Effects of multi-gravitational suspension-based therapy on posture, physical fitness, quality of life, depression, and sleep quality in women without regular exercise habits.

BACKGROUND: Multi-gravitational suspension-based therapy (M-Gravity) is a comprehensive discipline based on the principles of non-gravity, which serves to increase the quality of life and holistic health of the individual with the rehabilitation content of non-pressure inversion therapy and suspension systems. AIMS: To examine the effects of M-Gravity exercise on posture, physical fitness, quality of life, depression, and sleep quality in women without regular exercise habits. METHODS: This study included 20 women without regular exercise habits, who participated in M-Gravity exercise and 20 women who did not participate in any exercise program. Posture was measured by the New York posture rating chart, flexibility of the hamstring and pectoral muscles were assessed with flexibility tests, and endurance of the core muscles was measured with plank test. Depression levels were measured by Beck Depression Inventory, sleep quality was measured by Pittsburgh Sleep Quality Index, and Nottingham Health Profile was used to measure the perceived health levels of the subjects. Measurement of the core stability was performed with the Stabilizer Pressure Biofeedback. Two evaluations were made at baseline and after 4 weeks of exercise program. RESULTS: Although statistically significant results were achieved for all parameters in the M-Gravity group, no differences were observed in the control group between baseline and post-test scores (p < 0.05). CONCLUSIONS: We came to the idea that eight sessions of M-Gravity program may have positive effects on posture, physical fitness and quality of life in women who do not have regular exercise habits.

Effects of vibration-based biofeedback on multifidus muscle activity and pelvic tilt angle in subjects with hip flexion limitation.

BACKGROUND: Sedentary work may lead to low back pain. In particular, a slumped sitting position may exacerbate low back pain because of tissue damage caused by excessive lumbar flexion and posterior pelvic tilting. Subjects with low back pain may have excessive changes in the lumbopelvic posture and back muscle activity in the sitting position. OBJECTIVE: The purpose of this study was to compare the effects of vibration-based biofeedback using a motion sensor belt and no biofeedback on multifidus (MF) muscle activity and pelvic tilt angle during typing. METHODS: Thirty subjects with low back pain accompanied by hip flexion limitation (15 each in the biofeedback and non-biofeedback groups) were enrolled. Electromyography was used to investigate MF muscle activity before and after typing for 30 min. Pelvic tilt was measured after typing in a sitting position for 30 min. Independent t-tests were used to compare MF muscle activity, and pelvic and second sacrum tilt angles, between the biofeedback and non-biofeedback groups. RESULTS: After typing for 30 min, changes in MF muscle activity (11.45% and -7.19% for the biofeedback and nonbiofeedback groups, respectively) and pelvic and second sacrum tilt angles (3.15∘ and 4.12∘ for the biofeedback group and -11.05∘ and -18.16∘ for the non-biofeedback group, respectively) were significantly smaller in the biofeedback than non-biofeedback group (p< 0.05). CONCLUSION: Vibration-based biofeedback minimizes the reduction in MF muscle activity and changes in pelvic and second sacrum tilt angles during typing in individuals with low back pain accompanied by hip flexion limitation.

Knee joint repositioning error in different trunk positions among females with chronic nonspecific low back pain: A cross-sectional study.

PURPOSE: Proprioception is a self-perceived sense of position and movement of one's body and its deficits can lead to motor control problems such as delayed muscle reflexes. Previous studies have confirmed lumbar proprioception impairments among individuals with Low Back Pain (LBP), which can afflict the normal central sensory-motor control and hence increases the risk of abnormal loading on the lumbar spine. Although the local investigation of proprioception is important, its influence on other joints in a kinetic chain particularly between extremities and spine should not be ignored. Therefore, the aim of this study was to compare the proprioception of knee joint in different trunk positions among females with chronic nonspecific low back pain (CNSLBP) and healthy females. DESIGN: The study included 24 healthy subjects and 25 patients with CNSLBP participated in this study. Repositioning error of knee joint in four different lumbar positions including flexion, neutral position, 50% ROM of left rotation and 50% ROM right rotation was evaluated using an inclinometer. Absolute error and constant error were obtained and analyzed. RESULTS: Absolute error in flexion and neutral positions in the individuals with CNSLBP were significantly higher than in healthy individuals; whereas, there was no significant difference in absolute and constant error between the two groups in 50% rotation to either side. CONCLUSION: This study showed that knee joint repositioning accuracy was reduced in patients with CNSLBP compared to healthy ones.

