The anatomical myofascial continuum between the neck and eyes.

The posterior myofascial chain (PMC) or superficial back line encompasses a series of muscles interlinked by the deep fascia, extending from the foot to the fascial sheath of the eyeball. The deep cervical fascia of the neck, the epicranial aponeurosis of the head, and the fascial sheath of eyeball, form the proximal PMC. Although the literature has reported an anatomical myofascial continuum between the neck, head, and eyes, the anatomical descriptions vary substantially. Moreover, there is still no plausible functional interrelationship between the proximal structural myofascial links. Chronic neck pain is usually associated with a plethora of symptoms including craniofacial pain and oculomotor disorders. Understanding the anatomy of the proximal myofascial chain could help clinicians improvise treatment strategies for managing such painful head and neck disorders.

The influence of fascial manipulation on function, ankle dorsiflexion range of motion and postural sway in individuals with chronic ankle instability.

BACKGROUND: Proprioceptive deficits may attribute to functional Chronic ankle instability (CAI) with impairments in balance and postural control. Physical therapy interventions such as taping, bracing, manual therapy, and balance training play an essential role in managing ankle instabilities. Fascial Manipulation (FM) is a manual therapy technique considered to restore function by improving the joint range of motion and proprioception. However, the effects of FM on Ankle dorsiflexion range of motion (ADROM) and postural sway in athletes with chronic ankle instability are unclear. OBJECTIVE: This study aims to determine the effect of FM on function, ADROM, and Postural sway in athletes with CAI. DESIGN: Single group, pretest-posttest design. METHODS: Individuals with a history of recurrent ankle sprains with the Cumberland ankle instability tool (CAIT) score of ≤27 were included. FM was applied to the painful and densified center of coordination points on the lower limb myofascial lines based on Stecco's FM method. The outcomes measures include Foot and ankle disability index (FADI), ADROM during the weight-bearing lunge, and postural sway (excursion of the center of pressure during single limb stance). RESULTS: There was a significant improvement in the FADI scores (Z = -3.626, p < 0.05), ADROM [F (2)=38.056, p<0.05], ηp 2 = 0.69 following FM. However, the center of pressure excursion with both opened and closed eyes showed no differences following FM. CONCLUSION: Since fascial manipulation had shown improvement in the function and ankle dorsiflexion range, it can be used as an adjunct treatment strategy in CAI management.

Comparison of respiratory parameters in participants with and without chronic low back pain.

BACKGROUND: Individuals with chronic low back pain (CLBP) may lack coordination between the stabilising and respiratory functions of trunk muscles. The trunk stabilisers compromise breathing to maintain spinal stability, leading to breathing dysfunctions. Maximal voluntary ventilation (MVV) is indicative of the respiratory muscle endurance and strength whereas end-tidal carbon dioxide (PETCO2) gives an estimate of breathing patterns that closely reflect the arterial measurement of CO2. CLBP has been shown to have a significant effect on respiratory functions. However, the impact has not yet been quantified. Further, there is a dearth of literature comparingrespiratory functions between CLBP and healthy individuals. This study investigates respiratory functions in participants with and without CLBP. METHODS: The study compared the respiratory functions of maximal voluntary ventilation (MVV) and End-Tidal Carbon Dioxide (PETCO2) between 14 participants with CLBP and 14 healthy individuals. Participants in both groups were matched for age, height, weight and body surface area. The assessment of MVV and PETCO2 were performed sitting, standing on a stable surface, and on an unstable surface (BOSU ball). RESULTS: The mean of measured MVV (L/min) was found to be lower (p < 0.05) in the CLBP group when compared to the healthy group. Mean PETCO2 and respiratory rate was found to be higher in CLBP group when compared to the healthy group in all three positions, although this was not found to be statistically significant. CONCLUSION: The findings of this study demonstrated sub-optimal respiratory parameters in participants with chronic low back pain. However, when adjusted for gender, the difference was not found to be significant between the two groups.