Not looking where you are leaping: a novel method of oriented travel in the caterpillar Calindoea trifascialis (Moore) (Lepidoptera: Thyrididae).

The prepupation caterpillar of the Southeast Asian moth Calindoea trifascialis constructs a leaf shelter that jumps across the ground using a jumping method novel among the insects. We found that movement path direction was correlated to the direction opposite to the most intense light. Correlated random walk (CRW) analyses found net squared displacements higher than predicted by a CRW, and fractal dimension analysis indicated straighter paths at large spatial scales. Rearing experiments showed high mortality from predation on the ground, but higher mortality resulted from sun exposure. We interpret jumping path orientation as an efficient search strategy to find shade in a variable landscape, given limited perception, in the presence of overheating and desiccation risks.

Spine Day 2012: spinal pain in Swiss school children- epidemiology and risk factors.

BACKGROUND: The key to a better understanding of the immense problem of spinal pain seems to be to investigate its development in adolescents. Based on the data of Spine Day 2012 (an annual action day where Swiss school children were examined by chiropractors on a voluntary basis for back problems), the aim of the present study was to gain systematic epidemiologic data on adolescent spinal pain in Switzerland and to explore risk factors per gender and per spinal area. METHOD: Data (questionnaires and physical examinations) of 836 school children were descriptively analyzed for prevalence, recurrence and severity of spinal pain. Of those, 434 data sets were included in risk factor analysis. Using logistic regression analysis, psycho-social parameters (presence of parental back pain, parental smoking, media consumption, type of school bag) and physical parameters (trunk symmetry, posture, mobility, coordination, BMI) were analyzed per gender and per spinal area. RESULTS: Prevalence of spinal pain was higher for female gender in all areas apart from the neck. With age, a steep increase in prevalence was observed for low back pain (LBP) and for multiple pain sites. The increasing impact of spinal pain on quality of life with age was reflected in an increase in recurrence, but not in severity of spinal pain. Besides age and gender, parental back pain (Odds ratio (OR)=3.26, p=0.011) and trunk asymmetry (OR=3.36, p=0.027) emerged as risk factors for spinal pain in girls. Parental smoking seemed to increase the risk for both genders (boys: OR=2.39, p=0.020; girls: OR=2.19, p=0.051). Risk factor analysis per spinal area resulted in trunk asymmetry as risk factor for LBP (OR=3.15, p=0.015), while parental smoking increased the risk for thoracic spinal pain (TSP) (OR=2.83, p=0.036) and neck pain (OR=2.23, p=0.038). The risk for TSP was further enhanced by a higher BMI (OR=1.15, p=0.027). CONCLUSION: This study supports the view of adolescent spinal pain as a bio-psycho-social problem that should be investigated per spinal area, age and gender. The role of trunk asymmetry and passive smoking as risk factors as well as the association between BMI and TSP should be further investigated, preferably in prospective studies.

Chronic mechanical neck pain in adults treated by manual therapy: a systematic review of change scores in randomized clinical trials.

OBJECTIVE: This study provides a systematic analysis of group change scores in randomized clinical trials of chronic neck pain not due to whiplash and not including headache or arm pain treated with manual therapy. METHODS: A comprehensive literature search of clinical trials of chronic neck pain treated with manual therapies up to December 2005. Only clinical trials scoring above 11.5 (Amsterdam-Maastricht Scale) were included in the analysis. RESULTS: From 1980 citations, 19 publications were selected. Of the 16 trials analyzed (3 were rejected for poor quality), 9 involved spinal manipulation (12 groups), 5 trials (5 groups) were for spinal mobilization or nonmanipulative manual therapy (1 trial overlapped), and 2 trials (2 groups) involved massage therapy. No trials included trigger point therapy or manual traction of the neck. For manipulation studies, the mean effect size (ES) at 6 weeks for 7 trials (10 groups) was 1.63 (95% confidence interval [CI], 1.13-2.13); 1.56 (95% CI, 0.73-2.39) at 12 weeks for 4 trials (5 groups); 1.22 (95% CI, 0.38-2.06) from 52 to 104 weeks for 2 trials (2 groups). For mobilization studies, 1 trial reported an ES of 2.5 at 6 weeks, 2 trials reported full recovery in 63.8% to 71.7% of subjects at 7 to 52 weeks, and 1 trial reported greater than 2/10 point pain score reduction in 78.3% of subjects at 4 weeks. For massage studies, 1 reported an ES of 0.03 at 6 weeks, whereas the other reported mean change scores of 7.89/100 and 14.4/100 at 1 and 12 weeks of, respectively. CONCLUSIONS: There is moderate- to high-quality evidence that subjects with chronic neck pain not due to whiplash and without arm pain and headaches show clinically important improvements from a course of spinal manipulation or mobilization at 6, 12, and up to 104 weeks posttreatment. The current evidence does not support a similar level of benefit from massage.

