Effects of cervical muscle fatigue on the perception of the subjective vertical and horizontal

Introduction: Cervical functional capacity outcome measures that are simple and reliable are urgently needed in order permit accurate assessment/reassessment during treatments and rehabilitation. Induced neck muscle fatigue has been shown to alter functional capacities such as balance and kinaesthetic sense in the standing posture. The Rod and Frame Test has also shown promise as a method of assessing the effects of chronic neck pain and injury, but currently only in the sitting position. The objectives of this project were therefore 1) to validate the computerised rod and frame test in the standing posture, and 2) to measure the effects that different cervical muscle fatigue protocol would have on the assessment of the subjective visual vertical and horizontal. Method: The validation of the standing computerised rod and frame test in the standing posture was obtained by comparing results (n = 74) between the sitting and standing positions with the Spearman's correlation coefficient. In addition, agreement between the two methods was analysed with the Bland-Altman method. Participants (n = 56) resisted with their neck muscles approximately 35% maximum isometric voluntary contraction force for 15 minutes on a purpose built apparatus in eight different directions. Wilcoxon signed rank tests analysed changes in horizontal and vertical rod and frame test between the neutral and all different directions of contraction. The changes of recorded unsigned vertical and horizontal errors for the combined frame condition in all situations of isometric contraction were analysed with two respective one-way repeated measures analysis of variance (ANOVA). Discussion: The Spearman's rho and Bland-Altman plots show that the Rod and Frame Test works equally well in sitting and standing positions. After muscle contraction, there were significant increases in error in all participants for both horizontal and vertical rod and frame tests, except after flexion. These errors were predominantly present after fatigue of muscles in the coronal plane of contraction. Proprioception alone cannot explain the difference in the rod and frame results between different muscle groups. It is suggested that an evolutionary advantage of developing improved subjective verticality awareness in the same direction as the main visual field could explain these findings. © 2014 Gosselin and Fagan

Assessing the Financial Health of Medicaid Managed Care Plans and the Quality of Patient Care They Provide

Examines the administrative and medical expenses, quality of care, and financial stability of publicly traded health plans contracted to manage the care of Medicaid beneficiaries by plan characteristics and compared with non-publicly traded plans

Melt-extruded polyethylene oxide (PEO) rods as drug delivery vehicles: Formulation, performance as controlled release devices and the influence of co-extruded excipients on drug release profiles

The utility of controlled release medication formulations lies in their ability to keep drugs at steady levels in the blood plasma of recipients and within the termini of the maximum and minimum effective therapeutic levels. This avoids the “ups” and “downs” of medication levels within the body which would have been the result had conventional immediate release tablets been administered instead. In the veterinary field, controlled release medications are essential¹ because of the logistical difficulties of administering drugs on a regular (e.g., daily) basis to animals. The chief advantages of controlled release veterinary medications lie in the ease with which they can be administered; decrease in stress for animals, owing to less need for rounding up and frequent dosing; and, most importantly for farmers, the reduced cost of treatment relative to that for a multiple dosage regime