Change in Low Back Movement Patterns After Neurosurgical Intervention for Lumbar Spondylosis.

Objectives: The purpose of this study was to assess the use of computer-aided combined movement examination (CME) to measure change in low back movement after neurosurgical intervention for lumbar spondylosis and to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from lumbar disk disease, disk protrusion, and nerve root compression cases.

Methods: A test-retest, cohort observational study was conducted. Computer-aided CME was used to record lumbar range of motion in 18 patients, along with pain, stiffness, disability, and health self-report questionnaires.

Structure-Specific Movement Patterns in Patients With Chronic Low Back Dysfunction Using Lumbar Combined Movement Examination.

Objective: A test-retest cohort study was conducted to assess the use of a novel computer-aided, combined movement examination (CME) to measure change in low back movement after pain management intervention in 17 cases of lumbar spondylosis. Additionally we desired to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from 3 specific structural pathologic conditions: intervertebral disc, facet joint, and nerve root compression.

Methods: Computer-aided CME was used before and after intervention, in a cohort study design, to record lumbar range of movement along with pain, disability, and health self-report questionnaires in 17 participants who received image-guided facet, epidural, and/or rhizotomy intervention.

The Role of Botulinum Toxin Type A in the Clinical Management of Refractory Anterior Knee Pain.

Anterior knee pain is a highly prevalent condition affecting largely young to middle aged adults. Symptoms can recur in more than two thirds of cases, often resulting in activity limitation and reduced participation in employment and recreational pursuits. Persistent anterior knee pain is difficult to treat and many individuals eventually consider a surgical intervention.

An exploratory examination of the association between altered lumbar motor control, joint mobility and low back pain in athletes.

Background: Low back pain (LBP) is a common cause of lost playing time and can be a challenging clinical condition in competitive athletes. LBP in athletes may be associated with joint and ligamentous hypermobility and impairments in activation and coordination of the trunk musculature, however there is limited research in this area.

Objectives: To determine if there is an association between altered lumbar motor control, joint mobility and low back pain (LBP) in a sample of athletes.

Nucleus pulposus deformation in response to rotation at L1-2 and L4-5.

Background: Spinal rotation couples with lateral flexion as a composite movement. Few data report the in vivo mechanical deformation of the nucleus pulposus following sustained rotation. MRI provides a non-invasive method of examining nucleus pulposus deformation by mapping the hydration signal distribution within the intervertebral disc.

Enduring efficacy of Botulinum toxin type A injection for refractory anterior knee pain.

Purpose: To examine long-term outcomes of Botulinum toxin type A (BoNT-A) injection to vastus lateralis (VL) for refractory anterior knee pain (AKP).

Methods: Two cohorts (private clinic referrals and previous research participants) injected with BoNT-A for AKP by one neurologist were surveyed retrospectively. Primary outcomes were self-reported benefit, duration of symptom relief, and knee surgery post-injection.

Treatment of refractory anterior knee pain using botulinum toxin type A (Dysport) injection to the distal vastus lateralis muscle: a randomised placebo controlled crossover trial.

Objectives: This randomised controlled crossover trial examined the efficacy of botulinum toxin type A (BoNT-A) injection, plus an exercise programme, to remediate chronic anterior knee pain (AKP) associated with quadriceps muscle imbalance.

Methods: 24 individuals with refractory AKP received either BoNT-A (500 U Dysport) or the same volume saline injection to the vastus lateralis (VL) muscle and performed home exercises focusing on re-training the vastus medialis (VM) muscle. All subjects were offered open-label injection at 12 weeks.

Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation.

Whilst there are numerous studies examining aspects of sagittal plane motion in the lumbar spine, few consider coronal plane range of motion and there are no in vivo reports of nucleus pulposus (NP) displacement in lateral flexion. This study quantified in vivo NP deformation in response to side flexion in healthy volunteers. Concomitant lateral flexion and axial rotation range were also examined to evaluate the direction and extent of NP deformation.

Prolonged vastus lateralis denervation after botulinum toxin type A injection.

Intramuscular injection of botulinum toxin (BoNT) produces reversible blockade of neuromuscular transmission. In animal experimental models, recovery begins within four weeks and is usually complete by twelve weeks. We present evidence of prolonged denervation following BoNT injection of the vastus lateralis (VL) muscle to correct quadriceps muscle imbalance in patients with chronic anterior knee pain.

Assessment of osteoporotic fracture risk in community settings: a study of post-menopausal women in Australia.

The healthcare cost of managing osteoporotic fractures is projected to rise because of the change in population demographics. To reduce the fracture epidemic, strategies are needed to identify those at risk early to allow preventative intervention to be implemented. The aim of this study was to investigate if low-cost community-based assessments, such as calcaneal ultrasound and falls risk assessments, can discriminate a group of elderly women at risk of osteoporotic fracture from those at lower risk.

Clinical utility of calcaneal quantitative ultrasonometry and thoracic kyphosis assessments in identifying vertebral fractures in community settings.

Objective: Individuals with existing vertebral fractures may not be aware that they are at high risk of subsequent fractures. We investigated if calcaneal quantitative ultrasonometry (QUS) and assessment of thoracic kyphosis could discriminate a group of older women with prevalent vertebral fracture from those without.

Methods: One hundred four women (mean age 71.

