Journal of Bodywork and Movement Therapies - Articles in Press

The ARTT of palpation? - Corrected Proof

Leon Chaitow — 2012-02-03

‘Palpation cannot be learned by reading or listening; it can only be learned by palpation’ () Studies regularly emerge that question the reliability of manual palpation and assessment methods () – with, unsurprisingly, periodic acknowledgment that well-trained practitioners perform more accurately and reliably than novices (), and also that – sometimes – palpation methods are actually reliable ().

Reliability testing of the patellofemoral joint reaction force (PFJRF) measurement during double-legged squatting in healthy subjects: A pilot study - Corrected Proof

Javid Mostamand, Dan L. Bader, Zoë Hudson — 2012-02-02

Summary: Introduction: Anterior knee pain or patellofemoral pain syndrome (PFPS) is supposed to be related to patellofemoral joint reaction forces (PFJRF). Measuring these forces may therefore provide reliable evidence for conservative treatments to correct probable malalignment in subjects with PFPS. The aim of the present study was to examine the reliability of PFJRF measurements during double-legged squatting in healthy subjects.Methods: Using a motion analysis system and one forceplate, PFJRF of 10 healthy subjects were assessed during double-legged squatting. Data were collected from superficial markers taped to selected landmarks. This procedure was performed on the right knees, at three different knee flexion angles of 30, 45 and 60° during three separate double-legged squats. Subjects were then requested to repeat this test procedure on two separate test sessions at different occasions. The PFJRF was calculated using a biomechanical model of the patellofemoral joint.Results: The data reveal an increase in PFJRF values (from mean, SD of 425.2, 35.5N to 1075.4, 70.1N)with an increase in the tibiofemoral joint angle during double-legged squatting. The CV (coefficient of variation) values during within and between session tests, revealed the high repeatability and reproducibility of PFJRF measurements, while the ICC (intra class correlation coefficient) values showed the low reliability of these measurements.Conclusion: The low reliability of PFJRF measurements suggests that the PFJRF measurement during double-legged squatting should be performed with caution with improving the method of kinetic measurement of the patellofemoral joint in healthy subjects.

Effectiveness of two manipulative therapies in sacroiliac joint syndrome – Thoughts for research and clinical applications - Corrected Proof

Leonard Joseph, Ubon Pirunsan, Aatit Paungmali — 2012-02-02

We enjoyed reading the recently published paper titled ‘The effects of two manipulative therapy techniques and their outcome in patients with sacroiliac joint syndrome’ by (). We applaud the authors for their innovative thoughts to compare the effectiveness of two manipulative techniques on sacroiliac joint. We agree with the authors that the current topic is not well researched enough and clinically important as dysfunction of lumbar spine and sacroiliac joint may co-exist. Thus, it places the study on high interest among clinicians and readers. In relating the study findings to clinical practice, we wish to share our opinions and suggestions consideration by the authors and the readers.

Isometric hand grip strength correlated with isokinetic data of the shoulder stabilizers in individuals with chronic stroke - Corrected Proof

2012-02-02

Summary: The purpose of this study was to examine the relationships between isometric hand grip (HG) strength and isokinetic strength data of the glenoumeral and scapulothoracic muscles in 12 individuals with chronic hemiparesis due to stroke. Measures of maximal grip strength were obtained on the HG dynamometer Jamar®. Isokinetic measures of peak torque and work during shoulder rotations and scapular protraction-retraction movements were obtained with the isokinetic dynamometer at a speed of 60°/s. Pearson correlation coefficients between isometric HG and isokinetic strength data ranged between 0.60 and 0.82 for the peak torque and between 0.59 and 0.86 for the isokinetic work. The findings suggested that, in absence of isokinetic dynamometers, isometric HG strength measurements could be clinically used to monitor strength levels of the shoulder stabilizers and to guide load progressions during strengthening interventions for people with chronic hemiparesis.

