Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test

Study Design. Cross-sectional study. Objective. The present study compared activity of deep and superficial cervical flexor muscles and craniocervical flexion range of motion during a test of craniocervical flexion between 10 patients with chronic neck pain and 10 controls. Summary of Background Data. Individuals with chronic neck pain exhibit reduced performance on a test of craniocervical flexion, and training of this maneuver is effective in management of neck complaints. Although this test is hypothesized to reflect dysfunction of the deep cervical flexor muscles, this has not been tested. Methods. Deep cervical flexor electromyographic activity was recorded with custom electrodes inserted via the nose and fixed by suction to the posterior mucosa of the oropharynx. Surface electrodes were placed over the superficial neck muscles ( sternocleidomastoid and anterior scalene). Root mean square electromyographic amplitude and craniocervical flexion range of motion was measured during five incremental levels of craniocervical flexion in supine. Results. There was a strong linear relation between the electromyographic amplitude of the deep cervical flexor muscles and the incremental stages of the craniocervical flexion test for control and individuals with neck pain ( P = 0.002). However, the amplitude of deep cervical flexor electromyographic activity was less for the group with neck pain than controls, and this difference was significant for the higher increments of the task ( P < 0.05). Although not significant, there was a strong trend for greater sternocleidomastoid and anterior scalene electromyographic activity for the group with neck pain. Conclusions. These data confirm that reduced performance of the craniocervical flexion test is associated with dysfunction of the deep cervical flexor muscles and support the validity of this test for patients with neck pain.

Evidence-based practice and rehabilitation: occupational therapy in Australia and New Zealand experiences

Evidence-based practice has become the dominant paradigm in the delivery of rehabilitation programme. However, occupational therapists in Australia and New Zealand have been slow in making the transition to become evidence-based practitioners. Collaboration between the university/ tertiary institute and clinical setting is one way that clinicians can be assisted with incorporating research into their practice. Two case examples are presented outlining how collaborative practice can result in improved out.. comes for all concerned.

What is an aphasia-friendly environment?

Background: The provision of aphasia-friendly environments is important for reducing the disability experienced by people with aphasia. However, the term aphasia-friendly environment has yet to be explicitly defined in the literature. Aims. This review defines aphasia-friendly environments, critically evaluates the relevant literature. and highlights the gaps in research in this area. Main Contribution: The World Health Organisation's (WHO) International Classification of Functioning, Disability and Health (ICF) (WHO, 2001) is Used as a framework for identifying the specific barriers and facilitators that need to be considered when creating an aphasia-friendly environment. Research focusing on Multiple ICF environmental factor domains is presented, followed by a review Of Studies that focus on specific environmental factor domains. Conclusions. More research identifying the range of environmental factors that may be important to consider when creating aphasia-friendly environments is required. In addition, further rigorous studies focusing on specific ICF environmental factor domains are needed.

Traumatic tear of tibialis anterior during a Gaelic football game: A case report

Reports of traumatic injury to the anterior lower leg muscles are scarce, with only a handful of reports of traumatic injury to the tibialis anterior. A database search of Medline, Cinhal, and Sports Discus only revealed three such cases, and they did not result from a direct sporting injury. This report documents the case of a traumatic rupture of tibialis anterior muscle in a young female Gaelic football player. It details the surgical repair and management of tibialis anterior muscle and the physiotherapy rehabilitation to full function.

Behaviour state analysis in Rett syndrome: Continuous data reliability measurement

Awareness of optimal behaviour states of children with profound intellectual disability has been reported in the literature as a potentially useful tool for planning intervention within this population. Some arguments have been raised, however, which question the reliability and validity of previously published work on behaviour state analysis. This article sheds light on the debate by presenting two stages of a study of behaviour state analysis for eight girls with Rett syndrome. The results support Mudford, Hogg, and Roberts' (1997, 1999) concerns with the pooling of participant data. The results of Stage 2 also suggest, however, that most categories of behaviour state can be reliably distinguished once definitions of behaviours for each state are clearly defined.

Introducing the pressure-sensing palatograph - the next frontier in electropalatography

Primary Objective. To extend the capabilities of current electropalatography (EPG) systems by developing a pressure-sensing EPG system. An initial trial of a prototype pressure-sensing palate will be presented. Research Design. The processes involved in designing the pressure sensors are outlined, with Hall effect transistors being selected. These units are compact, offer high sensitivity and are inexpensive. An initial prototype acrylic palate was constructed with five embedded pressure sensors. Syllable repetitions were recorded from one adult female. Main Outcomes, Results and Future Directions. The pressure-sensing palate was capable of recording dynamic tongue-to-palate pressures, with minimal to no interference to speech detected perceptually. With a restricted number of sensors, problems were encountered in optimally positioning the sensors to detect the consonant lingual pressures. Further developments are planned for various aspects of the pressure-sensing system. Conclusions. Although only in the prototype stage, the pressure-sensing palate represents the new generation of EPG. Comprehensive analysis of tongue-to-palate contacts, including pressure measures, is expected to enable more specific and effective therapeutic techniques to be developed for a variety of speech disorders.

