Reliability of measuring the passive range of shoulder horizontal adduction using a smartphone in the supine versus the side-lying position

[Purpose] The purpose of this study was to compare the reliability of the measurement of the passive range of motion (PROM) of shoulder horizontal adduction (SHA) measurements using a smartphone for the assessment posterior shoulder tightness (PST) between the side-lying and supine test positions. [Subjects and Methods] Forty-seven subjects (mean ± age, 24.9 ± 3.5 years) without shoulder pathology were included in this study. Intra-rater and inter-rater reliabilities were determined using intraclass correlation coefficients. The SHA PROM of each subject’s dominant shoulder was measured using a smartphone by two investigators in two positions: the standard supine position, and a side-lying position on the tested side. [Results] The intra-rater reliability of the supine measurements was fair to good (ICC_3,1 = 0.72–0.89), and for the side-lying measurements was excellent (ICC_3,1 = 0.95–0.97). The inter-rater reliability of the supine measurements was fair (ICC_2,2 = 0.79) and for the side-lying measurements was excellent (ICC_2,2 = 0.94). [Conclusion] These results suggest that for healthy subjects, measurements of SHA using smartphones in the side-lying position has superior intra-rater and inter-rater reliabilities compared to the standard supine position.Key words: Reliability, Horizontal adduction, Smartphone     

Analysis of the pulmonary functions of normal adults according to pillow height

[Purpose] The purpose of this study is to examine changes in pulmonary functions in relation to the sleeping positions of the experimental subjects. [Subjects and Methods] The subjects for this study were twenty randomly selected males and females from K University. Measurements were taken in the supine position at three different pillow heights: 0 cm, 5 cm, and 10 cm. Pulmonary functions (vital capacity, tidal volume, inspiratory reserve volume, and expiratory reserve volume) were evaluated using a Fit mate. [Results] These findings suggest that a pillow height of 5 cm makes a significant difference in vital capacity (VC). When the three pillow heights were compared, significant differences were seen between 0 cm and 5 cm, and between 5 cm and 10 cm, in terms of vital capacity for the pulmonary functions among the three positions. [Conclusion] In conclusion, changing the positions of the subjects produces changes in pulmonary functions. The greatest change occurred in the 5 cm pillow height. Presumably, ventilation is affected by the body structures. The results will provide objective data to establish the most suitable positions for stroke patients when they perform respiratory exercises.Key words: Pulmonary function, Pillow, Height     

Characteristics of Upper Quadrant Posture of Young Women with Temporomandibular Disorders

[Purpose] This study aimed to investigate the characteristics of upper quadrant posture of young women with temporomandibular disorders. [Subjects] The participants were 19 female patients with temporomandibular disorders (patient group: mean age, 30.1 years) and 14 controls (control group: mean age, 24.6 years). [Methods] Outcome measures were the neck inclination angle (formed by a line connecting C7 and the ear tragus with a horizontal line), the angle of the shoulder (formed by a line connecting C7 and the acromial angle with a horizontal line), the cranial rotation angle (formed by a line connecting the ear tragus and the corner of the eye with a horizontal line), and the neck-length/shoulder-width ratio [the ratio of the neck length (from C7 to the tragus) to the width of the shoulder between the acromial angle]. The maximum range of mouth opening was measured using a scale. [Results] The neck inclination angle and maximum range of mouth opening were significantly smaller in the patient group than in the control group. No significant differences were observed in the other outcome measures between the two groups. [Conclusion] Temporomandibular disorders with limited mouth opening in young females are associated with the head position relative to the trunk.Key words: Posture, Temporomandibular disorders, Ultrasound-based three-dimensional motion analyser     

Effect of Treatment Table Height on Shoulder Muscles during Ultrasound Therapy Work

