Colorectal cancer pain upon diagnosis and after treatment: a cross-sectional comparison with healthy matched controls

Background The current study sought to explore whether cancer pain (CP) already exists in patients at colorectal cancer (CRC) diagnosis before treatment compared with patients with colorectal cancer (CRC) after treatment and a healthy matched control group. The study also sought to examine whether factors related to physical health status could enhance pain processes. Methods An observational cross-sectional study was conducted following the STROBE checklist. Twenty-nine newly diagnosed and forty post-treatment patients with CRC and 40 healthy age/sex-matched controls were included for comparison. Pain, local muscle function, and body composition outcomes were assessed by a physiotherapist with > 3 years of experience. ANCOVA and Kruskal–Wallis tests were performed, with Bonferroni and Dunn-Bonferroni post hoc analyses and Cohen’s d and Hedge’s effect size, as appropriate. Results The analysis detected lower values of pressure pain threshold (PPT) points, the PPT index, and abdominal strength and higher values of self-reported abdominal pain in newly diagnosed patients, with even more marked results observed in the post-treatment patients, where lower lean mass and skeletal muscle index values were also found than those in the healthy matched controls (p < 0.05). In the post-treatment and healthy matched control groups, positive associations were observed between the PPT lumbar dominant side points and abdominal isometric strength and lean mass, and negative associations were observed between the lumbar dominant side points and body fat (p < 0.05). Conclusion Upon diagnosis, patients with CRC already show signs of hyperalgesia and central sensitization and deteriorated physical conditions and body composition, and this state could be aggravated by subsequent treatments.

Asymmetry in internal oblique muscle thickness: Not the key to a cricket fast bowler's performance

Purpose Previous studies found that trunk muscle asymmetry may play a role in preventing injury in cricket fast bowlers, while the association with bowling performance has not been investigated. This study aims to describe the side-to-side differences in trunk muscle thickness and determine the association between bowling performance and these side-to-side differences in trunk muscle thickness in adolescent fast bowlers. Methods In this observational cross-sectional study, bowling performance, namely ball release speed and bowling accuracy, was recorded in adolescent fast bowlers. Ultrasound imaging measured external oblique, internal oblique, transversus abdominis and lumbar multifidus muscle thickness. Results Fast bowlers (n = 46) with a mean age of 15.9 (±1.2) years participated. On the non-dominant side, the external oblique and internal oblique at rest were thicker than on the dominant side (external oblique: p = 0.011, effect size = 0.27; internal oblique: p < 0.0001, effect size = 0.40), while the transversus abdominus ( p = 0.72, effect size = 0.19) and lumbar multifidus ( p = 0.668, effect size = 0.04) were symmetrical. Weak correlations existed between bowling performance and the side-to-side differences in the thickness in all muscles, except for two moderate correlations: 1. The smaller the side-to-side difference in absolute thickness of the external oblique when contracted, the faster the ball release speed (Spearman's (ρ) = −0.455, p = 0.002). 2. Also, a smaller side-to-side difference in external oblique contraction ratio (Spearman's (ρ) = −0.495, p = 0.0001) was associated with faster ball release speed. Conclusions No relationship between bowling performance and side-to-side differences in internal oblique muscle thickness could be established, while more symmetrical external oblique muscles may be linked to faster ball release speeds.

Sex Differences in Neck Strength Force and Activation Patterns in Collegiate Contact Sport

The purpose of this study was to assess changes in cervical musculature throughout contact-heavy collegiate ice hockey practices during a regular season of NCAA Division III ice hockey teams. In this cross-sectional study, 36 (male n = 13; female n = 23) ice hockey players participated. Data were collected over 3 testing sessions (baseline; pre-practice; post-practice). Neck circumference, neck length, head-neck segment length, isometric strength and electromyography (EMG) activity for flexion and extension were assessed. Assessments were completed approximately 1h before a contact-heavy practice and 15 min after practice. For sternocleidomastoid (SCM) muscles, males had significantly greater peak force and greater time to peak force versus females. For both left and right SCMs, both sexes had significantly greater peak EMG activity pre-practice versus baseline, and right (dominant side) SCM time to peak EMG activity was decreased post-practice compared to pre-practice. There were no significant differences for EMG activity of the upper trapezius musculature, over time or between sexes. Sex differences observed in SCM force and activation patterns of the dominant side SCM may contribute to head stabilization during head impacts. Our study is the first investigation to report changes in cervical muscle strength in men’s and women’s ice hockey players in the practical setting.

