Kinesiological Treatment of Early Spine Osteoarthritis in a Motorcyclist

This case report speculates that the prolonged vibrations from enduro off-road sports are deleterious to the spine. The results of this case report may also aid sports physicians in better understanding this complex and relatively unknown phenomenon. No published data are present in the current literature that demonstrate the correlation between early spine osteoarthritis from enduro motorcycle overuse and the long-term management effects of a non-invasive kinesiological approach to reduce pain and inflammation and improve spine mobility and muscle strength.

Pelvic pain in Maigne’s syndrome—a multi-segmental approach

Background Maigne’s syndrome is a poorly understood condition that affects the thoracolumbar junction. The symptoms can range from pain in the low back, pelvis, hip, lower abdomen, and groin. These symptoms can have bio-mechanical and neurophysiological attributions due to the complexity of spinal mechanics. Thoraco-lumbar junction (T12-L1) is a transitional zone with a higher degree of mean angular motion and a mean translation motion than T10-T11 and T11-T12. This higher degree of translational and rotation mobility predisposes these segments to a higher degree of stress, making them more prone to biomechanical faults such as dysfunctions and positional faults. These altered static and dynamic mechanics can create a cascade of problems along the biomechanical chain. The co-existence of thoracolumbar junction problems with pelvic pain and dysfunctions strengthens the idea of regional interdependence. Case presentation The patient is a 44-year-old Caucasian male who reported pain in the low back with symptoms radiating to the right hip, iliac region, lower abdomen, and gluteal region. The patient tested positive for Sacroiliac joint dysfunction with both Laslett’s cluster testing and palpatory sacroiliac examination. In addition, the segmental examination showed restriction in thoracolumbar junction with positive skin rolling test and hypomobility in manual segmental testing. Thus, the manual therapy treatment targeted the thoracolumbar junction and sacroiliac joint to address the underlying biomechanical dysfunctions. Conclusions The manual therapy targeting both sacroiliac and thoracolumbar spine can improve pelvic and thoracic spine mobility. In addition, therapeutic exercises can focus on enhancing anterior and posterior chain force generation capacity. This combined approach helped improve functional outcomes with a significant decrease in the Modified Oswestry Disability index and significant improvement on Visual analog scale.

Efficacy of Myofascial Release on Pain and Pulmonary Function during First Phase of Cardiac Rehabilitation - An Evidence Based Study

Background: Cardiovascular disease includes disease of heart and blood vessels. It is most common causes of mortality around the globe as well as in India.[1],[2] Cardiac rehabilitation and secondary prevention programs aim to improve all lifestyle habits, quality of life and physical and psychological function. However, surgical procedures like coronary artery bypass grafting have some complications. They may affect different systems but most frequent Complications are pulmonary complications. As a result of Surgical trauma in highly vascularised and innervated pleura and chest wall, severe pain after sternotomy occurs. which will cause weakens the respiratory muscles, reduces chest expansion, glenohumeral joint and spine mobility, as well as lessen expectoration of secretions. Purpose: To provide an overview of current evidence with respect to: Effect of manual therapy (OMT, MFR) in post sternotomy acute and chronic pain. Immediate effect of manual therapy pulmonary system. Effect of manual therapy functional recovery and length of hospital stay, reduce analgesia consumption, improve ROM. Effect of MFR on pulmonary function. Methodology: ➢ Search engines used were: • Google scholar • PubMed • PEDro • ScienceDirect • ResearchGate ➢ Key words used were: • Sternotomy • Post sternotomy pain • Pulmonary function • Myofascial release • OMT • Respiratory function and sternotomy Total 10 studies were selected. Results: Evidences were reviewed and analysis was done. Articles shows that MFR reduce post-operative pain, improve respiratory function, reduces length of stay and dose of analgesia consumption. Conclusion: Based on evidences, it is reviewed that MFR and manual therapy is beneficial in seance of reducing pain and improving pulmonary function in post sternotomy patients. Keywords: Sternotomy, Post sternotomy pain, Pulmonary function, Myofascial release, OMT, Respiratory function and sternotomy.

Assessment of spine mobility in patients with ankylosing spondylitis by ultrasound scanning (preliminary data)

Spine involvement in ankylosing spondylitis (AS) resulting in limited mobility requires a search for accurate, quantitatively methods of assessment of the decline of its function and monitoring of its dynamics. One of the promising methods for assessing movements in the spine in AS is ultrasound examination (US).Objective: to determine the relationship between the mobility of the spine measured sonographically, and the activity and functional status of patients with AS.Patients and methods. Spinal ultrasound was performed in 15 patients (10 men and 5 women, mean age 40.8±11.4 years, mean duration of the disease 5.5±3.5 years) with a confirmed diagnosis of AS, admitted to the V.A. Nasonova Research Institute of Rheumatology from April to August 2019. All patients underwent a double examination (at baseline and after 2 weeks) according to a specially developed protocol.Results and discussion. A comparative analysis of the results of sonographic measurements of the distance between the spinous processes of the vertebrae of the studied spine segment at baseline and after 2 weeks revealed a tendency towards an increase in these parameters both in the initial position and during flexion. There was no relationship between age, body mass index, duration of the disease and the distance between the spinous processes in all parts of the spine measured by sonography in initial position and during flexion. Correlation analysis data indicate the presence of a correlation between an increase in the distance between the spinous processes in the cervical and lumbar spine and a decrease in ESR, and i increase in the distance between the spinous processes in the lumbar spine and level of CRP. A weak negative relationship was found between the BASDAI index and the mobility of the spine at the LIV–V level and between sonographic measurements in all segment of the spine and the BASMI index.Conclusion. The sonographic method of determining the mobility of the spine can be recommended in patients with AS, both for initial examination and during follow-up, but it can't substitute the BASMI metrological index. Further research is needed to confirm the findings.

