Head and Neck Diseases by Alexandros G.Sfakianakis: 03/06/17

Δευτέρα 6 Μαρτίου 2017

Medial Olivocochlear function in children with poor speech-in-noise performance and language disorder

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Caroline Nunes Rocha-Muniz, Renata Mamede Mota-Carvalo, Eliane Schochat
ObjectivesContralateral masking of transient-evoked otoacoustic emissions is a phenomenon that suggests an inhibitory effect of the olivocochlear efferent auditory pathway. Many studies have been inconclusive in demonstrating a clear connection between this system and a behavioral speech-in-noise listening skill. The purpose of this study was to investigate the activation of a medial olivocochlear (MOC) efferent in children with poor speech-in-noise (PSIN) performance and children with language impairment and PSIN (SLI+PSIN).MethodsTransient evoked otoacoustic emissions (TEOAEs) with and without contralateral white noise were tested in 58 children (between 6 and12 years). These children were arranged in three groups: typical development (TD) (n=25), PSIN (n=15) and SLI+PSI (n=13).ResultsPSIN and SLI+PSI groups presented reduced otoacoustic emission suppression in comparison with the TD group.ConclusionOur finding suggests differences in MOC function among children with typical development and children with poor SIN and language problems.

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Association of airway abnormalities with 22q11.2 deletion syndrome

Publication date: May 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 96
Author(s): Rosalba Sacca, Karen B. Zur, T. Blaine Crowley, Elaine H. Zackai, Kathleen D. Valverde, Donna M. McDonald-McGinn
Introduction22q11.2 deletion syndrome (22q11.2DS) presents with complex but variable symptoms, including cardiac, immune, palatal, endocrine, cognitive, and psychiatric issues. However, an association of 22q11.2DS with structural airway abnormalities has not been formally described. The aim of this study was to document the frequency of this association.MethodsWe retrospectively reviewed medical records of patients with 22q11.2DS evaluated in the 22q and You Center at the Children's Hospital of Philadelphia between 1999 and 2015 referred to otolaryngology for an airway assessment. Type of airway abnormality and presence of comorbidities, such as congenital heart disease, tracheostomy, and association with prenatal symptomatology such as polyhydramnios, were noted.ResultsOf the 104 patients who underwent an otolaryngology procedure (microlaryngoscopy or bronchoscopy), 71% (n = 74) had airway abnormalities. Patients with airway abnormalities ranged in age from 5 months to 37 years, with similar prevalence among males and females. Observed airway abnormalities included tracheomalacia (36%), subglottic stenosis (28%), laryngomalacia (26%), glottic web (21%), and bronchomalacia (16%). Most patients with airway abnormalities (91%) had an associated congenital heart defect, with ventricular septal defect and Tetralogy of Fallot being the most prevalent. Importantly, 30% of patients required a tracheostomy, and overall polyhydramnios was noted in 16% of pregnancies.ConclusionAirway abnormalities are a common feature of 22q11.2DS, leading to substantial morbidity, particularly when combined with complex cardiac disease. Polyhydramnios may be an important prenatal clue to both the diagnosis of 22q11.2DS and airway anomalies. Postnatal assessment of airway structure and function among patients with 22q11.2DS is an important component of overall evaluation and will help guide long-term management.

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Reliability and validity of the Dutch pediatric Voice Handicap Index

