A comparison of mobilization and mobilization with movement on pain and range of motion in people with lateral ankle sprain: A randomized clinical trial

BackgroundMaitland and Mulligan mobilization techniques are two manual therapy methods to increase the range of motion following immobility treatment. The present study was conducted to compare two therapeutic methods, namely mobilization and mobilization with movement (MWM), on the pain and range of motion in people with lateral ankle sprain.MethodsA total of 40 individuals with grade two lateral ankle sprain were randomly divided into two groups, including the Maitland's mobilization intervention group, and the Mulligan's mobilization intervention group. Both groups underwent treatment every other day for two consecutive weeks. The pain intensity was measured using the Visual Analogue Scale (VAS), and the ankle dorsiflexion movement range using the Weight Bearing Lunge Test (WBLT) before and one day after the intervention.ResultsThere were no significant differences between the two groups in terms of pain (P = 0.297) and range of motion (P = 0.294) before the intervention. Meanwhile, after the intervention, a significant change was observed in both groups in terms of these variables, which indicates the effectiveness of both interventions (P < 0.001) and the greater effect of the mobilization with movement in reducing pain (P = 0.037) and increasing the range of motion (P = 0.021).ConclusionsBoth techniques significantly improved the range of motion and reduced pain in people with lateral ankle sprain, but Mulligan's technique was significantly more effective among the two, perhaps due to joining active and passive mobilizing tensile forces as well as interaction of afferents and efferents in the reflex arc.     

Steep Decrease of Gender Difference in DSM-IV Alcohol Use Disorder: A Comparison of Two Nation-wide Surveys Conducted 10 Years Apart in Korea

While decreasing trend in gender differences in alcohol use disorders was reported in Western countries, the change in Asian countries is unknown. This study aims to explore the shifts in gender difference in alcohol abuse (AA) and dependence (AD) in Korea. We compared the data from two nation-wide community surveys to evaluate gender differences in lifetime AA and AD by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Face-to-face interviews using the Composite International Diagnostic Interview (CIDI) were applied to all subjects in 2001 (n=6,220) and 2011 (n=6,022). Male-to-female ratio of odds was decreased from 6.41 (95% CI, 4.81-8.54) to 4.37 (95% CI, 3.35-5.71) for AA and from 3.75 (95% CI, 2.96-4.75) to 2.40 (95% CI, 1.80-3.19) for AD. Among those aged 18-29, gender gap even became statistically insignificant for AA (OR, 1.59; 95% CI, 0.97-2.63) and AD (OR, 1.18; 95% CI, 0.80-2.41) in 2011. Men generally showed decreased odds for AD (0.55; 95% CI, 0.45-0.67) and women aged 30-39 showed increased odds for AA (2.13; 95% CI 1.18-3.84) in 2011 compared to 2001. Decreased AD in men and increased AA in women seem to contribute to the decrease of gender gap. Increased risk for AA in young women suggests needs for interventions.     

手工凝聚胺试验影响因素分析

目的分析各种因素对手工凝聚胺试验的影响；方法应用手工凝聚胺（manual polgbrene test，MPT）做交叉配血及抗体筛选试验；结果血液标本、操作手法、凝聚胺试剂、药物（肝素、止血敏、高浓度KCl等）等对试验均有影响；其中以药物、操作手法影响较大，可致假阴性和假阳性结果；结论手工凝聚胺试验做交叉配血及抗体筛选时应注意排除药物和操作手法对试验结果的影响。     

Hand and gender differences in the organization of aiming in 5-year-old children.

The aim of the present study was to analyze the organization of aiming movements in right-handed children aged 5 years, depending on gender and hand used to perform the task. We first tested the hypothesis that aiming movements are predominantly organized in a feed-forward manner before the age of six. Using a direction pre-cueing protocol, we analyzed the effect of gender and hand used to perform the task on reaction time (RT), movement time (MT), spatial accuracy (SA) and acceleration profiles (APs) in children aged 5 years. Differences in RT between the uncued and pre-cued conditions suggest that the direction is actually specified prior to the execution of the movement at the age of five. However, the results also show significant hand and gender effects on MTs, spatial error and APs. Specifically, in girls, MT and kinematics profiles vary as a function of hand and target localization, whereas this is not the case in boys. In addition, SA is lower when aiming with the non-dominant hand in boys, but not in girls. These results suggest that multiple movement strategies are already available to the child at the age of five. Girls appear to be able to change movement strategy as a function of the constraints of the task, resulting in a stability of spatial accuracy (SA). On the contrary, the functional advantage of the right hand on MT and SA generally reported in right-handed males is not present in the boys at the age of five.     

