feature is presented in the temperature field measured by simulated thermometer and generated under suspension moxibustion at Zusanli (ST 36). The warm stimulation effect of sparrow-pecking moxibustion is much more obvious at the moxibustion-exerted center as compared with mild moxibustion and the area of warm stimulation generated by sparrow-pecking moxibustion is more concentrated as compared with mild moxibustion. The radiation energy produced by suspension moxibustion is scattered and attenuated in skin tissue, resulting in a certain temperature gradient in the temperature field. The warm stimulation generated at skin surface by moxibustion has a warming-dredging effect.

The influence of rotational movement exercise on the abdominal muscle thickness and trunk mobility - Randomized control trial.

BACKGROUND: Trunk rotations are important functional movements which form the foundations of human motion pattern, especially in the functions of walking and running. They prevent the functional impairments and structural lesions resulting from axial overloading in static positions such as sitting. OBJECTIVES: The aim of the study was to assess the influence of rotational movement training exercises on the abdominal muscle thickness and spinal mobility range. STUDY DESIGN: Randomized controlled trial. METHODS: The study involved 73 individuals aged 18-45. The subjects were randomly divided into two groups. The study group (TG) comprised 40 people who performed rotational movement exercises over the period of 4 weeks (16 training sessions). In the control group (CG) the training was not applied. Changes in the thickness of selected abdominal muscles on ultrasound imaging were evaluated, as well as trunk mobility, based on the trunk lateral flexion test. RESULTS: The analysis of the obtained data has demonstrated a statistically significant increase in the thickness of the abdominal internal (IO) (p < 0.05) and external oblique muscles (EO) (p < 0.001) in the study group (TG) between measurements I and II, and measurements I and III. A similar increase in the thickness was found in the summation measurement of TrA + IO + EO. Bilateral increase in the trunk lateral flexion range in the frontal plane has also been noted. CONCLUSIONS: Rotational movement training of the trunk leads to an increase in the thickness of the abdominal oblique muscles. Rotational movement exercise training increases trunk mobility in the frontal plane.

Electromyographic analysis of muscle activation of the trunk and lower limbs during human gait and hippotherapy using different ride mount materials.

OBJECTIVE: Activation of the trunk and lower limb muscles, namely the multifidus, rectus abdominis, rectus femoris, and tibialis anterior, was analyzed using surface electromyographyin 40 young, healthy, and sedentary individuals. METHODS: Data were collected from sneaker-clad subjects with independent gait and during hippotherapy using saddles and blankets, with the feet in and out of the stirrups. RESULTS: Surface electromyography results demonstrated a statistically significantly greater activation of the rectus femoris comparison to tibialis anterior muscle during hippotherapy. No statistically significant differences were observed when comparing variables related to the mount materials used in hippotherapy and human gait. CONCLUSION: In this study, similarities were observed between activation of the trunk and lower limb muscles during hippotherapy and human gait. In addition, the mount materials and practices used in hippotherapy did not influence muscle activity.

[Analysis on the route of conception vessel and governor vessel in Huangdi Neijing (The Yellow Emperor's Inner Classic)].

On the base of the analysis on the original text in Huangdi Neijing (The Yellow Emperor ¢s Inner Classic) and in association with the meridian tracing experiment results in transparent fish, rats and human body, the routes of conception vessel and governor vessel were recognized de novo. The starting site of conception vessel has been described as "the center of uterus" and "the inferior part of Zhongji (CV 3)", which refer to the same region. The running course of conception vessel includes 3 routes, named the deep abdominal route, the deep dorsal route and the superficial abdominal route. The governor vessel starts at Qugu (CV 2) on the pubis and its running course includes 4 routes, named the buttock-spine ascending route, the head-back descending route, the abdomen-face ascending route and the head-back midline route. Both the conception vessel and the governor vessel distribute on the anterior and the posterior aspects of the trunk, head and face, but they are in deep and shallow layers respectively, forming two cycles internally and externally. Such recognition is really not the pattern, known by the people, that conception vessel distributes in the front, while the governor vessel on the back.

Effects of Thrust Magnitude and Duration on Immediate Postspinal Manipulation Trunk Muscle Spindle Responses.

OBJECTIVE: The purpose of this study was to characterize trunk muscle spindle responses immediately after high-velocity, low-amplitude spinal manipulation (HVLA-SM) delivered at various thrust magnitudes and thrust durations. METHODS: Secondary analysis from multiple studies involving anesthetized adult cats (N = 70; 2.3-6.0 kg) receiving L6 HVLA-SM. Muscle spindle afferent recordings were obtained from L6 dorsal rootlets before, during, and immediately after HVLA-SM. L6 HVLA-SM was delivered posteriorly-to-anteriorly using a feedback motor with peak thrust magnitudes of 25%, 55%, and 85% of cat body weight (BW) and thrust durations of 25, 50, 75, 100, 150, 200, and 250 ms. Time to the first action potential and muscle spindle discharge frequency at 1 and 2 seconds post-HVLA-SM were determined. RESULTS: A significant association between HVLA-SM thrust magnitude and immediate (≤2 s) muscle spindle response was found (P < .001). For non-control thrust magnitude, pairwise comparisons (25%, 55%, 85% BW), 55% BW thrust magnitude had the most consistent effect on immediate post-HVLA-SM discharge outcomes (false discovery rate < 0.05). No significant association was found between thrust duration and immediate post-HVLA-SM muscle spindle response (P > .05). CONCLUSION: The present study found that HVLA-SM thrust magnitudes delivered at 55% BW were more likely to affect immediate (≤2 s) post-HVLA-SM muscle spindle response.

The influence of the trunk muscle activation on occlusion pressure and respiratory muscle strength in healthy participants: Randomized controlled trial.

OBJECTIVES: The purpose of the study was to check if the trunk muscle activation done in accordance with rules of the Bobath concept affects the occlusion pressure and respiratory muscle efficacy in forced breathing manoeuvres in healthy participants. DESIGN: Randomized controlled trial. Between-subjects design. PARTICIPANTS: Seventy-four healthy volunteers, aged 20-26 years, were recruited from medical students, randomly assigned to the experimental or control groups. INTERVENTION: The intervention in the experimental group was individual physiotherapy based on the Bobath concept. It was provided by qualified physiotherapist and lasted about 60 min. The Bobath concept is an inclusive, individualized therapeutic approach to optimize movement recovery, informed by contemporary movement and neuro-sciences. The control group participated in a 45-minute lecture on the importance of the stability of trunk muscle and the diaphragm position that is adequate for its respiratory work. The described interventions, in both groups, were performed once, between the initial and final measurement of the respiratory drive. OUTCOME MEASURES: The subjects underwent two assessments of the following variables: occlusion pressure (P0.1) and the respiratory muscle strength: maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), maximal occlusion pressure (P0.1max) with the use of MasterScope Spirometer. In experimental group, the physiotherapy assessment was carried out before intervention. RESULTS: As a result of the applied intervention, P0.1 in the experimental group increased (p = 0.001; 82.45 vs 103.73), which was not observed in the control group (p = 0.629; 88.95 vs 85.83). The intervention did not change the results of all other outcomes including P0.1 max; PImax and PEmax. CONCLUSION: The activation of trunk muscles such as transversus abdominis, multifidius and muscles of the pelvic floor was found to improve the effectiveness of diaphragmatic work during tidal breathing as measured with P0.1 values. Established abdominal pressure, which stabilizes the trunk and prevents chest mobility, might be the reason why forced measurements (PImax, PEmax, P.01 max) remain unchanged.