Side Effects After Vaccination Using the Pfizer-Biontech (Bnt162b2) Against Sars-Cov-2 in the Young Adults

Background: In order to limit the spread of the SARS-CoV-2 virus, national immunization programs have started in many countries. Vaccinations are effective in preventing infection and severe clinical form of COVID-19, which affects 15% of patients. Despite the high efficacy of The Pfizer-BioNTech (BNT162b2) vaccine, the characterization of side effects in age-stratified populations is still not exhaustive in the literature.Aim: The aim of our study is to determine what side effects affect the population of young adults following vaccination with the Pfizer-BioNTech vaccine (BNT162b2).Material and methods: An anonymous survey was conducted. People vaccinated with two doses of the SARS-CoV-2 vaccine (BNT162b2) were qualified for the study. The Paired Wilcoxon and Fisher's exact tests were used for statistical analysis.Results: The main side effects after the first dose were increased pain, pain and swelling at the injection site. After the 2nd dose, the dominant side effects were weakness, fever and headache. In the case of the 2nd dose, no difference in side effects was observed between those who suffered of COVID-19 and those who had no symptoms of COVID-19 in their past medical history.

COMPARISON OF MUSCLE LENGTH IN DOMINANT VERSUS NON-DOMINANT LOWER EXTREMITY IN YOUNG ASYMPTOMATIC INDIVIDUALS

Muscle length is the length where maximum amount of force a muscle is able to produce. This length is determined by the joint angle that corresponds to the muscle. Understanding the optimal muscle length as well as its comparison between the extremities is very important as a part of examination in physiotherapy. Ranges that are obtained of muscle length helps therapist to recognize individuals with reduced flexibility. Identification and knowledge of muscle length has several role including; evaluation of pre-competition risk for injury, decreased flexibility as an predictor of muscle injury and guides in determining interventional strategy plus training program for an individual. Objectives: To compare muscle length of rectus femoris, hamstring’s, iliopsoas, gastrocnemius in dominant as well as non-dominant side of young asymptomatic individuals in the age group of 18 to 25 years. Method: Through standard goniometer muscle length data was obtained between dominant, non-dominant lower extremity. The methods of assessment used were; active knee extension (AKE) tests the hamstrings length, Thomas and modified Thomas test had been used to evaluate iliopsoas and rectus femoris while prone, figure-four position accompanied by dorsiflexion utilized for gastrocnemius. Result: Values were calculated using goniometric measurements through the group mean values. There is statistically significant variation between the muscle length of hamstring, rectus femoris, iliopsoas and gastrocnemius between the dominant and non-dominant side (p<0.05). Conclusion: Along with data about lower limb muscle length of asymptomatic individuals, we conclude notable difference in dominant to non-dominant extremities muscle length in individuals eighteen to twenty five year.

Changes in elbow joint contact area in symptomatic valgus instability of the elbow in baseball players

The aim of this study was to evaluate the joint contact area of the dominant side and that of the non-dominant side without valgus instability in symptomatic pitchers. Ten symptomatic elbow medial ulnar collateral ligament (UCL) deficient baseball pitchers participated in this study. Computed tomography (CT) data from the dominant and non-dominant elbows were obtained with and without elbow valgus stress. The CT imaging data of each elbow joint were reconstructed using a 3D reconstruction software package, and the radiocapitellar and ulnohumeral joint contact areas were calculated. The center of the contact area and the translation from the position without stress to the position with valgus stress were also calculated. With elbow valgus stress, the contact area changed, and the center of the radiocapitellar joint contact area translated significantly more laterally in the dominant elbow than in the non-dominant elbow (p = 0.0361). In addition, the center of the ulnohumeral joint contact area translated significantly more posteriorly in the dominant elbow than in the non-dominant elbow (p = 0.0413). These changes in contact areas could be the reason for cartilage injury at the posterior trochlea in pitchers with UCL deficiency.

Muscle strength evaluation of limb dominance in prepubescent swimmers boys and girls

Background: The aim of this study was to compare the lower limb muscle strength in terms of gender and limb dominancy in prepubescent swimmers. Material and Methods: Seventy-four prepubescent swimmers (mean age: 11.01±1.58 years; 42 boys; 32 girls) who were training for at least 8 hours a week and without current lower limb pain participated in the study. Isometric muscle strength of lower limb was measured by hand-held dynamometry. Independent samples-t test was used to determine the difference between genders, while paired samples-t test was used for dominant-nondominant side comparison. The significance level was accepted as p<0.05. Results: Knee flexion (p<0.001), extension (p<0.001) and ankle dorsiflexion (p=0.003) muscle strength were stronger on the dominant side than on the non-dominant side. Knee flexion/extension strength ratio was similar (p=0.957); while ankle plantar flexion/dorsiflexion strength ratio was significantly different (p=0.011). Boys swimmers had stronger isometric muscle strength in the dominant side together with knee flexion (p=0.018) and knee flexion extension strength ratio (p=0.007) than girls swimmers. Conclusion: Boys swimmers had higher dominant side knee flexion muscle strength compared to female peers. Gender and lower limb dominancy might be important for lower limb muscle strength to show varieties in prepubescent swimmers before planning a training program.