Ergonomic risk assessment during massage among physiotherapists: Introduction of generic postures notion.

BACKGROUND: Musculoskeletal disorders are prevalent among physiotherapists. They perform many repetitive tasks in awkward postures that require a high muscle load. This issue was often addressed through subjective analysis (questionnaire) but rarely using postural evaluation combined with an ergonomic assessment. OBJECTIVE: The aim of this article was to decompose draining lymphatic massage performed by physiotherapists in generic postures (GP) to quickly assess the musculoskeletal disorder risk. METHODS: Based on numeric video recorded in frontal and sagittal planes, 3360 postures were defined from 20-minutes lymphatic drainage massage performed by 7 physiotherapists over a period of 6 months. A hierarchical cluster analysis was applied to define the GP. RESULTS: Seven GP were identified, which were described by their average joint angles, variability and relative frequency. GP6, GP4 and GP2 had the highest frequencies (17.6%, 16.9% and 16.8% respectively). Trunk and neck were essentially flexed (neck: 17.0±10.0° for GP1; trunk: 20.4±8.7° for GP4). Shoulder flexion and abduction ranged from 15° (GP7) to 60° (GP4). Mean and variability of RULA score completed the analysis. The highest scores were computed for GP2 and GP3 (respectively 5.5±1.3 and 5.8±1.2, p < 0.05). GP4 had the lowest (4.0±1.1, p < 0.05). The results suggest that massages have to be monitored. Attention should be paid to the postures used to prevent the occurrence of MSDs. CONCLUSION: The massages could be described as a combination of generic posture for a rapid ergonomic assessment.

Feasibility of a 4-Week Manual Therapy and Exercise Intervention on Posture and Function in Community-Dwelling Older Adults: A Pilot Study.

BACKGROUND AND PURPOSE: Thoracic hyperkyphosis is a common condition that progresses with aging and has been associated with impaired functional performance, increased risk of falls, and even mortality. Previous studies to improve posture primarily used exercise for durations of 3 months or longer. The purpose of this pilot study was to examine the feasibility of a manual therapy intervention in community-dwelling older adults over a 4-week time frame that is comparable to the typical clinical setting, to test the appropriateness and procedures for the measurement of posture and function in the older population with hyperkyphosis, and to collect preliminary data to describe change in posture and function measures. METHODS: Twenty-four participants with hyperkyphosis or forward head posture were recruited, and 22 participants completed this pilot study. Feasibility was measured based on attendance, tolerance, safety, and retention. Issues with measurement procedures were recorded. The intervention included manual therapy and exercise 3 times a week for 4 weeks to target spinal and peripheral joint stiffness, muscle lengthening, and muscle activation. Outcomes included height, kyphotic index (KI), Block Test, Acromion to Table (ATT), Timed Up and Go (TUG), 5 times sit-to-stand (5XSTS), Functional Reach (FR), 2-minute walk test (2MWT), and Patient-Specific Functional Scale (PSFS). Data collected at visits 1, 6, and 12 were analyzed using 1-way repeated-measures multivariate analysis of variance. RESULTS AND DISCUSSION: Measurement and intervention protocols were found to be feasible. A significant effect for the aggregate dependent variables change over time was found. Univariate analysis of each dependent variable showed significance except for FR. All postural measures (height, KI, Block Test, and ATT) significantly improved statistically. The KI and ATT exceed the minimal detectable change for clinical significance. Function showed statistical improvements in the TUG, 5XSTS, 2MWT, and PSFS. Clinical significance was reached with the PSFS. Seven of 9 measures showed a statistically significant change in just 2 weeks. CONCLUSIONS: This pilot study suggests that manual therapy and exercise applied to older adults shows promise for improvement in measures of posture and functional performance in a clinically feasible 4-week time frame.

The Effect of Acute Administration of the Aqueous Calyx Extract of Hibiscus sabdariffa on Blood pressure, Heart rate and Double Product of Apparently Healthy Human Subjects during Different Postures.

