scholarly journals The effect of cervical spine manipulation on grip strength and muscle activity in asymptomatic participants with cervical spine dysfunction

2018 ◽  
Author(s):  
◽  
Daniel James Fenton
Keyword(s):  
Cervical Spine ◽  
Treatment Group ◽  
Treatment Effect ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Force Output ◽  
Cervical Spine Manipulation ◽  
Neurophysiological Mechanisms ◽  
Extensor Carpi Radialis ◽  
Over Time

Objective: The effects of spinal manipulation are well documented, however there is a gap in the current literature regarding the neurophysiological mechanisms responsible for these effects. Further evidence is required to reveal the specific neurophysiological mechanisms of spinal manipulative therapy and its effect on muscle activity. The objectives of this study were to investigate the short-term effects of a single cervical spine manipulation on grip strength and muscle activity of the forearm flexors and extensors in an asymptomatic sample when compared to a control. Methods: A randomised, controlled, pre-test, post-test, repeated measures design allowed for 46 participants, aged 18-35 years old, with joint dysfunction at C7 to be allocated to either a cervical spine manipulation or a control group. Force output and muscle activity of the forearm flexors and extensors were measured before and immediately after the intervention and again at 5, 10 and 15-minutes. IBM SPSS was used to analyse the data with significance set at (p=0.05). Repeated measures ANOVA testing and Post hoc contrast studies were used to determine significance within, and between, groups. Results: In the treatment group there was a statistically significant change in muscle activity over time in the Extensor carpi radialis (p=0,013) and Extensor digitorum (p=0,021). Similarly, force output increased within the treatment group over time (p=0,012). A statistically significant beneficial treatment effect was identified between the groups in the Extensor carpi radialis (p=0,001) and Flexor digitorum superficialis (p=0,019) muscles only. Conclusion: Though statistical significance was not detected in all muscle groups, this study showed a trend of a treatment effect following cervical spine manipulation (C7) with most values lying just outside the parameters set for significance. Specific muscles of the forearm were affected more than others. Future studies are required with a larger sample to validate the trends observed in this study.

Consistent Immediate Effects of Foot Orthoses on Comfort and Lower Extremity Kinematics, Kinetics, and Muscle Activity

2004 ◽  
Vol 20 (1) ◽  
pp. 71-84 ◽  
Author(s):  
Anne Mündermann ◽  
Benno M. Nigg ◽  
R. Neil Humble ◽  
Darren J. Stefanyshyn
Keyword(s):  
Lower Extremity ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Significant Interaction ◽  
Second Step ◽  
Foot Orthoses ◽  
Analog Scale ◽  
Repeated Measures Anova ◽  
Recreational Runners ◽  
Over Time

In order to accommodate patients to new foot orthoses over time, two steps are required: The first is to obtain a baseline reading of the immediate effects across several weeks to ensure consistency. The second step is to look at changes with progressively longer wear periods similar to what occurs in general practice. This study addressed the first step. The purpose of this study was to determine whether the baseline reading of the immediate effects of foot orthoses on comfort and lower extremity kinematics, kinetics, and muscle activity is consistent between days. Participants were 21 recreational runners who volunteered for the study. Three orthotic conditions (posting, custom-molding, posting and custom-molding) were compared to a control (flat) insert. Lower extremity kinematic, kinetic, and EMG data were collected for 108 trials per participant and condition in 9 sessions for each person for running at 4 m/s. Comfort for all orthotic conditions was assessed in each session using a visual analog scale. Statistically significant session effects were detected using repeated-measures ANOVA (α = .05). Three of the 93 variables had a significant session effect. A significant interaction between orthotic condition and session was observed for 6 of the 93 variables. The results of this study showed that the effects of foot orthoses on comfort, lower extremity kinematics, kinetics, and muscle activity are consistent across a 3-week period when the wear time for each condition is restricted. Thus, foot orthoses lead to immediate changes in comfort, kinematics, kinetics, and muscle activity with limited use. These immediate effects of foot orthoses on comfort, kinematics, kinetics, and muscle activity are consistent between days.