From clinical experience to a model for the human fascial system - Corrected Proof

Julie Ann Day, Lorenzo Copetti, Giorgio Rucli — 2012-02-02

Summary: Studies of fascial anatomy, histology, and physiology are changing comprehension of the role of fascia in many body functions. In the light of these studies, evidence-based models of the human fascial system that provide immediate clinical applications for manual therapists working with movement dysfunctions and pain are necessarily evolving. This paper presents an overview of one proposed biomechanical model and discusses some of its underlying hypotheses.Developed initially from extensive review of anatomical texts and clinical experience, subsequent anatomical dissections, histological, biomechanical, and some clinical studies have investigated this model. These studies are discussed, also in reference to other contemporary musculoskeletal research.This model for the human fascial system could represent new perspectives for clinicians and researchers regarding the functional integration of fascia within the musculoskeletal system.

Weaving a mat of fascia research - Corrected Proof

Geoffrey M. Bove — 2012-01-24

My first thought when asked to write this editorial was “I don’t know enough about fascia to do this.” I had the same feeling when I was asked to be the chair of the scientific review committee for the first Fascia Research Congress in 2007. My guess was that I was asked because I was in the Harvard system, was an “alternative-therapy” minded researcher, and the meeting was to be held in a Harvard facility. Only later did I realize the main reason, which was that some of my research had characterized the innervation of the fascia of nerves. Already, new connections were being made.

Analysis of electromyographic activity in spastic biceps brachii muscle following neural mobilization - Corrected Proof

2012-01-20

Summary: Introduction: Hypertonia is prevalent in anti-gravity muscles, such as the biceps brachii. Neural mobilization is one of the techniques currently used to reduce spasticity.Objective: The aim of the present study was to assess electromyographic (EMG) activity in spastic biceps brachii muscles before and after neural mobilization of the upper limb contralateral to the hemiplegia.Materials and Methods: Repeated pre-test and post-test EMG measurements were performed on six stroke victims with grade 1 or 2 spasticity (Modified Ashworth Scale). The Upper Limb Neurodynamic Test (ULNT1) was the mobilization technique employed.Results: After neural mobilization contralateral to the lesion, electromyographic activity in the biceps brachii decreased by 17% and 11% for 90° flexion and complete extension of the elbow, respectively. However, the results were not statistically significant (p gt; 0.05).Conclusions: When performed using contralateral techniques, neural mobilization alters the electrical signal of spastic muscles.

The inter-rater and intra-rater reliability of passive physiological accessory movement assessment of lumbar spine in novice manual therapists - Corrected Proof

Mangesh Deore, Stephen May — 2012-01-20

Summary: Passive Physiological Accessory Movements (PPAVMs) are commonly used assessment and treatment techniques in patients with low back pain. Many physiotherapists, including novices, consider PPAVMs an important tool for assessment and treatment of low back pain. Reliability is important as a judgement on the reproducibility of assessment procedures between therapists. However, the reliability of PPAVMs seems to have some problems, and reliability of PPAVMs has not yet been established amongst novice manual therapists. This study aimed at investigating inter-rater and intra-rater reliability of PPAVMs in novice physiotherapists. Fifty two healthy participants were recruited for the study. PPAVMs were applied by two novice physiotherapists and accessory movements were assessed, and both the raters were blinded from each others’ findings to avoid bias. The mobility was graded on a three point scale with grade 1 being considered as hypomobile, 2 as normal and 3 as hypermobile. This procedure was performed on all five lumbar segments. Each participant was assessed on the same day for inter-rater reliability, and for intra-rater reliability the participant was assessed by one rater a week later. Kappa (κ) was calculated for all the levels of lumbar spine which ranged between 0.01 and 0.30 for inter-rater reliability and 0.24 to 0.57 for intra-rater reliability. Percentage exact agreement was also computed which showed a range between 38.4% and 57.6%. The values of ‘κ’ showed poor intra-rater and inter-rater reliability. However, further research is advisable in order to assess the role of experience in reproducibility of PPAVMs.