The aqueous calyx extract of Hibiscus sabdariffa (HS) is widely consumed as a beverage in Northern Nigeria and other parts of the world. HS has been reported to lower blood pressure (BP) in animals and man. However, not much is known about the effect of HS on BP in different postures. We tested the hypothesis that HS may lower BP, heart rate (HR) and heart rate-pressure product or double product (DP) by attenuating the discharge of the autonomic nervous system in different postures. Experiments were performed in accordance with the Principles of the Declaration of Helsinki. Following ethical approval and informed consent, BP and HR were measured in different postures (supine, sitting and standing) in apparently healthy human subjects (n=20) before and after (+HS) the oral administration of 15mg/Kg HS. Mean arterial pressure (MAP; taken as representative BP) and DP were calculated. Results are expressed as mean ±SEM. Paired t test and ANOVA with a post hoc Bonferroni test were used for statistical analyses. P<0.05 was considered significant. In the supine position MAP, HR and DP were significantly (P<0.0001 each) reduced in the presence of HS (85.6±1.7mmHg, 72.1±1.1/min and 8716±320mmHg.bpm) compared to its absence (89.6±2.0mmHg, 73.7±1.6/min and 8921±444mmHg.bpm). Similar trends were observed in the sitting position in the presence of HS (85.4±2.7mmHg, 73.7±1.8/min and 9098±345mmHg.bpm vs its absence: 91.4±2.3mmHg, 77.1±1.9/min and 9388±478mmHg.bpm; P<0.0001, P<0.0001 and P=0.007 respectively) and in the standing position (+HS: 89.3±2.0mmHg,         78.1±1.8/min and 10164±230mmHg.bpm vs its absence: 94.3±2.1mmHg, 81.8±2.3/min and 10742±268mmHg.bpm; P<0.0001, P<0.0001 and P=0.007 respectively). In the absence of HS, HR and DP were significantly higher in the standing posture (81.8±2.3/min, 10742±268mmHg.bpm) compared to the sitting (77.1±1.9/min, 9388±478mmHg.bpm; P<0.05 and P<0.0001 respectively) and the supine (73.7±1.6/min, 8921±444mmHg.bpm; P<0.001 each) postures while the BP remained similar. A similar trend was observed across          the three postures in the presence of HS although the parameters were significantly lower. It is concluded that HS lowered BP, HR and DP by modulating autonomic mechanisms through the inhibition of both parasympathetic withdrawal and sympathetic nervous system discharge across the postures. Also the standing posture is associated more with a higher sympathetic nervous system discharge and a higher cardiac oxygen demand and workload than the sitting and supine postures in the absence or presence of HS.

Chiropractic care of Parkinson's disease and deformity.

Parkinson's disease (PD) is a progressive neurological disease characterized by muscle stiffness, tremor, slowness of movement, and difficulties with posture and walking. Muscle and joint pain are frequent non-motor symptoms of PD. Pain associated with PD is mainly caused by a combination of truncal dystonia, stooped posture, and muscle rigidity. However, PD deformities were rarely discussed in the literature. A 68-year-old Asian female with PD treated with Levodopa for six years complained of progressive neck pain, contractures, and subluxation of both hands in the last two years. A positron emission tomography (PET) scan revealed decreased rostrocaudal gradient uptake in both posterior putamen. After 9 months of multimodal chiropractic rehabilitation, the patient had significant improvement in symptoms, including pain resolution as per the numeric rating scale and physical and mental improvement as per the PD questionnaire. Radiographic measurement showed significantly improved postural alignment and stability. Measurement of joint motion and angles showed an improvement in hand deformity. Although PD is a neurodegenerative disease that is not curable, multimodal rehabilitation may improve neurological and musculoskeletal functions by inducing proprioceptive balance, motor strength, and joint movement. The current study may illustrate multimodal rehabilitation addressing orthopedic deformity associated with symptoms in a PD patient.

Implanted System for Orthostatic Hypotension in Multiple-System Atrophy.