Bimonthly assessment of magnetization transfer magnetic resonance imaging parameters in multiple sclerosis: a 14-month, multicentre, follow-up study

2010 ◽  
Vol 16 (3) ◽  
pp. 325-331 ◽  
Author(s):  
S. Mesaros ◽  
MA Rocca ◽  
MP Sormani ◽  
P. Valsasina ◽  
C. Markowitz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Effect ◽  
Repeated Measures ◽  
Magnetization Transfer ◽  
Random Effect ◽  
Lesion Volume ◽  
Sample Sizes ◽  
Double Blind ◽  
Over Time

This study was performed to assess the temporal evolution of damage within lesions and the normal-appearing white matter, measured using frequent magnetization transfer (MT) MRI, in relapsing—remitting multiple sclerosis (RRMS). The relationship of MT ratio (MTR) changes with measures of lesion burden, and the sample sizes needed to demonstrate a treatment effect on MTR metrics in placebo-controlled MS trials were also investigated. Bimonthly brain conventional and MT MRI scans were acquired from 42 patients with RRMS enrolled in the placebo arm of a 14-month, double-blind trial. Longitudinal MRI changes were evaluated using a random effect linear model accounting for repeated measures, and adjusted for centre effects. The Expanded Disability Status Scale (EDSS) score remained stable over the study period. A weak, but not statistically significant, decrease over time was detected for normal-appearing brain tissue (NABT) average MTR (—0.02% per visit; p = 0.14), and MTR peak height (—0.15 per visit; p = 0.17), while average lesion MTR showed a significant decrease over the study period (—0.07% per visit; p = 0.03). At each visit, all MTR variables were significantly correlated with T2 lesion volume (LV) (average coefficients of correlation ranging from —0.54 to —0.28, and p-values from <0.001 to 0.02). At each visit, NABT average MTR was also significantly correlated with T1-hypointense LV (average coefficient of correlation = —0.57, p < 0.001). The estimation of the sample sizes required to demonstrate a reduction of average lesion MTR (the only parameter with a significant decrease over the follow-up) ranged from 101 to 154 patients to detect a treatment effect of 50% in a 1-year trial with a power of 90%. The steady correlation observed between conventional and MT MRI measures over time supports the hypothesis of axonal degeneration of fibres passing through focal lesions as one of the factors contributing to the overall MS burden.

Effects of methylphenidate (MP) on symptom couplets associated with cancer-related fatigue (CRF) in patients with advanced cancer.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 191-191
Author(s):  
Sriram Yennu ◽  
Janet L. Williams ◽  
Minjeong Park ◽  
Diane D Liu ◽  
Eduardo Bruera
Keyword(s):  
Clinical Trials ◽  
Advanced Cancer ◽  
Treatment Effect ◽  
Repeated Measures ◽  
Repeated Measure ◽  
Significant Treatment Effect ◽  
Significant Treatment ◽  
Repeated Measures Analysis ◽  
Baseline Group ◽  
Over Time

191 Background: Psychostimulant clinical trials on CRF in pts with advanced cancer suggest mixed effects on CRF. The aim of this study was to determine the effects of MP and placebo (PL) on the pts with clinically significant CRF and associated symptoms such as depression, sedation, or depression and sedation (couplets). Methods: Secondary analysis of pts who received MP as a part of 3 prospective controlled clinical trials on MP for CRF. Pts were categorized one of 4 groups, fatigue+depression (FD), fatigue+ drowsiness (FDR), fatigue+drowsiness+depression (FDDR) or fatigue only (F), and outcomes were change in FACIT-F subscale and ESAS -fatigue scores at Day 8 of treatment with MP and PL. Repeated measures analysis was applied to assess the effects of treatment over time (Day8 – Day0) among the 4 groups on FACIT-F subscale and ESAS fatigue. Results: Of the 322 evaluable pts (34 FD, 100 FDR, 78 FDDR, 107F), at Day 8 there was a significant improvement in the ESAS fatigue in MP compared to PL groups [median (IQR)-2 (-4, -1) vs 2 (-3.5,0),p = 0.03, but the difference in the change of FACIT-F between the groups was not significant [median(IQR) 8(2,17) VS7(0,12), p = 0.09). Repeated measures analysis on FACIT-F with pairwise interactions(Time X Baseline Group, Time X Treatment) shows that regardless of treatment, the increase of FACIT-F from Day0 to Day8 was significantly different between FD and F (p = 0.001) and between FDDR and F (p = 0.03).However the change over time was not significantly different between two treatment groups (p = 0.23). Furthermore, the repeated measure analysis including three term interactions(Time X Treatment X Baseline Group) indicates no significant the treatment effect on FACIT-F over time is not significantly different among the four groups (p = 0.89). Similarly, there is no significant treatment effect in ESAS fatigue score over time among the four groups. Conclusions: Although there was a general improvement in CRF (FACIT-F) scores over time, there was no significant treatment effect on this improvement over time among F or FD, or FDR, or FDDR groups defined by fatigue/depression/sedation in the whole study population. Further studies are needed.