Does leg predomination affect the measurement of patellofemoral joint reaction force (PFJRF) during single leg squatting?: A reliability study - Corrected Proof

Javid Mostamand, Dan L. Bader, Zoë Hudson — 2012-01-20

Summary: Introduction: Although measuring patellofemoral joint reaction forces (PFJRF) may provide reliable evidence for conservative treatments to correct probable malalignment in subjects with patellofemoral pain syndrome (PFPS), it may be necessary to determine whether the inherent properties of the dominant leg influences the reliability of measuring PFJRF. The aim of the present study was to examine the effect of leg predomination on reliability testing of the PFJRF measurement during single leg squatting in healthy subjects.Methods: Using a motion analysis system and one force plate, PFJRF of 10 healthy subjects with a right dominant leg was assessed during single leg squatting. Data was collected from superficial markers taped to selected landmarks. This procedure was performed on the both right and left legs, during three separate single leg squats from a neutral position to a depth of approximately 30° of knee flexion. Subjects were then asked to repeat the test procedure after a minimum of a week’s interval. The PFJRF was calculated using a biomechanical model of the patellofemoral joint.Results: There was significant difference between the PFJRF mean values of paired test of right (mean, SD of 1887.7, 325.1 N) and left knees (mean, SD of 2022.6, 270.5 N) (p < 0.05). The CV (coefficient of variation) values during within and between session tests, revealed the high repeatability and reproducibility of PFJRF measurements on both knees. The ICC (intra class correlation coefficient) values during within and between sessions tests showed the high reliability of these measurements on both knees.Conclusion: The high reliability of PFJRF measurements on both dominant and non-dominant legs of healthy subjects suggests that the PFJRF measurement would not be influenced by the leg predomination during single leg squatting.

Embodying the body in anorexia nervosa – a physiotherapeutic approach - Corrected Proof

Liv-Jorunn Kolnes — 2012-01-13

Summary: Body dissatisfaction and disturbances in bodily sensations are prevailing qualities among patients with anorexia nervosa (AN). However, therapies addressing the body are typically marginalized within treatment programs for anorexia nervosa. The purpose of this article is to 1) describe common bodily symptoms and experiences of anorexia nervosa patients and discuss the accompanying physical and emotional impact, and 2) present physiotherapeutic approaches to help patients with anorexia nervosa. Recommendations are based on the author’s clinical observations and patient testimonials, in addition to the theory and methodology outlined by Norwegian Psychomotor Physiotherapy (NPMP), body awareness therapies, and current knowledge on bodily stability. It is the author’s experience that anorexia nervosa patients tend to have significant impairments in their body awareness, a restricted breathing pattern, significant muscular tension, poor postural stability, and they are frequently engaged in compulsive physical activity. A body awareness approach for these patients may contribute to novel ways of sensing and interpreting bodily signals, improving emotional awareness, experiencing the body and integrating the body as one’s own, i.e., becoming an embodied person. Embodying the body in patients with anorexia nervosa by utilizing approaches from NPMP and body awareness therapies, in addition to stability training principles, may help stabilize the body and the mind, and thus, constitute a beneficial addition to overall treatment for anorexia nervosa.

The effect of abdominal resistance training and energy restricted diet on lateral abdominal muscles thickness of overweight and obese women - Corrected Proof

Pardis Noormohammadpour, Ramin Kordi, Saeed Dehghani, Mohsen Rostami — 2012-01-12

Summary: The role of transabdominal muscles (external oblique, internal oblique and transversus abdominis) on core stability has been shown previously. Energy restricted diet and abdominal resistance training are commonly used by overweight and obese people to reduce their weight. In this study we investigated the impact of 12 weeks concurrent energy restricted diet and abdominal resistance training on the thickness of the lateral abdominal muscles of 19 obese and overweight women employing ultrasonography in resting and drawing-in maneuvers. The results showed significant increase of the muscle thicknesses during drawing-in maneuver after 12 weeks intervention. Based on our findings, it can be concluded that 12 weeks concurrent abdominal resistance training and energy restricted diet in addition to weight loss lead to improvement of transabdominal muscles thickness in obese and overweight people. Considering the role of these muscles in core stability, using this therapeutic protocol in obese people, particularly in those who have weakness of these muscles might be helpful.