Publication date: May 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 96
Author(s): Laura Veder, Bas Pullens, Marieke Timmerman, Hans Hoeve, Koen Joosten, Marieke Hakkesteegt
IntroductionThe pediatric voice handicap index (pVHI) has been developed to provide a better insight into the parents' perception of their child's voice related quality of life. The purpose of the present study was to validate the Dutch pVHI by evaluating its internal consistency and reliability. Furthermore, we determined the optimal cut-off point for a normal pVHI score.MethodsAll items of the English pVHI were translated into Dutch. Parents of children in our dysphonic and control group were asked to fill out the questionnaire. For the test re-test analysis we used a different study group who filled out the pVHI twice as part of a large follow up study. Internal consistency was analyzed through Cronbach's α coefficient. The test-retest reliability was assessed by determining Pearson's correlation coefficient. Mann-Whitney test was used to compare the scores of the questionnaire of the control group with the dysphonic group. By calculating receiver operating characteristic (ROC) curves, sensitivity and specificity we were able to set a cut-off point.ResultsWe obtained data from 122 asymptomatic children and from 79 dysphonic children. The scores of the questionnaire significantly differed between both groups. The internal consistency showed an overall Cronbach α coefficient of 0.96 and an excellent test-retest reliability of the total pVHI questionnaire with a Pearson's correlation coefficient of 0.90. A cut-off point for the total pVHI questionnaire was set at 7 points with a specificity of 85% and sensitivity of 100%. A cut-off point for the VAS score was set at 13 with a specificity of 93% and sensitivity of 97%.ConclusionsThe Dutch pVHI is a valid and reliable tool for the assessment of children with voice problems. By setting a cut-off point for the score of the total pVHI questionnaire of 7 points and the VAS score of 13, the pVHI might be used as a screening tool to assess dysphonic complaints and the pVHI might be a useful and complementary tool to identify children with dysphonia.

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Management of orbital cellulitis and subperiosteal orbital abscess in pediatric patients: A ten-year review

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Vittorio Sciarretta, Marco Demattè, Paolo Farneti, Martina Fornaciari, Ilaria Corsini, Ottavio Piccin, Domenico Saggese, Ignacio Javier Fernandez
ObjectivePediatric periorbital cellulitis represents a common disease complicating a nasal infection.MethodsA ten–year retrospective review of fifty-seven children admitted to our institution with the diagnosis of periorbital cellulitis as a complication of sinus infections was carried out.ResultsThe age varied from one month to eleven years (mean 3.9 years). Thirty-five were males (62%), while twenty-two were females (38%). Nine out of fifty-seven (15.8%) presented exophthalmos associated with eyelid erythema and edema, while the rest suffered mainly from eyelid erythema and edema. Twenty-two patients complaining of exophthalmos or not responding to medical therapy within 48 hours were assessed with a computed tomography scan (38.6%). A subperiosteal orbital abscess was detected in nine cases and these patients underwent surgical drainage (15,8%). Recurrence of orbital infection occurred in three cases (5.3%).ConclusionsMedical management is the main treatment for both preseptal and postseptal orbital cellulitis. Nevertheless, there is no universally accepted guideline for the treatment of subperiosteal abscesses and each case should be treated accordingly. Urgent surgical drainage should be considered in cases not responding to adequate medical management, or those cases presenting visual deterioration.

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Coblation of suprastomal granulomas in tracheostomy-dependent children

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): C. Scott Brown, Marisa A. Ryan, Vaibhav H. Ramprasad, Anatoli F. Karas, Eileen M. Raynor
ObjectiveSuprastomal granulomas pose a persistent challenge for tracheostomy-dependent children. They can limit phonation, cause difficulty with tracheostomy tube changes and prevent decannulation. We describe the use of the coblator for radiofrequency plasma ablation of suprastomal granulomas in five consecutive children from September 2012 to January 2016.MethodRetrospective case series at a tertiary medical center.ResultsThe suprastomal granuloma could be removed with the coblator in all 5 cases. Three were removed entirely endoscopically and 2 required additional external approach through the tracheal stoma for complete removal. There were no intraoperative or postoperative complications. One patient was subsequently decannulated and 2 patients have improved tolerance of their speaking valves. Two patients remain ventilator dependent, but their bleeding and difficulty with tracheostomy tube changes resolved. Three of the patients have had subsequent re-evaluation with bronchoscopy, demonstrating resolution or markedly decreased size of the granuloma. This technique is time efficient, simple and minimizes risks associated with other techniques. The relatively low temperature and use of continuous saline irrigation with the coblator device minimizes the risk of airway fires. Additionally, the risk of hypoxia from keeping a low fractional inspiratory oxygen level (FIO2) to prevent fire is avoided. The concurrent suction in the device decreases blood and tissue displacement into the distal airway.ConclusionCoblation can be used safely and effectively with an endoscopic or external approach to remove suprastomal granulomas in tracheostomy-dependent children. More studies that are larger and have longer follow-up are needed to evaluate the use of this technique.

