Assessment of cervical range of motion in patients after axis fracture

Background Surgical treatment of odontoid fractures with posterior C1/C2 fusion always leads to severe limitations in mobility of the cervical spine and head. Purpose To assess the mobility of the cervical spine in patients treated with various surgical methods after an axis body fracture. Material and methods A group of 61 subjects receiving surgical treatment in a group of 214 subjects treated for odontoid fractures at one ward of neurosurgery at a regional hospital. Studies also included odontoid peg and Hangman fractures. The range of motion of the head was compared to standards by the International Standard Orthopedic Measurements (ISOM) and to head mobility in a control group of 80 healthy subjects without any pathologies or complaints associated with the cervical spine. Ranges of motion were measured with the CROM goniometre with regard to flexion, extension, right and left lateral flexion and right and left rotation. The functional status was evaluated with Neck Disability Index (NDI) standard questionnaires indicated for patients with cervical spine pain. Results Except for flexion and extension, patients after odontoid fractures had a statistically significantly smaller range of motion of the cervical spine in all planes compared to the control group and ISOM standards. Conclusions Odontoid fractures lead to limitations in mobility of the cervical spine even after treatment with methods that in theory should preserve the C1/C2 mobility

Rehabilitacja po chirurgicznym leczeniu lędźwiowej przepukliny krążka międzykręgowego – przegląd badan oraz propozycje postępowania

Introduction: In the scholarly literature, many examples of rehabilitation approaches following surgical treatment of discopathy can be found. However, little is known about the effectiveness of those methods assessed according to the standards of Evidence Based Medicine. Aim: The aim of this study was to analyse publications of experimental clinical studies including assessment of quality of the applied methodology and, based on this analysis, to evaluate the effectiveness of rehabilitation following surgical therapy of lumbar disc herniation. Material and methods: The analysis comprised clinical studies with and without randomisation and case-control clinical studies on rehabilitation therapy after surgery due to lumbar disc herniation. The overview was conducted using the following databases: MEDLINE, EMBASE, PEDro, Cochrane Database, CEBP and comprised the period of time from 1985 to 2006. Results: Nineteen publications were finally included in the analysis; 10 of them were randomised clinical trials of high methodological quality, 7 were randomised clinical trials of low methodological quality, and 2 reports of case-control, non-randomised studies. Conclusions: So far, there is no strong scientific evidence confirming the efficacy of rehabilitation initiated immediately following surgery. There is strong evidence confirming high effectiveness of intensive rehabilitation exercises initiated in the 4th – 6th week following surgery that improve mobility, stabilise the spine and strengthen back muscles. Intensive rehabilitation, as compared to the traditional or less intensive rehabilitation and to the lack of rehabilitation (moderate scientific evidence), significantly improves patients’ quality of life, ameliorates functioning, reduces pain and thus accelerates patients’ return to work. However, there are no scientifically confirmed guidelines as to which types of exercises should be recommended

Immediate Effect of Cryo-Compression Therapy on Biomechanical Properties and Perfusion of Forearm Muscles in Mixed Martial Arts Fighters

Mixed martial arts (MMA) fighters use their arms and hands for striking with the fists, grappling, and defensive techniques, which puts a high load on the forearms and hand muscles. New methods are needed to decrease the risk of injury and increase the effectiveness of regeneration. This study aimed to assess the effectiveness of cryo-compression (CC) therapy of different times (3 and 6 min) on forearm muscles in MMA fighters by investigating muscle pain, stiffness, tension, elasticity strength, and perfusion. Twenty professional male MMA fighters aged 26.5 ± 4.5 years, with training experience of 10.3 ± 5.0 years, were enrolled on an experimental within-group study design. The participants underwent CC therapy at a temperature of 3 °C and compression of 75 mmHg for 3 min and, in the second session, for 6 min. The investigated parameters were in the following order: (1) perfusion in non-reference units (PU), (2) muscle tone (T—[Hz]), (3) stiffness (S—[N/m]), (4) elasticity (E—[arb]), (5) pressure pain threshold (PPT—[N/cm]), and (6) maximum isometric force (Fmax [kgf]) at two time points: (1) at rest—2 min before CC therapy (pre) and (2) 2 min after CC therapy (post). There were significant differences between 3 and 6 min of CC therapy for PU and T. Meanwhile, F, E, PPT, and S were significantly different when comparing pre- to post-conditions. These results provide evidence that CC therapy is a stimulus that significantly affects parameters characterizing muscle biomechanical properties, pain threshold, strength, and tissue perfusion