The objective is to determine if pain and disability outcomes of patients treated with neural mobilisation differ for sub-classifications of low back and leg pain (LB&LP). Radiating leg pain is a poor prognostic factor for recovery in patients with LBP. To improve outcome, a new pathomechanism-based classification system was proposed: neuropathic sensitization (NS), denervation (D), peripheral nerve sensitization (PNS) and musculoskeletal (M). Seventy-seven patients with unilateral LB&LP were recruited. Following classification, all subjects were treated seven times with neural mobilisation techniques. A successful outcome was defined as achieving a minimal clinically important change in pain intensity (11-point numerical rating scale), physical function (Roland Morris disability questionnaire) and global perceived change (7-point Likert scale: from 1 = ''completely recovered'' to 7 = ''worse than ever''). The proportion of responders was significantly greater in PNS (55.6%) than the other three groups (NS 10%; D 14.3% and M10%). After adjusting for baseline differences, mean magnitude of improvement of the outcome measures were significantly greater in PNS compared to the other groups. Patients classified as PNS have a more favourable prognosis following neural mobilisation compared to the other groups.
This study was designed to investigate the relationship between trunk muscle fatigue and associated changes in the electromyographic (EMG) signals during a dynamic iso-inertial test. Eleven subjects performed dynamic trunk flexion/extension movements against 40% maximum voluntary contraction (MVC) torque until exhaustion in a tri-axial trunk dynamometer. EMG parameters in the time and frequency domain were studied by analysing changes of the signal amplitudes and the spectral density (using the zero-crossing-rate and the median frequency). The kinematics of the movement were analysed according to the movement velocities and the deviations from the required movement plane. The flexion and extension velocities decreased from the beginning to the end of the test. Movement deviations from the sagittal plane into the frontal and transverse plane increased with increasing test duration, as did the EMG amplitude. The median frequency during periods with maximum muscle activity decreased, as did the zero-crossing-rate. The increase in amplitude and decrease in median frequency were more pronounced in the trunk flexors than in the trunk extensors. The parameters of median frequency, zero-crossing-rate and amplitude seem to be sensitive identifiers of muscle fatigue during well-controlled dynamic contractions. While the kinematic data did not yield any information on the mechanisms of the fatigue, changes in the EMG parameters demonstrated that the duration of the test was limited by the fatigue of the trunk flexors.
Recently, an implantable hearing aid for rehabilitation of sensorineural hearing loss has been developed. One component of the device is the microphone for implantation into the posterior canal wall. The membrane of the microphone can be covered by skin, cartilage, or fascia, avoiding reduction in sound transmission at the same time. In the study presented here, the microphone was implanted into 50 cadaver specimens of human temporal bone. Localization of the microphone was determined by the anatomical situation of the facial nerve. The microphone and the piezoelectric transducer could be implanted in 78% of the temporal bones after total mastoidectomy. In the final version of the microphone, the size was 4.5 mm and total weight 400 mg.
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