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Five-years’ experience with outpatient thyroglossal duct cyst surgery

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Ana Coelho, Catarina Sousa, Ana Sofia Marinho, Joana Barbosa Sequeira, João Ribeiro Castro, Fátima Carvalho, João Moreira-Pinto
ObjectivesMany pediatric surgeons feel uncomfortable doing Sistrunk procedure without drain placement and in an outpatient setting. This study aimed to review our pediatric surgery department's experience in managing thyroglossal duct cyst surgery and to prove feasibility and safety of Sistrunk procedure without drain placement in an outpatient setting.MethodsA retrospective review was performed of all patients who underwent Sistrunk procedure, between January 2011 and December 2015, in our department.ResultsA total of 36 patients were included, with age ranging from 1 to 14 years (mean 6.3 years). Sixteen patients underwent day surgery, and 20 stayed overnight (with less than 24h postoperative discharge). The main reason to stay overnight was distance (greater than 60km or 1hour driving) between the hospital and patient's residence. All patients had histopathological confirmation of the diagnosis. None of the patients had a drain placed intraoperatively. There was only one readmission at 48h postoperative; a patient who underwent day surgery came back with cervical edema, which resolved with non-operative treatment. Short-term complications included post-operative local wound infection (11,4%) and hematoma (2,9%), none of which required surgical treatment.ConclusionsSistrunk procedure without drain placement is safe and can be performed in an outpatient setting.

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The Analysis of Reliability and Validity of the IT-MAIS, MAIS and MUSS

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Yan Zhong, Tianqiu Xu, Ruijuan Dong, Jing Lv, Bo Liu, Xueqing Chen
ObjectiveThe aim of this study was to investigate the reliability and validity of the Infant-toddler Meaningful Auditory Integration Scale (IT-MAIS), Meaningful Auditory Integration Scale (MAIS), and Meaningful Use of Speech Scale (MUSS).MethodsIT-MAIS, MAIS and MUSS were divided into 3 sub dimensions. 300 children with cochlear implants (CI) were included in the investigation. To assess test-retest reliability of these questionnaires, 30 children were selected randomly to be evaluated at a two-week interval indicated that there were no significant changes between test and retest. Furthermore random test analysis by different evaluators was also administered to 30 users.ResultsReliability test: Test-retest reliability of the three scales was proved to be satisfactory. All domains had correlation coefficients that exceeded 0.750(P<0.01). The Cronbach's α of the three scales and their three domains were greater than 0.700. Reliability between evaluators of the three scales were considered to be satisfactory. All domains had correlation coefficients that exceeded 0.750(P<0.01). Validity test: The evaluation of content validity by expert review showed the questionnaire had good content validity; The correlation coefficients between the overall scores of the three scales and their three domains were 0.699∼0.978(P<0.01). There were correlations among the three sub-domains but the strength of the correlations was relatively low. There was certain construct validity.ConclusionsIT-MAIS, MAIS, MUSS scales have good reliability and validity, and can be used to measure the outcome for children with cochlear implants hearing and speech evaluation.

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Peri-operative management of high-risk paediatric adenotonsillectomy patients: A survey of 35 UK tertiary referral centres

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Ryan Chin Taw Cheong, Philippe Bowles, Andrew Moore, Simon Watts
IntroductionPeri-operative management of high-risk paediatric patients undergoing adenotonsillectomy for treatment of obstructive sleep apnoea varies between tertiary referral hospitals. 'Day of surgery cancellation' (DoSC) rates of up to 11% have been reported due to pre-booked critical care being unavailable on the day of surgery as a result of competing needs from other hospital departments. We report the results of a survey of peri-operative management in UK tertiary care centres of high-risk paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea (OSA).MethodsAn 8-point questionnaire was developed using a cloud-based software platform (www.surveymonkey.com). A web-link to the survey was embedded in a customised e-mail which was sent via secure server to the Clinical Leads for Paediatric Otolaryngology at 35 United Kingdom (UK) Tertiary referral centres.ResultsThe survey response rate was 60% (n=21). Almost all (94.1%) of centres considered paediatric critical care facilities to be limited, with 70.6% (n=12) stating that DoSC often occurred due to unavailable paediatric critical care capacity. There was variation between tertiary referral units in the practice applied for pre-booking critical care beds (our survey identifies 6 variations) (Table 1). The most frequent selection method reported (47.1%) was at the discretion of the booking clinician at the time of listing the patient for surgery.ConclusionIn the context of limited critical care resources, variation in practice and difficulty in accurately predicting which patients will require post-operative critical care beds, a review and consensus on best practice in the peri-operative management of high risk paediatric adenotonsillectomy patients may offer a safe means of reducing cancellations and improving patient care, resource allocation and hospital efficiency.