[Purpose] The purpose of this study was to propose a table height that can reduce shoulder muscle fatigue by analyzing and comparing median frequencies of shoulder muscles at different table heights when performing therapeutic ultrasounds work. [Subjects and Methods] The subjects were 63 healthy male adults who were equally and randomly assigned to a standard height group (SHG), a high height group (HHG), and a low height group (LHG). The standard table height was set at the level of the elbow joint when the subjects flexed their elbow while in a sitting position. High height and low height were set 10 cm higher and 10 cm lower, respectively, than the standard height. Muscle fatigue of the upper trapezius, middle deltoid, rhomboid, and infraspinatus of the subjects was measured during ultrasound treatment work at each table height. [Results] Median frequencies of the upper trapezius, middle deltoid, rhomboid, and infraspinatus muscles were significantly lower in the HHG than in to the LHG. [Conclusion] When therapeutic ultrasound is performed using a table that has a height lower than that of the elbow joint, the median frequency of the shoulder muscle increases, hence decreasing muscle fatigue. This way, musculoskeletal pain as a result of performing therapeutic ultrasound can be prevented.Key words: Therapeutic ultrasound, Work environment, Table height     

Altered interpretation of neck proprioceptive signals in persons with subclinical recurrent neck pain.

OBJECTIVE: To evaluate whether subjects with subclinical recurrent neck pain have an altered interpretation of neck proprioceptive signals. DESIGN: A comparative group design. SUBJECTS: Twelve subjects with recurrent neck pain and 12 control subjects. METHODS: The shoulder, head, trunk and whole-body position were measured under the following conditions: active and passive elevation and depression of the right shoulder and vibration of the trapezius muscle. RESULTS: During passive shoulder movements both groups moved their head in the opposite direction (p<0.05). During passive elevation subjects with recurrent neck pain showed a significant over-appraisal of shoulder position. Both groups responded similarly to active movements. Subjects with recurrent neck pain and control subjects showed similar trunk and head-to-trunk movements during shoulder movements. Subjects with recurrent neck pain, however, made larger movements compared with healthy subjects (p<0.05). During trapezius muscle vibration similar whole-body movements were found in both groups. CONCLUSION: These results show a modified interpretation of neck proprioceptive signals in subjects with recurrent neck pain and may reflect an offset in the egocentric reference frame or a decreased capacity to switch between reference frames. Better insight into these mechanisms might lead to better evaluation and treatment of subjects with recurrent neck pain and to a reduction in recurrent episodes.     

Effect of different hand positions on trunk and shoulder kinematics and reaction forces in sitting pivot transfer

[Purpose] The purpose of this study was to compare the changes in trunk and shoulder angles, and reaction forces under the two hands elicited by different hand base of support positions during sitting pivot transfer. [Subjects and Methods] Eighteen unimpaired subjects performed independent sitting pivot transfer. Subjects performed sitting pivot transfer between an initial seat to a target seat by only using their hands positioned at the same height as and lower than the seat position. Trunk and shoulder kinematics, and reaction forces on the trailing and leading hands were calculated. Mean peak joint angles and forces were compared between the hand positions using the pared t-test for the lift phase of the transfer. [Results] There were significant increases in the trunk angles of forward and lateral flexion, even though rotation decreased while transferring in the lower hand position. Increased shoulder flexion, anterior/posterior forces and reduced lateral forces were also shown. [Conclusion] Placing the hands of the supporting arms lower than the seat position during sitting pivot transfer was identified as having biomechanical advantages. Therefore, the lower hand position can be recommended as an effective and safe method for sitting pivot transfer by patients with spinal cord injury and can be utilized as a reference data for considering the appropriate height of aids for a wheelchair.Key words: Hand position, Sitting pivot transfer, Shoulder pain     

Pain,Work-related Characteristics,and Psychosocial Factors among Computer Workers at a University Center

