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Matthijs Oudkerk - One of the best experts on this subject based on the ideXlab platform.
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measurement of angular and linear segmental lumbar Spine flexion extension motion by means of image registration
European Spine Journal, 2005Co-Authors: L Penning, R Irwan, Matthijs OudkerkAbstract:Background The presently available method of measuring segmental lumbar Spine Mobility by means of superimposition of lumbar Spine radiographs in flexion and extension lacks precision due to differences in the cortical outline of the vertebral bodies in flexed and extended position. The introduction of digital image processing has opened the possibility of computerised superimposition (‘matching’) of digital vertebral body images by means of image registration. Theoretically this technique allows more accurate image matching and, consequently, greater precision of measurement because the whole vertebral body image (not only its cortical outline) can be chosen as region of interest, with registration of all available digital information within this region.
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measurement of angular and linear segmental lumbar Spine flexion extension motion by means of image registration
European Spine Journal, 2005Co-Authors: L Penning, R Irwan, Matthijs OudkerkAbstract:The presently available method of measuring segmental lumbar Spine Mobility by means of superimposition of lumbar Spine radiographs in flexion and extension lacks precision due to differences in the cortical outline of the vertebral bodies in flexed and extended position. The introduction of digital image processing has opened the possibility of computerised superimposition (‘matching’) of digital vertebral body images by means of image registration. Theoretically this technique allows more accurate image matching and, consequently, greater precision of measurement because the whole vertebral body image (not only its cortical outline) can be chosen as region of interest, with registration of all available digital information within this region. To check accuracy and convenience of the new method, two computer program experts performed five image registration measurements of the five lumbar motion segments in five consecutive flexion-extension studies of old lumbar fracture, spondylolytic spondylolisthesis and degenerative anterolisthesis. For comparison an experienced radiologist performed the same repeated measurements with the manual superimposition method. Measurement error of the image registration method proved to be significantly smaller than that of the manual superimposition method. There was no overlap between the 95% confidence intervals of the mean standard deviations of experts A and B using the image registration method and the 95% confidence interval of the mean standard deviations of the experienced radiologist using the manual superimposition method. Besides, the image registration method proved to be more convenient because the whole procedure from import of the image data to display of the measurement outcomes lasted 2–3 min compared to 3–6 min for the superimposition method.
Arja Hakkinen - One of the best experts on this subject based on the ideXlab platform.
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associations of neck muscle strength and cervical Spine Mobility with future neck pain and disability a prospective 16 year study
BMC Musculoskeletal Disorders, 2021Co-Authors: Juhani Multanen, Arja Hakkinen, Hannu Kautiainen, Jari YlinenAbstract:BACKGROUND Neck pain has been associated with weaker neck muscle strength and decreased cervical Spine range of motion. However, whether neck muscle strength or cervical Spine Mobility predict later neck disability has not been demonstrated. In this 16-year prospective study, we investigated whether neck muscle strength and cervical Spine Mobility are associated with future neck pain and related disability in women pain-free at baseline. METHODS Maximal isometric neck muscle strength and passive range of motion (PROM) of the cervical Spine of 220 women (mean age 40, standard deviation (SD) 12 years) were measured at baseline between 2000 and 2002. We conducted a postal survey 16 years later to determine whether any subjects had experienced neck pain and related disability. Linear regression analysis adjusted for age and body mass index was used to determine to what extent baseline neck strength and PROM values were associated with future neck pain and related disability assessed using the Neck Disability Index (NDI). RESULTS The regression analysis Beta coefficient remained below 0.1 for all the neck strength and PROM values, indicating no association between neck pain and related disability. Of the 149 (68%) responders, mean NDI was lowest (3.3, SD 3.8) in participants who had experienced no neck pain (n = 50), second lowest (7.7, SD 7.1) in those who had experienced occasional neck pain (n = 94), and highest (19.6, SD 22.0) in those who had experienced chronic neck pain (n = 5). CONCLUSIONS This 16-year prospective study found no evidence for an association between either neck muscle strength or Mobility and the occurrence in later life of neck pain and disability. Therefore, screening healthy subjects for weaker neck muscle strength or poorer cervical Spine Mobility cannot be recommended for preventive purposes.
