The purpose of this investigation was to examine the intrasession and interrater reliability of rehabilitative ultrasound imaging (RUSI) to measure the deep neck flexors (DNF). Two investigators traced the DNF muscle borders in eight female subjects aged 33 ± 11.2 years. Of the eight subjects, five subjects reported a greater than 6-month history of neck pain, and three subjects were asymptomatic healthy controls. Cross-sectional area (CSA) (cm(2)) of right and left muscle groups were calculated. The intraclass correlation coefficients (ICC) for CSA measures were 0.67 (95% CI: 0.27-0.87) for rater 1 with a standard error of measurement (SEM) of 0.06 cm(2); 0.87 (95% CI: 0.65-0.96) for rater 2 with an SEM of 0.09 cm(2); and 0.68 (95% CI: 0.44-0.87) for interrater reliability between rater 1 and rater 2 with an SEM of 0.11 cm(2). The mean difference between CSA (cm(2)) measures were 0.00 ± 0.10 cm(2) for rater 1 and 0.09 ± 0.13 cm(2) for rater 2. The mean differences for CSA were 0.04 ± 0.12 cm(2). This pilot investigation suggests that RUSI could be used to reliably assess the size of the deep neck flexors.
A palpation reference line coursing between the superior-most aspect of the iliac crests has been reported to cross the L4 spinous process or L4/L5 intervertebral space in approximately 80% of the population. Comparable data have not been defined for the line coursing between the posterior superior iliac spines (PSIS). The purpose of this study was to compare the anatomical consistency of the PSIS to the iliac crest as landmarks used for spinal palpation. One hundred computerized tomographic images were reviewed in a three-dimensional setting. Two horizontal lines were constructed on each image: Line 1 representing the superior-most aspect of the iliac crest and Line 2 representing the inferior margin of the PSIS. The vertical distance between each horizontal line and the inferior edge of its respective spinous process were measured. The PSIS corresponded to the S2 spinous process in 81% of subjects and the iliac crest to the L4 spinous process in 59% of subjects. Distance measures suggest that the PSIS was closer to S2 versus the iliac crest to L4 (t = 6.998; P < 0.01). The PSIS crossed S2 more frequently than the iliac crest crossed L4 (chi(2) = 12.719, P < or = 0.01). The study findings support the relationship between the PSIS, and the spinous process of S2 is more consistent when compared to the iliac crest and the spinous process of L4. The PSIS reference line may be used to find S2 as a reference standard in validity and reliability palpation studies in the lower lumbar spine.
Study Design: Nonexperimental, normative research design. Objectives: To test a proposed model to locate the level of the transverse processes (TPs) of the thoracic spine through surface palpation. Background: Palpation of the TPs of the thoracic spine is challenging because of their depth relative to the more superficial structures of the spine. Many clinicians use the more superficial spinous processes (SPs) of the thoracic spine to orient themselves for palpation of the TPs. In 1979, Mitchell described a ''rule of threes,'' which attempted to predict the location of the level of the thoracic TPs relative to their corresponding SPs. We previously conducted a pilot study to investigate the validity of the rule of threes and concluded that it is not an accurate predictor of the level of the location of the TPs of the thoracic spine. Based on that previous work, we hypothesized that a more accurate model for predicting the level of the TPs would be that they are generally at the level of the SP of the adjacent cranial thoracic vertebra throughout the thoracic spine. Methods and Measures:We dissected 15 cadavers and measured the vertical distance between the transverse (horizontal) plane of the TPs of 1 vertebra and the SP of the adjacent cranial thoracic vertebra for all levels of the thoracic spine. Results: Mean vertical distances ranged from 2.0 to 4.0 mm. The means for all thoracic vertebral levels except for T11 and T12 were significantly less than the normal 6-mm threshold of 2-point discrimination of the fingertips (PϽ.01). Conclusion:The results of this study indicate that the TPs of each thoracic vertebra are generally at the level of the SP of the vertebra 1 level above, throughout the thoracic spine. It may be more difficult to predict the location of the TPs of the 2 most caudal levels (T11 and T12), given their greater variability of position.
Purpose: Hospitalization can result in functional loss, especially in older adults. The purpose of the study was to determine the effect of intensive rehabilitation on changes in physical function in healthy older subjects after 1 week of bed rest and 3 days of rehabilitation. Methods: Six healthy subjects older than 60 years completed 7 days of bed rest followed by 3 days of rehabilitation including stretching, strengthening, balance, gait, and stair climbing. Results: Bed rest reduced the distance walked over 6 minutes, slowed gait speeds, and increased sit-to-stand times. Muscle flexibility and isokinetic quadriceps strength varied after bed rest. Three days of rehabilitation restored outcomes measures to baseline levels. Conclusions: A short bout of focused rehabilitation after a week of bed rest restored physical function measures to pre-bed rest levels in healthy older subjects. Similar training protocols may result in increased functional measures in older hospitalized patients.
Background: Anterior knee pain during knee extension may be related to a meniscal movement restriction and increased meniscal load during function. One method of treatment involves the use of manual posterior mobilization of the tibia to specifically target the meniscotibial interface of the knee joint. Purpose:The purpose of this study was to measure motion at a cadaveric medial meniscus anterior horn during a posterior tibial mobilization.
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