Clinical reasoning for a patient with neck and upper extremity symptoms: A case requiring referral - Corrected Proof

Spyridon A. Chaniotis — 2012-01-12

Summary: The purpose of this case report is to describe a 56-year old female patient with a bizarre pattern of cervicobrachial symptoms. The patient was managed according to the McKenzie “Mechanical Diagnosis and Therapy” principles and the physical examination alongside the movement testing showed inconsistent findings. Due to the patient's cancer-related medical history, presence of night pain, general weakness and the non-response to treatment, a referral to a medical specialist was immediately made. Imaging studies revealed metastases to the axial skeleton in multiple sites and a metastatic lesion was established as a medical diagnosis. With many physical therapists becoming first-entry providers it is likely that encounters with cases other than the purely musculoskeletal will increase. Serious pathologies can mimic musculoskeletal disorders, confusing even the most experienced therapist and as a result, pernicious and possibly life-threatening disease might easily be missed. This would be crucial especially in cases when the patient should immediately be referred to a medical specialist. Physical therapists should hone their clinical skills not only in treatment aspects but also in screening procedures in order to prompt a referral when it is required.

The effectiveness of the Pilates method: Reducing the degree of non-structural scoliosis, and improving flexibility and pain in female college students - Corrected Proof

2012-01-09

Summary: Objective: To evaluate the effectiveness of Pilates with regard to the degree of scoliosis, flexibility and pain.Method: The study included 31 female students divided into two groups: a control group (CG = 11), which had no therapeutic intervention, and an experimental group (EG = 20), which underwent Pilates-based therapy. We used radiological goniometry measurements to assess the degree of scoliosis, standard goniometry measurements to determine the degree of flexibility and the scale of perceived pain using the Borg CR 10 to quantify the level of pain.Results: The independent t test of the Cobb angle (t = - 2.317, p = 0.028), range of motion of trunk flexion (t = 3.088, p = 0.004) and pain (t = −2.478, p = 0.019) showed significant differences between the groups, with best values in the Pilates group. The dependent t test detected a significant decrease in the Cobb angle (Δ% = 38%, t = 6.115, p = 0.0001), a significant increase in trunk flexion (Δ% = 80%, t = −7.977, p = 0.0001) and a significant reduction in pain (Δ% = 60%, t = 7.102, p = 0.0001) in the EG. No significant difference in Cobb angle (t = 0.430, p = 0.676), trunk flexion, (t = 0.938p = 0.371) or pain (t = 0.896, p = 0.391) was found for the CG.Conclusion: The Pilates group was better than control group. The Pilates method showed a reduction in the degree of non-structural scoliosis, increased flexibility and decreased pain.

Musculoskeletal myths - Corrected Proof

Craig Liebenson — 2011-12-19

Summary: This paper discusses a number of common myths in the musculoskeletal pain management and rehabilitation/athletic development fields. The origins or rationale for these beliefs are reviewed. New scientific evidence disputing or refuting the myth is then presented followed by and explanation and evidence for an updated perspective.

Comparison of Brunnstrom movement therapy and motor relearning program in rehabilitation of post-stroke hemiparetic hand: A randomized trial - Corrected Proof