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intra and inter rater reliability of thoracic Spine Mobility and posture assessments in subjects with thoracic Spine pain
BMC Musculoskeletal Disorders, 2020Co-Authors: Jani Takatalo, Jari Ylinen, Tuomo Pienimaki, Arja HakkinenAbstract:The thoracic Spine (TS) has been neglected in the study of the Spine despite its essential role in the stability and posture of the entire spinal complex. Therefore, there is an inevitable need to investigate the reproducibility of different thoracic spinal posture measures used in subjects with TS pain. Thirty-two subjects (16 females and 16 males, mean age 39 years) were evaluated by two physiotherapists on the same day to gauge inter-rater reliability and on two consecutive days to gauge intra-rater reliability. TS posture was assessed by observation, and thoracic Spine Mobility was measured by manual assessment of segmental flexion and extension Mobility in a seated position. Additionally, posterior-to-anterior accessory Mobility in a prone position was assessed manually. Moreover, cervicothoracic flexion in a seated position, thoracic posture, and thoracic flexion and extension Mobility in a standing position were assessed with a tape measure, and flexion and extension Mobility in a seated position and TS posture in seated and standing positions were measured with an inclinometer. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), mean difference (MD), Bland-Altman (B&A) plot features and coefficient of repeatability (CR) were calculated. The mean and standard deviation (SD) of the duration of TS pain was 22 (SD 45) months, with the intensity of pain being rated at 27 (SD 21) mm on a visual analogue scale (VAS). Intra-rater reliability was very strong (ICC ≥ 0.80) for the evaluation of seated and standing upper TS posture, standing whole TS posture and seated lower TS posture with an inclinometer. Moreover, TS posture evaluation with a measuring tape, posture inspection in a seated position, and manual assessment of segmental extension were found to have very strong intra-rater reliability. Inter-rater reliability was very strong for inclinometer measurements of standing and seated upper TS posture as well as standing whole TS posture. Intra-rater reliability was higher than inter-rater reliability in most of the evaluated measurements. Overall, posture measurements with an inclinometer were more reliable than Mobility measurements with the same instrument. The manual assessments can be used reliably when same evaluator performs the examination. Clinical Trials, NCT01884818. Registered 24 June 2013, https://clinicaltrials.gov/ct2/show/NCT01884818?cond=thoracic+Spine&cntry=FI&rank=1
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neck muscle strength and Mobility of the cervical Spine as predictors of neck pain a prospective 6 year study
Spine, 2012Co-Authors: Petri Salo, Jari Ylinen, Hannu Kautiainen, Keijo Hakkinen, Arja HakkinenAbstract:STUDY DESIGN Follow-up study. OBJECTIVE To study whether neck muscle strength or cervical Spine Mobility values could serve as predictors for future neck pain among originally pain-free working-age subjects during a long period. SUMMARY OF BACKGROUND DATA Neck pain has been associated with weaker neck muscle strength and lower cervical Spine Mobility in several studies. However, causality between physical capacity and neck pain has not been shown. METHODS Isometric neck muscle strength and passive range of motion of the cervical Spine of 220 healthy female volunteers, aged 20 to 59 years, were measured. A postal survey was conducted 6 years later to determine whether any volunteers had experienced neck pain. The receiver operator characteristics curve was used to study how well the neck strength and Mobility values in different movement planes at baseline served as predictors of future neck pain. RESULTS Of the 192 (87%) responders, 37 (19%) reported neck pain for 7 days during the past year. In predicting neck pain, areas under the receiver operator characteristics curves (95% confidence intervals) in different movement planes were 0.52 to 0.56 (0.41-0.66) for isometric neck strength and 0.54 to 0.56 (0.44-0.76) for passive Mobility of the cervical Spine. CONCLUSION The results suggest that neither isometric neck muscle strength nor passive Mobility of cervical Spine has predictive value for later occurrences of neck pain in pain-free working-age women. Thus, screening healthy subjects for weaker neck muscle strength or decreased Mobility of the cervical Spine may not be recommended for preventive purposes.
