Accelerometer-based prediction of ground reaction force in head-out water exercise with different exercise intensity countermovement jump

Background Water jumping exercise is an alternative method to achieve maintenance of bone health and reduce exercise injuries. Clarifying the ground reaction force (GRF) of moderate and high cardiopulmonary exercise intensities for jumping movements can help quantify the impact force during different exercise intensities. Accelerometers have been explored for measuring skeletal mechanical loading by estimating the GRFs. Predictive regression equations for GRF using ACC on land have already been developed and performed outside laboratory settings, whereas a predictive regression equation for GRF in water exercises is not yet established. The purpose of this study was to determine the best accelerometer wear-position for three exercise intensities and develop and validate the ground reaction force (GRF) prediction equation. Methods Twelve healthy women (23.6 ± 1.83 years, 158.2 ± 5.33 cm, 53.1 ± 7.50 kg) were recruited as participants. Triaxial accelerometers were affixed 3 cm above the medial malleolus of the tibia, fifth lumbar vertebra, and seventh cervical vertebra (C7). The countermovement jump (CMJ) cadence started at 80 beats/min and increased by 5 beats per 20 s to reach 50%, 65%, and 80% heart rate reserves, and then participants jumped five more times. One-way repeated analysis of variance was used to determine acceleration differences among wear-positions and exercise intensities. Pearson’s correlation was used to determine the correlation between the acceleration and GRF per body weight on land (GRFVLBW). Backward regression analysis was used to generate GRFVLBW prediction equations from full models with C7 acceleration (C7 ACC), age, percentage of water deep divided by body height (PWDH), and bodyweight as predictors. Paired t-test was used to determine GRFVLBW differences between values from the prediction equation and force plate measurement during validation. Lin’s CCC and Bland–Altman plots were used to determine the agreement between the predicted and force plate-measured GRFVLBW. Results The raw full profile data for the resultant acceleration showed that the acceleration curve of C7 was similar to that of GRFv. The predicted formula was − 1.712 + 0.658 * C7ACC + 0.016 * PWDH + 0.008 * age + 0.003*weight. Lin’s CCC score was 0.7453, with bias of 0.369%. Conclusion The resultant acceleration measured at C7 was identified as the valid estimated GRFVLBW during CMJ in water.

Conservative Management of Cervical Rib- A Case Report

Background: An additional rib that develops from the seventh cervical vertebra is known as a cervical rib, a congenital anomaly placed above the typical first rib, affecting 0.2- 0.5 percent of the total population. It may be seen on either the left or right sides. The majority of patients have little or no complaints and are identified by chance during an X-ray or CT scan. Due to the extreme compression on the arteries, veins and nerves caused by the position of the rib, which varies in shape and size, they might develop thoracic outlet syndrome. A cervical rib is a prolonged ossification of the lateral costal segment of the Cervical 7th vertebra. Clinical Presentation: A 18 years old female patient was diagnosed with cervical rib on X-ray due to persistent pain at right hand. Patient concern with reduced mobility of the right upper limb and unable to lift the hand. The patient went physiotherapy treatment which comprise of exercise and electro therapy for 10 weeks which resulted in improvements in pain and range of motion and functional activities Conclusion: The case report suggest that a prompt structured physical rehab let to improving the functional goals progressively and significantly which is a measured aspect leading to a successful recovery.

Repeatability and reproducibility of a topographic system to evaluate the spine

Objective: This study aimed to determine the repeatability and reproducibility of a topographic system for evaluating the spine in students. Methods: Thirty-seven students participated in this study. Participants were positioned with their backs facing the system, in orthostatic posture, with bare backs. The spinous processes of the seventh cervical vertebra (C7) and second sacral vertebra (S2), and the right and left posterior superior iliac spine (PSIS) were marked. Each student was evaluated five times, once on the first day and four times on the second day. The following variables were used for evaluation: kyphosis angle, lordosis angle, trunk length, and anterior and lateral perturbations. SPSS 17.0 (IBM, Armont, NY, USA) was used for performing statistical analyses, which included descriptive analysis, Intraclass Correlation Coefficient (ICC), and one-way ANOVA, with a significance level of 0.05. Results: topographic system showed excellent values, and a positive correlation was observed with reference to the ICC of reproducibility and repeatability for all analyzed variables. Conclusion: These results show that this system can be used to diagnose postural changes, and to estimate thoracic kyphosis and lumbar lordosis angles. It can also be used for providing additional information on the positioning of the surface of the back.

