Influence of cervical spine stabilization via Stiff Neck on the postural system in healthy patients: compensation or decompensation of the postural system?

Functional and structural disorders of the cervical spine are often regarded as the cause of non-specific vertigo. Pathogenetically, disorders of proprioceptive connections between neck muscles and vestibular cores as well as the proprioceptors in the cervical facette joints are presumed. According to a study by Hulse and Ho (HNO 48:295-301, 1), after manual therapeutic intervention in patients with functional disorders of the cervical spine 50% of the probands stated a significant reduction of their vertigo. This was backed up in posturography, which documented an improvement in vestibulospinal reactions. To date, the effects of artificial as well as surgical stabilization of the cervical spine on the balance system have not been explored yet. In a first pilot study, we examined the influence of artificial stabilization of the cervical spine via cervical collar Stiff Neck, manufactured by Ambu/Perfit ACE] on the balance system of 20 healthy probands. For this purpose, a posturography (Balance Master Systems, Neuro-Com, Clackamas, OR, USA) was applied to 20 healthy probands (10 males, 10 females) with a mean age of 35 years who had no prior spine pathology. Posturography was analyzed under static and dynamic test situations with and without Stiff Neck cervical collar. The results were compared statistically to the Wilcoxon test. In the static test situation of the modified clinical test of sensory interaction on balance, a significantly improved standing stability occurred. In none of the dynamic tests did fixation of the cervical spine by Stiff Neck cuff lead to a measurable impairment of the movement coordination. All probands felt subjectively more stable when wearing the Stiff Neck. In healthy probands, a fixation of the cervical spine leads to a stabilization of the postural balance situation. This fixation seems to be helpful in compensating the malfunction of other components of balance information. In a next step, this same model of analysis is applied to patients with cervical instability. Standing stability and movement coordination before and after cervical fusion are being explored

Influence of cervical spine stabilization via Stiff Neck on the postural system in healthy patients: compensation or decompensation of the postural system? (vol 267, pg 1623, 2010)

Functional and structural disorders of the cervical spine are often regarded as the cause of non-specific vertigo. Pathogenetically, disorders of proprioceptive connections between neck muscles and vestibular cores as well as the proprioceptors in the cervical facette joints are presumed. According to a study by Hulse and Ho (HNO 48:295-301, 1), after manual therapeutic intervention in patients with functional disorders of the cervical spine 50% of the probands stated a significant reduction of their vertigo. This was backed up in posturography, which documented an improvement in vestibulospinal reactions. To date, the effects of artificial as well as surgical stabilization of the cervical spine on the balance system have not been explored yet. In a first pilot study, we examined the influence of artificial stabilization of the cervical spine via cervical collar Stiff Neck, manufactured by Ambu/Perfit ACE] on the balance system of 20 healthy probands. For this purpose, a posturography (Balance Master Systems, Neuro-Com, Clackamas, OR, USA) was applied to 20 healthy probands (10 males, 10 females) with a mean age of 35 years who had no prior spine pathology. Posturography was analyzed under static and dynamic test situations with and without Stiff Neck cervical collar. The results were compared statistically to the Wilcoxon test. In the static test situation of the modified clinical test of sensory interaction on balance, a significantly improved standing stability occurred. In none of the dynamic tests did fixation of the cervical spine by Stiff Neck cuff lead to a measurable impairment of the movement coordination. All probands felt subjectively more stable when wearing the Stiff Neck. In healthy probands, a fixation of the cervical spine leads to a stabilization of the postural balance situation. This fixation seems to be helpful in compensating the malfunction of other components of balance information. In a next step, this same model of analysis is applied to patients with cervical instability. Standing stability and movement coordination before and after cervical fusion are being explored

Entwicklung und in Vitro-Funktionsanalyse des Prototyps einer menschlichen Mittelohrprothese Abschlussbericht

At present the functional results of patients with chronic middle ear diseases due to permanent insufficiency of the Eustachian tube and/or middle ear mucosa are still problematic. In order to restore defined sound conduction to the inner ear, the prototype of a complete mechanical middle ear prosthesis 'CoMEP' was developed. The prosthesis consists of a two-cylinder-system. The lateral cylinder contains an artificial tympanic membrane and a columella-like sound conduction across the stapes-footplate to the inner ear. A second cylinder serves for coupling the prostheses to the wall of the tympanic cavity. The prosthesis, which is epithelialized at its' outer surface does not require an intact mucosa or a functioning Eustachian tube. A prototype of the prosthesis was developed and investigated in terms of acoustical and biological aspects. The epithelialization of the artificial tympanic membrane was tested histologically. A material was found which can be completely covered by a cell-layer and thus supply protection against the penetration of bacteria. The sound transmitting properties were analyzed using optical measurements and were compared with the transfer functions of the normal middle ear as well as with commercially available tympanoplastics. It was found that the sensitivity of the human middle ear can be completely restored by the CoMEP. Furthermore the variability of the transmission is smaller compared to conventional tympanoplastics as it does not rely greatly on the performance of the implantation. The prosthesis has to be fitted individually to suit the different properties of the patient's middle ear cavities. Therefore anatomical data was acquired via high-resolution spiral CT and processed by a Computer-Aided-Design-System. The outcome of the CAD-System controlled a milling machine and the prototype of the prosthesis could be manufactured automatically with a precision of 0.25 mm. (orig.)Available from TIB Hannover: F97B1687+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman

Decreased postural control in adolescents born with extremely low birth weight

This is an accepted manuscript of an article published by Springer in Experimental Brain Research on 14 March 2015, available online: https://doi.org/10.1007/s00221-015-4239-3 The accepted version of the publication may differ from the final published version.The survival rates of infants born preterm with extremely low birth weight (ELBW ≤ 1000 g) have gradually improved over the last decades. However, these infants risk to sustain long-term disorders related to poor neurodevelopment. The objective was to determine whether adolescents born with ELBW have decreased postural control and stability adaptation. Twenty-nine ELBW subjects performed posturography with eyes open and closed under unperturbed and perturbed standing by repeated calf vibration. Their results were compared with twenty-one age- and gender-matched controls born after full-term pregnancy. The ELBW group had significantly decreased stability compared with controls in anteroposterior direction, both during the easier quiet stance posturography (p = 0.007) and during balance perturbations (p = 0.007). The ELBW group had similar stability decrease in lateral direction during balance perturbations (p = 0.013). Statistically, the stability decreases were similar with eyes closed and open, but proportionally larger with eyes open in both directions. Both groups manifested significant adaptation (p ≤ 0.023) to the balance perturbations in anteroposterior direction, though this adaptation process could not compensate for the general stability deficits caused by ELBW on postural control. Hence, adolescent survivors of ELBW commonly suffer long-term deficits in postural control, manifested as use of substantially more recorded energy on performing stability regulating high-frequency movements and declined stability with closed and open eyes both in anteroposterior and lateral direction. The determined relationship between premature birth and long-term functional deficits advocates that interventions should be developed to provide preventive care in neonatal care units and later on in life.Published versio