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pain trunk muscle strength Spine Mobility and disability following lumbar disc surgery
Journal of Rehabilitation Medicine, 2003Co-Authors: Arja Hakkinen, Hannu Kautiainen, Jari Ylinen, Olavi Airaksinen, Arto Herno, Ulla Tarvainen, Ilkka KivirantaAbstract:Objective: To study associations between pain, trunk muscle strength, flexibility and disability in patients with lumbar disc herniation 2 months after surgery. Design: Clinical cross-sectional survey. Participants: 172 operated lumbar disc herniation patients. Methods: Back and leg pain on Visual Analogue Scale, Oswestry Disability Index and Brief Depression Scale were applied to assess the subjectively perceived outcome. Isometric and dynamic strength of trunk muscles and Mobility of the lumbar Spine were measured to mirror physical impairment. Results: Two months after the operation median leg pain had decreased by 87% and back pain by 81%, respectively. However, moderate or severe leg pain was still reported by 25% and back pain by 20% of the patients. Approximately 30% of the patients perceived moderate or severe disability measured by the Oswestry index. Decreased muscle strength and Spine Mobility caused functional disability, especially in older patients and patients with postoperative pain. Furthermore, the ratio of trunk extension/flexion strength had changed in favour of the flexion muscles, being 0.98. Greater age and depression were associated with poorer postoperative recovery. Conclusion: Pain, decreased trunk muscle strength and decreased Mobility still remained in a considerable proportion of patients with lumbar disc herniation 2 months after surgery. Early identification of those patients with restrictions is essential in order to commence rehabilitation.
Ulrich Hubbe - One of the best experts on this subject based on the ideXlab platform.
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laminectomy and fusion in multilevel degenerative cervical myelopathy correlation between objective and subjective postoperative restriction of cervical Spine Mobility
Journal of Clinical Neuroscience, 2021Co-Authors: Christoph Scholz, Waseem Masalha, Yashar Naseri, Janhelge Klingler, Marc Hohenhaus, Ulrich HubbeAbstract:Abstract For patients with multilevel degenerative cervical myelopathy (DCM), laminectomy and fusion is an established technique. A concomitant effect of multilevel fusion is a restriction of cervical Spine Mobility. This retrospective study on DCM-patients with at least 4 laminectomy and fusion levels, compares data between objective and subjective restriction of the postoperative cervical Spine Mobility. The patient-reported restriction of cervical Spine Mobility was acquired by a five-step score. Measurements of cervical range of motion were performed using the CROM device and were correlated with the subjective scores. Fusion was performed over 6 levels in most of the 36 patients. For the subjective cervical Spine Mobility, 52.8% reported none to medium, 38.9% severe and 8.3% complete restriction. Mean objective cervical range of motion was 45.0° for flexion-extension, 26.3° for total lateral flexion and 51.4° for total rotation and therefore evidently reduced compared to non-operated patient cohorts in literature. There was a significant medium, negative correlation between the objective measurements and the patient-reported general restriction of cervical Spine Mobility, and with the physical component summary of SF-8. The significant objective reduction of cervical range of motion after laminectomy and multilevel fusion correlates with the patient-reported assessment for general restriction.
