Cervical radiograph of a patient with cervicogenic dizziness

Clinical image. This is a cervical X-ray of a patient suffering from long term dizziness and associated neck pain and stiffness.The X-ray showed that the C1 cervical vertebrae were in a rotated position.In some cases of dizziness, one of the causes can be attributed to pathology or dysfunction of upper cervical spine

Test-Retest Reliability of Measuring the Vertebral Arterial Blood Flow Velocity in People With Cervicogenic Dizziness

Abstract OBJECTIVES: The purpose of this study was to determine the within-session and between-sessions reliability of measuring the vertebral artery blood flow velocities in people with cervicogenic dizziness using Doppler ultrasound at both upper and lower cervical levels. METHODS: Outcome measures were taken on 2 occasions 3 weeks apart with no active treatment provided in between the assessments on 12 participants. Pulsed-wave Doppler ultrasound was used to quantify time-averaged mean velocities through the vertebral artery at upper cervical (C0-1) and lower cervical vertebrae (C5-6). The clinical outcome measures were also recorded in people with cervicogenic dizziness. The intraclass correlation coefficient (ICC) was used to determine the within-session and between-session repeatability. Paired t test was used to determine the differences in the time-averaged mean velocities of blood flow at the same site of the vertebral artery and the clinical outcome measures in 2 sessions 3 weeks apart. RESULTS: In people with cervicogenic dizziness, there was no significant change in both clinical outcome measures and the time-averaged mean velocities when the patients were measured 3 weeks apart (P > .05). This study identified good within-session (ICC: 0.903-0.967) and between-session (ICC: 0.922-0.984) repeatability in measuring the vertical blood flow velocities in patients with cervicogenic dizziness when the clinical outcome measures were unchanged. CONCLUSIONS: This study supports the use of Doppler ultrasound to identify changes in mean vertebral arterial blood flow velocities before and after intervention in people with cervicogenic dizziness in future studies

The effect of elastic therapeutic taping on lumbar extensor isokinetic performance

Objective: To investigate the effects of elastic therapeutic tape when applied overlaying the lumbar extensors on different measures of muscle performance, compared to a placebo taping technique and a no-tape control. Relevance: Elastic therapeutic tape is frequently used as an adjunct to enhance athletic performance amongst athletes. However, limited research exists supporting its application on isokinetic performance of the lumbar extensor muscles. Methods: A cross-sectional experimental study. 21 participants received three taping conditions in a randomised order: elastic therapeutic tape, a placebo tape and a no-tape control. Peak torque, the time taken to reach peak torque and peak velocity were measured using an isokinetic dynamometer. Analysis: Friedman’s test and post-hoc Wilcoxon signed-rank test were used to determine the statistical differences between the three taping conditions. Level of significance was set at 0.05. Results: A statistically significant improvement in peak lumbar extensor torque was observed when comparing elastic therapeutic tape with the no-tape control (p 0.05). Conclusions: Results demonstrate that the application of elastic therapeutic tape overlaying the primary lumbar extensors significantly improves the maximal lumbar extension peak torque in healthy, asymptomatic adults

The Effects of Midfoot Strike Gait Retraining on Impact Loading and Joint Stiffness

Objective: To assess the biomechanical changes following a systematic gait retraining to modify footstrike patterns from rearfoot strike (RFS) to midfoot strike (MFS). Design: Pre-post interventional study. All participants underwent a gait retraining program designed to modify footstrike pattern to MFS. Setting: Research laboratory. Participants: Twenty habitual RFS male runners participated. Main Outcome Measures: Gait evaluations were conducted before and after the training. Footstrike pattern, loading rate (LR), ankle and knee joint stiffness were compared. Results: Participants’ footstrike angle was reduced (p<0.001, Cohen’s d=1.65) and knee joint stiffness was increased (p=0.003, Cohen’s d=0.69). No significant difference was found in the vertical loading rates (p>0.155). Further sub-group analyses were conducted on the respondents (n=8, 40% of participants) who exhibited MFS for over 80% of their footfalls during the post-training evaluation. Apart from the increased knee joint stiffness (p=0.005, Cohen’s d=1.14), respondents exhibited a significant reduction in the ankle joint stiffness (p=0.019, Cohen’s d=1.17) when running with MFS. Conclusions: Gait retraining to promote MFS was effective in reducing runners’ footstrike angle, but only 40% of participants responded to this training program. The inconsistent training effect on impact loading suggests a need to develop new training protocols in an effort to prevent running injuries

