Immediate Effect of Strong Surged Faradic Stimulation vs Self-Stretching in Less Tensed Position on Chronic Upper Trapezius Spasm in Young Females

Faulty postural habits lead to upper trapezius spasm causing pain and affection of neck mobility. The study aimed to compare the immediate effect of Strong Surged Faradic Stimulation and self-stretching in Less Tensed Position in chronic trapezius spasm in young females. 46 female subjects with unilateral chronic trapezius spasm between the age 18-25 years were randomly allocated into Strong Surged Faradic Stimulation group and self-stretching group. Pre and post intervention Numeric Pain Rating Scale and cervical lateral flexion range of motion was measured. Both the interventions were effective in reducing pain (p < 0.0001) and improving range of motion (p <0.0001). When compared for pain, both were equally effective (p = 0.3664) but for range of motion self-stretching in Less Tensed Position was more effective (p < 0.0001). Key words: Trapezius spasm, Strong Surged Faradic Stimulation, Self-Stretching, young females.

Neck Braces and Driving Posture Affect Neck Mobility on Powered Two-Wheelers

Cervical spine injuries are a major concern for motorcyclists in traffic accidents and racing competitions. Neck braces aim to prevent cervical spine injuries during accidents by reducing the neck range of motion, and keeping it under physiological limits. This work aims to evaluate the ability of neck braces to reduce neck mobility for two driving postures associated with PTW configurations. The neck mobility of twelve volunteer subjects testing four neck braces on two powered two-wheelers (scooter and racing motorbike) is measured using an optoelectronic motion capture system. With the tested neck braces worn, neck mobility is significantly reduced as compared to the physiological range of motion in all degrees of freedom. However, only flexion/extension is reduced by all neck braces tested. This suggests that these brace designs do not provide protection against all the cervical spine loading directions that may occur in a trauma. Furthermore, specific type of each powered two-wheeler considered significantly affects the neck mobility in axial rotation, as well as the postero-anterior and caudo-cranial translations, thus underscoring the need to consider the driving posture when evaluating neck brace devices.

Preseason Neck Mobility Is Associated With Throwing-Related Shoulder and Elbow Injuries, Pain, and Disability in College Baseball Pitchers

Background: Shoulder and elbow injuries in baseball pitchers, which can lead to significant pain and disability, have been on the rise at all levels of play for 3 decades. Despite anatomic and neurophysiological relationships, neck mobility has not been explored as a contributor to shoulder and elbow injuries in baseball pitchers. Hypothesis: Impaired neck mobility will increase the risk of shoulder and elbow injuries in college baseball pitchers. Study Design: Cohort study; Level of evidence, 2. Methods: Posture, neck mobility, and shoulder passive range of motion were measured in healthy college baseball pitchers during the 2018 preseason. Time loss (days lost because of shoulder or elbow injuries) and patient-reported disability via Functional Arm Scale for Throwers (FAST) scores were used to dichotomize pitchers into injured and uninjured groups. Receiver operating characteristic curves were generated, and accuracy values and risk ratios (RRs) were calculated to assess the diagnostic utility of the physical measures. Time-to-injury analysis was conducted to assess the timing of injuries. Results: A total of 49 pitchers (mean age, 19.92 ± 1.48 years; mean height, 187.04 ± 6.02 cm; mean weight, 89.14 ± 12.08 kg) completed the study. There were 10 pitchers (20.4%) who sustained a time-loss injury >7 days because of a shoulder or elbow injury. A Cervical Flexion-Rotation Test (CFRT) finding on the dominant side of ≤39° resulted in over 9 times the increased risk of time-loss injuries (RR, 9.38 [95% CI, 1.28-68.49]). Time-to-injury analysis demonstrated differences between the 2 groups (χ2 = 7.667; P = .01). Pitchers with a >39.25° finding on the CFRT played a mean 109.4 of 112 days (95% CI, 105-114) before the injury, while pitchers with ≤39.25° only played 83.6 of 112 days (95% CI, 68-99). A CFRT finding of ≤38° (RR, 3.91 [95% CI, 1.23-12.39]), cervical flexion range of motion of ≤64° (RR, 10.56 [95% CI, 1.50-74.34]), and weight of >86.9 kg (RR, 10.42 [95% CI, 1.14-213.70]) were also associated with an increased risk of patient-reported pain and disability on the FAST pitcher module. Conclusion: College baseball pitchers with less neck mobility during the preseason had an increased risk of time loss and shoulder and elbow disability during the season. The predictive value of these measures as part of a risk screening profile should be further explored.

