scholarly journals Effects of Neuromuscular Electrical Stimulation (NMES) Plus Upper Cervical Spine Mobilization on Forward Head Posture and Swallowing Function in Stroke Patients with Dysphagia

2020 ◽  
Vol 10 (8) ◽  
pp. 478
Author(s):  
Yung Hyun Jeon ◽  
Kyun Hee Cho ◽  
Shin Jun Park

After a stroke, forward head posture occurs, resulting in swallowing dysfunction. Neuromuscular electrical stimulation (NMES) combined with upper cervical spine mobilization has demonstrated enhanced recovery of the swallowing function in stroke patients. This study investigated the therapeutic effects of NMES in conjunction with upper cervical mobilization in stroke patients with dysphagia. Thirty-four stroke patients were recruited (in a randomized controlled clinical trial) and divided into an experimental group (n = 17; NMES plus upper cervical spine mobilization) and a control group (n = 17; NMES plus sham mobilization). Forward head posture was measured by craniocervical flexion test (CCFT) and craniovertebral angle (CVA). Swallowing function was measured by variations in video fluoroscopic dysphagia scale (VDS) and penetration–aspiration scale (PAS) scores using the video fluoroscopic swallowing study (VFSS). All measurements were done at baseline and after four weeks of NMES plus mobilization. A significant increase was observed in CCFT, CVA, VDS (total VDS score, oral stage score, pharyngeal stage score), and PAS score in all variations in the experimental group. The CCFT, CVA, pharyngeal stage score, total VDS, and PAS score were significantly higher in the experimental group when compared to the control group. NMES plus upper cervical spine mobilization can be regarded as a promising method to improve swallowing function and forward head posture changes in stroke patients with dysphagia.

2021 ◽  
Vol 67 (3) ◽  
pp. 291-299
Author(s):  
Na-Yeon Kang ◽  
Sang-Cheol Im ◽  
Kyoung Kim

Objectives: This study aims to investigate how exercise programs not directly applied to the cervical spine affect office workers with forward head posture (FHP). Patients and methods: Between March 2018 and June 2018, a total of 32 office workers with FHP (13 males, 19 females; mean age 36.63 years; range, 23 to 57 years) were randomized either to experimental (n=16) or control groups (n=16). Scapular stabilization and thoracic extension exercises were applied to the experimental group and cervical stabilization and stretching exercises to the control group. The results of the pre-intervention and after six weeks measurement of the craniovertebral angle (CVA), respiration, pain, and disability were compared and analyzed. Results: For intra-group comparison, both groups showed significant differences (p<0.05) in CVA, forced expiratory volume at 1 sec (FEV1), Visual Analog Scale (VAS), and neck disability index at pre- and post-intervention, while only the experimental group showed a significant difference (p<0.05) in maximum inspiratory pressure, maximum expiratory pressure, and forced vital capacity. For inter-group comparison, a significant difference (p<0.05) between FEV1 and VAS was observed. Conclusion: The combination of scapular stabilization and thoracic extension exercises, not directly applied to the cervical spine, has an effect on improving the posture, respiration, neck pain, and disability in office workers with FHP.


2020 ◽  
Vol 27 (4) ◽  
pp. 18-22
Author(s):  
Sonu Punia ◽  
Manoj Malik ◽  
Shalu Jangra ◽  
Jaspreet Kaur ◽  
Varun Singh

Abstract Introduction. Migraine is a common debilitating disorder of neurovascular origin which affects younger adults, especially women. Material and Methods. It was an experimental study design. A convenience type of sampling was used for recruitment of the subjects. A total of 21 participants diagnosed with migraine (6 males and 15 females) fulfilling the inclusion criteria were taken for this study and assigned to one of the two groups (experimental or control group). PFT measured with PFT apparatus (Spirolab 111, Serial No. A23-053 13974) and HDI score were calculated before the start of the intervention and after the intervention. Afterwards, PFT was performed by each participant followed by HVLA thrust manipulations to the migraine patients and an equal period of rest to the control group. Results. There are no significant differences between baseline and post-intervention outcome variables and in mean changes between the two groups. One-way ANOVA was used to analyze the change in HDI score which was calculated three times (pre- prior to intervention, post- after the intervention and 1 month after the intervention). The experimental group showed a significant reduction in the score after the manipulation. It was found that FVC and PEF were positively correlated to FEV1, and FVC was also positively correlated to PEF. Conclusions. The findings of the study revealed that high-velocity thrust manipulations of upper cervical spine were not effective in improving pulmonary functions of migraine patients although it was found effective in improving subjective symptoms of the patients evaluated through HDI.


2012 ◽  
Vol 02 (04) ◽  
pp. 16-21
Author(s):  
Mohamed Faisal C. K. ◽  
Priyabandani Neha Om Prakash ◽  
Ajith S.

