Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial

BackgroundMechanical neck pain is one of the common musculoskeletal disorders. Muscle energy technique (MET) may be a useful intervention for treating such disorder.ObjectiveThe aim of this study was to compare the effect of MET with passive stretching on pain and functional disability in people with mechanical neck pain.MethodsA randomized controlled trial was undertaken. Sixty patients with mechanical neck pain were randomly allocated to either the MET group or control group. The former group received MET, and the latter group received static stretching. Both groups received conventional therapy. Treatment was given once a day for 6 days. A visual analogue scale (VAS) was used to measure the intensity of pain, and functional disability was assessed using the neck disability index (NDI) was immediately before treatment and again on the 6^th day.ResultsVAS and NDI scores showed a significant improvement in both MET and stretching groups on the 6^th day postintervention (p < 0.05). However, both VAS and NDI scores showed better improvement in the MET group as compared to the stretching group (p < 0.025).ConclusionMuscle energy technique was better than stretching technique in improving pain and functional disability in people with mechanical neck pain.     

等渗溶液Ca2+浓度改变对去神经主动脉平滑肌生物张力及兴奋性作用研究

目的 研究等渗高Ca2+环境对去神经主动脉平滑肌膜电流的影响,以及不同前负荷状态和Ca2+通道阻滞剂干预下去神经主动脉平滑肌的肌源性自主舒缩变化.方法 平滑肌标本取自昆明小鼠主动脉平滑肌层.标本在松弛状态下被两端固定并浸润于任氏液中,待稳定后于显微镜下将玻璃微电极吸附于平滑肌肌膜并高阻封接,观察生理渗透压环境下的膜电流状态.将任氏液中Ca2+浓度由0.9 mol/L提高至1.2 mol/L,观察渗透压改变后的即刻膜电流变化.增加标本前负荷至1 g,观察前负荷增加后标本在同等渗透压环境下膜电位的改变,并记录此时的标本自主舒缩曲线.结果 平滑肌标本处于松弛状态时,在等渗环境下将Ca2+浓度由0.9 mol/L提高至1.2 mol/L后,膜电流改变幅度由(10.25±1.34)pA增至(24.91±3.27)pA,差异具有统计学意义(P＜0.05);前负荷增加后标本在等渗高Ca2+及低Ca2+环境下的膜电流改变幅度较松弛状态时均有所增加(低Ca2+浓度时(15.33±4.33) pA比(10.25±1.34) pA,高Ca2+浓度时(33.31±7.25) pA比(24.91±3.27) pA),差异均具有统计学意义(均P＜0.05).低Ca2+浓度为0.9 mol/L时,若仅增加前负荷,标本肌源性自主舒缩幅度可增加175％;而Ca2+浓度增至1.2 mol/L时,标本自主舒缩幅度可进一步增长40％.经Ca2+通道阻滞剂(质量浓度为0.5 g/L尼群地平)预处理后,高Ca2+环境下的膜电流及肌源性自主舒缩均明显减弱,结果表明膜电位及自主舒缩均由Ca2+主导.结论 细胞外Ca2+浓度的增加既提高了主动脉平滑肌细胞膜的兴奋性,又使平滑肌产生较明显的自主性舒缩,可在前负荷改变时有效地改善平滑肌组织顺应性.Ca2+通道阻滞剂抑制了Ca2+主导的跨膜电流,降低了肌源性自主舒缩,增加了平滑肌的僵直度,这可能会对改善弹性储器血管的功能产生负面影响.     

