Objective To investigate the differences of spinal curvature, thoracic sagittal mobility, and respiratory strength between patients with chronic neck pain (CNP) and people without cervical pain, and to determine the correlation between respiratory strength and thoracic mobility in CNP patients.Methods A total of 78 participants were finally included in this study, of whom 30 had no cervical pain and 48 had CNP. The Neck Disability Index (NDI), cervical lordotic curvature, thoracic kyphotic curvature, thoracic sagittal range of motion (ROM), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were measured and analyzed.Results In males, thoracic sagittal ROM<sub>MEP-MIP</sub> and MEP showed a significant difference between the no cervical pain group and the CNP group. In females, thoracic kyphotic curvature, thoracic sagittal ROM<sub>MEP-MIP</sub>, MIP, and MEP were significantly different between the no cervical pain group and the CNP group. Thoracic kyphotic curvature was significantly correlated with MEP and MIP in all population groups, and significantly correlated with NDI in the female group. Thoracic sagittal ROM<sub>MEP-MIP</sub> had a significant linear relationship with NDI, MEP, and MIP in all population groups.Conclusion The thoracic mobility during forced respiration was reduced in patients with CNP and was correlated with respiratory strength. Changes in the biomechanics of the cervicothoracic spine and rib cage due to CNP may contribute to impairment of respiratory strength.
High intensity focused ultrasound (HIFU) has been widely used in gynecology and believed as a safe, effective, nonsurgical modality for treating uterine fibroids. A 36-year-old woman had a HIFU treatment owing to uterine adenomyosis and experienced pain, motor weakness of around right lower extremity and pelvis. The electrodiagnostic study suggested right lumbar plexopathy and sacral radiculopathy.
Sinking skin flap syndrome is defined by a series of neurological symptoms with skin depression at the site of cranial defect. We experienced neurological improvement in a patient with markedly sunken craniectomy site after ventriculoperitoneal shunt (V-P shunt) clamping operation. A 17-year old female patient was in vegetative state and spastic quadriplegia after traumatic brain injury. She was suffered from frequent vomiting. To evaluate central nervous system problem we checked brain computed tomography which showed that right frontotemporoparietal craniectomy area was markedly sunken and midline was shifting to the left. After V-P shunt clamping operation, craniectomy site was elevated and midline shifting was improved. Vomiting was disappeared. Coma Recovery Scale-revised (CRS-R) score was improved from 3 to 6.
Botulinum toxin (BoNT) injection is widely used to improve spasticity. However, after the treatment, the patient may experience pain, inflammation, swelling and redness at the injection site. In this case, we addressed deep vein thrombosis (DVT) after BoNT treatment of the upper limb. A male aged 37 years had spasticity and dystonia in his left upper extremity. BoNT-A 100 U was injected into the left biceps brachii and an equal amount into the brachialis to relieve spasticity. After three days, he developed redness and painful swelling in the left upper arm and the next day, through the upper extremity computed tomography venography, DVT was identified in the left cephalic vein. The thrombus resolved after the anticoagulation therapy with rivaroxaban (Xarelto). We hypothesized the role of mainly three mechanisms in the development of DVT in this case: repetitive strenuous activity, relative stasis due to reduced muscle tone, and possible direct mechanical damage to the vessel wall.
Objective:The objectives of this study were to evaluate the correlation between upper extremity strength and oral health in stroke patients, as well as to determine the need for improvement in oral health measures, including rehabilitation to enhance upper extremity strength, and education and training for patients and their guardians related to oral hygiene. Methods:To evaluate the oral health of stroke patients, we performed an examination of oral health and survey of oral hygiene behavior. Using the Oral Health Assessment Tool, an examiner evaluated oral health using a dental mirror. The upper extremity muscle strength was also assessed using the Manual Muscle Testing (MMT) grading system.Results: Patients with higher-grade upper extremity muscle strength had better oral health. Patients with higher MMT grades were more likely to brush their teeth independently, and more often, compared to those with lower grades. Conclusion:The MMT grade of patients with chronic stroke was significantly related to the oral health. Therefore, to improve oral health, patients should receive oral hygiene education and rehabilitation to increase their MMT grade. Combined efforts by rehabilitation and dental departments are required to improve the oral health of chronic stroke patients.
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