Shanta Pandian, Kamal Narayan Arya, E. W. Rajkumar Davidson — 2011-12-08

Summary: Background: Motor recovery of the hand usually plateaus in chronic stroke patients. Various conventional and contemporary approaches have been used to rehabilitate the hand post-stroke. However, the evidence for their effectiveness is still limited.Objective: To compare the hand therapy protocols based on Brunnstrom approach and motor relearning program in rehabilitation of the hand of chronic stroke patients.Methodology: Design: Randomized trial.Setting: Outpatients attending the occupational therapy department of a rehabilitation institute.Subjects: 30 post-stroke subjects (35.06 ± 14.52 months) were randomly assigned into two equal groups (Group A and Group B), Outcome Measures: Brunnstrom recovery stages of hand (BRS-H), Fugl–Meyer assessment: wrist and hand (FMA-WH).Intervention: Group A received Brunnstrom hand manipulation (BHM). BHM is the hand treatment protocol of the Brunnstrom movement therapy, which uses synergies and reflexes to develop voluntary motor control. Group B received the Motor Relearning Program (MRP) based hand protocol. MRP is the practice of specific motor skills, which results in the ability to perform a task. Active practice of context-specific motor task such as reaching and grasping helps regain the lost motor functions.Results: Both the therapy protocols were effective in rehabilitation of the hand (BRS-H; p = 0.003 to 0.004, FMA-WH; p < 0.001). However, the results were statistically significant in favor of group A undergoing BHM for FMA-WH (p < 0.004) and FMA item VIII (hand motor recovery) (p < 0.033).Conclusion: BHM was found to be more effective than MRP in rehabilitation of the hand in chronic post-stroke patients.

The effect of “the core conditioning exercises” using the stretch pole on thoracic expansion difference in healthy middle-aged and elderly persons - Corrected Proof

Shigeki Yokoyama, Kazuyoshi Gamada, Shinji Sugino, Rie Sasano — 2011-11-11

Abstract: Objective: We investigated the effects of the Core Conditioning exercises (CC) using the Stretch Pole. We hypothesized that thoracic expansion difference is better improved by CC with the Stretch Pole than CC without it.Methods: Participants were 14 healthy middle-aged and elderly females. Participants were randomly allocated to CC with the stretch pole (SP group) or CC without it (control [C] group). The protocol for both groups consisted of 10 exercises aiming to relax the thoracic and lumbar muscles. The exercises were regularly performed twice a day for one week. Thoracic mobility was measured at the axillary and the 10th rib levels and the thoracic elevation difference was calculated.Results: and conclusion: The post-intervention values of the SP group were higher than the C group at both the axillary and 10th rib levels. These results indicate that CC using the Stretch Pole improves thoracic mobility.

Acute repetitive lumbar syndrome: A multi-component insight into the disorder - Corrected Proof

Moshe Solomonow, Bing He Zhou, Yun Lu, Karen B. King — 2011-10-24

Summary: Purpose: Repetitive Lumbar Injury (RLI) is common in individuals engaged in long term performance of repetitive occupational/sports activities with the spine. The triggering source of the disorder, tissues involved in the failure and biomechanical, neuromuscular, and biological processes active in the initiation and development of the disorder, are not known. The purpose is, therefore, to test, using in-vivo feline model and healthy human subjects, the hypothesis that RLI due to prolonged exposure to repetitive lumbar flexion–extension is triggered by an acute inflammation in the viscoelastic tissues and is characterized by lingering residual creep, pronounced changes in neuromuscular control and transient changes in lumbar stability. This report, therefore, is a summary of a lengthy research program consisting of multiple projects.Methods: A series of experimental data was obtained from in-vivo feline groups and normal humans subjected to prolonged cyclic lumbar flexion–extension at high and low loads, high and low velocities, few and many repetitions, as well as short and long in-between rest periods, while recording lumbar displacement and multifidi EMG. Neutrophil and cytokines expression analysis were performed on the dissected feline supraspinous ligaments before loading (control) and 7 h post-loading. A comprehensive, time based model was designed to represent the creep, motor control, tissue biology and stability derived from the experimental data.Results: Prolonged cyclic loading induced creep in the spine, reduced muscular activity, triggered spasms and reduced stability followed, several hours later, by acute inflammation/tissue degradation, muscular hyperexcitability and hyperstability. Fast movement, high loads, many repetitions and short rest periods, triggered the full disorder, whereas low velocities, low loads, long rest and few repetitions, triggered only minor but statistically significant pro-inflammatory tissue degradation and significantly reduced stability.Conclusion: Viscoelastic tissue failure via inflammation is the source of RLI and is also the process which governs the mechanical and neuromuscular characteristic symptoms of the disorder. The experimental data validates the hypothesis and provides insights into the development of potential treatments and prevention.

