Additional sensory input improves the strategy of stepping over obstacle in individuals with knee osteoarthritis.

BACKGROUND: The use of bandages improves quasi-static posture control in individuals with knee osteoarthritis, but it is unknown whether this increased sensory input influences postural control in dynamic tasks. OBJECTIVE: Assess the effect of bandage use on motor performance and reported pain in individuals with knee osteoarthritis during obstacle crossing. METHODS: Twenty-four individuals with knee osteoarthritis were enrolled. A force plate was used to measure the vertical and anterior-posterior components of the ground reaction force during obstacle crossing, for the trailing and leading legs, under conditions with and without the use of a bandage. Pain was assessed using the visual analogue scale. RESULTS: With use of a bandage, the propulsive time, time to active peak, propulsive peak, passive peak, and active impulse were significantly reduced in the trailing leg, and the braking peak was significantly increased in the leading leg. The pain parameters did not exhibit any variation. CONCLUSIONS: These results suggest that the use of a bandage allowed for a more rapid movement, better estimates of the force applied against the ground in the propulsive stage, and a reduction in the overload on the locomotor system in the loading response stage.

Agreement and reliability of two non-invasive methods for assessing cervical range of motion among young adults.

BACKGROUND: Cervical range of motion (CROM) is a fundamental component of the functional evaluation in physical therapy interventions. The CROM device stands out as a reliable, non-invasive and easy-to-use method, but it is a very expensive tool. In clinical practice, more affordable tools such as Fleximeters are preferred. However, the reliability of Fleximeters for the cervical spine has not been adequately tested. OBJECTIVES: To compare the Fleximeters and the CROM device for the analysis of CROM, and to investigate the intra- and inter-examiner reliability of both tools. METHODS: Cervical movements (flexion, extension, lateral flexion and rotation) were assessed in 20 asymptomatic young women by three examiners using both tools. The statistical analyses were performed using the intra-class correlation coefficient (ICC). RESULTS: The agreement between the tools was considered moderate for flexion and left rotation (0.71; 0.58) and excellent for all of the other movements (0.76-0.87). The intra-examiner reliability for the CROM device was moderate for flexion and right rotation (0.70; 0.69) and excellent for all of the other movements (0.79-0.88). For the Fleximeter, the agreement was excellent for inclination and right rotation (0.80; 0.77) and moderate for all of the other movements (0.69-0.75). The inter-examiner reliability for the CROM device was excellent for all movements (0.76-0.93) and for the Fleximeter, it was moderate for right and left rotation (0.66; 0.75) and excellent for all of the other movements (0.81-0.88). CONCLUSIONS: There was agreement between the CROM assessments using the Fleximeter and the CROM device. Furthermore, both devices showed acceptable reliability for clinical practice.

Concordância e confiabilidade de dois métodos não-invasivos para a avaliação da amplitude de movimento cervical em adultos jovens / Agreement and reliability of two non-invasive methods for assessing cervical range of motion among young adults

CONTEXTUALIZAÇÃO: A amplitude de movimento (ADM) cervical é fundamental na avaliação funcional e na intervenção fisioterapêutica. O Cervical Range of Motion (CROM) destaca-se por ser um método confiável, não invasivo e de fácil manuseio, porém de alto custo. Na prática clínica, opta-se por aparelhos mais acessíveis, como o Flexímetro, cuja confiabilidade ainda não foi adequadamente testada para o segmento cervical. OBJETIVOS: Comparar o Flexímetro com o CROM na análise da ADM cervical e verificar a confiabilidade intra e interexaminadores de ambas as ferramentas. MÉTODOS: Os movimentos cervicais de flexão, extensão, inclinação lateral e rotação foram mensurados, com ambas as ferramentas, por três examinadores em 20 indivíduos jovens, do sexo feminino, assintomáticos. A análise estatística foi realizada pelo Coeficiente de Correlação Intraclasse (ICC). RESULTADOS: A concordância entre as ferramentas foi considerada moderada nos movimentos de flexão e rotação esquerda (0,71;0,58) e excelente nos demais movimentos (0,76-0,87). A confiabilidade intraexaminadores com o CROM foi moderada para os movimentos de flexão e rotação direita (0,70; 0,69) e excelente para os demais movimentos (0,79-0,88); com o Flexímetro, foi excelente para inclinação e rotação direita (0,80; 0,77) e moderada para os demais movimentos (0,69-0,75). A confiabilidade interexaminadores com o CROM foi excelente em todos os movimentos (0,76-0,93) e, com o Flexímetro, foi moderada para os movimentos de rotação direita e esquerda (0,66; 0,75) e excelente para os demais movimentos (0,81-0,88). CONCLUSÕES: Os valores obtidos na avaliação da ADM cervical feita pelo Flexímetro concordam com aqueles mensurados pelo CROM. Além disso, ambas as ferramentas apresentam confiabilidades aceitáveis para a prática clínica.