scholarly journals PSXII-33 Effects of feed additives on performance of yearling bulls fed high forage diet

2019 ◽  
Vol 97 (Supplement_3) ◽  
pp. 425-425
Author(s):  
Alexandre A Miszura ◽  
Daniel M Polizel ◽  
José P R Barroso ◽  
André S Martins ◽  
Gabriela B Oliveira ◽  
...  
Keyword(s):  
Treatment Effect ◽  
Repeated Measures ◽  
Block Design ◽  
Bos Indicus ◽  
Experimental Period ◽  
Feed Additives ◽  
Water Restriction ◽  
Delivery Vehicle ◽  
High Forage ◽  
Over Time

Abstract The aim of this study was to compare the effects of three additives (narasin, lasalocid, and virginiamycin) on the performance of bulls fed a high-forage diet. One hundred and sixty Nellore (Bos indicus) yearling bulls were assigned to a randomized completed block design, according to initial BW (212.5 kg ± 3.1; 10 pen/treatment; 4 animals/pen). Yearling bulls were fed daily and diets were composed of 96% of coastcross haylage (12% CP) and 4% of concentrate, used as the delivery vehicle for the additives. Once a day, the concentrate and forage were offered separately. The forage was offered after the entire consumption of the concentrate. The experimental diets consisted of CON: Control (no additives); NAR: 13 ppm of narasin; LAS: 20 ppm of lasalocid; and VIR: 20 ppm of virginiamycin. The experimental period lasted 140 d and the yearling bulls were individually weighed at d 0, 28, 56, 84, 112 e 140 after 14h of feed and water restriction. The orts were recorded to determine the DMI. Data were analyzed as repeated measures over time using the MIXED procedure of SAS and the LSMEANS option was used to generate individual means. There was a treatment effect on DMI (CON: 5.26b: NAR: 5.69a; LAS: 5.16b; VIR: 5.11b kg/d; SEM = 0.14; P = 0.03), ADG (CON: 0.451b; NAR: 0.557a: LAS: 0.498ab; VIR:0.459b kg; SEM = 0.03; P = 0.04), FE (0.080c, 0.095a, 0.092ab and 0.085bc; SEM = 0.0044; P = 0.05) and final BW (CON: 273.9b; NAR: 287.8a; LAS: 277.1b; VIR: 275.7b kg SEM = 3.4; P = 0.03). In conclusion, the inclusion of 13 ppm of narasin improves the performance of yearling bulls fed high-forage diets.

scholarly journals Clinical characterization of dysautonomia in long COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicolas Barizien ◽  
Morgan Le Guen ◽  
Stéphanie Russel ◽  
Pauline Touche ◽  
Florent Huang ◽  
...  
Keyword(s):  
Mixed Models ◽  
Repeated Measures ◽  
Physical Medicine ◽  
Persistent Symptoms ◽  
Index Changes ◽  
Changes Over Time ◽  
And Control ◽  
Testing Group ◽  
Over Time

AbstractIncreasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement of the autonomic nervous system, expressed by a dysautonomia, which can aggregate all these neurological symptoms has not been prominently reported. Here, we hypothesize that dysautonomia, could occur in secondary COVID-19 infection, also referred to as “long COVID” infection. 39 participants were included from December 2020 to January 2021 for assessment by the Department of physical medicine to enhance their physical capabilities: 12 participants with COVID-19 diagnosis and fatigue, 15 participants with COVID-19 diagnosis without fatigue and 12 control participants without COVID-19 diagnosis and without fatigue. Heart rate variability (HRV) during a change in position is commonly measured to diagnose autonomic dysregulation. In this cohort, to reflect HRV, parasympathetic/sympathetic balance was estimated using the NOL index, a multiparameter artificial intelligence-driven index calculated from extracted physiological signals by the PMD-200 pain monitoring system. Repeated-measures mixed-models testing group effect were performed to analyze NOL index changes over time between groups. A significant NOL index dissociation over time between long COVID-19 participants with fatigue and control participants was observed (p = 0.046). A trend towards significant NOL index dissociation over time was observed between long COVID-19 participants without fatigue and control participants (p = 0.109). No difference over time was observed between the two groups of long COVID-19 participants (p = 0.904). Long COVID-19 participants with fatigue may exhibit a dysautonomia characterized by dysregulation of the HRV, that is reflected by the NOL index measurements, compared to control participants. Dysautonomia may explain the persistent symptoms observed in long COVID-19 patients, such as fatigue and hypoxia. Trial registration: The study was approved by the Foch IRB: IRB00012437 (Approval Number: 20-12-02) on December 16, 2020.