[Purpose] Complaint of pain is common in computer workers, encouraging the investigation of pain-related workplace factors. This study investigated the relationship among work-related characteristics, psychosocial factors, and pain among computer workers from a university center. [Subjects and Methods] Fifteen subjects (median age, 32.0 years; interquartile range, 26.8–34.5 years) were subjected to measurement of bioelectrical impedance; photogrammetry; workplace measurements; and pain complaint, quality of life, and motivation questionnaires. [Results] The low back was the most prevalent region of complaint (76.9%). The number of body regions for which subjects complained of pain was greater in the no rest breaks group, which also presented higher prevalences of neck (62.5%) and low back (100%) pain. There were also observed associations between neck complaint and quality of life; neck complaint and head protrusion; wrist complaint and shoulder angle; and use of a chair back and thoracic pain. [Conclusion] Complaint of pain was associated with no short rest breaks, no use of a chair back, poor quality of life, high head protrusion, and shoulder angle while using the mouse of a computer.Key words: Ergonomics, Low back pain, Workplace     

Supine effect of passive cycling movement induces vagal withdrawal

[Purpose] The purpose of this study was to examine changes in vagal tone during passive exercise while supine. [Subjects and Methods] Eleven healthy males lay supine for 5 min and then performed passive cycling for 10 min using a passive cycling machine. The lower legs moved through a range of motion defined by 90° and 180° knee joint angles at 60 rpm. Respiratory rates were maintained at 0.25 Hz to elicit respiratory sinus arrhythmia. Heart rate variability was analyzed using the time domain analysis, as the root mean squared standard differences between adjacent R-R intervals (rMSSD), and spectrum domain analysis of the high frequency (HF) component. [Results] Compared to rest, passive cycling decreased rMSSD (rest, 66.6 ± 92.6 ms; passive exercise, 53.5 ± 32.5 ms). However, no significant changes in HR or HF were observed (rest, 68.2 ± 6.9 bpm, 65.6 ± 12.0 n.u.; passive exercise, 70.2 ± 7.2 bpm, 67.9 ± 10.0 n.u.). [Conclusion] These results suggest that passive exercise decreases rMMSD through supine-stimulated mechanoreceptors with no effect on HR or HF. Therefore, rMSSD is not affected by hydrostatic pressure during passive cycling in the supine position.Key words: Passive cycling movement, Supine position, Vagal tone     

Accuracy of long head of the biceps tendon palpation by physical therapists; an ultrasonographic study

[Purpose] Examination and treatment of the long head of the biceps tendon (LHBT) requires accurate palpation. The purpose of this study was to determine physical therapists’ reliability and ability to accurately palpate the LHBT in two arm positions with ultrasound as the gold standard. [Participants and Methods] Examiners palpated the LHBT within the intertubercular groove (ITG) of the humerus on the bilateral shoulders of 32 asymptomatic (21 female; 24.3 ± 1.9 years) participants in 2 arm positions. The magnitude of distance between a marker and the border of the ITG was compared between 2 positions using an independent t-test. Percent accuracy was calculated. [Results] Inter-rater reliability was poor (position 1, k=1.04; position 2, k=0.016). Overall accuracy rate was 45.7% (117/256). Accuracy was 49.2% (63/128) and 42.2% (54/128) for testing position 1 and position 2 respectively. Mean distance palpated from the groove was M=2.58 mm (± 6.2 mm) for position 1 and M=3.77 mm (± 6.6 mm) for position 2. Inaccurate palpation occurred medially 72.3% (47/65) and 93.2% (69/74) in position 1 and position 2 respectively. [Conclusion] Results of this study did not support one arm position being more accurate over another for LHBT palpation.Key words: Palpation, Accuracy, Long head of biceps tendon     

