Journal of Bodywork and Movement Therapies - Articles in Press

Effects of different focus of attention rehabilitative training on gait performance in Multiple Sclerosis patients - Corrected Proof

Mohsen Shafizadeh, Geoffrey K. Platt, Baharak Mohammadi — 2012-05-14

Abstract: The present investigation studied the effects of different focus of attention training on gait performance. Twelve volunteers with Multiple Sclerosis and with an average disability score (Expanded Disability Status Scale=6.5) were selected from a Medical School and took part in a three-phase intervention including baseline, internal focus, and external focus, for eight weeks. In the baseline condition, the participants walked on a treadmill without any information. In the first (internal-focus) intervention they focused on foot performance and in the second (external-focus) intervention they focused on external markers and auditory information. The results of within-group analysis of variance showed that the external intervention was significantly (p .05).In conclusion, the second (external-focus) intervention was found to be an appropriate perceptual training method and to result in improvements in some of the gait performance parameters.

Applied kinesiology: Distinctions in its definition and interpretation - Corrected Proof

Anthony L. Rosner, Scott C. Cuthbert — 2012-05-14

Abstract: Modification of the motor system in assessing and treating as well as understanding one of the causes of musculoskeletal dysfunctions is a topic of growing importance in healthcare. Applied kinesiology (AK) addresses this interest in that it is a system which attempts to evaluate numerous aspects of health (structural, chemical, and mental) by the manual testing of muscles combined with other standard methods of diagnosis. It leads to a variety of conservative, non-invasive treatments which involve joint manipulations or mobilizations, myofascial therapies, cranial techniques, meridian and acupuncture skills, clinical nutrition and dietary management, counseling skills, evaluating environmental irritants, and various reflex techniques. The effectiveness of these ancillary treatments is believed to be consistent with the expanded construct validity of the manual muscle test (MMT), as described, although this assertion has primarily been tested in outcome studies.AK and its adjunctive procedures (challenge and therapy localization) are highlighted in this review providing details of its implementation as prescribed by an International College of Applied Kinesiology's Board of Examiners, cited for its scholarly and scientific activities. Because these procedures are believed to identify specific articular, soft tissue, biochemical, or emotional issues underlying muscle function, the applicability of this diagnostic method for all clinicians treating muscle imbalance disorders is described. As of yet, MMT efficacy in therapy localization and challenge techniques has not been established in published, peer-reviewed research.A variety of challenges likewise remain for professional AK to establish itself as an emerging science, with numerous gaps in the literature and testable hypotheses enumerated. Of particular concern are a multiplicity of derivatives of AK that have been described in the literature, which should be greeted with caution in light of the fact that they lack one or more of the essential attributes of AK as described in this report. The validity of these studies which have been critical of applied kinesiology appears in many instances to be no greater than several of the randomized controlled trials, cohort studies, case control studies, and case studies found in this communication to support various aspects of applied kinesiology.

Ottawa panel evidence-based clinical practice guidelines on therapeutic massage for neck pain - Corrected Proof

2012-05-11

Summary: Objective: To update evidence-based clinical practice guideline (EBCPG) on the use of massage compared to a control or other treatments for adults (>18 years) suffering from sub-acute and chronic neck pain.Methods: A literature search was performed from January 1, 1948 to December 31, 2010 for relevant articles. The Ottawa Panel created inclusion criteria focusing on high methodological quality and grading methods. Recommendations were assigned a grade (A, B, C, C+, D, D+, D−) based on strength of evidence.Results: A total of 45 recommendations from ten articles were developed including 8 positive recommendations (6 grade A and 2 grade C+) and 23 neutral recommendations (12 grade C and 11 grade D).Discussion: Therapeutic massage can decrease pain, tenderness, and improve range of motion for sub-acute and chronic neck pain.Conclusion: The Ottawa Panel was able to demonstrate that the massage interventions are effective for relieving immediate post-treatment neck pain symptoms, but data is insufficient for long-term effects.