Difference in the running biomechanics between preschoolers and adults

Background: High vertical loading rate is associated with a variety of running-related musculoskeletal injuries. There is evidence supporting that non-rearfoot footstrike pattern, greater cadence, and shorter stride length may reduce the vertical loading rate. These features appear to be common among preschoolers, who seem to experience lower running injury incidence, leading to a debate whether adults should accordingly modify their running form. Objective: This study sought to compare the running biomechanics between preschoolers and adults. Methods: Ten preschoolers (4.2 ± 1.6 years) and ten adults (35.1 ± 9.5 years) were recruited Q3 and ran overground with their usual shoes at a self-selected speed. Vertical average (VALR) and vertical instantaneous loading rate (VILR) were calculated based on the kinetic data. Footstrike pattern and spatiotemporal parameters were collected using a motion capture system. Results: There was no difference in normalized VALR (p = 0.48), VILR (p = 0.48), running speed (p = 0.85), and footstrike pattern (p = 0.29) between the two groups. Preschoolers demonstrated greater cadence (p < 0.001) and shorter normalized stride length (p = 0.01). Conclusion: By comparing the kinetic and kinematic parameters between children and adults, our findings do not support the notion that adults should modify their running biomechanics according to the running characteristics in preschoolers for a lower injury risk. © 2020 Associac¸ao˜ Brasileira de Pesquisa e Pos-Graduac¸ ´ ao˜ em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved

Effects of deceptive footwear condition on subjective comfort and running biomechanics

Comfort is a major criterion for footwear selection. Previous studies have suggested that physical properties were not enough to predict comfort and psychological factors could also affect the perception. To understand comfort, this study examined the effect of controlled shoe description and price cue on the perception of comfort. Furthermore, this study also examined the running biomechanics in response to footwear conditions of differing comfort. Fifteen runners completed treadmill running tests in two conditions: Shoe A and Shoe B. The same pair of neutral running shoes was used in both conditions, yet, Shoe B was described to be the “latest model designed to maximize comfort” and more expensive than Shoe A. Comfort assessment was conducted after the running trial of each condition. Participants reported significantly greater comfort in Shoe B than Shoe A (p=0.011, Cohen’s d=0.70). There were no significant differences found among the temporal-spatial parameters (p>0.916) and the vertical loading rates (p>0.161) when comparing the more and less comfortable conditions. In conclusion, runners exhibited a biased perception of footwear comfort when presented with different shoe description and price information. However, such a difference in perceived comfort alone is not likely to affect running biomechanics

Gait Retraining for the Reduction of Injury Occurrence in Novice Distance Runners: 1-Year Follow-up of a Randomized Controlled Trial

Background: The increasing popularity of distance running has been accompanied by an increase in running-related injuries, such that up to 85% of novice runners incur an injury in a given year. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with many running ailments. However, softer footfalls may not necessarily prevent running injury. Purpose: To examine vertical loading rates before and after a gait retraining program and assess the effectiveness of the program in reducing the occurrence of running-related injury across a 12-month observation period. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 320 novice runners from the local running club completed this study. All the participants underwent a baseline running biomechanics evaluation on an instrumented treadmill with their usual running shoes at 8 and 12 km/h. Participants were then randomly assigned to either the gait retraining group or the control group. In the gait retraining group (n = 166), participants received 2 weeks of gait retraining with real-time visual feedback. In the control group (n = 154), participants received treadmill running exercise but without visual feedback on their performance. The training time was identical between the 2 groups. Participants’ running mechanics were reassessed after the training, and their 12-month posttraining injury profiles were tracked by use of an online surveillance platform. Results: A significant reduction was found in the vertical loading rates at both testing speeds in the gait retraining group (P 0.99), whereas the loading rates were either similar or slightly increased in the control group after training (P = .001 to 0.461, Cohen’s d = 0.03 to −0.14). At 12-month follow-up, the occurrence of running-related musculoskeletal injury was 16% and 38% in the gait retraining and control groups, respectively. The hazard ratio between gait retraining and control groups was 0.38 (95% CI, 0.25-0.59), indicating a 62% lower injury risk in gait-retrained runners compared with controls. Conclusion: A 2-week gait retraining program is effective in lowering impact loading in novice runners. More important, the occurrence of injury is 62% lower after 2 weeks of running gait modification. Registration: HKUCTR-1996 (University of Hong Kong Clinical Trials Registry)

Impact loading during distracted running before and after auditory gait retraining.