Analysis of dynamic angle of gait and radiographic features in subjects with hallux abducto valgus and hallux limitus.

Background: Hallux abducto valgus and hallux limitus are two commonly encountered foot deformities causing altered structure and function of the first metatarsophalangeal joint and subsequent compensatory mechanisms. This study was undertaken to determine the relationships between these two deformities and transverse plane position of the foot, or angle of gait, and several radiographic angular and linear parameters with established reliability.

Methods: A convenience sample of 23 subjects with hallux abducto valgus, 22 subjects with hallux limitus, and 20 control subjects was used.

Reliability and validity of the Hindi version of the Neck Pain and Disability Scale in cervical radiculopathy patients.

Purpose: To assess the reliability and validity of the Neck Pain and Disability Scale (NPAD) translated into Hindi.

Method: Following a pilot study to ascertain uncertainties with existing terminology in the NPAD scale, a cervical radiculopathy patient cohort (n = 63) was assessed with the translated NPAD. Reliability was assessed by regression analysis for test-retest and by item-factor and factor-total score correlations.

An MRI investigation of intervertebral disc deformation in response to torsion.

Background: The nucleus pulposus deforms towards an area of least compression in response to offset loading, however, there is a lack of data reporting the deformation patterns of nuclear material in rotated positions of the lumbar spine. Our purpose was to assess a novel methodology using MRI to track nuclear deformation in response to flexion and extension positions, and the combined positions of flexion with left rotation and extension with left rotation, at L1-2 and L4-5.

Methods: Three asymptomatic female subjects, mean age 27 years, underwent T2 weighted MRI sequences in flexed, extended, and left rotated positions combined with flexion and extension.

Validation of the spin-T goniometer, a cervical range of motion device.

Objective: To test the validity of the Spin-T goniometer for the assessment of cervical range of movement.

Methods: A linear regression analysis for paired neck movements using first a foam head model and then human subjects was performed to quantify the differences between the measurements obtained from the MotionStar, a movement-tracking device, and the Spin-T. A within-subject repeated measures design using simultaneous data acquisition was completed.

Reliability of the spin-T cervical goniometer in measuring cervical range of motion in an asymptomatic Indian population.

Objective: To examine the intratester reliability of the Spin-T goniometer, a cervical range of motion device, in a normal Indian population.

Methods: Subjects comprised 30 healthy adults with mean age of 34 years (range, 18-65 years). The subjects were stabilized in the sitting position and the Spin-T goniometer mounted on the head of the subject.

Radiographic investigation of angular and linear measurements including first metatarsophalangeal joint dorsiflexion and rearfoot to forefoot axis angle.

This study investigated intra- and inter-rater reliability of several radiographic angular and linear parameters using 6 subjects. Using standard weight-bearing radiographs, the following measurements were performed: first metatarsal protrusion distance, hallux abductus, first intermetatarsal, calcaneal inclination and lateral intermetatarsal angles. Measurement of lateral stressed dorsiflexion of the first metatarsophalangeal joint and the rearfoot-to-forefoot-axis angle taken using a composite view were also obtained.

In vivo short-term precision of hip structure analysis variables in comparison with bone mineral density using paired dual-energy X-ray absorptiometry scans from multi-center clinical trials.

Hip structural analysis (HSA) is a technique for extracting strength-related structural dimensions of bone cross-sections from two-dimensional hip scan images acquired by dual energy X-ray absorptiometry (DXA) scanners. Heretofore the precision of the method has not been thoroughly tested in the clinical setting. Using paired scans from two large clinical trials involving a range of different DXA machines, this study reports the first precision analysis of HSA variables, in comparison with that of conventional bone mineral density (BMD) on the same scans.

Incidence of ankle contracture after moderate to severe acquired brain injury.

Objective: To examine an adult population undergoing rehabilitation after brain injury to determine the incidence of ankle contracture and factors contributing to the development of this deformity.

Design: Descriptive study

Setting: Specialist inpatient neurosurgical rehabilitation unit in Australia.

Participants: Patients (N=105) admitted with a new diagnosis of moderate to severe brain injury over a 12-month period.

Is there a difference in hip joint position sense between young and older groups?

Background: Joint position sense (JPS) in the knee has been shown by many authors to decline with age. It has been speculated that this decrease contributes to abnormal joint mechanics during load-bearing activities and putatively results in joint degeneration. Surprisingly little research has been conducted on the human hip to determine benchmarks for normal JPS.

Age-related changes in collagen, pyridinoline, and deoxypyridinoline in normal human thoracic intervertebral discs.

Human thoracic discs were analyzed for collagen and collagen cross-links to determine the distribution due to segmental, age, and gender influences. Thoracic discs from 26 cadaveric spines (1 to 90 years old) were graded macroscopically, then separated into anular and nuclear samples. Only grade I (i.

Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults.

Objective: To determine the potential short-term benefit of serial plaster casting in the management of equinovarus deformity associated with acquired brain injury.

Design: Prospective uncontrolled interventional trial.

Setting: Inpatient rehabilitation facility in Australia.

Influence of age on cervicothoracic spinal curvature: an ex vivo radiographic survey.

Objective: To define the post-mortem cervicothoracic spinal curvature relative to age.

Design: Spinal curvature assessment of lateral cervicothoracic radiographs.

Background: A late consequence of age is the progressive accentuation of spinal curvatures, particularly the thoracic kyphosis.