ABSTRACT
BACKGROUND@#Myofascial Pain Syndrome (MPS) is a persistent pain on the shoulders and cervical spine related to limitation of motion (LOM), muscle weakness, and loss of function. It is a cumulative, repetitive injury causing disability among the middle-aged working population. This study will determine the differences in upper trapezius' superficial and deep fascia displacements among participants with and without MPS based on the effects of cervical active range of motion (AROM).@*METHODS@#This is a retrospective records review study with two interlinked parts. In the reliability study, the Tracker will determine the physiotherapy interns' intertester and intratester reliability in assessing the musculoskeletal ultrasound videos. Using MedCalc Software and the Bland-Altman plot, the single measures ICC will determine the reliability. In determining clinically acceptable use of the Tracker, a <0.40 cut-off reliability will be used. In the case-control study, physiotherapy interns will assess 2,904 musculoskeletal ultrasound videos. The difference between the superficial and deep fascia displacements will be determined using paired t-test and the mean differences using an independent t-test. A significant difference between groups will be determined using a p-value of <0.05.@*EXPECTED RESULTS@#This study expects that cervical AROM with overpressure will displace the superficial and deep fascia of the upper trapezius, particularly among patients with MPS. Proving the correlation between LOM and altered fascia displacement will help rehabilitation professionals create new manual therapy techniques and emphasize the use of existing fascia-related treatments.
ABSTRACT
BACKGROUND@#Myofascial Pain Syndrome (MPS) is a persistent pain on the shoulders and cervical spine related to limitation of motion (LOM), muscle weakness, and loss of function. It is a cumulative, repetitive injury causing disability among the middle-aged working population. This study will determine the differences in upper trapezius' superficial and deep fascia displacements among participants with and without MPS based on the effects of cervical active range of motion (AROM).@*METHODS@#This is a retrospective records review study with two interlinked parts. In the reliability study, the Tracker will determine the physiotherapy interns' intertester and intratester reliability in assessing the musculoskeletal ultrasound videos. Using MedCalc Software and the Bland-Altman plot, the single measures ICC will determine the reliability. In determining clinically acceptable use of the Tracker, a <0.40 cut-off reliability will be used. In the case-control study, physiotherapy interns will assess 2,904 musculoskeletal ultrasound videos. The difference between the superficial and deep fascia displacements will be determined using paired t-test and the mean differences using an independent t-test. A significant difference between groups will be determined using a p-value of <0.05.@*RESULTS@#This study expects that cervical AROM with overpressure will displace the superficial and deep fascia of the upper trapezius, particularly among patients with MPS. Proving the correlation between LOM and altered fascia displacement will help rehabilitation professionals create new manual therapy techniques and emphasize the use of existing fascia-related treatments.
ABSTRACT
Background: Deep fascia is dense and well developed in limbs. In the upper limb the deep fascia is tightly adherent to the underlying muscles especially in the forearm, thereby, restricting the space available to muscular swelling causing painful compartment syndrome. Division of this inelastic fascia or fasciotomy is an emergency procedure to decrease the morbidity and mortality.Methods: 30 patients with acute compartment syndrome of the upper extremity of various aetiologies were studied. Adults with painful, swollen and tense upper extremities with progressive neurological dysfunction were studied. Compartment pressures before and after fasciotomy were measured by a standard Whiteside’s device. Various fasciotomies were carried out and associated skeletal and vascular injuries were also noted.Results: The majority of patients were males with average age being 29.33 years. 56.67% patients with upper limb compartment syndrome sustained road traffic injury, 20% were constrictive tight cast, 20% of patients sustained burn and 1 patient was shot by bullet. Of the 30 patients fractures of both ulna and radius (40%) were the most common. Fractures of the humerus, radius, ulna and small bone of metacarpals together account for 36.67% of the affected patients. 3 patients were found to have injury to major vessels. Compartment pressure was measured by Whiteside’s device and fasciotomy resulted in a drastic drop of the pressure from pre-fasciotomy pressure of 44.8±7.9 mmHg to post-fasciotomy pressure of 12.33±3.61 mmHg.Conclusions: The diagnosis of compartment syndrome should be confirmed swiftly and prompt fasciotomy is the treatment of choice. This offers the best chance at decreasing compartment pressure and preventing further damage.
ABSTRACT
Objective To investigate the method to prevent the displacement of tissue expander implanted between the panniculus carnosus and deep fasia in rabbits .Method 40 rabbits were divided into two groups randomly: the experimental group and the control group .Through an incision on the back , a pocket was made by dissecting between the rabbit panniculus carnosus and deep fasia .The panniculus carnosus at the pocket boundary were sutured with the deep fascia inside the pocket by interrupted 3-0 sutures.A 50 mL kidney-shaped tissue expander was implanted .The expander was inflated with 10 mL saline after the wound was sutured .7 days after implantation , black tattoos were made on the skin around the expander to mark the site of expander .Two months after implantation , the expanders in the experimental group were inflated with 10 mL saline weekly to a total of 140 mL.7 days after implantation the expanders of control group were inflated with 10 mL saline weekly to a total of 140 mL.The incidence of expander displacement , dehiscence of incision , reversal of injection pot and death were recorded .Results There was no expander displacement in the 19 rabbits of experimental group .All the expanders were located within the tattoo area .There was no expander displacement in 11 rabbits of the control group .4 expanders of the control group moved from the back to belly .The difference between them was statistically significant ( P 0.05 ) .Meanwhile there was no significant difference in the incidences of reversal of injection pot , infections and deaths ( P >0.05 for all ) .Conclusions Sutures between the panniculus carnosus and the deep fascia at the pocket boundary asisted by delayed inflating can prevent the displacement of tissue expander implanted between the panniculus carnosus and deep fasia in rabbits , thus to obtain effective expansion .