Normal Kinematics of the Neck: The Interplay Between the Cervical and Thoracic Spines.

Normal kinematics of the neck: The interplay between the cervical and thoracic spines.

Man Ther. 2013 Apr 27;
Tsang SM, Szeto GP, Lee RY

The movement coordination between the cervical and thoracic spine was examined in 34 asymptomatic participants (24 female and 10 male). Three-dimensional electromagnetic motion sensors were attached to the skin overlying the head, T1, T6, and T12 spinous processes to measure the angular displacement of the cervical, upper thoracic, and lower thoracic spine during active neck movements. These displacement measurements were found to have excellent reliability, with intraclass correlation coefficient ranging from 0.899 to 0.993. The angular displacement-time curves of the cervical and upper thoracic spine were also highly repeatable, with coefficient of multiple determinations ranging from 0.900 to 0.967. Both the cervical and thoracic spines were found to contribute to active neck motion, the greatest contribution being from the cervical region in all movement directions. The inter-regional movement coordination between the cervical spine and upper thoracic spine in all three planes of movement was found to be high, as determined by cross-correlation analysis of the movements of the regions. The current results suggest that the motion of the thoracic spine, in particular the upper thoracic spine, contributes to neck mobility, and that the upper thoracic spine should be included during clinical examination of neck dysfunction. HubMed – rehab


Meta-Analysis of Botulinum Toxin A Detrusor Injections in the Treatment of Neurogenic Detrusor Overactivity following Spinal Cord Injury.

Arch Phys Med Rehabil. 2013 Apr 27;
Mehta S, Hill D, McIntyre A, Foley N, Hsieh J, Ethans K, Teasell RW, Loh E, Welk B, Wolfe D

OBJECTIVE: To examine the effectiveness of botulinum toxin A (BTX A) on neurogenic detrusor overactivity (NDO) in individuals with spinal cord injury (SCI). DATA SOURCES: Medline, CINAHL, EMBASE and PsycINFO databases were searched for all relevant articles published from 1980 to June 2012. DATA SELECTION: Trials examining the use of BTX-A injections into the detrusor wall in treatment of NDO after SCI were included if ? 50% of study sample was comprised of subjects post SCI, outcomes of interest were assessed before and after treatment with a single injection of BTX and if the sample size was ?3. DATA EXTRACTION: A standardized mean difference (SMD) ± standard error (95% confidence interval, CI) was calculated for at least one of the following outcomes in every study: post-void residual urine volume, reflex detrusor volume, bladder capacity, bladder compliance, catheterization frequency, and max flow rate. Results from all studies were then pooled using a random effects model. Treatment effect sizes were interpreted as: small>0.2, moderate>0.5, or large>0.8. DATA SYNTHESIS: Fourteen studies representing data from 734 subjects were included. Post BTX A injection, large treatment effects were observed in post-void residual urine volume, reflex detrusor volume, bladder capacity, bladder compliance, and catheterization frequency (p<0.01). Rate of incontinence episodes was reduced from 23% to 1.31% post BTX-A treatment. No significant decrease in max flow rate was observed (p=0.403). CONCLUSION: Results of the meta-analysis indicate BTX-A is effective in treating NDO after SCI. The use of BTX-A was associated with a decrease in incontinence episodes, catheter use and bladder pressures. HubMed – rehab


Cariogenic potential of commercial sweeteners in an experimental biofilm caries model on enamel.

Arch Oral Biol. 2013 Apr 27;
Giacaman RA, Campos P, Muñoz-Sandoval C, Castro RJ

OBJECTIVE: Scarce evidence is available on the cariogenic potential of the widely used commercial sweeteners. The aim of this study was to evaluate the effect of several sweeteners on enamel demineralisation and on the cariogenic properties of Streptococcus mutans biofilms in an artificial caries model. METHODS: S. mutans-UA159 biofilms were cultured on bovine enamel slabs and exposed to one of the following commercial sweeteners in tablet or powder form: stevia, sucralose, saccharin, aspartame or fructose. Ten percent sucrose and 0.9% NaCl were used as caries-positive and caries-negative controls, respectively. Slabs/biofilms were exposed to the sweeteners three times per day for 5min each time. After 5 days, biofilms were recovered to determine: biomass, bacterial counts and intra- and extracellular polysaccharides. Surface microhardness was measured before and after the experiment to assess enamel demineralisation, expressed as percentage of surface hardness loss (%SHL). Data were analysed using analysis of variance (ANOVA) and Bonferroni (p<0.05). RESULTS: All tested commercial sweeteners, except fructose, showed less enamel demineralisation than sucrose (p<0.05). Only saccharine showed less biomass and intracellular polysaccharides than the rest of the groups (p<0.05). Stevia, sucralose and saccharine reduced the number of viable cells when compared with sucrose (p<0.05). All sugar alternatives reduced extracellular polysaccharide formation when compared with sucrose (p<0.05). CONCLUSIONS: Most commercial sweeteners appear to be less cariogenic than sucrose, but still retaining some enamel demineralisation potential. Products containing stevia, sucralose and saccharine showed antibacterial properties and seem to interfere with bacterial metabolism. Further studies are necessary to deepen these findings. HubMed – rehab


Rapid Assessment of Neurovisual Integrity Using Multiple Rarebits.

Ophthalmology. 2013 Apr 27;
Frisén L

OBJECTIVE: Rapid assessments of vision commonly rely on visual acuity testing alone. Although well suited for uncovering optical defects, visual acuity tests may fail to detect dysfunction of the neural substrate. There is a need for a rapid companion test sensitive to neural damage. DESIGN: Evaluation of diagnostic tests. PARTICIPANTS AND CONTROLS: Forty-seven patients with optic nerve or visual pathway lesions of low to moderate severities and 30 normal subjects. METHODS: A new computer-based quick test of neurovisual integrity was developed using segmented digits defined by rarebits, that is, receptive field-size bright dots briefly presented on a dark background. MAIN OUTCOME MEASURES: The test variable was the number of rarebits per segment; digit size was fixed. The test task was to call out verbally all digits that were seen during an 8-second presentation sequence. Test outcomes were contrasted with the results of an optotype acuity test and automated perimetry. RESULTS: All subjects easily grasped the test task. The normal subjects read, on average, 5.6 (±0.5 standard deviation) of the 6 digits contained in the test sequence, whereas the patients averaged 3.3±1.8 digits. The numbers of digits read correlated modestly with the acuity and perimetry results. Analysis of receiver operating characteristic curves indicated that the multiple rarebit test provided the best discrimination. CONCLUSIONS: The multiple rarebit test seemed to be highly capable of detecting neurovisual dysfunction. Its simplicity and uniquely short duration indicate a useful role in screening settings. The test is available free on the Internet. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references. HubMed – rehab