Effect of the application of local vibration in scaption on joint stability

[Purpose] The aim of this study was to determine the initial effect of local vibration on the stability of the shoulder joints by applying local vibration to the shoulder joints. [Subjects and Methods] For the test, the subjects held a FlexBar with one hand, at about 10 cm from one end, and performed the oscillation movement with the shoulder at 90° flexion and the elbow in the full-extension position in scaption; the vibration stimulus was set to 5 Hz. Then, the subjects underwent the Upper Quarter Y Balance Test to evaluate the stability of the shoulder joints. [Results] The moving distances in the left, right, and upper directions after the oscillation movement were increased significantly compared with the results before the oscillation movement. [Conclusion] A vibration stimulus is effective as an exercise method to increase the stability of the shoulder joints.Key words: Local vibration, Shoulder joint, Stability     

Pillow use: The behaviour of cervical pain,sleep quality and pillow comfort in side sleepers

A random allocation single blind block design pillow field study was undertaken to investigate the behaviour of cervico-thoracic spine pain in relation to pillow use.Participants (N = 106) who reported preference for side sleep position with one pillow were recruited via a telephone survey and newspaper advertisement. They recorded sleep quality and pillow comfort ratings, frequency of retiring and waking cervical pain and duration of waking cervical pain while sleeping for a week on their usual pillow, polyester, foam, feather and rubber pillows of regular shape and a foam contour pillow.Analysis was undertaken comparing sleep quality, pillow comfort, waking and temporal cervical pain reports, between the usual pillow and the trial pillows, between pillows of differing content and foam pillows of differing shape.This study provides evidence to support recommendation of rubber pillows in the management of waking cervical pain, and to improve sleep quality and pillow comfort. The rubber pillow performed better than subjects' own pillow in most instances. Subjects' own pillow performed similarly to foam and polyester pillows, and there is no evidence that the use of a foam contour pillow has advantages over the regular shaped pillows. Feather pillows should not be recommended.     

A novel objective evaluation method for trunk function

[Purpose] To investigate whether an objective evaluation method for trunk function, namely the “trunk righting test”, is reproducible and reliable by testing on different observers (from experienced to beginners) and by confirming the test-retest reliability. [Subjects] Five healthy subjects were evaluated in this correlation study. [Methods] A handheld dynamometer was used in the assessments. The motor task was a trunk righting motion by moving the part with the sensor pad 10 cm outward from the original position. During measurement, the posture was held at maximum effort for 5 s. Measurement was repeated three times. Interexaminer reproducibility was examined in two physical therapists with 1 year experience and one physical therapist with 7 years of experience. The measured values were evaluated for reliability by using intraclass correlation coefficients (ICC 1.1) and interclass correlation coefficients (ICC 2.1). [Results] The test-retest reliability ICC 1.1 and ICC 2.1 were all high. The ICC 1.1 was >0.90. The ICC 2.1 was 0.93. [Conclusion] We developed the trunk righting test as a novel objective evaluation method for trunk function. As the study included inexperienced therapists, the results suggest that the trunk righting test could be used in the clinic, independent of the experience of the therapists.Key words: Trunk function, Reliability, Handheld dynamometer     

Electromyography comparison of normal chair-desk system and assistant chair-desk system on fatigue

[Purpose] This study was designed to test the effects of the Assistant Chair-Desk System (ACDS), which can reduce the forward tilt of the neck and trunk and the level of fatigue during long lasting study in the sitting position. [Subjects] Fourteen middle school students and 14 college students of mixed gender participated in this study. [Methods] Fatigue level, the trapezius muscle, and the forward tilt angle of the head and trunk as well as distance factors were assessed before after using a normal chair-desk system (NCDS) and the ACDS for 120 minutes. [Results] There was an interaction effect in the angle and length of the neck from the sitting posture changes after 2 hours of studying using the NCDS and ACDS. There were also significant differences in the fatigue levels, hip joint angles and the lengths from the head according to the main effects of the chair-systems. [Conclusion] The studying position while using the ACDS was determined to prevent significant fatigue levels of the muscle and body, provide support to the head, by limiting the forward movement of the neck, and prevent forward tilt of the neck and trunk, by enabling the target point and gaze to be closer to the horizontal direction.Key words: Chair-desk system, Fatigue, Posture     