Orthostatic hypotension is a cardinal feature of multiple-system atrophy. The upright posture provokes syncopal episodes that prevent patients from standing and walking for more than brief periods. We implanted a system to restore regulation of blood pressure and enable a patient with multiple-system atrophy to stand and walk after having lost these abilities because of orthostatic hypotension. This system involved epidural electrical stimulation delivered over the thoracic spinal cord with accelerometers that detected changes in body position. (Funded by the Defitech Foundation.).

Physiotherapeutic methods of treatment of mandibular distal occlusion and the progress of therapy: A case report.

BACKGROUND: Studies have demonstrated a relationship between dental malocclusion and posture defects. The aims of the study were to present (1) the effect of a physiotherapeutic approach to a patient with a distal occlusion defect with the use of a set of exercises to strengthen the muscles responsible for mandibular protrusion, and (2) a non-invasive and easy-to-use method to monitor the effects of therapy. METHODS: Five year old girl with a distal occlusion and with a low basic postural tone was referred to physiotherapy. A therapeutic program i.a. concerning a strengthening of the temporomandibular joint muscles with the use of a flexible tape was proposed. To assess the functional changes of the masticatory apparatus a photoanthropometric method was used. In side-face photos, proportions of 2 linear measurements and values of two angles on the first day of therapy, after 2 and after 4 months of exercises, with the mandible located freely and in the maximum protrusion were compared. RESULTS: A comparison of indices and angles showed a marked improvement in mandibular mobility already after two and four months of the exercises. Using the elastic resistance tape in addition to general developmental exercises allowed for increasing the mobility in the temporomandibular joint. CONCLUSION: Malocclusion should not be considered separately, without taking into account the body posture. The work of the physiotherapist can benefit the orthodontist, correcting postural defects and consequently affecting malocclusion. A comparison of linear measurements and angles can be used to assess the progress of the therapy.

Biofeedback Posture Training for Adolescents with Mild Scoliosis.

Adolescent idiopathic scoliosis (AIS) is characterized by uneven shoulders, spinal curvature, and uneven hips, and asymmetry in paraspinal muscle activities is common in AIS. This pilot study was aimed at examining the use of a surface electromyography (sEMG) biofeedback posture training program in adolescents with mild scoliosis (Cobb's angle < 30°) to attenuate asymmetry in paraspinal muscle activities and control the curve progression. Seven female adolescents (age, 12-14 years) with mild scoliosis (Cobb's angle < 30°) were recruited. The participants received 30 tailor-made sessions of sEMG biofeedback posture training at a rate of one to two sessions per week for approximately 6 months. The activities of the paraspinal muscles (the trapezius, latissimus dorsi, thoracic erector spinae, and lumbar erector spinae) measured by sEMG during habitual sitting postures and spinal deformity evaluated by 3D ultrasound imaging were compared before and after training. The mean values of the root-mean-square sEMG ratio, an index of symmetry in paraspinal muscle activities of the muscle pairs between the concave and convex sides of the spinal curve, revealed significant asymmetry over the trapezius and lumbar erector spinae before the training (p <0.05). After the training, all seven adolescents achieved relatively more symmetrical paraspinal muscle activities over these two muscle pairs (p < 0.05). In two adolescents, the spinal curvature decreased by 5.7° and 5.6°, respectively, whereas the remaining adolescents showed a minimal curve progression with changes in the spinal curvature controlled under 5°. To conclude, sEMG biofeedback posture training can reduce asymmetry in paraspinal muscle activities and control curve progression in adolescents with mild scoliosis and can potentially be considered an alternative early intervention for muscle reeducation in this cohort.

The role of spatial alignment in posture-cognition dual task interaction.

BACKGROUND: A range of cognitive tasks can interfere with postural control, particularly in older adults. In the case of spatial tasks, the spatial alignment between the task and postural control can incur dual-task costs separately from task load. It has been suggested that spatial tasks incur dual-task costs because accessing the visuospatial sketchpad component of working memory reduces the capacity to utilize external visual information for postural control. RESEARCH QUESTION: We investigated whether the spatial alignment between a cognitive and a postural control task can affect postural stability even when visual perception is not involved in either task and task load does not differ between aligned and non-aligned conditions. We predicted that any such effect would be greater in older people and in a more challenging stance. METHODS: Fifty healthy adults (27 aged 20-35, 23 aged 59-88) with no history of balance or cognitive difficulties performed a mental navigation task while standing in open or closed stance with eyes closed. The mental navigation task was presented in a reference plane that was either aligned or non-aligned to the horizontal reference plane in which the posture control system controlled the position of the body's center of gravity. Task performance was measured as accuracy and response time and postural sway as anteroposterior (AP) and mediolateral (ML) sway velocity. RESULTS: The older group were less accurate in the mental navigation task, and both groups had higher AP and ML sway velocity in closed stance. When standing in the more challenging stance, the older group had higher AP sway velocity while performing the mental navigation task in the non-aligned than the aligned reference plane condition. SIGNIFICANCE: The spatial configuration compatibility between a cognitive task and postural control can affect postural stability even when visual information is not being used for either task and task load is unchanged.