Yoga and massage therapy reduce prenatal depression and prematurity - Corrected Proof

2011-09-26

Summary: Eighty-four prenatally depressed women were randomly assigned to yoga, massage therapy or standard prenatal care control groups to determine the relative effects of yoga and massage therapy on prenatal depression and neonatal outcomes. Following 12 weeks of twice weekly yoga or massage therapy sessions (20 min each) both therapy groups versus the control group had a greater decrease on depression, anxiety and back and leg pain scales and a greater increase on a relationship scale. In addition, the yoga and massage therapy groups did not differ on neonatal outcomes including gestational age and birthweight, and those groups, in turn, had greater gestational age and birthweight than the control group.

Lifelong physical activity affects mini mental state exam scores in individuals over 55 years of age - Corrected Proof

Habibollah Nemati Karimooy, Mahmoud Hosseini, Maryam Nemati, Habib Ollah Esmaily — 2011-09-19

Summary: Introduction: The positive effects of physical activity on cognition have been widely documented. Human studies and the results obtained from animal models of Alzheimer’s disease (AD) have shown that if commenced early in life, exercise effectively reduces the development of cognitive deficits caused by aging. In the present study, the scores on Mini Mental State Exam (MMSE) of individuals over 55 years old who had a history of exercising have been compared to those without a history of exercising.Methods: This research was carried out on 273 individuals over 55 years of age. The subjects were randomly chosen from different areas of Mashhad and from exercise clubs. Each person completed a personal information form containing data such as demographics in addition to details of their involvement in sporting activity. Subjects were categorized as follows: 1- non-exercised, 2- exercised. The people in group 2 were then divided into non-professionally exercised (with a history of 2–10 years exercising) or professionally – exercised subjects (i.e. people who were currently, or had previously been members of an exercise club and/or had been trained for at least 10 years).Result: Out of 273 subjects questioned in the present study, 229 were males and 44 were females. The MMSE score in men was significantly higher than women (p < 0.001). The exercised individuals of both sexes had significantly higher scores compared to non-exercised group (p < 0.001). There was no significant difference between professionally- exercised individuals of either sex in comparison with exercised ones.Conclusion: It is suggested that lifelong physical activity and exercise affects cognitive performance in old age.

Effect of flexibility exercise on lumbar angle: A study among non-specific low back pain patients - Corrected Proof

2011-09-01

Summary: The study investigated the influence of lumbar flexibility exercise on the lumbar angle among patients with non-specific low back pain (LBP). Pre–experimental one-group pretest-posttest design trial was conducted at Health Service Center, Chulalongkorn University, Thailand. Thirty-five non-specific LBP patients with limitation in lower back range of motion and without neurological deficits were recruited (based on the LBP guidelines by ). Lumbar flexibility exercise program developed based on McKenzie therapy was performed individually each day for 2 weeks. Patients attended an exercise program daily in the first week under the supervision of a physiotherapist. The exercise program consisted of 7 sets a day (3-2-2 in the morning-afternoon-evening) in series of 10 repetitions for each set for 2 weeks. Lumbar angle was measured at the beginning and at the end of 2 weeks in order to determine the range of motion improved. The results indicated that the low back pain symptom improved as well as the angle.

Immediate beneficial effects of self-monitoring body movements for upright postural stability in young healthy individuals - Corrected Proof

2011-07-08

Summary: Objective: The present study is an investigation of whether an intervention involving awareness of joint movement without vision (i.e., self-monitoring) contributes to improved stability of upright posture as measured immediately after self-monitoring.Methods: Eighteen young adults (ages: 22.6 ± 2.2 years) participated in two interventions: self-monitoring and control. In the self-monitoring intervention, the blindfolded participants tried to reproduce a target angle using both the ankle and the wrist while self-monitoring the movement. In the control intervention, they performed the same task while continuously performing an arithmetic subtraction task.Results: Pre-post measurements of postural stability using a force plate for each intervention showed that self-monitoring significantly improved the stability of unipedal posture but not that of bipedal posture. Such beneficial effect for unipedal posture was obtained even when the participant monitored the wrist movement.Conclusions: Self-monitoring was effective to improve postural stability in cases in which maintaining the whole body balance was challenging.