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MYO15A splicing mutations in hearing loss: A review literature and report of a novel mutation

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Mahsa Motavaf, Mahdieh Soveizi, Majid Maleki, Nejat Mahdieh
Sensorineural hearing loss (SNHL) is the most prevalent genetic sensory defect in humans, affecting about 1 in 1000 newborns around the world. Non-syndromic SNHL accounts for nearly 70% of hereditary hearing loss and 80% of SNHL cases show an autosomal recessive mode of inheritance (ARNSHL). In the present study, we applied targeted-exome sequencing to a family with a single proband affected by congenital sensorineural hearing loss. 127 known genes were sequenced to find the causative mutation. One novel homozygous donor splice site mutation, c.4596 + 1G > A (IVS12 + 1G> A) was found in MYO15A gene. Analysis of this mutation within the family showed that the mutation segregates with hearing loss. New DNA sequencing technologies could lead to identification of the disease causing variants especially in highly heterogeneous disorders such as hearing loss.

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The public health resource utilization impact of airway foreign bodies in children

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Jeffrey Cheng, Beiyu Liu, Alfredo E. Farjat, Jonathan Routh
ObjectiveQuantify the resource utilization associated with airway foreign bodies in children in the United States using a national database and report observed trends over time. Study type: Cross-sectional analysis of national inpatient database with weighted estimates.Data sourceThe KID database (2000-2009).MethodsICD-9-DM codes for foreign body aspiration were used to identify patients to be included for investigation. Admission rates and charges were aggregated and compared among geographic region, location, and teaching hospital status. These factors were then also trended over time.ResultsFrom 2000 to 2009, airway foreign body diagnoses in children accounted for an estimated 4,000 to 5,000 admissions, resulting in a mean admission rate of 6.6 per 10,000 pediatric patients annually. Charges related to airway foreign bodies in children rose from a total of $93 million to $486 million in the observed period. There is an increasing trend over time of total charges per patient. Charges appear to be higher in urban locations and teaching hospitals.ConclusionsThe public health and economic burden of pediatric airway foreign bodies appears to be rising. Further investigation may be helpful to examine factors that may be contributing to increasing charges and creating strategies to improve cost effectiveness, as well as why there seems to be increased resource utilization in urban locations and teaching hospitals.

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Theory of mind and language development in Japanese children with hearing loss

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Hiroshi Fujino, Kunihiro Fukushima, Akie Fujiyoshi
ObjectiveThis study investigates the development of theory of mind (ToM) in Japanese children with hearing loss (HL) and its relationship with language abilities using the data of a large sample size.MethodsParticipants were 369 children with HL, ranging from around 4 to 12 years of age. The mean hearing level of the better ear was 100.7 dB. A "change in location"-type false belief task similar to the "Sally-Anne test" was given to the participants.ResultsThe pass rates for the false belief task were in the 20% range for 4 to 6-year-olds, 35.6% for 7-year-olds, 47.6% for 8-year-olds, and 63.6% for 9-year-olds. However, no children, even 12-year-olds, achieved a pass rate of 70%. A logistic regression analysis showed that the significant independent predictors of the false belief task performance were vocabulary age and syntactic comprehension level, and chronological age, hearing level, syntactic production level, and nonverbal intelligence were excluded.ConclusionThe results demonstrate that there is a delay in the development of ToM in Japanese children with HL. This finding is consistent with findings in English-speaking countries. Additionally, it is suggested that language abilities play an important role in the acquisition of ToM for children with HL.