Achilles tendinopathy: A prospective study on the effect of active rehabilitation and steroid injections in a clinical setting

In published efficacy studies on Achilles tendinopathy (AT) exercise alone results in improvement in 60–90% of the cases. However, this high success rate cannot be expected in usual clinical practice. We prospectively investigated the effectiveness of a treatment regimen consisting of home‐based exercises (concentric, eccentric, and stretching) and optional glucocorticosteroid (GCS) injections in patients with (AT) in a usual clinical setting. Patients unable to commence or progress in exercise were offered GCS, hypothesizing that the GCS would facilitate exercise. Ninety‐three consecutive patients with AT referred to two outpatient rheumatology clinics were registered, and seen at five visits over a 6‐month period. Exercises seemed to have a slow, but long‐lasting effect with GCS having a dramatic short‐term effect on symptoms. Twenty‐six percent of the patients could proceed with training alone, the remainder received one to three supplementary GCS. There were significant improvements on all outcome variables over time (P ≤ 0.001). At follow‐up, 42 had no more symptoms, 29 good result, 16 slightly improved, 4 unchanged, and 2 slightly worse. Overall, 94% of the patients had improved, and we thus recommend the use of GCS injections in AT patients if training alone does not lead to improvement.     

猪胸主动脉血管各向异性力学性能的实验研究

目的 研究猪胸主动脉血管各向异性的力学特性。 方法 收集21条猪胸主动脉血管并分成3组。沿每条血管的轴向剖开并展成平面,以展开后血管的长方向（即血管轴向）0°为起始角,逆时针方向分别切取30°、 45°、 60°、90°、120°、 135°、 150°、180° 8个角度方向的样本。以1、5、10 mm/min的加载速率分别对3组样本进行单轴拉伸测试,以获得血管样本在8个不同方向及3种加载速率下的弹性模量和极限应力。 结果 不同角度样本的应力 应变曲线呈现出不同的黏弹性行为;随着样本角度的变化,从30°开始,弹性模量逐渐增大,到90°时弹性模量最大,然后逐渐减小,直到180°;极限应力与弹性模量的变化规律基本一致。不同加载速率对弹性模量和极限应力的结果具有明显的影响,但对血管的各向异性度影响较小。结论 猪主动脉血管呈现较强的各向异性,研究结果为有限元分析建模中材料属性的赋值提供参数参考,对理解血管生物力学特性具有重要的意义。     

张力敏感性阳离子通道在机械牵张引起气道黏液高分泌中的作用

目的 观察张力敏感性阳离子通道、Ca2+内流和豆蔻酰化富丙氨酸C激酶底物(MARCKS)在机械牵张引起气道黏液高分泌中的作用.方法 人气道黏膜上皮细胞(HBE16)体外培养,采用小型生物撞击机给予机械牵张刺激,各组培养细胞依施加条件不同而分为对照、牵张、牵张+钆、牵张+硝苯吡啶、牵张+低分子量肝素、牵张+MARCKS效应结构域(ED)锁核酸(LNA)以及牵张+MARCKS的ED无关对照LNA序列共7组,分别采用逆转录聚合酶链反应(RT-PCR)和免疫荧光法观察与胞吐相关的突触相关膜蛋白SNAP23以及黏蛋白(MUC)5AC mRNA和蛋白表达,酶联免疫吸附试验(ELISA)方法检测细胞培养上清中MUC5AC分泌.结果 机械牵张能显著升高人气道黏膜上皮细胞中SNAP23和MUC5AC表达,显著提升细胞培养上清中MUC5AC分泌(P＜0.05);钆、硝苯吡啶、MARCKS的ED-LNA均能抑制机械牵张对SNAP23表达和MUC5AC表达、分泌的提升作用(均P＜0.05);而低分子量肝素未能显著降低SNAP23表达和MUC5AC表达、分泌(P＞0.05).结论 机械牵张能升高人气道黏膜上皮细胞MUC5AC的表达,其机制可能与张力敏感性阳离子通道、Ca2+内流和MARCKS途径有关.     

The Effects of Different Stretching Techniques of the Quadriceps Muscles on Agility Performance in Female Collegiate Soccer Athletes: A Pilot Study

Background

Stretching has long been an integral component of pre-performance activities for a multitude of athletic endeavors. Previous research has demonstrated that stretching may have detrimental effects on performance. Specific knowledge of the precise effects of stretching may influence the decision to appropriately apply stretching techniques in the sport and therapeutic settings.