On the role of static and dynamic visual afferent information in goal-directed aiming movements

Movement planning has been shown to be optimized when the participant is permitted to see his or her hand resting on the starting base prior to movement initiation. However, this proposition is opposed by contradictory results. In the present study, we wanted to determine whether these conflicting results were caused by procedural differences. The results showed that seeing one's hand on the starting base did not result in more accurate aiming movement than when this information was not available. However, lower aiming errors were found when one was asked to foveate the starting base and then the target prior to movement initiation, but only when no dynamic visual information was available during movement. When an aiming movement was performed while one's hand was visible in visual periphery, foveating the starting base or not prior to movement initiation did not modify aiming accuracy. These results suggest that gazing at the starting base and then at the target provides an eye-based representation of the movement to be performed that can be used by the CNS to plan a manual aiming movement. Information for better planning of the direction – but not the extent – dimension of an upcoming movement can also be derived from dynamic visual information available in peripheral vision. Electronic Publication     

Physiological responses and manual performance in humans following repeated exposure to severe cold at night

We evaluated human physiological responses and the performance of manual tasks during exposure to severe cold (–25°C) at night (0300–0500 hours) and in the afternoon (1500–1700 hours). Thirteen male students wearing standard cold protective clothing occupied a severely cold room (–25°C) for 20 min, and were then transferred to a cool room (10°C) for 20 min. This pattern of exposure was repeated three times, for a total time of exposure to extreme cold of 60 min. The experiments were started either at 1500 hours or 0300 hours and measurements of rectal temperature, skin temperature, blood pressure, performance in a counting task, hand tremor, and subjective responses were made in each condition. At the end of the experiment at night the mean decrease in rectal temperature [0.68 (SEM 0.04)°C] was significantly greater than that at the end of the experiment in the afternoon [0.55 (SEM 0.08)°C, P<0.01]. After the second cold exposure at night the mean increase in diastolic blood pressure [90 (SEM 2.0) mmHg] was significantly greater than that at the end of the second cold exposure in the afternoon [82 (SEM 2.8) mmHg, P<0.01]. At the end of the second cold exposure at night, mean finger skin temperature [11.8 (SEM 0.8)°C] was significantly higher than that at the comparable time in the afternoon [9.0 (SEM 0.7)°C, P<0.01]. Similarly for the toe, mean skin temperature at the start of the second cold exposure at night [25.6 (SEM 1.5)°C] was significantly higher than in the afternoon [20.1 (SEM 0.8)°C, P<0.01]. The increased skin temperatures in the periphery resulted in increased heat loss. Since peripheral skin temperatures were highest at night, the subjects noted diminished sensations of thermal cold and pain at that time. Manual dexterity at the end of the first cold exposure at night [mean 83.7 (SEM 3.6) times·min^–1] had decreased significantly more than at the end of the first cold exposure in the afternoon [mean 89.4 (SEM 3.5) times·min^–1, P<0.01]. These findings of a lowered rectal temperature and diminished manual dexterity suggest that there is an increased risk of both hypothermia and accidents for those who work at night. Electronic Publication     

Personality, manual preference and neuroendocrine reactivity in hirsute subjects

Behavioral and neuroendocrine differences may be postulated in hirsute subjects since central effects of gonadal steroids are well established. We conducted a controlled clinical study with 25 consecutive young hirsute participants compared with 20 consecutive controls. Neuropsychological evaluation included the Minnesota Multiphasic Personality Inventory (MMPI) and the Edinburgh Inventory of Manual Preference (EIMP). Neuroendocrine reactivity was assessed by the adrenocorticotropic hormone (ACTH) and cortisol responses to corticotropin releasing hormone (CRH). Hirsute participants presented a flattened personality profile with lower neurotic triad scores--146 +/- 20 versus 166 +/- 28. Left-hand preference was more common in hirsute participants--4/21 versus 0/20. Decreased ACTH [area under the curve (AUC)--36 +/-2 8 vs. 72 +/- 63 pg/ml h] and cortisol (AUC--18 +/- 4 vs. 25 +/- 10 microg/dl h) responses to CRH were found in the hirsute group. In the hirsute group, higher manual preference scores were associated with lower ACTH responses to CRH, while the opposite association was found in the control group. In the hirsute group, the hyporeactive hypothalamic-pituitary-adrenal (HPA) axis was associated with lower behavior-deviant scores, while in the control group, the hyporeactive HPA axis was associated with more psychopathology. We conclude that personality and HPA axis reactivity are different in hirsute female participants when compared with controls, with a trend for differences regarding handedness. Personality and handedness are differently associated with HPA reactivity. Distinctive features in hirsute participants are probably established very early during ontogenic development.     