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Using sildenafil (viagra) to treat congenital lymphatic malformations of the head and neck, our experience

Publication date: Available online 6 March 2017
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): John Rocke, Gavin Quail, Graeme Copley

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No catheter angiography is needed in patients with an obscure acute gastrointestinal bleed and negative CTA

Publication date: May–June 2017
Source:Clinical Imaging, Volume 43
Author(s): Pratik A. Shukla, Adam Zybulewski, Marcin K. Kolber, Erik Berkowitz, James Silberzweig, Morris Hayim
PurposeTo evaluate the negative predictive power of computed tomography angiography (CTA) for the identification of obscure acute gastrointestinal (GI) bleeding (GI bleeding not visualized/treated by endoscopy) on subsequent mesenteric angiography (MA) with the intention to treat.Materials and methodsA retrospective chart review of patients was performed who underwent mesenteric angiography for the evaluation/treatment of acute GI bleeding between November 2012 and July 2016. Patients with negative CTA examinations that proceeded to MA were identified. Negative predictive value (NPV) was calculated.Results20 patients (14 male, 6 female; average age: 73.1±12.8years) underwent 20 negative CTA examinations for the evaluation and treatment of GI bleeding followed by mesenteric angiography. Eighteen of 20 patients had negative subsequent MA (negative predictive value, NPV=90%). Both false negative cases were upper GI bleed (vs 0 lower GI bleed); this difference was significant (p<0.05).ConclusionsThe high NPV of CTA for the evaluation of GI bleeding suggests utility for excluding patients that are unlikely to benefit from MA and subsequent endovascular therapy. CTA may be considered for the first line diagnostic study for the evaluation of obscure GI bleeding.

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Fluorocholine PET/CT predicts skeletal progression, skeletal event and cancer specific survival in patients with biochemical relapse for prostate cancer

Publication date: May–June 2017
Source:Clinical Imaging, Volume 43
Author(s): Fabio Zattoni, Emanuela Agostini, Francesco Cattaneo, Marco Maruzzo, Umberto Basso, Filiberto Zattoni, Laura Evangelista
PurposeThe aim of our study is to evaluate the prognostic impact of ¹⁸F-Choline (FCh) positron emission tomography (PET)/computed tomography (CT), CT alone and methylene diphophonate bone scan (MDP-BS) in prostate cancer (PCa) patients with biochemical relapse.MethodsWe retrospectively selected 58 patients who underwent, between June 2010 and February 2013, both FCh-PET/CT and MDP-BS within a maximum time interval of 5months. All patients had a biochemical PCa recurrence after radical prostatectomy and/or radiation therapy. Two independent observers reviewed FCh-PET/CT and MDP-BS images. The bone window of CT portion from FCh-PET/CT was separately assessed. Time to progression (TTP), skeletal event free survival (SES) and cancer specific survival (CSS) were defined as the length of time between imaging and progression of disease, skeletal related events and cancer specific mortality, respectively. A patient based and a K agreement analysis was used to compare the findings of all three imaging modalities. Kaplan-Meier and log-rank analysis were computed for survival assessment. A multivariate Cox regression analysis was used to identify the independent predictors for TTP.ResultsBone metastases were detected in 22 (38%) patients at FCh-PET/CT, in 27 (47%) at MDP-BS and in 24 (41%) at CT. The agreement between FCh-PET/CT and MDP-BS, CT and MDP-BS, and FCh-PET/CT and CT were moderate/fair (respectively, k: 0.474, 0.267 and 0.424; all p<0.05). After 38months (IQR: 27–54months) of follow-up, 33 (57%) patients had a new recurrence of disease, 12 (21%) had skeletal related events and 19 (33%) died. Three subjects (5%) were lost during the observational period. At survival analyses, a worse TTP, SES and CSS were found in patients with a positive FCh-PET/CT at bone level than those with a negative scan (all p≤0.05). Conversely, any significant difference in TTP, SES and CSS was found for patients with both a positive MDP-BS and CT scan. At univariate analysis, a positive FCh-PET/CT at skeletal level was associated with all events (all p<0.05). However, only a positive FCh-PET/CT at any site was an independent prognostic variable of TTP (HR: 3.08; CI 95%: 1.85–9.05; p=0.04).ConclusionsPET/CT should be preferred to CT and BS in patients with prostate cancer with bone metastasis because it allows a better stratification of TTP, SES and CCS compared to CT and BS.