Health-Related Physical Fitness Benefits in Sedentary Women Employees after an Exercise Intervention with Zumba Fitness®

Background: The protective properties of high physical fitness levels on health are manifest independently of age, sex, fatness, smoking, alcohol consumption, and other clinical factors. However, women are less active than men, which contributes to low physical fitness and a high risk of CVD. Thus, the objective of this study is to analyze the effect of two exercise interventions on health-related physical fitness in sedentary employed females. Methods: A total of 98 physically inactive adult women were randomly assigned to 3 study groups: the control group (CG) = 31, the endurance training group based on Zumba Fitness® classes (ET; n = 39), and the concurrent training group that had an extra muscle-strengthening workout after the Zumba Fitness® class (CnT; n = 28). Body composition (BMI, waist circumference), motor fitness (one-leg stand test), musculoskeletal fitness (shoulder–neck mobility, handgrip strength test, jump and reach test, and dynamic sit-up test), and cardiorespiratory fitness (2-km test and estimated VO2 max) were assessed with the ALPHA-Fit test battery for adults. Results: Both interventions showed a significant improvement in the majority of health-related fitness and body composition variables/test (waist circumference: ET = −2.275 ± 0.95, p = 0.02, CnT = −2.550 ± 1.13, p = 0.03; one-stand leg test: ET = 13.532 ± 2.65, p < 0.001; CnT = 11.656 ± 2.88, p < 0.001; shoulder–neck mobility: ET = 1.757 ± 0.44, p < 0.001, CnT = 2.123 ± 0.47, p < 0.001; handgrip test: 0.274 ± 0.08, p < 0.001, CnT = 0.352 ± 0.08, p < 0.001; dynamic sit-up: ET = 1.769 ± 0.45, p < 0.001, CnT = −1.836 ± 0.49, p < 0.001; 2-km test time: −1.280 ± 0.25, p < 0.001, CnT = −1.808 ± 0.28, p < 0.001; estimated VO2 max: ET = 1.306 ± 0.13, p < 0.001, CnT = 1.191 ± 0.15, p < 0.001). There were no significant differences after the intervention between the two exercise intervention groups. Conclusions: Exercise interventions based on Zumba fitness® or Zumba fitness® combined with an extra muscle-strengthening workout based on bodyweight training exercises are effective strategies to improve the health-related physical fitness in sedentary women employees.

LEMON SCORE: A TOOL TO PREDICT DIFFICULT AIRWAY IN ED IN INDIAN SETTING.

Background: Airway management is a critical need in many acutely ill and injured patients. Inadequate delivery of oxygen to brain and other vital structures is the quickest killer. Emergency airway management is the major key for successful resuscitation in ED. Emergency medicine is an emerging branch in India at present and no research study has been conducted to evaluate difficult airway prediction score. Hence this study aimed to find the use of LEMON score as a tool to predict difficult airway in our ED. Methods: All the patients requiring invasive mechanical ventilation with age >12 years, not admitted outside and admitted to the emergency medicine department from July 2017 to September 2019 were included in our study. A total of 67 patients required invasive ventilation and were assessed by LEMON score for difficult intubation. This score is related to number of attempts required and Cormack lehane class of laryngoscopic view while intubation. Results: In the “LOOK EXTERNALLY” the most common finding was edentulous mouth with occurrence of 26.87%. In ‘EVALUATE’ component the most common difficulty was 2-3-2. In MALLAMPATI CLASS 56.71% were class I, 39.39% were class II. In OBSTRUCTION component of LEMON, 98.51% had no obstruction. In NECK MOBILITY component we found that 85.1% subjects had mobile neck and only 15.15% subjects had restricted neck mobility. We observed that the LEMON score is 60% sensitive and 96.15% specific to predict difficult airway. The positive predictive value was 83.33%. Conclusion: This tool can reduce the chance of unexpectedly encountering difficult airway.

Neck mobility in the Jurassic plesiosaur Cryptoclidus eurymerus: finite element analysis as a new approach to understanding the cervical skeleton in fossil vertebrates

The sauropterygian clade Plesiosauria arose in the Late Triassic and survived to the very end of the Cretaceous. Plesiosauria evolved the greatest species diversity of any marine reptile clade, attaining a global distribution. Plesiosauria consist of two clades, Rhomaleosauridae and Neoplesiosauria. Basal Neoplesiosauria have long necks with at least 30 cervicals, but show qualitative osteological evidence for a stiff neck. Here we quantify neck mobility in lateral, ventral, and dorsal directions based on finite element modeling of neck vertebrae from the Middle Jurassic plesiosaur Cryptoclidus eurymerus. We model the mobility in a single motion segment, consisting of two adjacent cervical vertebrae and the joints connecting them. Based on the model with a maximum intervertebral spacing of 3 mm, we find that in Cryptoclidus, the maximum angle of lateral deflection in the motion segment was 2°. The maximum angle of ventral deflection was 5° and of dorsal deflection was 5°. When these values are multiplied by the number of cervical vertebrae, it becomes apparent that neck mobility was limited in all directions. The maximum angle of total lateral deflection in the neck was 67°. The maximum angle of total ventral deflection was 148° and of total dorsal deflection was 157°. This raises the question of the function of such a long, multi-segment but immobile neck. We posit that the long neck served in hydrodynamic and visual camouflage, hiding the bulk of the body from the small but abundant prey, such as schooling fish and squid. Neck immobility may have been advantageous in withstanding strong hydrodynamic forces acting on the neck during predatory strikes.