Cervical spine injury after virtual reality gaming: a case report

Background We report a patient who fractured the seventh cervical vertebra while playing a virtual reality (VR) game, without any other trauma. This case report aims to describe the spinal trauma incurred during the use of a VR headset in a video game. Case presentation The Caucasian patient presented with pain and swelling in the lower cervical spine at our clinic after playing a video game involving a combination of shoulder, arm and head movements while wearing a VR headset. Preexisting comorbidities were not present in the 31-year-old male. No history of regular medication use or drug abuse was recorded. After performing a clinical examination and radiological diagnostics, we found a dislocated traumatic fracture of the spinous process of the seventh cervical vertebra. After a soft tissue defect was excluded through magnetic resonance imaging (MRI) diagnostics, a conservative therapy regimen with pain therapy and immobilization was started. After hospitalization, outpatient controls were conducted at 4, 6 and 12 weeks. At 6 weeks after hospitalization, the patient had recovered from the injury without complications. Conclusions Rapid movements during VR gaming can lead to injuries of the cervical spine. In addition to rapid movements, the additional weight of the VR headset as well as the decoupling of audiovisual stimuli from the perceived proprioceptive information should be considered. Determining whether this is an isolated incident induced by unknown preexisting factors or whether the trauma mechanism alone can lead to severe spinal trauma needs to be studied further with additional cases.

Biofotogrametric and electromyographic analysis in different position in women with temporomandibular disorder.

Introduction: The relationship established between TMJ (Temporomandibular Joint), cranium and cervical spine requires the synchrony of these structures for the proper performance of stomatognathic functions and muscle balance in this region. Objective: Evaluate the craniocervical posture and the electrical activity of masticatory and cervical muscles in sitting and standing positions in patients with TMD, correlating these variables. Method: The participants were 21 women, with mean age 28 ± 5.33 years and severe TMD. The participants were evaluated by electromyography of the masseter, anterior temporal and sternocleidomastoid (SCM) and upper trapezius muscles, bilaterally, in standing and sitting position. The body posture was evaluated by biophotogrammetry, with analysis of the Head Horizontal Alignment (HHA) and Acromion Horizontal Alignment (AHA) in frontal view and the Head Vertical Alignment (HVA) and Head Horizontal Alignment related to seventh cervical vertebra (HHAc7) in lateral view. Results: The electrical activity of masticatory muscles during resting did not differ between the different evaluated positions. During maximum intercuspation, the electrical activity was significantly lower in the left masseter (p=0.016), higher in the left anterior temporal muscle (p=0.046) and higher in the right (p=0.005) and left (p=0.015) upper trapezius muscles, in standing position when compared to sitting position. The photogrammetric values found were within the normal range. There was a significant and moderate negative correlation between the left SCM muscle and the right (r=0.386) and left (r=0.428) HHAc7 angle. Conclusions: Muscular electrical activity was modified with the change between sitting and standing positions, with an increase in cervical muscle recruitment and asynchrony of the masticatory muscles. Thus, it can be inferred that there is a postural destabilization with possible head anteriorization during maximum intercuspation, reinforcing the relation of synergy between the masticatory and cervical muscles.

Management of Neglected Post-traumatic Bilateral Facet Dislocation of Sub-axial Cervical Spine: A Case Series

Neglected bilateral facet dislocation of the lower cervical spine is a rare condition and found mostlyin developing countries like Nepal. Delayed presentation makes treatment more challengingconcerning decompression, reduction, neurological recovery, and overall outcome. We managedthree cases of bilateral facet dislocations of the fifth-sixth-seventh cervical vertebra level presentedafter three months of injury. All of those were treated surgically by combined anterior-posterioranterior approaches with the same principle. One patient had a complete neurological recovery, thesecond one recovered partially with few long-term complications and the third one did not improveat all.

The Measurement of Height Via 3D Scans of the Seventh Cervical Vertebra in Iranian Adults

Background: The cervical vertebrae are more durable than other skeletal components, and maybe the only remains of a deceased, and their role in determining the height of the deceased has been underestimated. The present study investigated the role of linear differential dimensions of the seventh cervical vertebrae in determining the height of the Iranian adult population using CT scans.Methods: In this cross-sectional study, height were evaluated by 10 indices of the seventh cervical vertebra. The indices were obtained through a CT scan of 66 adult patients, ≥18 years of age, who referred to Rasoul Akram and Firoozgar hospitals for spine CT scan. The sampling method was random, and the study was performed during the first six months of 2018. Results: Four indices of the Length of the Inferior Facets) LIF, (Length of the Inferior Surface of the Vertebral Body) LIVB, (Width of the Inf surface of the Vertebral Body) WIVB, (Length of Spinous Process ) LSP. were statistically significant differences.Conclusion: The results of this study show the accuracy of linear dimensions of the seventh cervical vertebrae for determining height from skeletal remains in the Iranian adult population.

