Effect of Lower Trapezius and Serratus Anterior Muscle Strengthening on Pain and Function in Patients with Chronic Mechanical Neck Pain

Background Neck pain is considered to be a very frequent and disabling complaint among the general population. Purpose To study the effect of strength training of Lower Trapezius and Serratus Anterior muscles on pain and function in patients with chronic mechanical neck pain. Method 24 chronic mechanical neck pain samples (12 experimental and 12 control groups) participated. The pre and post-assessment was done with Numerical Rating Scale (NRS), Algometer, Push-Pull Dynamometer and Neck Disability Index Scale (NDI) for Pain, Pain Pressure Threshold (PPT), Muscle Strength and Function respectively. The experimental group was given strength training along with conventional physiotherapy whereas the control group underwent only conventional physiotherapy. Results The results showed a statistically significant difference in PPT (p value 0.04), Lower Trapezius strength (p value 0.02), Serratus Anterior strength (p value 0.003) and NDI (p value 0.04). Conclusion Strength training for Lower Trapezius and Serratus Anterior muscles along with conventional physiotherapy should be incorporated in treatment of Chronic Mechanical Neck pain patients

Psychological Problems in Parents of Children with Spina Bifida

Parents of children with spina bifida face various psychological problems additional to burden of financial crisis and family compromises. Objective To understand various psychological problems faced by parents and about their available support systems. MethodA survey based study using self-devised pre validated questionnaire. Result Parents faced anxiety (78 %), psychological problems like getting upset on trivial things (72 %), impatient (74 %) and overreacting to situations (64 %), lack of energy (70 %) and unable to enjoy as before (44 %), (82 %) reported affirmative over support systems. ConclusionMeasures for psychological problems of parents should be addressed with treatment of child to improvise child and parent well-being

Assessment of Anaerobic Power and Balance among Elite Indian Under-19 Football Players

Objective: To assess anaerobic power and balance among elite indian under-19 football players. Method:22 Elite Indian under-19 players Football players were tested for Anaerobic power and Balance on Monark Cycle Ergometry and Neurocom Balance Master respectively. Result: Anaerobic Peak Power (W) for professional Indian under-19 football players was 498.70, while the mean for the Anaerobic Capacity (W/Kg) was 7.75. On Balance assessment, players had maximum sway velocity on foam surface with eyes closed with a mean of 0.76 (deg/sec) followed by eyes open on a foam surface with a mean of 0.54 (deg/sec). Reaction Time of players was found to be affected most in the forward component with a mean of 0.98(deg/sec) followed by Right direction and Left back direction component with mean of 0.69 and 0.67 respectively. The players showed lack of directional control maximum in the Right component with a mean of 87.25 (deg/sec) followed by Forward and Left components with mean of 86.89 and 81.10 respectively. Conclusion: Elite Indian under-19 players Football players were found to have low Anaerobic power and capacity with their reaction time and directional control affected on the dominant leg side

Comparison of Upper Limb Proprioception in Chronic Mechanical Neck Pain Patients with Age-Sex Matched Healthy Normals

Purpose: Primarily to compare the Upper Limb Proprioception in Chronic Mechanical Neck Pain Patients to Age - Sex Matched Normals. Method: 30 women, 19- 30 years of age were assessed via a digital inclinometer for repositioning error for shoulder, elbow and wrist joints. Results: It was found that there was a difference in upper Limb Proprioception in Chronic Mechanical Neck Pain patients as compared to age sex matched normal individuals. Conclusion: On comparison, individuals with Chronic Mechanical Neck Pain had a statistically significant difference in the shoulder and wrist proprioception as compared to age matched Normals

Measurement properties of smartphone applications for the measurement of neck range of motion: a systematic review and meta analyses

Background Smartphone applications offer an accessible and practical option to measure neck range of motion (ROM) and are becoming more commonly used in clinical practice. We assessed the validity, reliability, and responsiveness of smartphone applications (apps) to measure neck ROM in people with and without neck pain. Methods A comprehensive electronic search strategy of the main electronic databases was conducted from inception until June 2021. The identified studies investigated apps which measured neck ROM, and evaluated their validity, reliability, or responsiveness, in adult participants with neck pain or asymptomatic individuals. Two independent reviewers determined eligibility and risk of bias following COSMIN guidelines. The quality of evidence was assessed according to the GRADE approach. Results Eleven studies, with a total of 376 participants were included. Three types of apps were identified: clinometer apps, compass apps, and other apps of ‘adequate’ to ‘doubtful’ risk of bias. A meta-analysis revealed ‘good’ to ‘excellent’ intra-rater and inter-rater reliability across the three types of apps. The overall validity was rated from ‘moderate’ to ‘very high’ across all apps. The level of evidence was rated as ‘low’ to ‘very low’. Conclusion Smartphone applications showed sufficient intra-rater reliability, inter-rater reliability, and validity to measure neck ROM in people with and without neck pain. However, the quality of evidence and the confidence in the findings are low. High-quality research with large sample sizes is needed to further provide evidence to support the measurement properties of smartphone applications for the assessment of neck ROM. Study registration Following indications of Prisma-P guidelines, this protocol was registered in PROSPERO on 1/05/2021 with the number CRD42021239501

Measures of neck muscle strength and their measurement properties in adults with chronic neck pain-a systematic review.