The effects of pillow designs on neck pain,waking symptoms,neck disability,sleep quality and spinal alignment in adults: A systematic review and meta-analysis

BackgroundNeck pain is a prevalent condition that can adversely affect quality of life, productivity at work, and sleep quality. The aim of this systematic review and meta-analysis was to identify clinical trials assessing the effect of different types of pillows on neck pain, waking symptoms, neck disability, sleep quality, and spinal alignment.MethodsWe systematically searched CINAHL Complete, Cochrane Library, EMBASE, Medline, Pubmed and Psychinfo databases from inception to September 2020. Two reviewers independently assessed the articles and evaluated the methodological quality using PEDro.FindingsThirty-five articles fulfilled the inclusion criteria of the study. There were nine high-quality studies involving 555 participants. The meta-analysis revealed significant differences favouring the use of rubber pillows to reduce neck pain [standardized mean difference (SMD): -0.263; P < 0.001). Moreover, waking pain (SMD: -0.228; P < 0.001) and neck disability (SMD: -0.506; P = 0.020) were reduced while the satisfaction rate was enhanced (SMD: 1.144; P < 0.001) with pillow use. Pillow designs did not influence sleep quality (SMD = 0.047; P = 0.703) in patients with chronic neck pain.InterpretationThe use of spring and rubber pillows are effective in reducing neck pain, waking symptoms, and disability and enhancing pillow satisfaction in patients with chronic neck pain. Moreover, there may be no change in the alignment of the cervical spine in the side-lying position, regardless of the use of rubber or feather pillows. Rather, the cervical alignment may be significantly impacted by the shape and height of the pillow.     

Electromyographic Study of Neck Muscle Activity According to Head Position in Rugby Tackles

[Purpose] This study examined differences in neck muscle activity in two different head positions during tackles with the aim of contributing to the prevention of sports injuries. [Subjects] The subjects were 28 male high-school rugby players. [Methods] Two tackle positions were considered: a head-up position and a head-down position. Muscle activities of the sternocleidomastoid muscles and the upper, middle, and lower parts of the trapezius muscles were measured. [Results] Muscle activities of the sternocleidomastoid muscles and the right upper trapezius muscle were significantly increased in the head-up position, and the activity of the lower trapezius was significantly increased in the head-down position. [Conclusion] Tackling with the head-up position increases neck muscle activity and stability of the head and the neck.Key words: Sternocleidomastoid muscle, Trapezius muscle, Rugby     

剖宫产术后硬膜外留置镇痛泵产妇翻身方法探讨

目的探讨剖宫产术后两种不同翻身方法对硬膜外留置镇痛泵留置时间的影响。方法2004年9-11月200例行剖宫产且术后留置镇痛泵产妇,根据住院号单双数分为两组,观察组100例术后翻身方法为:产妇由仰卧位先转为半侧卧位或侧卧位,再将人体重心往床中心平移即先侧后移。对照组100例术后翻身方法为:产妇由仰卧位将人体重心移向床一侧,再向床中央旋转90°成侧卧位,即先移后侧。观察两组产妇镇痛泵的留置时间及导管滑脱情况。结果观察组滑脱率为9%(9/100),91例无脱落,正常保留至术后48h由麻醉师拔除,而对照组滑脱率为46%,54例留置时间达48h由麻醉师拔除。两组有显著性差异(P<0.01)。结论采取新的翻身方法可以延长硬膜外镇痛泵的留置时间,减少非计划性的留置管滑脱。     

Comparison of Muscle Activities Using a Pressure Biofeedback Unit during Abdominal Muscle Training Performed by Normal Adults in the Standing and Supine Positions