Medical exercise therapy, and not arthroscopic surgery, resulted in decreased depression and anxiety in patients with degenerative meniscus injury - Corrected Proof

Håvard Østerås, Berit Østerås, Tom Arild Torstensen — 2012-05-07

Summary: The purpose of this pilot study was to compare the effectiveness of conservative therapy involving medical exercise therapy (MET) versus arthroscopic surgery in patients with knee pain, with MRI-verified degenerative meniscus. The patients were randomly assigned either to MET (n = 9) or to arthroscopic surgery (n = 8). Patients receiving MET had 3 treatments a week for 3 months, a total of 36 treatments. The arthroscopy consisted of meniscectomy with no structured conservative therapy after surgery. Assessment of pain, function, anxiety and depression were performed at inclusion and after 3 months. At the end of treatment, which was 3 months after inclusion, there were no statistical differences between the two groups regarding pain and function. However, anxiety and depression were significantly reduced in the MET group compared with the patients receiving arthroscopic surgery. Bearing in mind the low number of included patients in this pilot study, arthroscopy was found to be no better than MET regarding knee pain and overall daily function. The results from this pilot study are similar to other clinical studies, thereby demonstrating that conservative therapy is just as effective as surgery.

Conservative care of sports hernias within soccer players: A case series - Corrected Proof

Erik A. Yuill, Jason A. Pajaczkowski, Scott D. Howitt — 2012-05-07

Summary: Objective: To detail the progress of 2 high-level soccer players and 1 recreational soccer player with chronic groin pain that was exacerbated by participation in sports and relieved by rest. The patients under went a conservative treatment plan featuring manual therapy, therapeutic modalities, and plyometric training.Clinical features: The most important examination findings were palpable tenderness over the internal oblique fascia and anterior pubic tubercle, pain with resisted hip adduction, and pain with a resisted abdominal curl-up. Conventional treatment aimed at decreasing healing time of the injury through manual therapy, including soft tissue and modality techniques; rehabilitative exercises, focusing on the pelvic muscles; and plyometric training, aiming at sport specific functional improvement.Intervention: The conservative treatment approach utilized in this case series involved manual therapy, 1–2 times a week for 6–8 weeks, consisting of soft tissue, laser, microcurrent, and acupuncture; rehabilitative exercise and plyometric training, 3 times a week for 8 weeks, to help improve strength, coordination, and correct pelvic muscle imbalances. Outcome measures included visual analog scale scores and resisted muscle testing.Summary: Three soccer players, of varying levels of ability, presenting with a suspected sports hernia (chronic groin pain exacerbated by sports and relieved by rest) were relieved of their pain after 8 weeks of conservative care featuring manual therapy, rehabilitative exercises, and plyometric training.

Rehabilitation of an osteochondral fracture using blood flow restricted exercise: A case review - Corrected Proof

Jeremy P. Loenneke, Kaelin C. Young, Jacob M. Wilson, J.C. Andersen — 2012-05-07

Abstract: Objectives: In this case review we report on a bodybuilder who used a practical model of blood flow restriction (BFR) training to successfully rehabilitate himself following an injury to his right knee.Results: The patient originally thought he had torn his meniscus however repeat radiographs and magnetic resonance imaging (MRI) confirmed an osteochondral fracture. The patient initially sought out a low load alternative to help with the maintenance of skeletal muscle mass. However, following rehabilitation with low load BFR resistance training, radiographs indicated that the bone had begun to heal suggesting that this type of training may also benefit bone.Conclusions: In conclusion, this case review provides evidence that practical BFR using knee wraps can serve as an effective stimulus during rehabilitation from a knee injury.

Use of the Gait Deviation Index and spatiotemporal variables for the assessment of dual task interference paradigm - Corrected Proof

2012-04-26

Summary: Three-dimensional gait analysis (3DGA) is an important element in the quantitative evaluation of gait in subjects with Parkinson's disease (PD). Indexes, such as the Gait Deviation Index (GDI), have recently been proposed as a summary measure of gait. The aim of the present study was to investigate the effectiveness of the GDI and spatiotemporal variables in the quantification of changes in gait during a dual-task (DT) exercise. Fourteen patients with idiopathic PD and nine healthy subjects (CG) participated in the study. All subjects walked under two conditions: free walking and DT walking. The GDI was computed from the 3DGA data. The results show gait impairment during DT, a significant difference between groups regarding GDI and an interaction effect involving the group, side and task factors. The CG and PDG were different independent of interference and side, but interference was only different for the PDG group. The results also demonstrate that the GDI should be an appropriate outcome measure for the evaluation of the effects of DT on patients with Parkinson's disease.

Corrected Proof

Jerry Hesch — 2012-04-19

I give this book a very enthusiastic 4.5/5 star recommendation. A slight confusion may exist in part of the title “physical medicine.” The reader is not given a clear definition thereof and it should not be confused with the medical specialty named Physical Medicine and Rehabilitation, of which there is apparently one contributing author. Rather, I believe that the term “Physical Medicine” applies to a broad category of hands-on, non-surgical, non-pharmacological approaches, practiced by a variety of clinicians, perhaps appreciated by perusing the table of contents, and the interdisciplinary, international list of contributing authors. Would “manual and movement therapies” be the same as “physical medicine?” It begs some definition. The contributing authors cover very wide territory, from multiple specialties. It truly is an inter-disciplinary work. Hence it is not a book to sell an alternative or complimentary paradigm, not a “we versus them” approach, but rather, a large palate that acknowledges the singular complex canvas of complex chronic pelvic pain that mandates multidisciplinary perspective, and certainly benefits from skilled hands-on expertise.