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subjective and objective change in cervical Spine Mobility after single level anterior cervical decompression and fusion
Spine, 2021Co-Authors: Christoph Scholz, Waseem Masalha, Yashar Naseri, Janhelge Klingler, Marc Hohenhaus, Ulrich HubbeAbstract:STUDY DESIGN Prospective, observational study. OBJECTIVE The aim of this study was to collect objective and especially subjective data on changes in cervical Spine Mobility after single-level anterior cervical decompression and fusion (ACDF) and to investigate the impact on quality of life and activities of daily living (ADLs). SUMMARY OF BACKGROUND DATA Although there are several studies dealing with the objective change in Mobility after single-level ACDF, there are few data on how spondylodesis of a motion segment affects subjective restriction of cervical Spine Mobility. METHODS Patients undergoing first-time, single-level ACDF for a symptomatic spondylotic process were eligible. Data were collected before surgery, at 3-month, and 1-year follow-up. Patients were assessed via clinical scores (pain intensity, Short-Form 8 [SF-8], among others) and asked for impairment in ADLs due to restriction of cervical Spine Mobility. The subjective restriction was acquired by a five-step patient-reported score. The range of motion was measured by the CROM device. RESULTS Data of 97 patients could be evaluated. For pain scores and SF-8 there were significant improvements 3 months and 1 year after surgery (P < 0.001). The impairment for most ADLs improved 3 months after surgery and further after 1 year. The subjective restriction showed a significant improvement in general and for all single directions 1 year after surgery. In the objective measurements, a significantly higher total rotation could be found 1 year after surgery compared to preoperatively (101.6° ± 21.2 vs. 93.9° ± 23.4; P = 0.002). There were no significant differences in total flexion-extension and lateral flexion. Increasing age was a significant predictor for objective and subjective restriction. CONCLUSION The concern of many patients of being severely restricted in their cervical Spine Mobility after single-level ACDF can be denied. Objectively, the rotation even showed a significant improvement. Regarding the subjective restriction, which is more important for the patients, we found a significant improvement in general and for all directions of movement after surgery.Level of Evidence: 3.
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laminectomy and fusion in multilevel degenerative cervical myelopathy how severely do patients feel restricted by a postoperatively reduced Mobility of the cervical Spine
Clinical Neurology and Neurosurgery, 2020Co-Authors: Christoph Scholz, Waseem Masalha, Yashar Naseri, Janhelge Klingler, Marc Hohenhaus, Ulrich HubbeAbstract:Abstract Objective Laminectomy and fusion is a standard technique in patients with multilevel degenerative cervical myelopathy (DCM). However, this procedure is associated with a reduction of cervical range of motion. This study examines how patients are subjectively restricted in cervical Spine Mobility, how they are impaired in activities of daily living (ADLs) and how this affects their quality of life. Methods In this single-center, retrospective cohort study patients with DCM operated via laminectomy and fusion over at least four segments were included. Clinical outcome was assessed via pain scores, NDI, patient satisfaction index, mJOA and SF-8. The patient-reported restriction of cervical Spine Mobility and the resulting impairment for various ADLs were acquired by a newly developed five-step score. Results 53 patients could be evaluated. 75.5 % were satisfied with the treatment. 41.5 % reported a moderate restriction of Mobility, followed by severe restriction in 34.0 % and mild restriction in 15.1 %. Of the various directions of movement, flexion was indicated as the least restricted. Overhead work was the most impaired activity (26.4 % severe restriction, 37.7 % complete restriction). 60.4 % experienced none to moderate impairment when driving a car. The mean values for the SF-8 were 37.5 for the physical and 47.8 for the mental component summary. Conclusion Despite multilevel fusion and the reduced physical component summary of the SF-8, more than half of the patients reported only mild to moderate restriction. The concern about a complete impairment in various ADLs is unfounded for the majority of patients.
Anett Reisshauer - One of the best experts on this subject based on the ideXlab platform.
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effect of treatment with low intensity and extremely low frequency electrostatic fields deep oscillation on breast tissue and pain in patients with secondary breast lymphoedema
Journal of Rehabilitation Medicine, 2008Co-Authors: Silke Jahr, Birgit Schoppe, Anett ReisshauerAbstract:OBJECTIVE: To investigate symptoms and functional impairment in women with secondary lymphoedema of the breast following surgical treatment and to assess the therapeutic benefit of treatment with low-intensity and extremely low-frequency electrostatic fields (Deep Oscillation), supplementing manual lymphatic drainage. METHODS: Twenty-one patients were randomized either to the treatment group (n=11): 12 sessions of manual lymphatic drainage supplemented by Deep Oscillation, or to the control group (n=10): manual lymphatic drainage alone. Assessment included subjective pain and swelling evaluation, range of motion of the shoulder and the cervical Spine, and analysis of breast volume using a 3D measuring system. RESULTS: Patients had high pain and swelling scores at baseline. Shoulder Mobility was impaired in all patients; restriction of cervical Spine Mobility was common at baseline and declined further in the control group. Deep Oscillation resulted in significant pain reduction in the treatment group. The subjective reported reduction of swelling in both groups was confirmed objectively by 3D measurement only in the treatment group. CONCLUSION: Additional Deep Oscillation supplementary to manual lymphatic drainage can significantly enhance pain alleviation and swelling reduction in patients with secondary breast lymphoedema compared with manual lymphatic drainage alone.