The role of visual feedback of hand position in the control of manual prehension

 Although it is obvious that vision plays a primary role in reaching and grasping objects, the sources of the visual information used in programming and controlling various aspects of these movements is still being investigated. One source of visual information is feedback relating to the characteristics of the reach itself – for example, the speed and trajectory of the moving limb and the change in the posture of the hand and fingers. The present study selectively eliminated this source of visual information by blocking the subject’s view of the reaching limb with an opaque barrier while still enabling subjects to view the goal object. Thus, a direct comparison was made between standard (closed-loop) and object-only (open-loop) visual-feedback conditions in a situation in which the light levels and contrast between an object and its surroundings were equivalent in both viewing conditions. Reach duration was longer with proportionate increases in both the acceleration and deceleration phases when visual feedback of the reaching limb was prevented. Maximum grip aperture and the proportion of movement time at which it occurred were the same in both conditions. Thus, in contrast to previous studies that did not employ constant light levels across closed- and open-loop reaching conditions, a dissociation was found between the spatial and temporal dimensions of grip formation. It appears that the posture of the hand can be programmed without visual feedback of the hand – presumably via a combination of visual information about the goal object and proprioceptive feedback (and/or efference copy). Nevertheless, maximum grip aperture (like the kinematic markers examined in the transport component) was also delayed when visual feedback of the reaching limb was selectively prevented. In other words, the relative timing of kinematic events was essentially unchanged, reflecting perhaps a tight coupling between the transport and grip components. Received: 3 July 1998 / Accepted: 18 November 1998     

Effect of arm-shoulder fatigue on carpenters at work

Summary The purpose of the study was to analyse the effect of arm-shoulder fatigue on manual performance. Ten experienced carpenters performed three standardized tasks (nailing, sawing and screwing). Electromyographic activity was recorded from six arm-shoulder muscles and the performances were video-filmed. After 45 min of standardized arm-cranking (arm-shoulder-fatiguing exercise of approximately 70%–80% maximal oxygen consumption), the tasks were repeated. The number of work movements and the time taken for each task were recorded and the quality of the work performed was compared. After the fatiguing exercise, only nailing was perceived as being harder and more mistakes were made during nailing and sawing. Movement performance was not influenced during nailing but was slightly slower during sawing and faster during screwing. However, there were increased mean EMG amplitudes in the upper trapezius and biceps muscles during nailing, in the upper trapezius, anterior deltoid and infraspinatus muscles during sawing and in the anterior deltoid muscle during screwing. Of the muscles studied the upper trapezius and anterior deltoid muscles increased their activity most after the arm-shoulder-fatiguing exercise.     

Effects of myofascial release applied to neck muscles and craniocervical flexor training in patients with chronic myofascial TMD: A single arm study

ObjectiveTo evaluate the effects of myofascial trigger point release applied to superficial neck muscles and strengthening of the deep flexor muscles in subjects with myofascial temporomandibular disorders (mTMD).MethodsFourteen women (23.4 ± 3.32 years old) presenting with mTMD and trigger points (TrPs) in the sternocleidomastoid, suboccipital, and upper trapezius muscles were included in this study. They were evaluated on two occasions during a baseline period (3 weeks apart) with no intervention and a third time after a 5-weeks intervention protocol. Outcome measures included pressure pain threshold (PPT) over the masticatory muscles, mandibular function, orofacial pain intensity, maximum mouth opening, and the craniocervical flexion test. All women received 10 treatment sessions that included strain-counterstrain technique applied to TrPs found in the prior listed superficial neck muscles and stabilization exercise using a pressure biofeedback for the deep neck flexor muscles. One-way ANOVA or correspondent non-parametric tests as well as effects sizes were used to compare the outcomes at baseline and after the treatment.ResultsStatistically significant improvements were found in the PPT over left masseter and temporalis (p < 0.05) (mean difference (MD) of 0.50 and 0.42 kg/cm²), orofacial pain intensity (MD = −3.39 points), mandibular function (MD = −7.22 points) and performance of the deep cervical muscles (MD = 130.42 points) compared to baseline period. Effect sizes were moderate or large.ConclusionThe protocol intervention may have positive effects in patients with mTMD. However, studies with better methodological quality need to be performed to confirm those effects.Registrationensaiosclinicos.gov.br (RBR-7x828q);