International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study

Background: A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. Objectives: To identify which physical examination tests international experts in physiotherapy consider the most clinically useful for the assessment of patients with headache. Design/methods: Delphi survey with pre-specified procedures based on a systematic search of the literature for physical examination tests proposed for the assessment of musculoskeletal dysfunction in patients with headache. Results: Seventeen experts completed all three rounds of the survey. Fifteen tests were included in round one with eleven additional tests suggested by the experts. Finally eleven physical examination tests were considered clinically useful: manual joint palpation, the cranio-cervical flexion test, the cervical flexion-rotation test, active range of cervical movement, head forward position, trigger point palpation, muscle tests of the shoulder girdle, passive physiological intervertebral movements, reproduction and resolution of headache symptoms, screening of the thoracic spine, and combined movement tests. Conclusions: Eleven tests are suggested as a minimum standard for the physical examination of musculoskeletal dysfunctions in patients with headache

Ag Surface and Bulk Segregations in Sputtered ZrCuAlNi Metallic Glass Thin Films

We report on the formation of Ag-containing ZrCuAlNi thin film metallic glass (nano)composites by a hybrid direct-current magnetron sputtering and high-power pulsed magnetron sputtering process. The effects of Ag content, substrate temperature and substrate bias potential on the phase formation and morphology of the nanocomposites were investigated. While applying a substrate bias potential did not strongly affect the morphological evolution of the films, the Ag content dictated the size and distribution of Ag surface segregations. The films deposited at low temperatures were characterized by strong surface segregations, formed by coalescence and Ostwald ripening, while the volume of the films remained featureless. At higher deposition temperature, elongated Ag segregations were observed in the bulk and a continuous Ag layer was formed at the surface as a result of thermally enhanced surface diffusion. While microstructural observations have allowed identifying both surface and bulk segregations, an indirect method for detecting the presence of Ag segregations is proposed, by measuring the electrical resistivity of the films