Objective

The purpose of this pilot study was to examine the effects of static stretching, proprioceptive neuromuscular facilitation (contract-relax) stretching, and no stretching of the quadriceps muscle group on agility performance.

Methods

Twelve healthy, female, collegiate soccer players aged 18 – 25 performed one of the three stretching protocols (static, contract-relax, no stretch) and the agility test (T-test) on three non-consecutive days. Agility times were recorded and compared based on stretching technique and day that each test was performed.

Results

No significant difference was found among the means of the different stretching techniques. The t-test agility performance times were as follows: control, =9.7 seconds; static stretch, =9.73 seconds; and contract-relax, =9.62 seconds.

Conclusion

The results of this study suggest that agility performance may be independent of stretching technique of the quadriceps performed in female collegiate soccer athletes. It is recommended that female soccer athletes about to engage in agility activity may perform either no stretch, static stretch, or contract-relax stretching according to individual preference.     

增塑剂对几种涂膜剂成膜材料韧性的影响研究

目的研究增塑剂对几种成膜材料的膜韧性影响。方法以甘油、邻苯二甲酸二乙酯等为增塑剂,测试不同种类及用量的增塑剂加入前后各成膜材料的膜拉长倍数和感官柔软性,以膜拉长倍数和感官柔软性为膜韧性指标,比较各增塑剂对各成膜材料韧性的影响。结果甘油、丙二醇、山梨醇能明显增加聚乙烯醇1788、聚乙烯醇124的膜拉长倍数和感官柔软性,且甘油、丙二醇的作用更强;邻苯二甲酸二乙酯、三乙酸甘油酯、邻苯二甲酸二丁酯能明显增加Ⅲ号丙烯酸树脂、Ⅳ号丙烯酸树脂的膜拉长倍数和感官柔软性,且对Ⅳ号丙烯酸树脂的膜拉长倍数影响更大。结论甘油、丙二醇、山梨醇能明显改善聚乙烯醇1788、聚乙烯醇124的膜韧性,甘油、丙二醇作用更强;邻苯二甲酸二乙酯、三乙酸甘油酯、邻苯二甲酸二丁酯能明显改善Ⅲ号丙烯酸树脂、Ⅳ号丙烯酸树脂的膜韧性,并对Ⅳ号丙烯酸树脂的作用更强。     

Effect of static stretching of muscles surrounding the knee on knee joint position sense

Background

Muscle stretching is widely used in sport training and in rehabilitation. Considering the important contribution of joint position sense (JPS) to knee joint stability and function, it is legitimate to question if stretching might alter the knee JPS.

Objective

To evaluate if a stretch regimen consisting of three 30 s stretches alters the knee JPS.

Design and setting

A blinded, randomised design with a washout time of 24 h was used.

Subjects

39 healthy students (21 women, 18 men) volunteered to participate in this study.

Methods and main outcome measures

JPS was estimated by the ability to reproduce the two target positions (20° and 45° of flexion) in the dominant knee. The absolute angular error (AAE) was defined as the absolute difference between the target angle and the subject perceived angle of knee flexion. AAE values were measured before and immediately after the static stretch. Measurements were repeated three times. The static stretch comprised a 30 s stretch followed by a 30 s pause, three times for each muscle.

Results

The AAE decreased significantly after the stretching protocols for quadriceps (3.5 (1.3) vs 0.7 (2.4); p<0.001), hamstring (3.6 (2.2) vs 1.6 (3.1); p = 0.016) and adductors (3.7 (2.8) vs 1.7 (2.4); p = 0.016) in 45° of flexion, but no differences were found for values of the gastrocnemius and popliteus muscles in this angle and for the values of all muscles in 20° of flexion (p>0.05).

Conclusion

The accuracy of the knee JPS in 45° of flexion is improved subsequent to a static stretch regimen of quadriceps, hamstring and adductors in healthy subjects.