BACKGROUND: Cervical range of motion (CROM) is a fundamental component of the functional evaluation in physical therapy interventions. The CROM device stands out as a reliable, non-invasive and easy-to-use method, but it is a very expensive tool. In clinical practice, more affordable tools such as Fleximeters are preferred. However, the reliability of Fleximeters for the cervical spine has not been adequately tested. OBJECTIVES: To compare the Fleximeters and the CROM device for the analysis of CROM, and to investigate the intra- and inter-examiner reliability of both tools. METHODS: Cervical movements (flexion, extension, lateral flexion and rotation) were assessed in 20 asymptomatic young women by three examiners using both tools. The statistical analyses were performed using the intra-class correlation coefficient (ICC). RESULTS: The agreement between the tools was considered moderate for flexion and left rotation (0.71; 0.58) and excellent for all of the other movements (0.76-0.87). The intra-examiner reliability for the CROM device was moderate for flexion and right rotation (0.70; 0.69) and excellent for all of the other movements (0.79-0.88). For the Fleximeter, the agreement was excellent for inclination and right rotation (0.80; 0.77) and moderate for all of the other movements (0.69-0.75). The inter-examiner reliability for the CROM device was excellent for all movements (0.76-0.93) and for the Fleximeter, it was moderate for right and left rotation (0.66; 0.75) and excellent for all of the other movements (0.81-0.88). CONCLUSIONS: There was agreement between the CROM assessments using the Fleximeter and the CROM device. Furthermore, both devices showed acceptable reliability for clinical practice.

Cervical mobility in women with migraine.

OBJECTIVE: To contrast the cervical range of motion (CROM) in women with episodic migraine (EM), transformed migraine (TM), and controls without migraine headaches. BACKGROUND: Migraineurs often complain about neck pain. Furthermore, neck problems can worsen the headaches in individuals with migraine. Individuals with neck pain usually have reduced CROM. Nonetheless, studies assessing the CROM in migraineurs are scarce. METHODS: Our sample was selected in an outpatient headache clinic, and consisted of 45 women aged 20-54 years old, 15 per group. Cervical mobility was evaluated in movements of flexion, extension, right lateral flexion, left lateral flexion, right rotation, and left rotation using the CROM technique, and was contrasted among the groups. Migraine clinical patterns were also evaluated (frequency, duration of migraine, pain in the moment of evaluation, pain in movement, and pain localization) as a function of CROM. RESULTS: Compared with controls, individuals with TM had numerically inferior CROM in all parameters, and significant reduction in 3 of them: extension (59.3 vs 68.1, P = .02), left lateral flexion (44.5 vs 49.1, P = .03), and right rotation (62.2 vs 69.6, P = .02). Compared with individuals with migraine, the TM group presented significantly reduced mobility only for extension (59.3 vs 68.4, P = .02). Migraineurs also had numerically inferior ROM, contrasted to controls, in 5 of the 6 parameters, although significance was seen just for right rotation (60.8 vs 68.6 P < .01). There was no correlation between cervical mobility and migraine parameters. The CROM was not reduced for the symptomatic side of migraine, in cases of unilateral pain. CONCLUSION: Contrasted to controls, individuals with episodic and TM have decreased cervical range of motion.