Context: Accurate joint position sense (JPS) is necessary for effective motor learning and high performance in activities that require fine motor control. Proprioceptive neuromuscular facilitation (PNF) can be a promising intervention. Objective: To examine existing peer-reviewed original studies that have investigated the effect of PNF techniques on the JPS in terms of the methodological quality, PNF techniques, outcomes, and participant characteristics. Evidence Acquisition: A systematic literature search was performed using PubMed, EMBASE, MEDLINE, CINAHL, SocINDEX, Scopus, and Cochrane Library from inception to January 2018. The following inclusion criteria were used: (1) assessment of the JPS; (2) peer-reviewed original studies with a randomized controlled trial or quasi-randomized controlled trial design; (3) participants with musculoskeletal disorders or healthy individuals (ie, neither animal studies nor those involving neurological problems); and (4) no cointervention with PNF, except for warm-up procedures. The methodological quality was assessed using PEDro scale and 5 additional criteria. Effect size (η2) was calculated where a positive value indicated an increased JPS after PNF as compared with other approaches including the wait-and-see method. Evidence Synthesis: Nine studies were examined for their methodological quality, and only one study scored >6 on the PEDro scale. Positive and large effect size (η2 > .14) was detected in 2 studies where JPS of the knee with contract-relax and replication techniques was assessed in healthy individuals. However, the methodological quality of these studies was poor (PEDro scores of 3 and ≤5 in the total quality score out of 16, respectively). Conclusions: The current study did not find multiple studies with high methodological quality and similar PNF techniques, outcomes, and characteristics of participants. More high-quality studies are required to achieve a comprehensive understanding of the effect of PNF on the JPS.
Objectives: The aim was to investigate the time savings and plane accuracy of multivendor head computed tomography (CT) using the intelligent work aid with automatic reformatting of the axial head image at the orbitomeatal line. Materials and Methods: We retrospectively reviewed 781 head CTs (median, 70 years; 441 men) collected by CT systems from 3 vendors. In addition to the orbitomeatal line image reformatted by a CT specialist as a reference, we obtained the fully automated orbitomeatal line image using the intelligent work aid. We calculated the offset angle from the reference of the automatically reformatted image. We defined the large offset angle groups as those with an offset angle greater than 3 degrees. Multivariate logistic regression was used to determine the independent factors for the large offset angle groups. We compared the postprocessing times measured using the intelligent work aid or by a CT specialist. Results: With the intelligent work aid, 99.7% of CTs were automatically reformatted to the orbitomeatal line without error. Furthermore, 88.1% of CTs were within the 3 degrees' offset angle when compared with the reference produced by a CT specialist. The median offset angle from the reference was 1.41 degrees. Multivariate analysis showed that the offset angle of the positioning plane was an independent factor (odds ratio, 1.045; P = 0.005) for predicting the large offset angle group. Furthermore, this technique was 4 times faster (6.4 ± 0.7 seconds) than a CT specialist (25.6 ± 6.4 seconds). Conclusions: The intelligent work aid can generate a fast and precise head CT image aligned at the orbitomeatal line, even in real-world clinical CTs. However, precise positioning remains essential.
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