The immediate effects of sigmoid colon manipulation on pressure pain thresholds in the lumbar spine - Corrected Proof

Terence P. McSweeney, Oliver P. Thomson, Ross Johnston — 2012-03-30

Summary: Visceral manual therapy is increasingly used by UK osteopaths and manual therapists, but there is a paucity of research investigating its underlying mechanisms, and in particular in relation to hypoalgesia. The aim of this study was to investigate the immediate effects of osteopathic visceral mobilisation on pressure pain thresholds. A single-blinded, randomised, within subjects, repeated measures design was conducted on 15 asymptomatic subjects. Pressure pain thresholds were measured at the L1 paraspinal musculature and 1st dorsal interossei before and after osteopathic visceral mobilisation of the sigmoid colon. The results demonstrated a statistically significant improvement in pressure pain thresholds immediately after the intervention (P<0.001). This effect was not observed to be systemic, affecting only the L1 paraspinal musculature. This novel study provides new experimental evidence that visceral manual therapy can produce immediate hypoalgesia in somatic structures segmentally related to the organ being mobilised, in asymptomatic subjects.

Low back pain and kidney mobility: local osteopathic fascial manipulation decreases pain perception and improves renal mobility - Corrected Proof

P. Tozzi, D. Bongiorno, C. Vitturini — 2012-03-05

Summary: Objectives: a) To calculate and compare a Kidney Mobility Score (KMS) in asymptomatic and Low Back Pain (LBP) individuals through real-time Ultrasound (US) investigation. b) To assess the effect of Osteopathic Fascial Manipulation (OFM), consisting of Still Technique (ST) and Fascial Unwinding (FU), on renal mobility in people with non-specific LBP. c) To evaluate ‘if’ and ‘to what degree’ pain perception may vary in patients with LBP, after OFM is applied.Methods: 101 asymptomatic people (F 30; M 71; mean age 38.9 ± 8) were evaluated by abdominal US screening. The distance between the superior renal pole of the right kidney and the ipsilateral diaphragmatic pillar was calculated in both maximal expiration (RdE) and maximal inspiration (RdI). The mean of the RdE–RdI ratios provided a Kidney Mobility Score (KMS) in the cohort of asymptomatic people. The same procedure was applied to 140 participants (F 66; M 74; mean age 39.3 ± 8) complaining of non-specific LBP: 109 of whom were randomly assigned to the Experimental group and 31 to the Control group. For both groups, a difference of RdE and RdI values was calculated (RD = RdE–RdI), before (RD-T0) and after (RD-T1) treatment was delivered, to assess the effective range of right kidney mobility.Evaluation: A blind assessment of each patient was carried using US screening. Both groups completed a Short-Form McGill Pain Assessment Questionnaire (SF-MPQ) on the day of recruitment (SF-MPQ T0) as well as on the third day following treatment (SF-MPQ T1). An Osteopathic assessment of the thoraco-lumbo-pelvic region to all the Experimental participants was performed, in order to identify specific areas of major myofascial tension.Intervention: Each individual of the Experimental group received OFM by the same Osteopath who had previously assessed them. A sham-treatment was applied to the Control group for the equivalent amount of time.Results: a) The factorial ANOVA test showed a significant difference (p-value < 0.05) between KMS in asymptomatic individuals (1.92 mm, Std. Dev. 1.14) compared with the findings in patients with LBP (1.52 mm, Std. Dev. 0.79). b) The ANOVA test at repeated measures showed a significant difference (p-value < 0.0001) between pre- to post-RD values of the Experimental group compared with those found in the Control. c) A significant difference (p-value < 0.0001) between pre- to post-SF-MPQ results was found in the Experimental cohort compared with those obtained in the Control.Conclusions: People with non-specific LBP present with a reduced range of kidney mobility compared to the findings in asymptomatic individuals. Osteopathic manipulation is shown to be an effective manual approach towards improvement of kidney mobility and reduction of pain perception over the short-term, in individuals with non-specific LBP.

