Physiospot Musculoskeletal

Physiospot Redirect

All of our Physiospot blogs can now be found together at www.physiospot.com

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New Year, New Start!

With the expansion in the number of Physispot blogs available in 2007 it has become quite a large task to continually juggle them all and is not conducive to an effective service for our readers. We have therefore made the decision to amalgamate all the blogs into one place at www.physiospot.com.  Whilst you will be able to read all the  articles that have been selected as clinically relevant and posted we have developed separate areas of the site for research in different clinical areas. 

By making the management process more efficient not only will we be able to devote more time to actually posting articles but it will also provide a number of additional benefits:

• Each clinical area can be easily accessed from the navigation bar at the top of each page, no more flicking between different blogs.
• Articles can be tagged with more than one clinical area thereby adding more articles to each individual clinical area.
• The search function will search across all clinical areas so that you will be looking for what you need amongst all the articles posted.
• More easily keep up-to-date with recent additions in multiple clinicl areas by freely subscribing to one or more of our update options.
• Authors can easily work in more than one clinical area which may be useful for their own professional development and evidence based practice.

There is one small inconvenience to our readers which can be easily overcome.  As of today the email alerts and feeds for all the old physispot blogs will cease to function.  You will need to sign up again to receive the update alerts that you are interested in.  Go to the update options page to sign up now for your RSS feed and Email Alerts.  You can also download our toolbar to receive updates straight to your desktop and follow us on Twitter from this page.

We hope that all our readers are happy with the developments and that you enjoy the site and continue to find it useful, had we not done this we may not have been able to carry on with the juggling!  Visit the new site at www.physiospot.com

Taking a Break!

With a couple of e-learning projects that require some dedicated time, I will be taking a break from writing on the CPDspot and Physiospot blogs for the rest of November and December. There may continue to be some posts from our other authors but I will be going quiet until the New Year. When I return in 2009 I will be refreshed and ready to get writing again. I will also have had some time to consider some of the ideas for new projects that have been mulling around for a while now, so you can expect some exciting developments next year.

Differences in Range of Motion Between Dominant and Nondominant Sides of Upper and Lower Extremities

Luciana Gazzi Macedo and David J. Magee

The objective of this study was to compare ranges of motion (ROM) between dominant and nondominant sides for the joints of the upper and lower extremities.  Ninety healthy white women from 18 to 59 years of age were measured in this study. Active and passive ROM were measured for the ankle, knee, hip, shoulder, elbow, and wrist using a standard goniometer. The results of this study showed a statistically significant difference between dominant and nondominant sides for 34 of the 60 ROM measured. The maximum mean difference between sides for all ROM measured was 7.5°.

The results of this show that some ROM are different between body sides and that when these differences exist they are minimal and may not be clinically insignificant. These results support the practice of using the opposite side of the body as an indicator of preinjury or normal extremity ROM.

Journal of Manipulative and Physiological Therapeutics, 2008, 31(8), 577-582

Link to Abstract

The validity and accuracy of clinical tests used to detect labral pathology of the shoulder – A systematic review

Wendy Munro and Raymond Healy

This review systematically evaluates the evidence for the accuracy of tests for labral pathology of the shoulder.  Six accurate tests; Biceps Load I, Biceps Load II, Internal Rotation Resistance, Crank, Kim and Jerk tests were identified from high quality single studies in selected populations. Subgroup analysis identified varying results of accuracy in the Crank test and the Active Compression (AC) test when evaluated in more than one study.

Manual Therapy, 8 November 2008, online article

Link to abstract

Longitudinal sliding of the median nerve in patients with non-specific arm pain

Andrew Dilley, Samuel Odeyinde, Jane Greening and Bruce Lynn

This study uses ultrasound imaging to examine median nerve sliding through the proximal and distal nerve segments in 18 non-specific arm pain (NSAP; also known as repetitive strain injury) patients. Longitudinal nerve sliding was measured during metacarpophalangeal, wrist and elbow movements. During elbow movements, the angle of elbow extension at which the nerve begins to move was determined, since this was expected to decrease with a restriction through the shoulder. The results from this study were compared with previously reported data. Nerve movements ranged from 1.26 to 4.73 mm in patients compared with 1.43–5.57 mm in controls. There was no significant difference in nerve sliding or in the angle of elbow extension at which the nerve began to move.

In summary, restriction of median nerve sliding is unlikely to play a major role in NSAP. Therefore, painful responses during limb movements which tension the nerve are unlikely to result from abnormal increases in nerve strain.

Manual Therapy, 2008, 13(6), 536-543.

Link to Abstract

Manual landmark identification and tracking during the medial rotation test of the shoulder: An accuracy study using three-dimensional ultrasound and motion analysis measures

D. Morrissey, M.C. Morrissey, W. Driver, J.B. King and R.C. Woledge

The purpose of this study was to measure the accuracy of palpation of shoulder girdle translation during the medial rotation test (MRT) of the shoulder. The translation of the gleno-humeral and scapulo-thoracic joints was measured using both three-dimensional ultrasound and palpation in order to determine the accuracy of translation tracking during the MRT of the shoulder. Two movements of 11 normal subjects were measured. The agreement between measures was good for scapulo-thoracic translation. Gleno-humeral translation was systematically under estimated although moderate correlation was found.

These results indicate that translation of the measured joints can be tracked by palpation.

Manual Therapy, 2008, 13(6), 529-535

Link to Abstract

Training the cervical muscles with prescribed motor tasks does not change muscle activation during a functional activity

Deborah Falla, Gwendolen Jull and Paul Hodges

The purpose of this study was to investigate whether either training regime changes muscle activation during a functional task which is known to be affected in people with neck pain and is not directly related to either exercise protocol. Fifty-eight female patients with chronic neck pain were randomised into one of two 6-week exercise intervention groups: an endurance-strength training regime for the cervical flexor muscles or low-load training of the cranio-cervical flexor muscles. The primary outcome was a change in electromyographic (EMG) amplitude of the sternocleidomastoid (SCM) muscle during a functional, repetitive upper limb task. At the 7th week follow-up assessment both intervention groups demonstrated a reduction in their average intensity of pain. However, neither training group demonstrated a change in SCM EMG amplitude during the functional task.

The results demonstrate that training the cervical muscles with a prescribed motor task may not automatically result in improved muscle activation during a functional activity, despite a reduction in neck pain.

Manual Therapy, 2008, 13(6), 507-512

Link to Abstract

An investigation into the effects of a unilaterally applied lumbar mobilisation technique on peripheral sympathetic nervous system activity in the lower limbs

Jo Perry and Ann Green

This study aims to extend the knowledge base underpinning the use of a unilaterally applied lumbar spinal mobilisation technique by exploring its effects on the peripheral sympathetic nervous system (SNS) of the lower limbs.  45 participants were randomly assigned to one of three experimental groups (control, placebo or treatment; a unilaterally applied postero-anterior mobilisation to the left L4/5 zygopophyseal joint). SNS activity was determined by recording skin conductance (SC) obtained from lower limb electrodes connected to a BioPac unit. Results indicated that there was a significant change in SC from baseline levels that was specific to the side treated for the treatment group during the intervention period (compared to placebo and control conditions).

This study provides preliminary evidence that a unilaterally applied postero-anterior mobilisation technique performed, at a rate of 2 Hz, to the left L4/5 lumbar zygopophyseal joint results in side-specific peripheral SNS changes in the lower limbs.

Manual Therapy, 2008, 13(6), 492-499

Link to Abstract