No abstract

Upper limb activities imply positioning of the head with respect to the visual target and may impact trunk posture. However, the postural constraints imposed on the neck remains unclear. We used kinematic analysis to compare head and trunk orientation during arm movements (pointing) with isolated movements of the head (heading). Ten right-handed healthy adults completed both experimental tasks. In the heading task, subjects directed their face toward eight visual targets placed over a wide frontal workspace. In the pointing task, subjects pointed to the same targets (each with their right arm). Movements were recorded using an electromagnetic spatial tracking system. Both orientation of the head and trunk in space (Euler angles) and orientation of the head relative to the trunk were extracted. The orientation of the head in space was closely related to target direction during both tasks. The trunk was relatively stable during heading but contributed to pointing, with leftward axial rotation. These findings illustrate that the neck compensates for trunk rotation during pointing, engaging in specific target-dependent 3D movement in order to preserve head orientation in space. Future studies may investigate neck kinematics of people experiencing neck pain in order to identify and correct inefficient movement patterns, particularly in athletes.

Background:Recent guidelines regarding systemic sclerosis (SSc) emphasized the need of measuring functioning along with organ-specific measures, pointing out the importance of patient-reported outcome measures (1). The International Classification of Functioning, Disability and Health (ICF) endorsed by the WHO in 2001 set a unified language covering all dimensions of human functioning, including body structures, body functions, activities and participation and environmental factors.Objectives:To develop a comprehensive ICF core set for SSc and to conceive a patient-centered ICF-based questionnaire assessing activities and participation in patients with SSc.Methods:The development of the ICF comprehensive core set followed 2 steps (2). In the first step, meaningful concepts related to SSc were collected using data source triangulation from patients (N=18), experts (N=10) and literature (N=174 articles). In the second step, concepts were linked to the best-matching ICF categories by 2 independent reviewers according to prespecified linking rules (3). Finally, patient-reported activities and participation categories of the comprehensive ICF core set were translated into understandable questionsResults:After linking concepts to ICF codes, 151 ICF categories were collected from focus groups, 22 from experts and 82 from literature. After fusion of the sources and removal of duplicates, the comprehensive ICF core set included 165 categories: 1 at the first level, 158 at the second level, 6 at the third level, with 50 categories on body functions, 15 on body structures, 53 on activities and participation and 47 on environmental factors. Patient-reported ICF categories on activitiesConclusion:We developed a comprehensive ICF core set that offers a conceptual framework for SSc patients’ care and health policy. Using a patient-centered approach, we conceived a patient-centered ICF-based questionnaire, the Cochin Scleroderma ICF-65 questionnaire, assessing activities and participation in patients with SSc.References[1] Merkel PA, Clements PJ, Reveille JD, Suarez-Almazor ME, Valentini G, Furst DE, et al. Current status of outcome measure development for clinical trials in systemic sclerosis. Report from OMERACT 6. J Rheumatol. 2003;30(7):1630-47.[2] Selb M, Escorpizo R, Kostanjsek N, Stucki G, Ustun B, Cieza A. A guide on how to develop an International Classification of Functioning, Disability and Health Core Set. Eur J Phys Rehabil Med. 2015;51(1):105-17.[3] Cieza A, Geyh S, Chatterji S, Kostanjsek N, Ustun B, Stucki G. ICF linking rules: an update based on lessons learned. J Rehabil Med. 2005;37(4):212-8.Disclosure of Interests:None declared

BackgroundIntervertebral disc therapies (IDT) for the management of non-specific chronic low back (NScLBP) pain are raising interest (1).ObjectivesTo review evidence on the benefits and harms of IDT in people with NScLBP.MethodsWe searched 4 databases and conference abstracts, from inception to July 2018, for randomized trials of IDT versus placebo interventions, active comparators or usual care. Two independent investigators extracted data and assessed the risk of bias. The primary outcome was LBP intensity at short, intermediate and long terms (2). Secondary outcomes were LBP-specific activity limitation and safety (3). Our review was registered with the International Prospective Register of Systematic Reviews (CRD42019106336).ResultsOf 17 eligible trials, 5 trials (436 patients) assessed glucocorticoid (GC) IDT and were included in a quantitative synthesis. Twelve trials assessed IDT of other products including ozone (n=2, 140 patients), methylene blue (n=1, 72 patients), stems cells (n=1, 24 patients), glycerol (n=1, 11 patients), etanercept (n=2, 96 patients), tocilizumab (n=1, 60 patients), platelet-rich plasma (n=1, 47 patients), chymopapaine (n=1, 39 patients) and rhGDF-5 (n=2, 55 patients) and were included in a narrative synthesis. Standardized mean differences (SMD) of GC IDT for LBP intensity and activity limitations were -1.33 (-2.34;-0.32) and -0.76 (-1.85;0.34) at short-term, -2.22 (-5.34;0.90) and -1.60 (-3.51;0.32) at intermediate-term and -1.11 (-2.91;0.70) and -0.63 (-1.68;0.42) at long-term, respectively. OR of GC IDT for serious and minor adverse events were 1.13 (0.20; 4.59) and 0.97 (0.49;1.91).ConclusionGC IDT are associated with a reduction in LBP intensity at short-term in people with NScLBP. Positive effects are not sustained. There is no effect on activity limitations.References[1] Knezevic NN, Mandalia S, Raasch J, Knezevic I, Candido KD. Treatment of chronic low back pain - new approaches on the horizon. J Pain Res. 2017;10:1111-23.[2] Chiarotto A, Boers M, Deyo RA, Buchbinder R, Corbin TP, Costa LOP, et al. Core outcome measurement instruments for clinical trials in nonspecific low back pain. Pain. 2018;159(3):481-95.[3] Team QAaSM. Safety of medicines : a guide to detecting and reporting adverse drug reactions : why health professionals need to take action. In: Organization WH, ed. Geneva; 2002.Disclosure of InterestsNone declared