Monitoring Cortico-cortical Evoked Potentials using Only Two 6-strand Strip Electrodes for Gliomas Extending to the Dominant Side of Frontal Operculum During One-step Tumor Removal Surgery

Resection of the dominant side of gliomas extending to the frontal operculum has a high-risk of permanent language dysfunction. Here, we report recording cortico-cortical evoked potentials (CCEP) using only two 6-strand strip electrodes to monitor language-related fibers intraoperatively. We examined whether this simple procedure is useful for removing gliomas extending to the dominant side of frontal operculum. This study included five cases of glioma extending to the left frontal operculum. The frontal language area (FLA) was first identified by functional mapping during awake craniotomy. Next, a 6-strand strip electrode was placed just above the FLA, while on the temporal lobe side, an electrode was placed so as to slide parallel to the Sylvian fissure toward the posterior language area. Electrical stimulation was performed using the electrode on the frontal side, and CCEPs were measured from the electrode on the temporal side. CCEPs were detected in all cases. Immediately after surgery, all patients demonstrated language dysfunction to varying degrees. CCEP decreased up to 10% in one patient, who recovered language function after 24 months. CCEP decreased slightly up to 80% in one, and in the three other cases, CCEPs did not change. These four patients soon recovered language function within 2 weeks to 1 month. This study confirmed the utility of CCEP monitoring using only two 6-strand strip electrodes during one-step surgery. We believe this simple method helped in monitoring intraoperative language function and aided predicting its postoperative recovery, in patients with gliomas extending to the dominant side of frontal operculum.

Association of intrinsic factors with non-contact low back pain among fast bowlers aged between 15-19 years in division 1 boys’ schools in Colombo

Background: Cricket fast bowlers are identified as the players with a higher risk of injury due to their susceptibility to develop low back pain (LBP). Aims and Objective: This study aims to investigate how intrinsic factors associate with LBP among fast bowlers aged between 15-19 years in Colombo division 1 boys’ schools in Sri Lanka. Materials and Methods: A descriptive cross-sectional study was conducted with one hundred and two (102) fast bowlers who were prospectively monitored over the competition period of 2019 cricket season and the demographic data, severity of LBP, general characteristics and intrinsic factors related data were recorded. Results: Thirty-seven (43.5%) of the subjects were presented with LBP. Reduction of quadriceps strength of dominant side, hamstring strength of non-dominant side and increased ankle dorsiflexion of non-dominant side were found to be significantly associated with non-contact LBP (P<0.05). There were significant differences for the quadriceps strength of dominant side and hamstring strength and ankle dorsiflexion of non-dominant side between the fast bowlers with and without LBP. Conclusion: The results concluded that reduced quadriceps muscle strength of dominant side, reduced hamstring muscle strength and higher ankle dorsiflexion of non-dominant side have an important role in predisposing a fast bowler to have an increase in non-contact LBP.

Effectiveness of Combined Stretching and Strengthening Exercise Using Rehabilitation Exercise System with a Linear Actuator and MR Damper on Static and Dynamic Sitting Postural Balance: A Feasibility Study

Postural imbalance induced by prolonged sitting can be improved by exercise therapy. The aim of study was to evaluate the influence of combined stretching and strengthening exercise using rehabilitation exercise system with a linear actuator and MR damper on static and dynamic sitting postural balance. Twelve subjects who sit almost 10 h a day participated in this study. The rehabilitation exercise system with a linear actuator and MR damper was manufactured to provide stretching and strengthening exercise. All subjects were asked to perform an exercise program that was designed to enhance postural balance by stretching the tight muscle and strengthening the weakened muscle. Body pressure distributions were analyzed for mean force and mean pressure using a seat sensor system. Trunk muscle activities were measured by attaching surface electrodes to the thoracic erector spinae, lumbar erector spinae, and lumbar multifidus muscle. All data were divided into two regions (dominant and non-dominant side) under four conditions: no pelvic tilt, lateral pelvic tilt, anterior pelvic tilt, and posterior pelvic tilt. Body pressure distributions and trunk muscle activities were compared between before and after performing exercise under static and dynamic sitting conditions. Both in static and dynamic sitting conditions, there were significant differences in body pressure distributions and trunk muscle activities between the DS and NDS before performing the exercise (p < 0.01). After performing exercise, the body pressure distributions increased on the dominant side while those decreased on the non-dominant side significantly (p < 0.01). In addition, the activities of all trunk muscles on the non-predominant side increased significantly (p < 0.01 and p < 0.05). These results showed that postural balance was improved by decreasing the differences in body pressure distribution and trunk muscle activity between the dominant and non-dominant side after performing exercise. From the results of this study, we concluded that the rehabilitation exercise system with a linear actuator and MR damper is suitable for providing combined stretching and strengthening exercise, and it could be helpful to maintain correct posture by enhancing postural balance during sitting.