Increasing Precision without Altering Treatment Effects: Repeated Measures Designs in Survey Experiments

2021 ◽  
pp. 1-18
Author(s):  
SCOTT CLIFFORD ◽  
GEOFFREY SHEAGLEY ◽  
SPENCER PISTON
Keyword(s):  
Treatment Effect ◽  
Repeated Measures ◽  
Treatment Effects ◽  
Repeated Measurements ◽  
Experimental Designs ◽  
Treatment Effect Size ◽  
Standard Design ◽  
Survey Experiments ◽  
Repeated Measures Designs ◽  
Alternative Designs

The use of survey experiments has surged in political science. The most common design is the between-subjects design in which the outcome is only measured posttreatment. This design relies heavily on recruiting a large number of subjects to precisely estimate treatment effects. Alternative designs that involve repeated measurements of the dependent variable promise greater precision, but they are rarely used out of fears that these designs will yield different results than a standard design (e.g., due to consistency pressures). Across six studies, we assess this conventional wisdom by testing experimental designs against each other. Contrary to common fears, repeated measures designs tend to yield the same results as more common designs while substantially increasing precision. These designs also offer new insights into treatment effect size and heterogeneity. We conclude by encouraging researchers to adopt repeated measures designs and providing guidelines for when and how to use them.

scholarly journals Estimating and reporting treatment effects in clinical trials for weight management: using estimands to interpret effects of intercurrent events and missing data

2021 ◽  
Author(s):  
Sean Wharton ◽  
Arne Astrup ◽  
Lars Endahl ◽  
Michael E. J. Lean ◽  
Altynai Satylganova ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Missing Data ◽  
Weight Management ◽  
Treatment Effect ◽  
Repeated Measures ◽  
Treatment Effects ◽  
Randomized Clinical Trials ◽  
Weight Losses ◽  
The Difference ◽  
Treatment Of Obesity

AbstractIn the approval process for new weight management therapies, regulators typically require estimates of effect size. Usually, as with other drug evaluations, the placebo-adjusted treatment effect (i.e., the difference between weight losses with pharmacotherapy and placebo, when given as an adjunct to lifestyle intervention) is provided from data in randomized clinical trials (RCTs). At first glance, this may seem appropriate and straightforward. However, weight loss is not a simple direct drug effect, but is also mediated by other factors such as changes in diet and physical activity. Interpreting observed differences between treatment arms in weight management RCTs can be challenging; intercurrent events that occur after treatment initiation may affect the interpretation of results at the end of treatment. Utilizing estimands helps to address these uncertainties and improve transparency in clinical trial reporting by better matching the treatment-effect estimates to the scientific and/or clinical questions of interest. Estimands aim to provide an indication of trial outcomes that might be expected in the same patients under different conditions. This article reviews how intercurrent events during weight management trials can influence placebo-adjusted treatment effects, depending on how they are accounted for and how missing data are handled. The most appropriate method for statistical analysis is also discussed, including assessment of the last observation carried forward approach, and more recent methods, such as multiple imputation and mixed models for repeated measures. The use of each of these approaches, and that of estimands, is discussed in the context of the SCALE phase 3a and 3b RCTs evaluating the effect of liraglutide 3.0 mg for the treatment of obesity.

scholarly journals Is the Occurrence of the Sticking Region in Maximum Smith Machine Squats the Result of Diminishing Potentiation and Co-Contraction of the Prime Movers among Recreationally Resistance Trained Males?

2021 ◽  
Vol 18 (3) ◽  
pp. 1366
Author(s):  
Roland van den Tillaar ◽  
Eirik Lindset Kristiansen ◽  
Stian Larsen
Keyword(s):  
Muscle Activity ◽  
Muscle Activation ◽  
Gluteus Maximus ◽  
Knee Extensors ◽  
Force Output ◽  
Activation Patterns ◽  
Muscle Activation Patterns ◽  
Prime Movers ◽  
Almost All ◽  
Height Data