Axial Spondyloarthritis and New Bone Formation

Axial spondyloarthritis is an inflammatory disease of the axial skeleton. Its pathogenesis is only partly understood. At the beginning, there are inflammatory changes in the sacroiliac joints which are followed by inflammation in vertebral bodies and in facet joints. Low back pain occurring in the morning hours is the dominant clinical symptom. In the early phase, inflammatory changes are detectably by MRI. Inflammation promotes a process of joint remodelling in the sacroiliac joints which leads to erosions, sclerosis and bony bridging, i. e. ankylosis, which are detectable by X-ray. In the spine, vertical osteophytes developing at sites of previous inflammation connect vertebral bodies as syndesmophytes. Additional ossification of longitudinal ligaments contributes to the so-called bamboo spine. Ossification of the spine promotes fixation of a severe kyphosis of the thoracic spine which strongly impairs spine mobility and quality of life. High disease activity seems a prominent risk factor for development of structural damage. However, although NSAIDs improve clinical symptoms, they do not reduce new bone formation. In contrast, TNFα and IL-17 inhibitors seem to retard new bone formation apart from their clinical efficacy. Research work of the last years identified immunological pathways of inflammation. However, the trigger and cellular components of the immune reaction in the bone marrow are still poorly defined. Osteoclasts are involved in the destruction of the subchondral bone, while osteoblasts facilitate new bone formation and cartilage ossification. This review gives an overview about diagnostics and therapy of axSpA and about risk factors for the development of structural damage. Concepts about the immune pathogenesis and joint remodeling in AS are given under recognition of genetic and histopathological studies.

Associations of neck muscle strength and cervical spine mobility with future neck pain and disability: a prospective 16-year study

Background Neck pain has been associated with weaker neck muscle strength and decreased cervical spine range of motion. However, whether neck muscle strength or cervical spine mobility predict later neck disability has not been demonstrated. In this 16-year prospective study, we investigated whether neck muscle strength and cervical spine mobility are associated with future neck pain and related disability in women pain-free at baseline. Methods Maximal isometric neck muscle strength and passive range of motion (PROM) of the cervical spine of 220 women (mean age 40, standard deviation (SD) 12 years) were measured at baseline between 2000 and 2002. We conducted a postal survey 16 years later to determine whether any subjects had experienced neck pain and related disability. Linear regression analysis adjusted for age and body mass index was used to determine to what extent baseline neck strength and PROM values were associated with future neck pain and related disability assessed using the Neck Disability Index (NDI). Results The regression analysis Beta coefficient remained below 0.1 for all the neck strength and PROM values, indicating no association between neck pain and related disability. Of the 149 (68%) responders, mean NDI was lowest (3.3, SD 3.8) in participants who had experienced no neck pain (n = 50), second lowest (7.7, SD 7.1) in those who had experienced occasional neck pain (n = 94), and highest (19.6, SD 22.0) in those who had experienced chronic neck pain (n = 5). Conclusions This 16-year prospective study found no evidence for an association between either neck muscle strength or mobility and the occurrence in later life of neck pain and disability. Therefore, screening healthy subjects for weaker neck muscle strength or poorer cervical spine mobility cannot be recommended for preventive purposes.

The effect of upper limb lymphedema in posture of patients after breast cancer surgery

BACKGROUND: Upper limb lymphedema is one of the complications following breast cancer-related surgery. It is a fact that there are alterations in posture of the trunk following surgery, however, there is not much data on whether upper limb lymphedema has any effect on body posture. OBJECTIVES: The main purpose of the study was to investigate the effect of upper limb lymphedema in the trunk posture and spine mobility of patients following breast cancer surgery. METHODS: Twenty-seven women with lymphedema and 29 women without lymphedema with mastectomy or breast-conserving surgery participated in the study. Posture was evaluated by the New York Posture Rating Chart and spinal stability and thoracic mobility were evaluated by the Spinal Mouse device. RESULTS: Posture and spine posture scores were significantly higher in the without lymphedema group (p= 0.004; 0.041; respectively). There was a significant difference between the groups in terms of lateral (p< 0.001) and posterior (p< 0.001) view of shoulders, spine (p= 0.027), upper (p< 0.001) and lower back (p= 0.009), and trunk postures (p= 0.001). CONCLUSIONS: Body posture and spine are more affected due to upper limb lymphedema following breast cancer surgery. Alterations of posture mainly occur on shoulders, spine, upper and lower back, and trunk, but not on head and neck postures.