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Robust detection and segmentation of cell nuclei in biomedical images based on a computational topology framework

Publication date: Available online 6 March 2017
Source:Medical Image Analysis
Author(s): Rodrigo Rojas-Moraleda, Wei Xiong, Niels Halama, Katja Breitkopf-Heinlein, Steven Dooley, Luis Salinas, Dieter W. Heermann, Nektarios A. Valous
The segmentation of cell nuclei is an important step towards the automated analysis of histological images. The presence of a large number of nuclei in whole-slide images necessitates methods that are computationally tractable in addition to being effective. In this work, a method is developed for the robust segmentation of cell nuclei in histological images based on the principles of persistent homology. More specifically, an abstract simplicial homology approach for image segmentation is established. Essentially, the approach deals with the persistence of disconnected sets in the image, thus identifying salient regions that express patterns of persistence. By introducing an image representation based on topological features, the task of segmentation is less dependent on variations of color or texture. This results in a novel approach that generalizes well and provides stable performance. The method conceptualizes regions of interest (cell nuclei) pertinent to their topological features in a successful manner. The time cost of the proposed approach is lower-bounded by an almost linear behavior and upper-bounded by O(n2) in a worst-case scenario. Time complexity matches a quasilinear behavior which is O(n1+ɛ) for ε < 1. Images acquired from histological sections of liver tissue are used as a case study to demonstrate the effectiveness of the approach. The histological landscape consists of hepatocytes and non-parenchymal cells. The accuracy of the proposed methodology is verified against an automated workflow created by the output of a conventional filter bank (validated by experts) and the supervised training of a random forest classifier. The results are obtained on a per-object basis. The proposed workflow successfully detected both hepatocyte and non-parenchymal cell nuclei with an accuracy of 84.6%, and hepatocyte cell nuclei only with an accuracy of 86.2%. A public histological dataset with supplied ground-truth data is also used for evaluating the performance of the proposed approach (accuracy: 94.5%). Further validations are carried out with a publicly available dataset and ground-truth data from the Gland Segmentation in Colon Histology Images Challenge (GlaS) contest. The proposed method is useful for obtaining unsupervised robust initial segmentations that can be further integrated in image/data processing and management pipelines. The development of a fully automated system supporting a human expert provides tangible benefits in the context of clinical decision-making.

Graphical abstract

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Impact of osteopathic therapy on pro-prioceptive balance and quality of life in patients with dizziness

Publication date: Available online 6 March 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): L. Papa, A. Amodio, F. Biffi, A. Mandara
The aim of the study was to evaluate the efficacy of osteopathic manipulative treatment (OMT) in patients with Benign-Paroxysmal-Positional Vertigo (BPPV).Thirty-one patients with BPPV were randomly assigned into two groups: 19 patients received osteopathic treatments (TG) and 12 patients received sham therapy (SG), both in four weekly sessions. Before the first and the last treatment, those patients were evaluated using Dizziness Handicap Inventory (DHI) and stabilometric platform to assess lifestyle modification and balance functions.After the treatment session, TG compared to SG showed an improvement in DHI global (p=0.02), functional (p=0.03) and physical (p=0.03) components, as well as a reduction of swinging area (p=0.02). An association between swinging area and lifestyle measures (global [r=0.53; p=0.02]; functional [r=0.50; p=0.03]; physical [r=0.60; p= 0.01]) changes were found in TG.These findings suggest that OMT could be a useful approach to reduce imbalance symptoms and to improve the quality of life in patients suffering from dizziness.