Measurement of neck muscle strength is common during the assessment of people with chronic neck pain (CNP). This systematic review evaluates the measurement properties (reliability, validity, and responsiveness) of neck muscle strength measures in people with CNP. This systematic review followed a PROSPERO registered protocol (CRD42021233290). Electronic databases MEDLINE (OVID interface), CINAHL, SPORTDiscuss via (EBSCO interface), EMBASE (OVID interface), and Web of Science were searched from inception to 21 June 2021. Screening, data extraction, and quality assessment (Consensus-based Standards for the selection of Health Measurement Instruments (COSMIN) checklist) were conducted independently by two reviewers. The overall strength of evidence was evaluated using the modified Grading of Recommendations Assessment, Development and Evaluation. From 794 records, nine articles were included in this review which concerned six different neck strength outcome measures. All studies evaluated reliability and one evaluated construct validity. The reliability of neck strength measures ranged from good to excellent. However, the risk of bias was rated as doubtful/inadequate for all except one study and the overall certainty of evidence was rated low/very low for all measures except for the measurement error of a handheld dynamometer. A multitude of measures are used to evaluate neck muscle strength in people with CNP, but their measurement properties have not been fully established. Further methodologically rigorous research is required to increase the overall quality of evidence. [Abstract copyright: © 2023. The Author(s).

Higher Education Strategy in Responding to the Generative AI Revolution Decolonising the Standard Response and Action Planning Protocols

Background: The Generative Artifical Intelligence (AI) revolution is here, and the availability of resources such as ChatGPT has triggered rapid responses, actions, and strategy to address the implications this has on education in the United Kingdom (UK). ChatGPT and other Generative AI provisions are viewed as both problematic and beneficial by Higher Education Institutes (HEI’s). Alongside HEI’s, Higher Education England (HEE) Technology Enhanced Learning (TEL) forums are just 1 of many additional UK national groups prioritising the discussion, Continual Professional Development (CPD), and strategical approaches to analysing Generative AI, in determining how it should be addressed in education and practice. In terms of standard practice at London South Bank University (LSBU), the planning of projects and research to explore new technology lies predominantly with those deemed as the most “skilled”, “technical” or “aware” of the technology. People who are in specific roles within the institute are expected to “lead” on strategy, and this onus of responsibility often remains with them throughout the process from start to finish. Recognising the imbalance of power and the benefits of privilege this practice could create, a decision was made to explore and propose re-design of the current protocols in place at LSBU. Aim: Demonstrate the inclusion of a Decolonising step at the earliest designing stage of the project, to influence a practice change in how a HEI could respond to major items affecting education and any subsequent action-planning or project designing. Method: 3 academic members of staff, and 3 undergraduate students, of Black, Asian, African or Minority ethnicity, will be recruited. Individual and group sessions will be conducted using Microsoft Teams. Sessions will involve the participants leading on the discussion and development of the project proposal and associated documents being used in the larger study. This will occur between 19th May – 1st June 2023, after which the project proposal will be registered with the LSBU research ethics committee and internal registration system (Haplo). The Decolonising strategy and effects will be appraised by an independent investigator making objective comparisons to a version of the project protocol originally written by the Principal Investigator as a lone researcher. Themes and major highlights to demonstrate these comparisons, will be presented as the outcome for this project. All results and recommendations will be ready for presentation by no later than 15th June 2023. Expected Outcomes: Recommendations based on the outcome could feasibly affect changes in the future strategy for responding to major items requiring adaptation and evolution in education/practices, and potential other general and/or specific response/action-planning protocols, at London South Bank University. Additional information: This project forms part of a larger LSBU Generative AI project to explore a potential solution to the issues surrounding Generative AI in Higher Education

Headache features in people with whiplash associated disorders: A scoping review.

Whiplash-associated headache (WAH) is one of the most common symptoms after a whiplash injury, leading to high disability. Nevertheless, the clinical characteristics of WAH have not been well described. To synthesise the existing literature on the clinical characteristics of WAH. Scoping review. The protocol for this scoping review was registered in Open Science Framework and the PRISMA extension for Scoping Reviews tool was used to ensure methodological and reporting quality. A systematic search was conducted in PubMed, EMBASE, CINAHL, Web of Science and Scopus. The search was performed by one author and the screening of articles was conducted by two authors independently. A total of 11363 articles were initially identified and finally 26 studies were included in the review. Headache intensity was the most commonly reported feature. Headache duration, frequency and location were also reported in at least four studies. Few studies reported physical impairments that may be related to the presence of WAH. A differentiation with concussion characteristics was only performed in eight studies. WAH appears to be of mild to moderate intensity, typically with episodes of short duration which is commonly experienced in the occipital region amongst other regions, and with a tendency to reduce in intensity over time. [Abstract copyright: Copyright © 2023. Published by Elsevier Ltd.