This study compared the kinetics, barbell, and joint kinematics and muscle activation patterns between a one-repetition maximum (1-RM) Smith machine squat and isometric squats performed at 10 different heights from the lowest barbell height. The aim was to investigate if force output is lowest in the sticking region, indicating that this is a poor biomechanical region. Twelve resistance trained males (age: 22 ± 5 years, mass: 83.5 ± 39 kg, height: 1.81 ± 0.20 m) were tested. A repeated two-way analysis of variance showed that Force output decreased in the sticking region for the 1-RM trial, while for the isometric trials, force output was lowest between 0–15 cm from the lowest barbell height, data that support the sticking region is a poor biomechanical region. Almost all muscles showed higher activity at 1-RM compared with isometric attempts (p < 0.05). The quadriceps activity decreased, and the gluteus maximus and shank muscle activity increased with increasing height (p ≤ 0.024). Moreover, the vastus muscles decreased only for the 1-RM trial while remaining stable at the same positions in the isometric trials (p = 0.04), indicating that potentiation occurs. Our findings suggest that a co-contraction between the hip and knee extensors, together with potentiation from the vastus muscles during ascent, creates a poor biomechanical region for force output, and thereby the sticking region among recreationally resistance trained males during 1-RM Smith machine squats.

scholarly journals Statistical analysis of two arm randomized pre-post designs with one post-treatment measurement

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Wan
Keyword(s):  
Treatment Effect ◽  
Repeated Measures ◽  
Informed Choice ◽  
Clinical Effectiveness ◽  
Change Score ◽  
Post Treatment ◽  
Analysis Of Covariance ◽  
Alternative Methods ◽  
Main Effect ◽  
Comparable Performance

Abstract Background Randomized pre-post designs, with outcomes measured at baseline and after treatment, have been commonly used to compare the clinical effectiveness of two competing treatments. There are vast, but often conflicting, amount of information in current literature about the best analytic methods for pre-post designs. It is challenging for applied researchers to make an informed choice. Methods We discuss six methods commonly used in literature: one way analysis of variance (“ANOVA”), analysis of covariance main effect and interaction models on the post-treatment score (“ANCOVAI” and “ANCOVAII”), ANOVA on the change score between the baseline and post-treatment scores (“ANOVA-Change”), repeated measures (“RM”) and constrained repeated measures (“cRM”) models on the baseline and post-treatment scores as joint outcomes. We review a number of study endpoints in randomized pre-post designs and identify the mean difference in the post-treatment score as the common treatment effect that all six methods target. We delineate the underlying differences and connections between these competing methods in homogeneous and heterogeneous study populations. Results ANCOVA and cRM outperform other alternative methods because their treatment effect estimators have the smallest variances. cRM has comparable performance to ANCOVAI in the homogeneous scenario and to ANCOVAII in the heterogeneous scenario. In spite of that, ANCOVA has several advantages over cRM: i) the baseline score is adjusted as covariate because it is not an outcome by definition; ii) it is very convenient to incorporate other baseline variables and easy to handle complex heteroscedasticity patterns in a linear regression framework. Conclusions ANCOVA is a simple and the most efficient approach for analyzing pre-post randomized designs.

scholarly journals Acute Comparative Effect of Foam Rolling and Static Stretching on Range of Motion in Rowers

2021 ◽  
Vol 13 (7) ◽  
pp. 3631
Author(s):  
Alfonso Penichet-Tomas ◽  
Basilio Pueo ◽  
Marta Abad-Lopez ◽  
Jose M. Jimenez-Olmedo
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Static Stretching ◽  
Foam Rolling ◽  
Significant Difference ◽  
Post Test ◽  
Alternating Treatment Design ◽  
Stroke Amplitude ◽  
Treatment Design ◽  
Over Time

Rowers’ anthropometric characteristics and flexibility are fundamental to increase stroke amplitude and optimize power transfer. The aim of the present study was to analyze the effect of foam rolling and static stretching on the range of motion over time. Eight university rowers (24.8 ± 3.4 yrs., height 182.3 ± 6.5 cm, body mass 79.3 ± 4.6 kg) participated in an alternating treatment design study with two-way repeated measures ANOVA. The sit and reach test was used to measure the range of motion. Both in the foam rolling and in the static stretching method, a pre-test (T0), a post-test (T1), and a post-15-min test (T2) were performed. A significant effect was observed on the range of motion over time (p < 0.001), but not for time x method interaction (p = 0.680). Significant differences were found between T0 and T1 with foam rolling and static stretching (p < 0.001, d = 0.4); p < 0.001, d = 0.6). The differences between T0 and T2 were also significant with both methods (p = 0.001, d = 0.4; p < 0.001, d = 0.4). However, no significant difference was observed between T1 and T2 (p = 1.000, d = 0.1; p = 0.089, d = 0.2). Foam roller and static stretching seem to be effective methods to improve the range of motion but there seems to be no differences between them.

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