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The Rebound Boots Change the Lower Limb Muscle Activation and Kinematics During Different Fitness Exercises

Publication date: Available online 6 March 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Mateus Rossato, Rodolfo André Dellagrana, Juliane Cristine Lopes dos Santos, Felipe P. Carpes, Rodrigo Ghedini Gheller, De Angelys de Ceselles Seixas da Silva, Ewertton de Souza Bezerra, João Otacílio Libardoni dos Santos
The purpose of this study was to evaluate electromyography and kinematic parameters of the lower limbs using rebound boots (RB) and barefoot during a gym workout. This information can be helpful to practitioners to schedule the rehabilitation and training programs. Ten women (25 ± 9 years) volunteered for the study; inclusion criteria were as follows: subjects must have experienced the RB and the analyzed exercises for at least 6 months, and have no previous injuries in the lower limbs. Seven exercises were performed for 30 seconds with the RB and subsequently on barefoot. Data from muscle activation of vastus lateralis (VL), biceps femoris (BF), lateral gastrocnemius (LG) and 2D kinematics were collected. The RB triggered postural changes, characterized by larger hip extension (4 exercises) and knee extension (6 exercises) for the landing. RB reduced activation mainly in LG (6 exercises) while no changes were observed for VL (except exercise 1) and BF. RB change kinematics and muscle activation suggesting changes in the way the legs absorb and transmit force during jumps. LG was the main muscle affected by the use of RB.

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Within-day and between-day reliability of thickness measurements of abdominal muscles using ultrasound during abdominal hollowing and bracing maneuvers

Publication date: Available online 6 March 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Mahnaz Aboufazeli, Nima Afshar-Mohajer
Ultrasonography imaging has been used as a non-invasive method to estimate the thickness and relative activities of the abdominal muscles in patients with lower back pain (LBP). However, the statistical reliability of US thickness measurements of abdominal muscles, including transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) muscles during abdominal hollowing (AH) and abdominal bracing (AB) maneuvers has not been well-investigated. This study was performed on a total of 20 female subjects (10 with LBP and 10 without LBP) in the age range of 25 to 55 years to assess within-day and between-day reliability of the measurements. US measurements on maneuvers were repeated after two hours for the within-day reliability and after five days for the between-day reliability assessment. High intra-class correlation coefficient (ICC) values (>0.75) for within-day and between-day reliability assessments during AH maneuver were concluded. The ICC values were moderate for reliability assessment during AB. The ICC values for AH were greater than AB both for within- and between-day reliabilities. The small standard error of measurement and minimal detectable change values (0.16 to 0.78 and 0.44 to 2.15, respectively) were found for both AH and AB. We recommend real-time US imaging as a reliable way of determining the thicknesses of the TrA and IO muscle (and to some extent, EO muscle) for both healthy and LBP patients.

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The effects of dorso-lumbar motion restriction on EMG activity of selected muscles during running

Publication date: Available online 6 March 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Joseph J. Morley, Edward Traum
AbstractThe effects of restricting dorso-lumbar spine mobility on electromyographic activity of the erector spinae, quadriceps femoris, hamstrings and gastrocnemius muscles in runners was investigated. Thermoplastic casting material was fashioned into a rigid orthosis and used to restrict spinal motion during running. Volunteers ran on a treadmill at 2.78 m/sec, under normal conditions and with spinal motion restricted. Surface electromyographic data was collected during both sets of trials. Normal electromyographic data was also compared with previous authors to determine similarity with their electromyographic data.ResultsCasted running resulted in an increase in erector spinae (p < 0.01) and quadriceps femoris (p= 0.02) electromyography activity. Total stride time and swing time of gait were decreased during casted running (p < 0.01), indicating a shift towards shorter and thus more frequent steps to run the same distance. The normal electromyographic data collected was in agreement with previously reported work.ConclusionsNeurological control over muscle and the fascia surrounding it is responsible for joint movement and load transfer. Experimentally restricting spinal motion during running demonstrated an increase in erector spinae and rectus femoris electromyographic activity. This lends support to the hypothesis that decreased spinal mobility may be a contributing factor to overuse muscle injuries in runners.

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Δευτέρα 6 Μαρτίου 2017

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