Changes in gait and balance parameters in elderly subjects attending an 8-week supervised Pilates programme - Corrected Proof

D. Newell, V. Shead, L. Sloane — 2012-02-29

Summary: Falls in the elderly have important clinical and economic costs and interventions that may reduce the risk of such problems are potentially important. Although evidence exists for a range of exercise interventions, few have looked at a Pilates-based intervention in a supervised community-based setting and none have specifically measured gait parameters as an outcome.This observational study investigated gait parameters including inter-stride variability (ISV) and postural sway in a group (n=9) of elderly (age range, 60–76) subjects attending a weekly Pilates class over eight weeks.The results suggest that significant improvement in walking speed (0.14m/s (95% CI: 0.06–0.21)), step cycle (0.07m (95% CI: 0.01–0.14)) and length (0.10m (95% CI: 0.05–0.15)) and a composite ambulation index (6.5% (95% CI: 1.85–11.26)) were seen post the intervention, while coefficients of variation decreased around 15%. In addition both anterior–posterior sway decreased along with a improvement in a fall risk index (FRI). Inter-stride variability on the other hand did not change.The results of this study suggest that a short Pilates program may have the potential to improve gait and sway parameters, including those associated with fall risk.

Selected fascial aspects of osteopathic practice - Corrected Proof

Paolo Tozzi — 2012-02-28

Summary: Fascia is a connective tissue organised as a three-dimensional network that surrounds, supports, suspends, protects, connects and divides muscular, skeletal and visceral components of the body. Studies suggest that fascia reorganises itself along the lines of tension imposed or expressed in the body, and in ways that may cause repercussions to fascial restriction that are body-wide. This may potentially create stress on any structures enveloped by fascia itself, with consequent mechanical and physiological effects. From an osteopathic perspective, fascial techniques aim to release such tensions, decrease pain and restore function. The proposed mechanism for fascial techniques is based on various studies that have looked at the plastic, viscoelastic and piezoelectric properties of connective tissue. This review explores some of the features described above, together with evidence supporting the therapeutic efficacy of fascial manipulation, offering a selected overview of the fascial component in osteopathic assessment and treatment.

Surgical considerations of the renal fascia and the retroperitoneal space around the kidney - Corrected Proof

Ryosuke Takahashi, Nobuki Furubayashi, Motonobu Nakamura, Yoshihiro Hasegawa — 2012-02-28

Summary: Surgical anatomy around the kidney remains controversial. We therefore examined the constitutions of renal fascia and retroperitoneal space around the kidney through the close observations of intraoperative views. The surface of the removed kidney was covered with a smooth membrane, which is the so-called renal fascia. However, such a smooth membrane could not be observed at the dissection site around the kidney during surgery. Only an intricate connective tissue could be observed. On the other hand, using an operative procedure such as dissection or pulling tissue in some direction, an intricate connective tissue changed to a membranous structure. These results suggest that the retroperitoneal area around the kidney would be filled with connective tissue including some fat, which is arranged in a chaotic manner without any specific alignment tridimentionally. As a result of operative procedures, such connective tissue would be grouped, which would be recognized as renal fascia.

Exercise induced bronchospasm in physically fit female students of Kerman University and their pulmonary function tests - Corrected Proof

2012-02-10

Summary: Introduction: High prevalence of respiratory symptoms and bronchial hyper-responsiveness has been reported in professionals athletes, particularly in relation to climate and environment. However, the airway response to exercise in active population has been poorly investigated especially in women. The aim of this study was to examine pulmonary function test changes in physically fit female students of Kerman University.Methods: Sixty physically fit female students (19 ± 1.12 years old) were randomly selected out of 500 students. Each subject underwent the physical fitness test (Couper test) of the maximal distance running in 12 min. The exercise induced bronchospasm (EIB) symptoms including coughing, wheezing, chest tightness, dyspnea, previously diagnosed asthma and allergy, the use of anti-asthmatics medication and the family history of asthma were recorded using a questionnaire. Pulmonary function tests including; forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal expiratory flow at 50% of the FVC (MEF50) were measured at rest (baseline), immediately, 5, and 15 min after an exercise test.Result: The result of this study showed that the prevalence of the symptoms of EIB was 40.0%. There was not any significant difference in baseline PFT values between symptomatic and asymptomatic subjects. However, All PFT values of symptomatic subjects were significantly lower than asymptomatic immediately after exercise (p < 0.05 to p < 0.01). In addition, PFT values were significantly reduced in all times intervals for the symptomatic subjects (p < 0.05 to p < 0.01).Conclusion: The results showed a high prevalence of respiratory symptoms and EIB in healthy female students.

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.

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.

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.

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.