Asymmetric Thickness of Oblique Capitis Inferior and Cervical Kinesthesia in Patients With Unilateral Cervicogenic Headache.

OBJECTIVE: The purpose of this study was to compare the thickness of the oblique cervical inferior (OCI) and the error of the head reposition test between the painful and nonpainful sides of patients with cervicogenic headache (CeH) and between the patients and the asymptomatic group. METHODS: Thirteen patients (24.5 ± 4.8 years) and 14 asymptomatic participants (23.9 ± 2.7 years) were included. The head reposition test was recorded by a 3-dimensional motion analysis system. The thickness of the OCI was recorded by ultrasonography. The measured outcomes were compared between the painful and nonpainful sides and with the asymptomatic participants. RESULTS: The thickness of the OCI in the rest condition on the painful side (9.92 ± 2.31 mm) was smaller than that of the nonpainful side (10.56 ± 2.24 mm). The constant error of the head-to-target test toward the nonpainful side was smaller in the patients with CeH (-1.6 ± 4.3°) than in the asymptomatic group (3.3 ± 3.7°, P = 0.005). CONCLUSION: Asymmetric OCI and cervical proprioception were demonstrated in patients with CeH.

Mechanical deformation of posterior thoracolumbar fascia after myofascial release in healthy men: A study of dynamic ultrasound imaging.

BACKGROUND: Myofascial release (MR) on the posterior thoracolumbar fascia (PLF) is one of the manual techniques aim to restore the normal length and tension of restricted fasciae and muscles. OBJECTIVES: The present study aimed to quantify the immediate effects of MR on fascial properties of the PLF in healthy men. DESIGN: Cross-sectional study. METHOD: Participants (N = 10, aged 22.8 ± 2.0 years) performed a press-down to maximal voluntary contraction (MVC) in the prone position. Deformation of the PLF was measured using an ultrasonographic apparatus. Force output was simultaneously measured. The stiffness index and hysteresis index were then represented by the slope of the loading curve, and the percentage of the area within the loading-unloading curve. One-way ANCOVA was used to compare differences in the stiffness index or hysteresis index of the PLF before and after MR. Two-way repeated ANOVA was used to compare deformation of the PLF or force output after MR. RESULTS: The primary findings included a decrease (before: 24.1 ± 8.3 vs. after: 18.9 ± 5.3 N/mm; mean difference, -5.2 ± 4.9 N/mm, p = 0.002 < 0.05) in the stiffness index of the PLF and a greater difference in deformation of the PLF between 50% and 100% MVC (before: Def50% = 6.5 ± 1.8 mm and Def100% = 9.8 ± 1.9 mm vs. after: Def50% = 6.4 ± 2.5 mm and Def100% = 10.2 ± 2.4 mm; p = 0.037 < 0.05, power = 58.5%). CONCLUSION: After MR, stiffness of the PLF decreased in healthy men.

Increased sliding of transverse abdominis during contraction after myofascial release in patients with chronic low back pain.

PURPOSE: Recent evidence suggested the significance of integrity of the tension balance of the muscle-fascia corset system in spinal stability, particularly the posterior musculofascial junction which is adjacent to dorsal located paraspinal muscles joining each other at lateral raphe (LR). The purpose of this study was to compare the contraction of the transversus abdominis (TrA) at both anterior and posterior musculofascial muscle-fascia junctions in patients with low back pain (LBP) and asymptomatic participants before and immediately after a sustained manual pressure to LR. METHODS: The present observational cohort study used a single-instance, test-retest design. The outcome variables included the resting thickness (Tr), the thickness during contraction (Tc), change in thickness (ΔT), sliding of musculofascial junction (ΔX), muscle length at rest (L) and displacement pattern (ΔD) of the TrA using ultrasonography. Vertical tolerable pressure at the LR was applied manual for 1 min. Tr, Tc, ΔT, and ΔX were analyzed by three-way ANOVA (musculofascial junction sites*group* pre-post manual release). ΔL and ΔD were analyzed by two-way ANOVA (group* pre-post manual release). RESULTS: Participants with LBP revealed less Tc, ΔT and ΔX at both sites (p < 0.005). After myofascial release, LBP group demonstrated a positive ΔD of the musculofascial junctions at both end (p < 0.001). Nevertheless, both groups increased the ΔT and ΔX at both sites (p < 0.001 and 0.001, respectively). CONCLUSION: The result indicated immediately effect of sustained manual pressure on musculofascial junction of TrA and supported the concept that the possible imbalanced tension of the myofascia corset of TrA in patients with LBP.