Can People with Chronic Neck Pain Recognize Their Own Digital Pain Drawing?

Background: Although the reliability of pain drawings (PDs) has been confirmed in people with chronic pain, there is a lack of evidence about the validity of the PD, that is, does the PD accurately represent the pain experience of the patient? Objectives: We investigate whether people with chronic neck pain (CNP) can recognize their own PD to support the validity of the PD in reporting the experience of pain. Moreover, we examined the association between their ability to recognize their own PD with their levels of pain intensity and disability and extent of psychosocial and somatic features. Study Design: Experimental. Setting: University Laboratory. Methods: Individuals with CNP completed their PD on a digital body chart, which was then automatically modified with specific dimensions using a novel software, providing an objective range of distortion and eliminating errors, which could potentially occur in manually controlled visual-subjective based methods. Following a 10-minute break listening to music, a series of 20 PDs were presented to each patient in a random order, with only 2 being their original PD. For each PD, the patients rated its likeliness to their own original PD on a scale from 0 to 100, with 100 representing “this is my pain.” Results: Overall, the patients rated their original PD with a median score of 92% similarity, followed by 91.8% and 89.5% similarity when presented with a PD scaled down to 75% and scaled up by 150% of the original size, respectively; these scores were not significantly different to the ratings given for their original PD. The PD with horizontal translation by 40 pixels (8%) and vertical translation by 70 pixels (12.8%) were rated as the most dissimilar to their original PD; these scores were significantly different to their original PD scores. The Spearman correlation coefficient revealed a significant negative association between their ability to recognize their original PD and their Modified Somatic Perceptions Questionnaire scores. Limitations: The patients in the study presented with relatively mild CNP, and the results may not be generalized to those with more severe symptoms. Conclusions: People with CNP are generally able to identify their own PD but that their ability to recognize their original PD is negatively correlated with the extent of somatic awareness

Microscopic changes in the spinal extensor musculature in people with chronic spinal pain: a systematic review.

Chronic spinal pain is one the most common musculoskeletal disorders. Previous studies have observed microscopic structural changes in the spinal extensor muscles in people with chronic spinal pain. This systematic review synthesizes and analyses all the existing evidence of muscle microscopic changes in people with chronic spinal pain. To assess the microscopy of spinal extensor muscles including the fiber type composition, the area occupied by fiber types, fiber size/cross sectional area (CSA) and narrow diameter (ND) in people with and without chronic spinal pain. Further, to compare these outcome measures across different regions of the spine in people with chronic neck, thoracic and low back pain. Systematic review with meta-analysis METHODS: MEDLINE (Ovid Interface), Embase, PubMed, CINAHL Plus and Web of Science were searched from inception to October 2020. Key journals, conference proceedings, grey literature and hand searching of reference lists from eligible studies were also searched. Two independent reviewers were involved in the selection process. Only studies examining the muscle microscopy of the spinal extensor muscles (erector spinae (ES) and/or multifidus (MF)) between people with and without chronic spinal pain were selected. The risk of bias from the studies was assessed using modified Newcastle Ottawa Scale and the level of evidence was established using the GRADE approach. Data were synthesized based on homogeneity on the methodology and outcome measures of the studies for ES and MF muscles and only four studies were eligible for analysis. All the five studies included were related to chronic low back pain (CLBP). Meta-analysis (inverse variance method for random effect to calculate mean difference and 95% CI) was performed for the ES fiber type composition by numbers for both type I and type II fibers (I =43% and 0% respectively indicating homogeneity of studies) and showed no difference between the people with and without CLBP with an overall effect estimate Z= 1.49 (p=0.14) and Z=1.06 (p=0.29) respectively. Meta-analysis was performed for ES fiber CSA for both type I and type II fibers (I =0 for both) and showed no difference between people with and without CLBP with an overall effect estimate Z= 0.08 (p=0.43) and Z=0.75 (p=0.45) respectively. Analysis was not performed for ES area occupied by fiber types and ND due to heterogeneity of studies and lack of evidence respectively. Similarly, meta-analysis was not performed for MF fiber type composition by numbers due to heterogeneity of studies. MF analysis for area occupied by fiber type, fiber CSA and ND did not yield sufficient evidence. For the ES muscle, there was no difference in fiber type composition and fiber CSA between people with and without CLBP and no conclusions could be drawn for ND for the ES. For the MF, no conclusions could be drawn for any of the muscle microscopy outcome measures. Overall, the quality of evidence is very low and there is very low evidence that there are no differences in microscopic muscle features between people with and without CLBP. [Abstract copyright: Copyright © 2022. Published by Elsevier Inc.