AbstractStroke is a worldwide health problem. Hand function is one of the important factors which are affected in stroke. Stroke patients are usually given a conventional physiotherapy but if an additional FNMES is given it might show better improvement. By keeping these facts in view, the present study aims at evaluating and comparing the efficacy of conventional physiotherapy and adding FNMES will make any better outcome in the acute stroke survivals. The subjects were randomly assigned to any of the two groups; control group consisted of 15 subjects who received only conventional therapy for 4 weeks and experimental group consisting of 15 subjects who received an additional FNMES along with conventional physiotherapy for 4 weeks. The hand function was assessed on day 1 and to know the recovery, at the end of four weeks of intervention with the help of action research arm test (ARAT) and box and block test (BBT). At the end of 4 weeks of intervention both the groups showed significant improvements. On ARAT, control group showed a mean of 10.2000 whereas, experimental group showed mean of 20.8000 with p = 0.001 (p ≤ 0.05) and on BBT, the control group showed a mean of 21.666 and experimental group showed 30.933 with p = 0.41 (p ≤ S 0.05). Therefore the study concludes that, though there was improvement in both the groups, the experimental group who received an additional FNMES along with conventional physiotherapy showed better improvement in hand functions in the acute stroke survivals.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Isha Sikka ◽  
Chandan Chawla ◽  
Shveta Seth ◽  
Ahmad H. Alghadir ◽  
Masood Khan

In contemporary societies, computer use by children is a necessity and thus highly prevalent. Using computers for long hours is related to a higher risk of computer-related muscular disorders like forward head posture (FHP) and neck pain (NP). Deep cervical flexor (DCF) muscles are important head-on-neck posture stabilizers; thus, their training may lead to an improvement in FHP and NP. The aim of this study was to determine if 4 weeks of DCF training is effective in alleviating NP, improving FHP, and functional status in adolescent children using computers regularly, a pretest-posttest experimental group design was used. Subjects were randomly assigned into the experimental group (receiving DCF training and postural education) and the control group (receiving postural education only). 30 subjects with a mean age of 15.7 ± 1.725 years with NP and FHP using computers regularly participated in the study. Dependent variables were measured on day 1 (at baseline) and after 4 weeks of training. Photographic analysis was used for measuring FHP, visual analog scale for NP intensity, and neck disability index for functional status. Data analysis showed that in both groups, no significant improvement occurred in FHP. In both groups, there was a significant improvement in functional status and NP. There was no significant difference between both groups for FHP and NP. There was a significant improvement in functional status in the experimental group in comparison to the control group. Four weeks of DCF training does not cause a significant improvement in FHP in 13 to 18 years old adolescent children using computers regularly.


2014 ◽  
Vol 20 (4) ◽  
pp. 404-410 ◽  
Author(s):  
Tsuyoshi Sugiura ◽  
Yukitaka Nagamoto ◽  
Motoki Iwasaki ◽  
Masafumi Kashii ◽  
Takashi Kaito ◽  
...  

Object The upper cervical spine is commonly involved in persons with rheumatoid arthritis (RA). Although 2D measurements have long been used in the evaluation of cervical lesions caused by RA, 2D measurements are limited in their effectiveness for detecting subtle and complex morphological and kinematic changes. The purpose of this study was to elucidate the 3D kinematics of the upper cervical spine in RA and the relationship between 3D morphological changes and decreased segmental rotational motion. Methods Twenty-five consecutive patients (2 men and 23 women, mean age 63.5 years, range 42–77 years) with RA (the RA group) and 10 patients (5 men and 5 women, mean age 69.9 years, range 57–82 years) with cervical spondylosis and no involvement of the upper cervical spine (the control group) underwent 3D CT of the cervical spine in 3 positions (neutral, 45° head rotation to the left, and 45° head rotation to the right). The segmental rotation angle from the occiput (Oc) to C-2 was calculated for each participant using a voxel-based registration method, and the 3D destruction of articular facets was quantified using the authors' own parameter, the articular facet index. Results The segmental rotation angle was significantly smaller at C1–2 and larger at Oc–C1 in the RA group compared with the control group. The degree of the destruction of the articular facet at C-1 and C-2 correlated with the segmental rotation angle. Conclusions In vivo 3D kinematics of the upper cervical spine during head rotation in patients with RA were accurately measured, allowing quantification of the degree of joint destruction for the first time. Joint destruction may play an important role in decreasing segmental motion of the upper cervical spine in RA.


Author(s):  
Wonho Choi

The purpose of this study was to investigate the effect of flexion exercise of the deep cervical muscles on headache and sleep disorders in patients with tension headaches and forward head posture. A total of 32 patients with tension headaches and forward head posture were randomly assigned to two groups: an experimental group (n = 16) and a control group (n = 16). The experimental group performed cervical deep muscle flexion exercises for 4 weeks, whereas the control group performed stretching exercises for the same period. The Henry Ford Hospital Headache Disability Inventory (HDI) was used for headache assessment, and the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K) was used for sleep disorder assessment. The experimental group showed a significant reduction in both HDI and PSQI-K score after 4 weeks of intervention (p < 0.001), while no significant difference was found in the control group (p > 0.05). On comparing the experimental and control groups, we found a significant difference in changes in the HDI and PSQI-K between the groups (p < 0.05). The results indicate that flexion exercise of the deep cervical muscles in patients with tension headache and forward head posture will improve the quality of life and activities of daily life by mitigating headaches and sleep disorders.


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