Estimating Sex from second and seventh cervical vertebras in Iranian adult population using Computed Tomography scan images

Objectives The study aimed to estimating the sex from several metric dimensions of second and seventh cervical vertebras using Computed Tomography (CT) scan images of a series of Iranian adult populations. In this study, sexual dimorphism of 15 indexes of second cervical vertebra and 10 indexes of the seventh cervical vertebra were investigated. Indexes were obtained from CT scan images of 70 patients who underwent CT scan imaging for other indications.Results Among measured dimensions of the second vertebra, 9 were associated with sex. Of these indexes, Maximum width of the superior Facet and Maximum height of axis were independent predictors of sex with correct sex classification of 81.4% when used in combination. Four of 10 seventh vertebra’s indexes were associated with sex: Length of superior facets, Length of the inferior surface of the vertebral body, Width of the inferior surface of the vertebral body, and the Length of spinous process. Length of the inferior surface of the vertebral body and the Length of spinous process were independent sex predictors and together provided sex classification accuracy of 78.6%. We found considerable accuracy in sex classification by using metric dimensions of second and seventh cervical vertebras in the Iranian adult population.

Comparison of neck length, relative neck length and height with incidence of cervical spondylosis

Objective: To compare the neck length, relative neck length and height between patients with cervical spondylosis and healthy subjects. Methods: This case control study was conducted at Patel hospital, Karachi after the ethical approval of Bahria University Medical and Dental College (BUMDC) and Patel hospital from September 2018 - February 2019. It enrolled eighty eight cases of cervical spondylosis and eighty eight healthy subjects. Radiographs were taken in the lateral view and neck length was measured as the distance from external occipital protuberance to seventh cervical vertebra spinous process. Then relative neck length was measured by dividing the neck length with height and multiplying it by 100. The Kellgren Lawrence grade scale was used to assess the severity of cervical spondylosis. Results: A total of 176 participants were analyzed. It was found that the height remains the significant determinant. The comparison of cases with control group was done using independent T-test which showed that the cases were significantly shorter than controls with a p-value < 0.05. The other variables such as neck length, and relative neck length were insignificant. Conclusion: Short height can be considered as a risk factor for cervical spondylosis. Short-statured individuals should be counseled to adopt measures for the prevention of cervical spondylosis. doi: https://doi.org/10.12669/pjms.36.2.832 How to cite this:Ahmed SB, Qamar A, Imram M, Fahim MF. Comparison of neck length, relative neck length and height with incidence of cervical spondylosis. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.832 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Flexed Posture in Parkinson Disease: Associations With Nonmotor Impairments and Activity Limitations

BackgroundPeople with Parkinson disease (PD) are twice as likely to develop flexed truncal posture as the general older population. Little is known about the mechanisms responsible beyond associations with age, axial motor impairments, and disease severity.ObjectiveThe objective was to explore: (1) the associations of the nonmotor impairments of PD with flexed posture, and (2) the relationships of flexed posture with activity limitations.DesignThis was a cross-sectional study.MethodsSeventy people with PD participated. Posture was measured in standing as the distance between the seventh cervical vertebra and a wall. Nonmotor impairments (cognition, depression, pain, fatigue, and proprioception) and activity performance (upper limb activity, bed transfers, respiratory function, and speech volume) were variously assessed using objective measures and self-report questionnaires. Univariate and multivariate regression analyses were performed to ascertain relationships between nonmotor impairments and truncal posture, and between truncal posture and activities.ResultsGreater disease severity, greater axial impairment, poorer spinal proprioception, greater postural fatigue, and male sex were significantly associated with flexed truncal posture. The multivariate model containing these factors in addition to age explained 30% of the variability in flexed truncal posture, with male sex and axial motor impairment continuing to make independent contributions. A significant association was found between greater flexed truncal posture and poorer upper limb activity performance and respiratory function.LimitationsA limitation to this study was that participants had mild-to-moderate disease severity.ConclusionsSpinal proprioception and postural fatigue were the only nonmotor impairments to make significant contributions to flexed posture. Given the negative influence of flexed posture on upper limb activity and respiratory function, interventions targeting spinal proprioception and postural awareness should be considered for people with PD who might develop flexed posture.