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Objective
Gross mandibular position and masticatory muscle activity have been shown to influence cervical muscles electromyographic activity. The purpose of this study was to investigate the influence of three different mandible positions including conscious occlusion, tongue tip against the anterior hard palate (Palate tongue position) and natural resting position (Rest), on sagittal plane cervical spine range of motion (ROM) as well as the flexion-rotation test (FRT) in asymptomatic subjects.
Materials and methods
An experienced single blinded examiner evaluated ROM using an Iphone in 22 subjects (7 females; mean age of 29.91years, SD 5.44).
Results
Intra-rater reliability for range recorded was good for the FRT with ICC (intraclass correlation) 0.95 (95% CI: 0.88–0.98) and good for sagittal plane cervical ROM with ICC 0.90 (95% CI: 0.77–0.96). A repeated measures ANOVA determined that mean ROM recorded during the FRT differed significantly between assessment points (F(1.99, 41.83) = 19.88, P < 0.001). Bonferroni Post hoc tests revealed that both conscious Occlusion and Palate tongue position elicited a significant large reduction in ROM recorded during the FRT from baseline (p < 0.01). Despite this, one activation strategy did not influence ROM more than the other. An additional repeated measures ANOVA determined that mean sagittal cervical ROM did not significantly vary between assessment points (F(2, 42) = 8.18, P = 0.08).
Conclusion
This current study provided further evidence for the influence of the temporomandibular region on upper cervical ROM. Results suggest that clinicians should focus on the natural mandible rest position when evaluating upper cervical mobility.
Objective:
To compare the short- and long-term effects of a structural-oriented (convential) with an activity-oriented physiotherapeutic treatment in patients with frozen shoulder.
Design:
Double-blinded, randomized, experimental study.
Setting:
Outpatient clinic.
Subjects:
We included patients diagnosed with a limited range of motion and pain in the shoulder region, who had received a prescription for physiotherapy treatment, without additional symptoms of dizziness, a case history of headaches, pain and/or limited range of motion in the cervical spine and/or temporomandibular joint.
Interventions:
The study group received treatment during the performance of activities. The comparison group was treated with manual therapy and proprioceptive neuromuscular facilitation (conventional therapy). Both groups received 10 days of therapy, 30 minutes each day.
Main measures:
Range of motion, muscle function tests, McGill pain questionnaire and modified Upper Extremity Motor Activity Log were measured at baseline, after two weeks of intervention and after a three-month follow-up period without therapy.
Results:
A total of 66 patients were randomized into two groups: The activity-oriented group (n = 33, mean = 44 years, SD = 16 years) including 20 male (61%) and the structural-oriented group (n = 33, mean = 47 years, SD = 17 years) including 21 male (64%). The activity-oriented group revealed significantly greater improvements in the performance of daily life activities and functional and structural tests compared with the group treated with conventional therapy after 10 days of therapy and at the three-month follow-up (p < 0.05).
Conclusions:
Therapy based on performing activities seems to be more effective for pain reduction and the ability to perform daily life activities than conventional treatment methods.
Hintergrund
Ziel dieser Studie ist es, die Auswirkungen einer Kinesiophobie auf die Emotions- sowie Lateralitätserkennung zu untersuchen.
Material und Methoden
67 Probanden mit chronischen muskuloskeletalen Schmerzen wurden untersucht. Hierbei erzielten 24 Probanden einen Wert von >37 auf der Tampa-Skala für Kinesiophobie und wurden in die Querschnittstudie eingeschlossen. Die Fähigkeit zur Erkennung mimisch codierter Basisemotionen wurde mittels des Facially-Expressed-Emotion-Labeling(FEEL)-Tests und die Lateralitätserkennung anhand eines speziellen Face-Mirroring-Assessment-and-Treatment-Programms ermittelt. Die Toronto-Alexithymie-Skala (TAS) 26 diente zur Erfassung einer Alexithymie.
Ergebnisse
Der FEEL-Score der Probanden mit Kinesiophobie war signifikant niedriger (p = 0,019). Die Basisemotionen Angst (p = 0,026), Ärger (p = 0,027) und Überraschung (p = 0,014) verdeutlichten einen signifikanten Unterschied zwischen den Ergebnissen der Querschnittstudie und gesunden Probanden. Der Alexithymiefragebogen TAS-26 zeigte lediglich in der TAS 1 (Schwierigkeiten bei der Identifikation von Gefühlen; p = 0,008) einen signifikanten Unterschied zwischen Probanden mit Kinesiophobie.
Schlussfolgerung
Die Ergebnisse zeigen, dass kinesiophobische Patienten Veränderungen in der Emotions- und Lateralitätserkennung sowie alexithyme Merkmale aufweisen.
Due to new research results in the past few years, interest in the fascia of the human body has increased. Dysfunctions of the fascia are indicated by various symptoms, amongst others, musculoskeletal pain. As a result stronger focus has been put on researching therapeutic approaches in this area. The main aim of this study was to investigate the effect of Foam Roll exercises on the mobility of the thoracolumbar fascia (TLF). Study has been conducted in a randomized and controlled trial which sampled 38 healthy athletic active men and women.