Visual feedback gait retraining has been reported to successfully reduce impact loading in runners, even when the runners were distracted. However, auditory feedback is more feasible in real life application. Hence, this study compared the peak positive acceleration (PPA), vertical average (VALR) and instantaneous (VILR) loading rate during distracted running before and after a course of auditory feedback gait retraining in 16 runners. The runners were asked to land with softer footfalls with and without auditory feedback. Low or high sound pitch was generated according to the impact of particular footfall, when compared with the preset target. Runners then received a course of auditory gait retraining, and after the gait retraining, runners completed a reassessment. Runners before gait retraining exhibited lower PPA, VALR and VILR with augmented auditory feedback (p0.104). A small effect of auditory feedback on VILR in runners after gait retraining was observed (p=0.032). Real time auditory feedback gait retraining is effective in impact loading reduction, even when the runners were distracted

Effect of minimalist and maximalist shoes on impact loading and footstrike pattern in habitual rearfoot strike trail runners: an in-field study

Running-related injuries among trail runners are very common and footwear selection may modulate the injury risk. However, most previous studies were conducted in a laboratory environment. The objective of this study was to examine the effects of two contrasting footwear design, minimalist (MIN) and maximalist shoes (MAX), on the running biomechanics of trail runners during running on a natural trail. Eighteen habitual rearfoot strike trail runners completed level, uphill and downhill running at their preferred speeds in both shod conditions. Peak tibial acceleration, strike index and footstrike pattern were compared between the two footwear and slopes. Interactions of footwear and slope were not detected for all the selected variables. There was no significant effect from footwear (F=1.23, p=0.27) and slope (F=2.49, p=0.09) on peak tibial acceleration and there was no footwear effect on strike index (F=3.82, p=0.056). A significant main effect of slope on strike index (F=13.24, p<0.001) was found. Strike index during uphill running was significantly greater (i.e., landing with a more anterior foot strike) when compared with level (p<0.001, Cohen’s d=1.72) or downhill running (p<0.001, Cohen’s d=1.44) in either MIN or MAX. The majority of habitual rearfoot strike runners switched to midfoot strike during uphill running while maintaining a rearfoot strike pattern during level or downhill running. In summary, wearing either one of the two contrasting footwear (MIN or MAX) demonstrated no effect on impact loading and footstrike pattern in habitual rearfoot strike trail runners running on a natural trail with different slopes

Accuracy assessment of recent ocean tide models

Over 20 global ocean tide models have been developed since 1994, primarily as a consequence of analysis of the precise altimetric measurements from TOPEX/POSEIDON and as a result of parallel developments numerical tidal modeling and data assimilation. This paper provides an accuracy assessment of 10 such tide models and discusses their benefits in many fields including geodesy, oceanography, and geophysics. A variety of tests indicate that all these tide models agree within 2-3 cm in the deep ocean, and they represent significant improvement over the classical Schwidersk1i 1980 model by approximately 5 cm rms. As a result, two tide models were selected for the reprocessing of TOPEX/POSEIDON Geophysical Data Records in late 1995. Current ocean tide models allow an improved observation of deep ocean surface dynamic topography using satellite altimetry. Other significant contributions include their applications in an improved orbit computation for TOPEX/POSEIDON and other geodetic satellites, to yield accurate predictions of Earth rotation excitations and improved estimates of ocean loading corrections for geodetic observatories, and to allow better separation of astronomical tides from phenomena with meteorological and geophysical origins. The largest differences between these tide models occur in shallow waters, indicating that the current models are still problematic in these areas. Future improvement of global tide models is anticipated with additional high-quality altimeter data and with advances in numerical techniques to assimilate data into high-resolution hydrodynamic models.Copyrighted by American Geophysical Union