Tongue stretching: technique and clinical proposal.

OBJECTIVES: The tongue is an organ with multiple functions, from sucking to phonation, from swallowing to postural control and equilibrium. An incorrect position or mechanics of the tongue can causes sucking problems in the newborn or atypical swallowing in the adult, with repercussions on the position of the head and neck, up to influencing upright posture and other problems. Tongue dysfunctions are quite frequent (10-15%) in the population. For the manual therapist, this frequency indicates one to two subjects every 30 patients. Exercises have been proposed to improve the tone and strength of the swallowing muscles but the results are not so clear in the literature. The aim of this study is to describe and provide a tongue muscle normalization technique that helps the manual therapist in the treatment of problems related to it. METHODS: The literature has been investigated through pubmed, Google scholar of the last 10 years, the keywords used and combined with the Boolean operators AND and OR, are: "tongue, tongue habits, tongue diseases, taste disorder, neck pain, posture, postural balance, atypical swallowing, muscle stretching exercise, tissue expansion, soft tissue therapy, osteopathic manipulative treatment". RESULTS AND CONCLUSIONS: The technique is possible to be executed even in a sitting position, in the case the patient is unable to assume a supine position, the subject should provides immediate feedback that allows the therapist to understand if the technique has been correctly executed. The simplicity of execution and application of the technique makes it a possible and immediate therapeutic tool in the clinical setting.

Effectiveness of lumbar support with built-in massager system on spinal angle profiles among high-powered traffic police motorcycle riders: A randomised controlled trial.

Traffic police riders are exposed to prolonged static postures causing significant angular deviation of the musculoskeletal, including the lumbar angle (L1-L5). This postural alteration contributes to awkward posture, musculoskeletal disorders and spinal injury, especially in the lower back area, as it is one of the most severe modern diseases nowadays. Thus, the study aimed to evaluate the effect of lumbar support with a built-in massager system on spinal angle profiles among traffic police riders. A randomised controlled trial (pre-testpost-test control design) was used to assess spinal angle pattern while riding the high-powered motorcycle for 20 minutes. Twenty-four traffic police riders were randomly selected to participate and 12 riders were assigned to the control group and 12 riders to the experimental group. The pre-test and post-test were conducted at a one-week interval. Each participant was required to wear a TruPosture Smart Shirt (to monitor spinal posture). The TruPosture Apps recorded the spinal angle pattern. The data indicated that the police riders using motorcycle seat with lumbar support and built-in massager system showed a huge improvement in maintaining posture which only involves slight spinal angle deviation changes from the spinal reference angle throughout the 20 minutes ride. The data collected then were analysed using the Mann-Whitney test and Wilcoxon signed-ranked test to verify a statistically significant difference between and within the control and experimental groups. There were significant differences in all sensors between the control group and experimental groups (p<0.05) and within the experimental group. According to the findings, it can be said that the ergonomic intervention prototype (lumbar support with built-in massager system) successfully helps to maintain and improve the natural curve of the spinal posture. This indirectly would reduce the risk of developing musculoskeletal disorders and spinal injury among traffic police riders.

The effects of body position and actual execution on motor imagery of locomotor tasks in people with a lower-limb amputation.