Interexaminer reliability of the hip extension test for suspected impaired motor control of the lumbar spine.

OBJECTIVE: The hip extension test may be a clinical sign of impaired motor control in the lumbar spine, which may have a negative impact on spine stability. The purpose of this study is to evaluate the interexaminer reliability of the hip extension test for suspected dynamic instability of the lumbar spine in patients with chronic low back pain. METHODS: Forty-two patients with chronic low back pain participated in this interexaminer reliability study. Chronic low back pain was defined as pain of greater than 7 weeks duration in the area between T12 and the buttocks, with or without leg pain. Two doctors of chiropractic simultaneously observed and independently assessed the left and right prone hip extension test on all 42 patients. Results for both examiners were given to an independent recorder. Each examiner was blinded to the results of the other examiner. RESULTS: The mean age of subjects was 38 years (SD 12.35); 73.8% were female. Sixty-eight percent (SD 1.72) reported current back pain intensity greater than 5 on an 11-point numerical rating scale. The mean score for the Roland-Morris Low Back Pain and Disability questionnaire was 5.8 (SD 4.34). The kappa measure of agreement was 0.72 for the left leg and 0.76 for the right leg. This indicated a substantial strength of agreement between examiners for both left and right hip extension tests. For the 8 cases of disagreement, rater 1 generally rated the tests as positive, whereas rater 2 consistently rated the tests as negative. CONCLUSIONS: The hip extension test appears to have good reliability in detecting deviation of the lumbar spine from the midline. Validity with regard to the test's ability to distinguish patients with chronic low back pain from normal individuals and its relation to lumbar spine stability remains to be determined.

Validity and reliability of a German version of the Neck Disability Index (NDI-G).

The Neck Disability Index (NDI) is a widely used questionnaire in the assessment of disability of neck patients. The aim of this study was to translate the NDI according to established guidelines into German (NDI-G) and to test the psychometric properties. Patients with acute (ACU) and chronic neck pain (CHR) and a healthy control group (HCG) completed the NDI-G twice with a mean test-retest interval of 3 days. The total score of NDI-G showed high reliability (Intraclass correlation coefficient (ICC2,1) = 0.92) and a high Cronbach's alpha (α = 0.96). The minimal detectable change was 7 points. The Bland-Altman plot revealed a small positive systematic error of 1.02 points. The Kruskal-Wallis test showed significant differences in the NDI-G total score among the three groups (χ(2) = 29.77, p < 0.001). Mann-Whitney U tests showed significant differences in the total score between ACU and HCG (p < 0.001), and CHR and HCG (p < 0.001). The factor analysis of NDI-G yielded 2 factors that together explained 67% of the variance. Spearman's phi coefficients showed no correlation between the NDI-G total score and the visual analogue scale (VAS) in the ACU group (phi = 0.23, p = 0.40), and a moderate correlation in the CHR group (phi = 0.55, p = 0.03). The item analysis of the NDI-G revealed moderate to good reliability for all items. Only the item 'work' could differentiate between the ACU and CHR group. The NDI-G emerged from this study as a valid and reliable assessment. Its psychometric properties are comparable with the original version. Thus, the NDI-G is recommended for research and clinical settings in neck pain in German speaking countries.

Adverse events associated with pediatric spinal manipulation: a systematic review.

BACKGROUND: Spinal manipulation is a noninvasive manual procedure applied to specific body tissues with therapeutic intent. Although spinal manipulation is commonly used in children, there is limited understanding of the pediatric risk estimates. OBJECTIVE: Our goal was to systematically identify and synthesize available data on adverse events associated with pediatric spinal manipulation. METHODS: A comprehensive search was performed of 8 major electronic databases (eg, Medline, AMED, MANTIS) from inception to June 2004 irrespective of language. Reports were included if they (1) were a primary investigation of spinal manipulation (eg, observation studies, controlled trials, surveys), (2) included a study population of children who were aged 18 years or younger, and (3) reported data on adverse events. Data were summarized to demonstrate the nature and severity of adverse events that may result rather than their incidence. RESULTS: Thirteen studies (2 randomized trials, 11 observational reports) were identified for inclusion. We identified 14 cases of direct adverse events involving neurologic or musculoskeletal events. Nine cases involved serious adverse events (eg, subarachnoidal hemorrhage, paraplegia), 2 involved moderately adverse events that required medical attention (eg, severe headache), and 3 involved minor adverse events (eg, midback soreness). Another 20 cases of indirect adverse events involved delayed diagnosis (eg, diabetes, neuroblastoma) and/or inappropriate provision of spinal manipulation for serious medical conditions (ie, meningitis, rhabdomyosarcoma). CONCLUSIONS: Serious adverse events may be associated with pediatric spinal manipulation; neither causation nor incidence rates can be inferred from observational data. Conduct of a prospective population-based active surveillance study is required to properly assess the possibility of rare, yet serious, adverse events as a result of spinal manipulation on pediatric patients.