The Effects of a Closed-Chain, Eccentric Training Program on Hamstring Injuries of a Professional Football Cheerleading Team

Objective Hamstring injuries are a common occurrence among professional football cheerleaders. The purpose of this study is to identify the effects of an eccentric, closed-chain hamstring exercise intervention on hamstring injury–associated pain during the course of the football season among professional football cheerleaders. Methods Forty-three female cheerleaders participated in an eccentric, closed-chain hamstring exercise intervention protocol provided by doctors of chiropractic that incorporated loops of elastic-band or Thera-Band Loops (Hygenic Corporation, Akron, OH) during practice and at home during the regular football season. Hamstring injury–related pain was assessed in June, during team selection; in September, at the start of the season; and in December, at the end of season. No intervention was applied between June and September, although the sample participated in 4 hours of practice 2 to 3 times per week. The intervention was applied to the entire sample regardless of hamstring injury–related pain during the regular football season between September and December. The interventions included 2 exercises and were completed bilaterally 2 times per week at each biweekly practice and were encouraged to be done at least 3 additional times per week at home on nonpractice days. Results Among the subsample who reported hamstring-related injury pain between June and September, the exercise intervention significantly decreased (P \u3c .007) pain between September (6.07 ± 0.58) and December (3.67 ± 0.65). Conclusions The eccentric, closed-chain hamstring exercise intervention reduced hamstring injury–related pain among this group of professional football cheerleaders

Sleep Characteristics in Patients with Whiplash-Associated Disorders: A Descriptive Study

Study Objectives: The purpose of this study was to explore sleep habits and characteristics of patients with whiplash-associated disorders (WAD) presenting at an outpatient, chiropractic clinic using the Medical Outcomes Study (MOS) Sleep Scale. Methods: Fifty-one patients from an outpatient chiropractic and physical therapy clinic specializing in spinal rehabilitation participated in this cross-sectional, descriptive study. Data were collected using a descriptive survey, the Visual Analog Scale (VAS), the Neck Disability Index (NDI), and the self-administered 12-item MOS Sleep Scale. Data analysis included descriptive statistics to describe pain, disability, and sleep characteristics of the study sample, and computation of confidence intervals to determine differences in means of sleep characteristics between the non-WAD population (as determined by previous studies) and the study sample of WAD patients. Results: Results indicate that when compared to normative values of the non-WAD population, the sample of WAD patients in this study presents with significantly greater measures of neck disability (NDI), neck pain (VAS), sleep disturbance, snoring, shortness of breath and headache, sleep somnolence and sleep problems index I and II. This sample also presents with significantly lower measures of optimal sleep when compared to the general population. Conclusion: Consistent with previous research, findings from this study indicate that WAD patients have increased neck disability and pain, and poorer sleep outcomes, indicating the need for clinicians to assess sleep characteristics and incorporate interventions aimed at alleviating these symptoms when planning rehabilitation. Findings provide evidence for the need to further explore sleep disturbances among WAD patients to establish a stronger understanding of the course and prognosis of this condition

The Effect of Kinesiology Tape on Pain and Neck Range of Motion After Cervical Manipulation

Background: Annually, 30%–50% of adults will experience some form of debilitating neck pain. One approach to treating neck pain is cervical manipulation. This treatment modality has, at times, been reported to result in a short-term increase in pain, which in turn has been linked to reduced neck range of motion (ROM). Elastic therapeutic tape (ETT) has been shown to reduce musculoskeletal pain, although limited research has been conducted to determine if ETT can mitigate pain and facilitate neck ROM following cervical manipulation. Purpose: The purpose of this study is to compare the pain and neck ROM among patients with acute neck pain who do and do not receive ETT following cervical manipulation. Methods: A convenience sample of 50 patients between 18 and 64 years of age presented with acute noncomplicated neck pain was recruited from an outpatient chiropractic clinic. Patients were randomly assigned to 2 groups. In the tape group (n = 27), ETT was applied to their neck immediately following cervical manipulation for neck pain. In the control group (n = 23), cervical manipulation was performed with no application of ETT following the procedure. Pain and neck ROM were recorded at the following 3 different intervals: pre-cervical manipulation (T1), within 5 minutes of cervical manipulation (T2), and 24–48 hours after manipulation (T3). In total, 6 cervical ROM values were recorded with dual inclinometers. Pain was measured by asking of each patient to rate their neck pain using the numeric pain rating scale from 0 to 10. Results: The tape group demonstrated a significant decline (P \u3c 0.00) in pain between T1 (x = 6.15) and T2 (x = 5.37) and between T1 and T3 (x = 4.89). The control group did not report significant changes in their pain over the duration of the study. Neither group reported any significant change in any measure of neck ROM over the duration of the study. Clinical Relevance: Results from this study support the use of ETT to reduce pain immediately and 24–48 hours following cervical manipulation among patients presenting with acute neck pain

The Short-Term Effects of 2 Different Cryotherapy Methods on Acute and Subacute, Noncomplicated, Bilateral Neck Pain

