Quantitative Shear Wave Speed Assessment for Muscles With the Diagnosis of Taut Bands and/or Myofascial Trigger Points Using Probe Oscillation Shear Wave Elastography: A Pilot Study.

Objective: To use probe oscillation shear wave elastography (PROSE) with two vibration sources to generate two shear waves in the imaging plane to quantitatively assess the shear wave speeds (SWSs) of muscles with and without the diagnosis of taut bands (TB) and/or myofascial trigger points (MTrPs).

Methods: Thirty-three patients were scanned with the PROSE technique. Shear waves were generated through continuous vibration of the ultrasound probe, while the shear wave motions were detected using the same probe.

Effect of Off-Axis Fluoroscopy Imaging on Two-Dimensional Kinematics in the Lumbar Spine: A Dynamic In Vitro Validation Study.

Spine intersegmental motion parameters and the resultant regional patterns may be useful for biomechanical classification of low back pain (LBP) as well as assessing the appropriate intervention strategy. Because of its availability and reasonable cost, two-dimensional (2D) fluoroscopy has great potential as a diagnostic and evaluative tool. However, the technique of quantifying intervertebral motion in the lumbar spine must be validated, and the sensitivity assessed.

Quantification of Myofascial Taut Bands.

Objective: To assess the correlation of clinician-identified myofascial taut bands with their presence and characteristics on magnetic resonance elastography (MRE) imaging.

Design: Cross-sectional study.

Setting: A magnetic resonance imaging (MRI) research laboratory.

Biomechanical and histological effects of augmented soft tissue mobilization therapy on achilles tendinopathy in a rabbit model.

Objective: Augmented soft tissue mobilization (ASTM) has been used to treat Achilles tendinopathy and is thought to promote collagen fiber realignment and hasten tendon regeneration. The objective of this study was to evaluate the biomechanical and histological effects of ASTM therapy on rabbit Achilles tendons after enzymatically induced injury.

Methods: This study was a non-human bench controlled research study using a rabbit model.

Lumbar trabecular bone mineral density distribution in patients with and without vertebral fractures: a case-control study.

Purpose: The proportion of load transmitted through the lumbar neural arch increases with aging, spinal degeneration, and lordosis, effectively shielding the lumbar vertebral bodies from load. This stress shielding may contribute to bone loss in the vertebral body, leading to increased fracture risk. To test his hypothesis, we performed a study to determine if vertebral body fractures were associated with a higher neural arch/vertebral body volumetric bone mineral density (vBMD) ratio.

Clinical effectiveness of single lumbar transforaminal epidural steroid injections.

Objectives: To assess the clinical effectiveness of single lumbar transforaminal epidural steroid injections (TFESIs) in subjects with radicular pain with or without radiculopathy.

Design: Retrospective observational series.

Setting: Single academic radiology pain management practice.

Transverse connectors providing increased stability to the cervical spine rod-screw construct: an in vitro human cadaveric study.

Object: The object of this study was to determine if the addition of transverse connectors (TCs) to a rod-screw construct leads to increased stabilization of the cervical spine.

Methods: Eleven human cadaveric cervical spines (C2-T1) were used to examine the effect of adding connectors to a C3-7 rod-screw construct in 3 models of instability: 1) C3-6 wide laminectomy, 2) wide laminectomy and 50% foraminotomy at C4-5 and C5-6, and 3) wide laminectomy with full medial to lateral foraminotomy. Following each destabilization procedure, specimens were tested with no TC, 1 TC between the C-5 screws, and 2 TCs between the C-4 and C-6 screws.

Biomechanical evaluation of posterior lumbar dynamic stabilization: an in vitro comparison between Universal Clamp and Wallis systems.

Treatment of chronic low back pain due to degenerative lumbar spine conditions often involves fusion of the symptomatic level. A known risk of this procedure is accelerated adjacent level degeneration. Motion preservation devices have been designed to provide stabilization to the symptomatic motion segment while preserving some physiologic motion.

Joint mobilization vs massage for chronic mechanical neck pain: a pilot study to assess recruitment strategies and estimate outcome measure variability.

Objective: The purpose of this study was to determine the feasibility of a trial comparing cervical spine mobilization and massage as adjuncts to usual physical therapy treatments (superficial heat and head and neck posture education) for chronic neck pain. Specific objectives were to assess procedures and recruitment strategies and estimate the variability of the Neck Disability Index (NDI) and visual analog scale (VAS) in a population of subjects with chronic nonspecific neck pain and calculate a sample size for a definitive trial.

Methods: Subjects with nonspecific chronic neck pain (≥3 months) were randomized to receive either sedative massage or cervical spine joint mobilization in addition to postural education and home exercises.

NASS Contemporary Concepts in Spine Care: spinal manipulation therapy for acute low back pain.

Background Context: Low back pain (LBP) continues to be a very prevalent, disabling, and costly spinal disorder. Numerous interventions are routinely used for symptoms of acute LBP. One of the most common approaches is spinal manipulation therapy (SMT).

Reduction in disk and fiber stresses by axial distraction is higher in cervical disk with fibers oriented toward the vertical rather than horizontal plane: a finite element model analysis.

Objective: The purpose of this study was to quantify the biomechanical changes that occur in a compressed cervical disk with the application of axial distraction when the annular fiber orientation angles are varied between the horizontal and vertical planes.

Methods: A 3-dimensional finite element (FE) model of a cervical motion segment was developed. From this model, 3 FE models were developed and validated corresponding to 3 different fiber angles relative to the end plate-disk interface: +/-25 degrees (oriented toward the horizontal plane), +/-45 degrees (midway between the horizontal and vertical planes), and +/-65 degrees (oriented toward the vertical plane).