Motor imagery (MI) is usually facilitated when performed in a congruent body position to the imagined movement, as well as after actual execution (AE). A lower-limb amputation (LLA) results in important structural and functional changes in the sensorimotor system, which can alter MI. In this study, we investigated the effects of body position and AE on the temporal characteristics of MI in people with LLA. Ten participants with LLA (mean age = 59.6 ± 13.9 years, four females) and ten gender- and age-matched healthy control participants (mean age = 60.1 ± 15.4 years, four females) were included. They performed two locomotor-related tasks (a walking task and the Timed Up and Go task) while MI times were measured in different conditions (in congruent/incongruent positions and before/after AE). We showed that MI times were significantly shorter when participants imagined walking in a congruent-standing position compared to an incongruent-sitting position, and when performing MI after actual walking compared to before, in both groups. Shorter MI times in the congruent position and after AE suggest an improvement of MI's temporal accuracy (i.e. the ability to match AE time during MI) in healthy individuals but not in the LLA group.

Comparison of Pelvic Tilt Before and After Hip Flexor Stretching in Healthy Adults.

OBJECTIVE: The purpose of this study was to assess the association between hip flexor length and pelvic tilt or lumbar lordosis by quantifying the effect of stretching on pelvic tilt and lumbar lordosis. METHODS: We quantified pelvic tilt and lumbar lordosis before and after a single session of passive hip flexor stretching in a sample of 23 male participants. Changes in hip flexor length were also characterized, using a Thomas test protocol to measure passive hip extension in supine lying. We investigated both the mean effect of the stretching protocol and potential correlations between changes in passive hip extension and changes in pelvic tilt or lumbar lordosis. RESULTS: Following the stretching protocol, there was a mean increase of 2.6° (P < .001) in passive hip extension and a corresponding mean reduction of 1.2° (P < .001) in anterior pelvic tilt. However, there was no change in lumbar lordosis, nor were there any meaningful correlations between change in passive hip extension and change in pelvic tilt or lumbar lordosis. CONCLUSION: The results suggest that hip muscle stretching may lead to immediate reductions in pelvic tilt during relaxed standing. Such stretching programs could play an important role in interventions designed to improve standing postural alignment.

Effect of Deep Cervical Flexor Muscle Training Using Pressure Biofeedback on Pain and Forward Head Posture in School Teachers with Neck Pain: An Observational Study.

BACKGROUND: Teaching is one of the professions where incidence and prevalence of neck pain is high. Prolonged use of computers, which has further increased due to online teaching amid pandemic, is known to cause neck pain and alter posture, while people with forward head posture (FHP) are prone to develop neck pain and related disability. Research has shown that impairment of deep cervical flexor (DCF) muscles leads to insufficiency in coordination, activation, overload, and poor support on cervical structures that further lead to development of neck pain and altered neck posture. The objective of this study was to see the effect of DCF muscle training using pressure biofeedback on pain and FHP in school teachers with neck pain. METHODS: This observational study was conducted at medical center in school premises. Fifty-five school teachers aged between 25 and 40 years with experience of more than 5 years were invited to participate in this study. Subjects were divided in two groups. Both the groups received conventional exercises while in experimental group DCF muscle training using pressure biofeedback was given additionally. Pain and FHP were assessed using NPRS and cranio-vertebral angle using digital photograph technique, respectively, at baseline and end of four weeks of treatment. RESULTS: Although pain and FHP improved in both the groups, mean improvement in both the measures was more in the group that also received DCF training using pressure biofeedback. CONCLUSIONS: This study shows that although pain and FHP improved following conventional exercises in school teachers with neck pain, mean improvement was more significant among those who received additional DCF muscle training using pressure biofeedback.

Yoga and Bone Health.

Osteoporosis is a public health problem affecting individuals globally. Yoga has been found to prevent and reverse bone loss. Yoga may result in better balance, improved posture, and greater range of motion, strength, and coordination, all factors that also mitigate the risk of falls and fractures. A 12-minute, 12-pose yoga regimen is discussed in detail. Once learned, the ongoing use of yoga is safe, without cost, and may be done lifelong.

Cervical Muscle Activation Due to an Applied Force in Response to Different Types of Acoustic Warnings.