The subjects were randomly assigned to a Foam Roll Group (FMG), a Placebo Group (PG) and a Control Group (CG). Depending on the assigned group the volunteers were either instructed to do exercises with the Foam Roll, received a pseudo treatment with the Foam Roll or received no treatment.
A total of three measurements were carried out. The most important field of research was the mobility of the TLF, which was determined using a sonographic assessment. In addition the lumbar flexion and the mechanosensivity of relevant muscles were determined.
After the intervention, the FMG showed an average increase of 1.7915 mm for the mobility of the TLF (p < 0.001/d = 0.756). In contrast, only an average improvement of 0.1681 mm (p = 0.397) was shown in the PG, while the CG showed a slight improvement of 0.0139 mm (p = 0.861). However, no significant changes were observed with regard to the lumbar flexion and mechanosensivity of the treated muscles.
Thus, evidence is that the use of Foam Roll exercises significantly improves the mobility of the thoracolumbar fascia in a healthy young population.
The primary objective of this study was to determine the structural and known-group validity as well as the inter-rater reliability of a test battery to evaluate the motor control of the craniofacial region. Seventy volunteers without TMD and 25 subjects with TMD (Axes I) per the DC/TMD were asked to execute a test battery consisting of eight tests. The tests were video-taped in the same sequence in a standardised manner. Two experienced physical therapists participated in this study as blinded assessors. We used exploratory factor analysis to identify the underlying component structure of the eight tests. Internal consistency (Cronbach's α), inter-rater reliability (intra-class correlation coefficient) and construct validity (ie, hypothesis testing-known-group validity) (receiver operating curves) were also explored for the test battery. The structural validity showed the presence of one factor underlying the construct of the test battery. The internal consistency was excellent (0.90) as well as the inter-rater reliability. All values of reliability were close to 0.9 or above indicating very high inter-rater reliability. The area under the curve (AUC) was 0.93 for rater 1 and 0.94 for rater two, respectively, indicating excellent discrimination between subjects with TMD and healthy controls. The results of the present study support the psychometric properties of test battery to measure motor control of the craniofacial region when evaluated through videotaping. This test battery could be used to differentiate between healthy subjects and subjects with musculoskeletal impairments in the cervical and oro-facial regions. In addition, this test battery could be used to assess the effectiveness of management strategies in the craniofacial region.
Ein Date mit der IMTA
(2017)
Geoffrey Maitlands Behandlungsweise prägt die Physiotherapie bis heute und hat nichts an Aktualität verloren. 1992 gründete er mit von ihm ausgebildeten Instruktoren die Internationale Maitland Teacher Association (IMTA). Diese feiert am 27. Januar 2018 in Stuttgart ihr 25-jähriges Bestehen im Rahmen des physiokongresses. Es erwarten Sie zehn Vorträge von hochkarätigen Referenten.
Schmerzen im Bereich des Steißbeins werden häufig unter dem Begriff Kokzygodynie zusammengefasst. Ursache der Beschwerden können hierbei lokal oder entfernt liegende Strukturen sein. Außerdem gibt es eine Reihe von inneren und psychischen Erkrankungen, die eine Kokzygodynie vortäuschen können und differenzialdiagnostisch abgeklärt werden müssen.
Dieser Artikel gibt eine Übersicht über Anatomie, Ätiopathologie, Diagnostik, Differenzialdiagnostik und Therapiemöglichkeiten bei Kokzygodynie. Der Schwerpunkt liegt dabei auf muskuloskeletaler Therapie. Es werden Techniken am Steißbein aus 4 manualtherapeutischen Konzepten vorgestellt.
Kreuzbandrisse (Rupturen des vorderen Kreuzbands, VKB) ziehen oft eine langwierige Rehabilitation und Wiedereingliederung nach sich. Die physiotherapeutische Nachbehandlung beinhaltet aktive und passive Maßnahmen. Bislang existieren keine Studien zu neurodynamischen Aspekten der Rehabilitation von Kreuzbandrissen. Das Ziel der vorliegenden Studie bestand darin, die Veränderung der Bewegung des N. tibialis des betroffenen und nicht betroffenen Beins bei Probanden nach einer VKB-Ruptur zu untersuchen.
Bestandteil der verblindeten Untersuchung der 19 Probanden waren der Knee Outcome Survey für alltägliche Aktivitäten (KOS) und verschiedene Funktionsuntersuchungen (Slump-Test mit passiver Knieextension, Long Sitting Slump Test mit passiver Dorsalextension des oberen Sprunggelenks, Straight Leg Raise Test, belastete Dorsalextension im Stand). Die longitudinale Nervenexkursion des N. tibialis wurde mit bildgebendem Ultraschall in sitzender Slump-Position untersucht. Die Auswertung der Ultraschallvideos erfolgte mit einer Frame-by-frame Cross Correlation Software.
Die Ergebnisse zeigten eine signifikant geringere Nervenexkursion des N. tibialis am betroffenen Knie. Allerdings fand sich kein klinisch signifikanter Zusammenhang zu den Funktionsuntersuchungen.