[Purpose] The purpose of this study was to assess the effects of draw-in exercise on abdominal muscle activity in the standing and supine positions. [Methods] Twenty healthy women participated in this study. The subjects were required to complete two draw-in exercises (standing and supine positions) using a biofeedback pressure unit. The root mean square (RMS) values of the EMG data were expressed as a percentage of the resting contraction. The data were analyzed using the independent t-test. [Results] According to the changes in the activities of the abdominal muscles, the draw-in exercise in the standing position produced the most significant increase in the activities of the rectus abdominis, the transverse abdominis, the internal oblique, and the external oblique muscles. [Conclusion] The activities of the trunk stability muscles (rectus abdominis, transverse abdominis, internal oblique, and external oblique) increased more in the standing than in the supine position, enabling the subjects to overcome gravity. Therefore, to strengthen the activation of the abdominal muscles, a standing position seems to be more effective than a supine position for draw-in exercises.Key words: Abdominal muscle activity, Positions, Pressure biofeedback unit     

Prevalence of Sport Injuries among Middle School Children and Suggestions for Their Prevention

[Purpose] The purpose of this study was to determine the incidence of injuries of children participating in sports, and to present advice on injury prevention. [Subjects and Methods] The study subjects were 445 children involved in sports with a mean age of 12.74±1.03 years, a mean height of 156.56±10.82 cm, and a mean weight of 45.39±10.29 kg; 52.8% of the study subjects were male, and 47.2% were female. The subjects were surveyed using a questionnaire developed by the author. [Results] The highest incidence of sport injury was in the foot-ankle region, and the lowest incidence was in the hip-femur region. The incidences of injuries to the neck, shoulder, elbow, hand, wrist, superior dorsal region, waist, hip-femur region, knee, and foot-ankle regions weren’t statistically significant. [Conclusion] This study established that children participating in competitive sports are at risk of injury. The causes of injuries were examined to propose preventive measures to minimize their occurrence and severity. It should not be overlooked that injuries can occur more easily among children because their musculoskeletal system is not fully developed, and coaches should be educated in the appropriate training intensities for children.Key words: Children, Sport injuries     

Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders

[Purpose] This study investigated upper-extremity muscle activities in natural, ideal, and corrected head positions. [Subjects and Methods] Forty subjects with a forward head posture and rounded shoulder were recruited and randomly assigned to the natural head position group (n = 13), ideal head position group (n = 14), or corrected head position group (n = 13). Muscle activities were measured using a four-channel surface electromyography system at the sternocleidomastoideus, upper and lower trapezius, and serratus anterior muscles on the right side during an overhead reaching task. [Results] The muscle activities of the upper trapezius and serratus anterior differed significantly among head positions. Post hoc tests revealed significant differences between natural and ideal head positions, and natural and ideal head positions for both the upper trapezius and serratus anterior. [Conclusion] Recovery of normal upper trapezius and serratus anterior muscle functions plays an important role in correcting forward head posture and rounded shoulders.Key words: Forward head posture, Muscle activity, Round shoulder     

Influence of pitching grip on shoulder and elbow injuries in junior baseball players,focusing on hand length and the metacarpophalangeal joint angle

[Purpose] We investigated the relationship of pitching grip with hand length and index finger metacarpophalangeal joint angle. [Participants and Methods] A total of 650 junior baseball players divided into two groups according to whether they experienced shoulder or elbow pain were divided into two groups based on their pitching grip, i.e., those who held the ball with the ulnar side of the thumb and those who held it with the finger pad of the thumb. The metacarpophalangeal joint angle was measured while the participants held a ball. [Results] The average hand length was 16.3 ± 1.4 cm for those holding the ball with the ulnar side of the thumb and 15.8 ± 1.2 cm for those holding it with the finger pad of the thumb. Hand length and metacarpophalangeal angle were significantly greater in the group using the ulnar side of the thumb. The two groups showed no significant differences in the distribution of grip type or history of shoulder/elbow pain. The index finger metacarpophalangeal angle and shoulder/elbow pain were significantly lower in the pain group. [Conclusion] With respect to the pitching grip for junior baseball players, we recommend a slightly flexed rather than extended position with the metacarpophalangeal angle.