BackgroundAbnormal intervertebral movements of spine have been reported to be associated
with trauma and pathological conditions. The importance of objective spinal motion
imaging assessment in the frontal plane was frequently underestimated. The
clinical evaluation of the segmental motion contribution could be useful for
detecting the motion pattern of individual vertebrae. Therefore the purpose of
this study was to investigate the shift of segmental contribution ratio in
patients with herniated disc during cervical lateral bending to provide additional
insights to cervical biomechanics.MethodsA total of 92 subjects (46 healthy adult subjects and 46 disc-herniated
patients) were enrolled in this case–control study. The motion images during
cervical lateral bending movements were digitized using a precise image protocol
to analyze the intervertebral motion and contribution.ResultsOur results showed that the intervertebral angulation during cervical lateral
bending for the C2/3 to C6/7 segments were 7.66°±2.37°, 8.37°±2.11°, 8.91°±3.22°,
7.19°±2.29°, 6.31°±2.11°, respectively for the healthy subjects. For the patients
with herniated disc, the intervertebral angulation for the C2/3 to C6/7 segments
were 6.87°±1.67°, 7.83°±1.79°, 7.73°±2.71°, 5.13°±2.05°, 4.80°±1.93°,
respectively. There were significant angulation and translational differences
between healthy subjects and the patients with herniated disc in the C5/6 and C6/7
segments (P=0.001-0.029). The segmental contributions of the individual vertebral
segments were further analyzed. There was a significant increase in segmental
contribution ratio of C3/4 (P=0.048), while a significant decrease in contribution
ratio of C5/6 (P=0.037) was observed in the patients with herniated disc. Our
results indicated that the segmental contribution shifted toward the middle
cervical spine in the patients with herniated disc.ConclusionsThe segmental contributions of cervical spine during lateral bending movement
were first described based on the validated radiographic protocol. The detection
of the shift of segmental contribution ratio could be helpful for the diagnosis
the motion abnormality resulted from the disc or, facet pathologies, and arthritic
changes of cervical spine.
Objectives: To investigate the influence of the chronic calf myofascial pain syndrome [MPS] on gait performance and the effectiveness of myofascial treatment programs in order to inform the clinical management for this impairment.Methods: A female subject suffered from chronic knee and ankle pain for five years as a result of calf muscles MPS. The range of motion, pain intensity, and gait analysis were evaluated before and after myofascial pain therapy. The eight-week calf myofascial treatment programs included manShyi-Kuen Wu, MS, PT, is Instructor, Downloaded by [UQ Library] at 14:16 15 July 2015 ual techniques, deep myofascial release, deep friction massage, and proprioceptive neuromuscular facilitation stretching, and a home program [self-stretching exercises].Results: There were significant improvements in the ankle-dorsiflexion range of motion of the affected leg after treatment [P < 0.01]. A trend of moderate improvement in pain conditions were recorded both in resting and after work. Although the kinematic data of gait analysis were quite similar across treatments except for improved knee flexion angles, the kinetic findings revealed significant effectiveness of myofascial treatments. The decreased peak ground reaction forces [P < 0.001], improved peak joint moments of ankle dorsiflexion [P = 0.008], foot supination [P = 0.002], and knee extension [P = 0.009] were demonstrated during walking.Conclusions: The chronic muscle tightness caused by MPS is a factor influencing the joint motion and easily ignored by clinicians. This study investigated the influence of calf myofascial pain on gait performance. The quantitative gait analysis was highly valuable to clarify the influence of chronic calf tightness on the mobility of ankle and knee joints and to assess the effectiveness of myofascial treatments.
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