Junction kinematics between proximal mobile and distal fused lumbar segments: biomechanical analysis of pedicle and hook constructs.

Background Context: Biomechanical studies have demonstrated increased motion in motion segments adjacent to instrumentation or arthrodesis. The effects of different configurations of hook and pedicle screw instrumentation on the biomechanical behaviors of adjacent segments have not been well documented.

Purpose: To compare the effect of three different fusion constructs on adjacent segment motion proximal to lumbar arthrodesis.

Biomechanical evaluation of a new fixation device for the thoracic spine.

The technology used in surgery for spinal deformity has progressed rapidly in recent years. Commonly used fixation techniques may include monofilament wires, sublaminar wires and cables, and pedicle screws. Unfortunately, neurological complications can occur with all of these, compromising the patients' health and quality of life.

Evidence-informed management of chronic low back pain with traction therapy.

The management of chronic low back pain (CLBP) has proven to be very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient.

Effect of multiple freeze-thaw cycles on intervertebral dynamic motion characteristics in the porcine lumbar spine.

Fresh frozen spine specimens are commonly used in biomechanical investigations of the spine. Since many study designs require staged preparation and testing, the effect of multiple freeze-thaw cycles on motion behavior should be understood. The objective of this study was to investigate the effect of multiple freeze-thaw cycles on the biomechanical parameters measured during dynamic pure moment loading.

Stress in lumbar intervertebral discs during distraction: a cadaveric study.

Background Context: The intervertebral disc is a common source of low back pain (LBP). Prospective studies suggest that treatments that intermittently distract the disc might be beneficial for chronic LBP. Although the potential exists for distraction therapies to affect the disc biomechanically, their effect on intradiscal stress is debated.

The effect of loading rate and degeneration on neutral region motion in human cadaveric lumbar motion segments.

Background: The quasistatic neutral zone is a surrogate for neutral region stiffness of spinal motion segments. No similar measure of dynamic stiffness has been validated. Because parameters related to stiffness are likely to be affected by loading rate and disc degeneration, we examined the effect of those factors on motion parameters derived from continuous motion data.

Comparison of the Neck Disability Index and the Neck Bournemouth Questionnaire in a sample of patients with chronic uncomplicated neck pain.

Objective: This study compares the sensitivity to change of the Neck Disability Index (NDI) and the Neck Bournemouth Questionnaire (NBQ) in patients with chronic uncomplicated neck pain.

Methods: This prospective longitudinal study was completed in an outpatient physical therapy clinic. Subjects, with uncomplicated neck pain (no concurrent shoulder pain or nerve root symptoms) for more than a 3-month duration, participated in a 4-week course of therapy that included moist heat, neck exercises, and either mobilization or massage.

Sagittal plane motion in the human lumbar spine: comparison of the in vitro quasistatic neutral zone and dynamic motion parameters.

Background: Disabling low back pain is often attributed to clinical instability but defining instability is problematic. The most common parameter used to characterize instability in the lab is the neutral zone which is measured with a quasi-static technique. But, it cannot be measured from continuous motion data.

Chronic lateral epicondylitis: comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening.

The objective of this study was to evaluate the effectiveness of eccentric strengthening. Ninety-four subjects (50 men) with chronic lateral epicondylitis were allocated randomly into three groups: stretching, concentric strengthening with stretching, and eccentric strengthening with stretching. Subjects performed an exercise program for six weeks.

Sensitivity of the Patient-rated Forearm Evaluation Questionnaire in lateral epicondylitis.

The purpose of this study was to examine the sensitivity, reliability, and concurrent validity of the Patient-rated Forearm Evaluation Questionnaire (PRFEQ). Reliability on three consecutive days was evaluated with 22 of 94 subjects who had chronic lateral epicondylitis (LE) and who concomitantly participated in an outcome study. The PRFEQ results were compared with results of the Visual Analogue Scale; the Disabilities of the Arm, Shoulder, and Hand questionnaire; the Medical Outcomes Study 36-Item Short Form Health Survey; and the pain-free grip strength measurement.

Are tender points associated with cervical radiculopathy?

Objective: To determine if there is an association between cervical radiculopathy and tender spots in the neck and upper extremity on the side of radiculopathy.

Design: Prospective cross-sectional study.

Setting: Outpatient spine clinic within an academic institution.

Distraction manipulation of the lumbar spine: a review of the literature.

Objective: The purpose of this study is to review the literature concerning distraction manipulation of the lumbar spine, particularly regarding physiological effects, clinical efficacy, and safety.

Data Sources: A search of the English language literature was conducted using the MEDLINE, Embase, CINAHL, Chiropractic Research Archives Collection, and Manual, Alternative, and Natural Therapies Information System databases. A secondary hand search of bibliographies was completed to identify older or nonindexed literature.

Comparative responsiveness of the disabilities of the arm, shoulder, and hand, the carpal tunnel questionnaire, and the SF-36 to clinical change after carpal tunnel release.

Purpose: The objective of this study was to compare the responsiveness (ability to accurately detect change) of 3 self-administered questionnaires to changes produced by carpal tunnel release.

Method: The Disabilities of the Arm, Shoulder and Hand (DASH), the Brigham and Women's Carpal Tunnel Questionnaire, and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were completed by 34 subjects before surgery and at 6 and 12 weeks after carpal tunnel release.

Results: The instrument most sensitive to clinical change at 12 weeks as judged by effect size and standardized response means was the Carpal Tunnel Questionnaire (effect size/standardized response means, 1.