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effect of treatment with low intensity and extremely low frequency electrostatic fields deep oscillation on breast tissue and pain in patients with secondary breast lymphoedema
Journal of Rehabilitation Medicine, 2008Co-Authors: Silke Jahr, Birgit Schoppe, Anett ReisshauerAbstract:OBJECTIVE: To investigate symptoms and functional impairment in women with secondary lymphoedema of the breast following surgical treatment and to assess the therapeutic benefit of treatment with low-intensity and extremely low-frequency electrostatic fields (Deep Oscillation), supplementing manual lymphatic drainage. METHODS: Twenty-one patients were randomized either to the treatment group (n=11): 12 sessions of manual lymphatic drainage supplemented by Deep Oscillation, or to the control group (n=10): manual lymphatic drainage alone. Assessment included subjective pain and swelling evaluation, range of motion of the shoulder and the cervical Spine, and analysis of breast volume using a 3D measuring system. RESULTS: Patients had high pain and swelling scores at baseline. Shoulder Mobility was impaired in all patients; restriction of cervical Spine Mobility was common at baseline and declined further in the control group. Deep Oscillation resulted in significant pain reduction in the treatment group. The subjective reported reduction of swelling in both groups was confirmed objectively by 3D measurement only in the treatment group. CONCLUSION: Additional Deep Oscillation supplementary to manual lymphatic drainage can significantly enhance pain alleviation and swelling reduction in patients with secondary breast lymphoedema compared with manual lymphatic drainage alone.
L Penning - One of the best experts on this subject based on the ideXlab platform.
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measurement of angular and linear segmental lumbar Spine flexion extension motion by means of image registration
European Spine Journal, 2005Co-Authors: L Penning, R Irwan, Matthijs OudkerkAbstract:Background The presently available method of measuring segmental lumbar Spine Mobility by means of superimposition of lumbar Spine radiographs in flexion and extension lacks precision due to differences in the cortical outline of the vertebral bodies in flexed and extended position. The introduction of digital image processing has opened the possibility of computerised superimposition (‘matching’) of digital vertebral body images by means of image registration. Theoretically this technique allows more accurate image matching and, consequently, greater precision of measurement because the whole vertebral body image (not only its cortical outline) can be chosen as region of interest, with registration of all available digital information within this region.
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measurement of angular and linear segmental lumbar Spine flexion extension motion by means of image registration
European Spine Journal, 2005Co-Authors: L Penning, R Irwan, Matthijs OudkerkAbstract:The presently available method of measuring segmental lumbar Spine Mobility by means of superimposition of lumbar Spine radiographs in flexion and extension lacks precision due to differences in the cortical outline of the vertebral bodies in flexed and extended position. The introduction of digital image processing has opened the possibility of computerised superimposition (‘matching’) of digital vertebral body images by means of image registration. Theoretically this technique allows more accurate image matching and, consequently, greater precision of measurement because the whole vertebral body image (not only its cortical outline) can be chosen as region of interest, with registration of all available digital information within this region. To check accuracy and convenience of the new method, two computer program experts performed five image registration measurements of the five lumbar motion segments in five consecutive flexion-extension studies of old lumbar fracture, spondylolytic spondylolisthesis and degenerative anterolisthesis. For comparison an experienced radiologist performed the same repeated measurements with the manual superimposition method. Measurement error of the image registration method proved to be significantly smaller than that of the manual superimposition method. There was no overlap between the 95% confidence intervals of the mean standard deviations of experts A and B using the image registration method and the 95% confidence interval of the mean standard deviations of the experienced radiologist using the manual superimposition method. Besides, the image registration method proved to be more convenient because the whole procedure from import of the image data to display of the measurement outcomes lasted 2–3 min compared to 3–6 min for the superimposition method.