Mild traumatic brain injury (mTBI) and whiplash-associated disorder are the most common head and neck injuries and result from a sudden head or body acceleration. The head and neck injury potential is correlated with the awareness, level of muscle activation, and posture changes at the time of the perturbation. Environmental acoustic stimuli or a warning system can influence muscle activation and posture during a head perturbation. In this study, different acoustic stimuli, including Non-Directional, Directional, and Startle, were provided 1000 ms before a head impact, and the amplitude and timing of cervical muscle electromyographic (EMG) data were characterized based on the type of warning. The startle warning resulted in 49% faster and 80% greater EMG amplitude compared to the Directional and Non-Directional warnings after warning and before the impact. The post-impact peak EMG amplitudes in Unwarned trials were lower by 18 and 21% in the retraction and rebound muscle groups, respectively, compared to any of the warned conditions. When there was no warning before the impact, the retraction and rebound muscle groups also reached their maximum activation 38 and 54 ms sooner, respectively, compared to the warned trials. Based on these results, the intensity and complexity of information that a warning sound carries change the muscle response before and after a head impact and has implications for injury potential.

Craniocervical Posture Assessed With Photogrammetry and the Accuracy of Palpation Methods for Locating the Seventh Cervical Spinous Process: A Cross-sectional Study.

OBJECTIVE: The purpose of this study was to compare craniocervical posture assessed by photogrammetry using 2 distinct palpation methods for locating the spinous process of the seventh cervical vertebra (C7SP). METHODS: This cross-sectional study was conducted in 2 phases. In phase I (n = 42), the assessor's accuracy in locating the C7SP using the flexion-extension and the modified thorax-rib static methods was compared to radiography. In phase II (n = 68), the craniocervical posture was analyzed with photogrammetry after palpation using the 2 methods. Neck pain intensity and disability were also determined. RESULTS: The accuracy in locating the C7SP was higher using the modified thorax-rib static method (67%, 95% confidence interval [CI], 55-79) compared to the flexion-extension method (38%, 95% CI, 26-50, P = .016). Lower values of the craniocervical angle were obtained with the flexion-extension method than the modified thorax-rib static method (mean difference = -1.1°, 95% CI, -1.6 to -0.6, P < .001). However, both palpation methods resulted in similar classifications of participants as with or without forward head posture (P = .096). Weak correlations were observed between the craniocervical angle and neck pain intensity (ρ = -0.088 and -0.099, respectively) and disability (ρ = -0.231 and -0.249, respectively). CONCLUSION: Craniocervical angles obtained using palpation methods with different accuracies were different, although the magnitude of the difference was insufficient to lead to different classifications of a forward head posture in adults with mild neck pain and disability. Craniocervical posture was weakly correlated with neck-pain intensity and disability.

Pelvic Sagittal Torsion Caused by Induced Leg Length Discrepancy: Geometrical Illusion May Influence Measures Based on Superior-iliac Spines Positions.

OBJECTIVE: To investigate whether a common measure of sagittal pelvic torsion based on the superior iliac spines behave similarly to predictions of a rigid (non-torsioned) plane, when leg length discrepancies (LLD) are induced. METHOD: Twenty-four young asymptomatic participants were subjected to pelvic posture measurements that use the anterior-superior iliac spines (ASISs) and posterior-superior iliac spines (PSISs) as references, while standing on level ground and with a one-, two- and three-centimeter lifts under the left foot. A special caliper with digital inclinometers was used. The following angles were measured: angles of the right and left PSIS-to-ASIS lines; right-left relative angle (RLRA), as the angle between the right and left PSIS-to-ASIS lines, which is a traditional lateral-view measure intended to detect sagittal torsions; angle of the inter-ASISs line; angle of the inter-PSISs line; anterior-posterior relative angle (APRA), as the angle between the inter-ASISs and inter-PSISs lines. According to trigonometric predictions based on the geometry given by the lines linking the superior iliac spines (i.e. a trapezoid plane), a pure lateral tilt of the pelvis, without interinnominate sagittal motion, would change RLRA in a specific direction and would not change APRA. RESULTS: Repeated-measures ANOVAs revealed that RLRA (p<0.001) and right and left PSIS-to-ASIS angles (p≤0.001) changed, and APRA did not change (p=0.33), as predicted. CONCLUSIONS: At least part of the sagittal torsion detected by measures that assume the PSIS-to-ASIS angles as the sagittal angles of the innominates is due to pelvic geometry and not to the occurrence of actual torsion, when LLDs are induced.