Reproducibility of the pressure biofeedback unit in measuring transversus abdominis muscle activity in patients with chronic nonspecific low back pain - Corrected Proof

2011-07-07

Summary: The Pressure Biofeedback Unit (PBU) is often used by clinicians and researchers to indirectly evaluate transversus abdominis (TrA) muscle activity. The purpose of this study was to evaluate the inter and intra-examiner reproducibility of the PBU in measuring TrA muscle activity in fifty patients with chronic nonspecific low back pain. This study was performed using a test-retest design with a seven day interval. An Intraclass Correlation Coefficient (ICC2,1) of 0.74 (95% CI 0.54 to 0.85) and 0.76 (95% CI 0.58 to 0.86) was observed for the intra and inter-examiner reproducibility, respectively. The intra-examiner agreement (Limits of Agreement - LOA = 2.1 to −1.8 mmHg) and the inter-examiner agreement (LOA = 2.0 to −1.9 mmHg) were within the limits of agreement on 95% of occasions. The reproducibility of PBU in measuring TrA muscle activity in patients with chronic nonspecific low back pain ranged from satisfactory to excellent.

Mathematical model of fiber orientation in anisotropic fascia layers at large displacements - Corrected Proof

Hans Chaudhry, Roman Max, Stecco Antonio, Thomas Findley — 2011-06-20

Summary: A mathematical model is developed to determine the relationship between stretch and the orientation of fibers in the fascia. The transversely isotropic stress- strain relation for large displacements valid for the human fascia reinforced by the collagen fibers is employed. The relation between the orientation of fibers in the un-deformed and deformed state depending upon the stretch is plotted. It is observed that for greater fiber angle orientation, the fibers are more resistant to reorientation as the fascia is stretched longitudinally. It is also concluded that the reinforced fascia will always be in tension as the stretch is applied. However, we suggest future research to resolve the tension and compression issues in fascia.

WITHDRAWN: Effect on performance of learning a pilates skill with or without a mirror - Corrected Proof

Jennifer A. Lynch, Gordon R. Chalmers, Kathleen M. Knutzen, LeaAnn T. Martin — 2011-06-15

The Publisher regrets that this article is an accidental duplication of an article that has already been published, doi:10.1016/j.jbmt.2008.09.003. The duplicate article has therefore been withdrawn.

Development of active myofascial trigger points in neck and shoulder musculature is similar after lumpectomy or mastectomy surgery for breast cancer - Corrected Proof

2011-06-15

Summary: Our aim was to describe the differences in the presence of myofascial trigger points (TrPs) in neck and shoulder muscles after 2 surgery approaches for breast cancer: mastectomy or lumpectomy. Thirty-two women (mean age: 50 ± 7 years) who received lumpectomy, 16 women (mean age: 48 ± 10 years) who had received mastectomy after breast cancer, and 16 women (mean age: 49 ± 9 years) with breast cancer who had not received either surgical treatment, participated. Myofascial TrPs in the upper trapezius, sternocleidomastoid, levator scapulae, scalene, infraspinatus and pectoralis major muscles were bilaterally explored by an assessor blinded to the women’s condition. TrPs were considered active when palpation reproduced local and referred pain symptoms recognized by the patient as familiar pain symptoms. The number of active TrPs within mastectomy (mean ± SD: 4.6 ± 1) and lumpectomy (mean ± SD: 4.5 ± 1) groups was significantly higher (P < 0.001) as compared to the control group (mean ± SD: 1.1 ± 1.3), but not significantly different between them (P = 0.641). Women who received either lumpectomy or mastectomy showed similar distribution of active TrPs and a higher prevalence of active TrPs as compared to the control group. Active TrPs in the pectoralis major muscle were the most prevalent in both surgery groups The number of active TrPs was weakly correlated with neck (rs = 0.385; P = 0.029) and shoulder/axillary (rs = 0.397; P = 0.024) pain intensity within the lumpectomy, but not the mastectomy group. This study found active TrPs in neck and shoulder musculature in women who had received lumpectomy or mastectomy. The induced local and referred pain pattern from active TrPs reproduced neck and shoulder/axillary symptoms and pain patterns in women after breast cancer surgery. Few active TrPs were found in a control group of women with breast cancer who had not received any surgical treatment.