Background: Cryotherapy has since long been used by physical therapists and chiropractors in the management of acute pain; more recently, its use has been shown to be effective in managing chronic pain. Multiple studies have shown that both ice and menthol reduce blood flow to the affected area and help control pain; however, there is limited research to determine the form of cryotherapy that works better on individual patients. Purpose: The purpose of this study was to compare the effect of a cold pack and menthol topical gel on reports of pain among individuals with neck pain. Methods: In this randomized study, 51 individuals in the age range of 19–65 years (37 ± 11.2 years) with bilateral, nonradicular, acute neck pain (myalgia) were included. Cold packs and Biofreeze®, a topical analgesic, were applied on either side of the neck (ie, ice on one side and Biofreeze on the other). The patients were asked to rate their pain on a 0–10 visual analog scale for either side of the neck both before and immediately following the 10-minute treatment. In addition, the patients were asked to answer 2 questions about which modality they would prefer to use in the future for pain management and their level of comfort with each modality during its application and to rate their answers on a 5-point scale (1 = very unlikely or very uncomfortable and 5 = very likely or very comfortable). On the next day of treatment with cold packs and Biofreeze, patients were asked to choose their preferred mode of treatment among the two and the modality that had a longer-lasting effect. Results: Overall, when asked to rate the comfort and preference, patients preferred Biofreeze 8:1 (P = .000). The average score on the 5-point Likert scale was 4.20 and 2.57 for Biofreeze and cold pack, respectively. In addition, 9 out of 10 patients reported that the effect of Biofreeze lasted longer than that of ice (P = .000). Further, the average score for Biofreeze and ice was 4.47 to 2.63, respectively. For actual levels of pain relief, the average pretreatment visual analog scale score decreased from 6.24 to 3.65 for Biofreeze and from 6.31 to 5.00 for ice. A paired t test showed that both cold packs and Biofreeze significantly reduced pain (P = .000). However, the pain reduction was 2-fold with the Biofreeze treatment. Conclusions: Both cold packs and Biofreeze significantly reduced pain; however, there was a 2-fold reduction in pain with Biofreeze. Biofreeze was rated as substantially more comfortable; patients preferred it, and its effect lasted longer in 9 out of 10 trials. This study was the first to evaluate the immediate effects of 2 different cryotherapy methods. It is not unexpected that the results of this study would differ slightly from other published studies evaluating menthol products. Conservative care specialists are often looking for methods to improve patient satisfaction and compliance. The present study indicates that Biofreeze is the preferred method of cryotherapy application by many neck pain patients on their first visit to the clinic

Does GD 356 have a Terrestrial Planetary Companion?

GD 356 is unique among magnetic white dwarfs because it shows Zeeman-split Balmer lines in pure emission. The lines originate from a region of nearly uniform field strength (delta B/B is approximately 0.1) that covers 10 per cent of the stellar surface in which there is a temperature inversion. The energy source that heats the photosphere remains a mystery but it is likely to be associated with the presence of a companion. Based on current models we use archival Spitzer IRAC observations to place a new and stringent upper limit of 12 Jupiter masses for the mass of such a companion. In the light of this result and the recent discovery of a 115 min photometric period for GD 356, we exclude previous models that invoke accretion and revisit the unipolar inductor model that has been proposed for this system. In this model a highly conducting planet with a metallic core orbits the magnetic white dwarf and, as it cuts through field lines, a current is set flowing between the two bodies. This current dissipates in the photosphere of the white dwarf and causes a temperature inversion. Such a planet is unlikely to have survived the RGB/AGB phases of evolution so we argue that it may have formed from the circumstellar disc of a disrupted He or CO core during a rare merger of two white dwarfs. GD 356 would then be a white dwarf counterpart of the millisecond binary pulsar PSR 1257+12 which is known to host a planetary system.Comment: 9 pages, 4 figures, accepted by MNRA

Head CT is of limited diagnostic value in critically ill patients who remain unresponsive after discontinuation of sedation

<p>Abstract</p> <p>Background</p> <p>Prolonged sedation is common in mechanically ventilated patients and is associated with increased morbidity and mortality. We sought to determine the diagnostic value of head computed tomography (CT) in mechanically ventilated patients who remain unresponsive after discontinuation of sedation.</p> <p>Methods</p> <p>A retrospective review of adult (age >18 years of age) patients consecutively admitted to the medical intensive care unit of a tertiary care medical center. Patients requiring mechanical ventilation for management of respiratory failure for longer than 72 hours were included in the study group. A group that did not have difficulty with awakening was included as a control.</p> <p>Results</p> <p>The median time after sedation was discontinued until a head CT was performed was 2 days (interquartile range 1.375–2 days). Majority (80%) of patients underwent head CT evaluation within the first 48 hours after discontinuation of sedation. Head CT was non-diagnostic in all but one patient who had a small subarachnoid hemorrhage. Twenty-five patients (60%) had a normal head CT. Head CT findings did not alter the management of any of the patients. The control group was similar to the experimental group with respect to demographics, etiology of respiratory failure and type of sedation used. However, while 37% of subjects in the control group had daily interruption of sedation, only 19% in the patient group had daily interruption of sedation (p < 0.05).</p> <p>Conclusion</p> <p>In patients on mechanical ventilation for at least 72 hours and who remain unresponsive after sedative discontinuation and with a non-focal neurologic examination, head CT is performed early and is of very limited diagnostic utility. Routine use of daily interruption of sedation is used in a minority of patients outside of a clinical trial setting though it may decrease the frequency of unresponsiveness from prolonged sedation and the need for head CT in patients mechanically ventilated for a prolonged period.</p