Postural control under visual and proprioceptive perturbations during double and single limb stances: Insights for balance training - Corrected Proof

2011-06-15

Summary: Single Limb Stance under visual and proprioceptive disturbances is largely used in clinical settings in order to improve balance in a wide range of functional disabilities. However, the proper role of vision and proprioception in SLS is not completely understood.The objectives of this study were to test the hypotheses that when ankle proprioception is perturbed, the role of vision in postural control increases according to the difficulty of the standing task. And to test the effect of vision during postural adaptation after withdrawal of the somesthetic perturbation during double and single limb stanceEleven males were submitted to double (DLS) and single limb (SLS) stances under conditions of normal or reduced vision, both with normal and perturbed proprioception. Center of pressure parameters were analyzed across conditions.Vision had a main effect in SLS, whereas proprioception perturbation showed effects only during DLS. Baseline stability was promptly achieved independently of visual input after proprioception reintegration.In conclusion, the role of vision increases in SLS. After proprioception reintegration, vision does not affect postural recovery. Balance training programs must take that into account.

Reliability of photogrammetry in the evaluation of the postural aspects of individuals with structural scoliosis - Corrected Proof

2011-06-15

Summary: Purpose: The purpose of this study was to investigate the reliability of photogrammetry in the measurement of the postural deviations in individuals with idiopathic scoliosis.Methods: Twenty participants with scoliosis (17 women and three men), with a mean age of 23.1±9 yrs, were photographed from the posterior and lateral views. The postural aspects were measured with CorelDRAW software.Results: High inter-rater and test–retest reliability indices were found. It was observed that with more severity of scoliosis, greater were the variations between the thoracic kyphosis and lumbar lordosis measures obtained by the same examiner from the left lateral view photographs. A greater body mass index (BMI) was associated with greater variability of the trunk rotation measures obtained by two independent examiners from the right, lateral view (r=0.656; p=0.002). The severity of scoliosis was also associated with greater inter-rater variability measures of trunk rotation obtained from the left, lateral view (r=0.483; p=0.036).Conclusions: Photogrammetry demonstrated to be a reliable method for the measurement of postural deviations from the posterior and lateral views of individuals with idiopathic scoliosis and could be complementarily employed for the assessment procedures, which could reduce the number of X-rays used for the follow-up assessments of these individuals.

Electromyographic analysis of masseter and anterior temporalis muscle in sleep bruxers after occlusal splint wearing - Corrected Proof

2011-06-15

Summary: Bruxism is widely defined as an anxiety response to environmental stress. Occlusal splints are frequently used in sleep bruxism, to protect teeth from damage resulting from the contraction force of mandibular muscles, or to reduce the orofacial pain by relaxing masticatory muscles. Surface electromyography (EMG) of the right and left masseter and temporalis muscles was performed in 15 women presenting sleep bruxism and temporomandibular disorders related to occupational stress, after nocturnal use of the occlusal splint. The EMG signals were recorded twice per patient: After a work shift (pre-splint) and after a night of sleep with the occlusal splint (post-splint) before a new workday. The parametric t-paired test was used to compare differences of the RMS amplitude between pre and post-splint records, for resting and maximal clenching effort. The level of significance for each comparison was set to p < 0.05. The results of the study supports the premise that the use of occlusal splint reduces EMG activity in the masseter and anterior temporalis muscles, in patients who presented with sleep bruxism related to occupational stress.