Suitability of acoustic perturbation measures in analysing periodic and nearly periodic voice signals

In recent years, acoustic perturbation measurement has gained clinical and research popularity due to the ease of availability of commercial acoustic analysing software packages in the market. However, because the measurement itself depends critically on the accuracy of frequency tracking from the voice signal, researchers argue that perturbation measures are not suitable for analysing dysphonic voice samples, which are aperiodic in nature. This study compares the fundamental frequency, relative amplitude perturbation, shimmer percent and noise-to-harmonic ratio between a group of dysphonic and non-dysphonic subjects. One hundred and twelve dysphonic subjects ( 93 females and 19 males) and 41 non-dysphonic subjects ( 35 females and 6 males) participated in the study. All the 153 voice samples were categorized into type I ( periodic or nearly periodic), type II ( signals with subharmonic frequencies that approach the fundamental frequency) and type III ( aperiodic) signals. Only the type I ( periodic and nearly periodic) voice signals were acoustically analysed for perturbation measures. Results revealed that the dysphonic female group presented significantly lower fundamental frequency, significantly higher relative amplitude perturbation and shimmer percent values than the non-dysphonic female group. However, none of these three perturbation measures were able to differentiate between male dysphonic and male non-dysphonic subjects. The noise-to-harmonic ratio failed to differentiate between the dysphonic and non-dysphonic voices for both gender groups. These results question the sensitivity of acoustic perturbation measures in detecting dysphonia and suggest that contemporary acoustic perturbation measures are not suitable for analysing dysphonic voice signals, which are even nearly periodic. Copyright (C) 2005 S. Karger AG, Basel.

Articulatory imprecision in dysarthria following childhood cerebellar tumor: A perceptual and acoustic investigation of three male participants

Articulatory imprecision has been documented as a key perceptual feature of the dysarthria associated with childhood cerebellar tumor (CCT). As yet the underlying acoustic and physiological characteristics of motor speech production that contribute to this perceptual feature have not been identified. The aim of the current study was to describe perceptual and acoustic characteristics of consonant production in three children with dysarthria associated with CCT The results indicated that in all three cases the timing of articulatory movements during stop consonant production differed from that measured in a control group of same-age peers. The impact of cerebellar lesions in adulthood on articulatory gestures is used as a reference for discussing the findings of the current study with similarities evident. Also discussed are future research directions for examining the underlying acoustic or physiological basis for articulatory imprecision in children with dysarthria associated with CCT.

The effect of pre-clinical fieldwork subject on the confidence and professional skills of undergraduate occupational therapy students

Objectives: This study investigated the effect of a pre-clinical fieldwork subject on the confidence and professional skills of undergraduate occupational therapy students during their first full-time clinical fieldwork placement. Methods: Participants were 31 third year students enrolled in the pre-clinical fieldwork subject (experimental group), and 25 students not enrolled in the subject (control group). Both quantitative and qualitative methodologies were employed to address the research question. Student anxiety levels were measured using the State-Trait Anxiety Inventory (STAI) and compared at three different intervals - prior to commencing the university semester, prior to commencing full-time practical placement, and following this full-time placement. Individual interviews were conducted with six students (three from the experimental group, three from the control group) to explore their perceptions regarding confidence levels and skill proficiencies during full-time placement. At each data analysis interval, responses for both groups were compared using independent samples t-tests. Responses were compared over time using analysis of variance (ANOVA). The qualitative data were subjected to thematic and content analysis. Results and Conclusions: In general, student anxiety levels did not differ between the experimental and control groups over time. However, qualitative results suggest that students who were enrolled in the pre-clinical subject have greater confidence and competence with occupational therapy skills, and have heightened awareness of the expectations on full-time placement.

Hip strategy for balance control in quiet standing is reduced in people with low back pain

Study Design. Quiet stance on supporting bases with different lengths and with different visual inputs were tested in 24 study participants with chronic low back pain (LBP) and 24 matched control subjects. Objectives. To evaluate postural adjustment strategies and visual dependence associated with LBP. Summary of Background Data. Various studies have identified balance impairments in patients with chronic LBP, with many possible causes suggested. Recent evidence indicates that study participants with LBP have impaired trunk muscle control, which may compromise the control of trunk and hip movement during postural adjustments ( e. g., hip strategy). As balance on a short base emphasizes the utilization of the hip strategy for balance control, we hypothesized that patients with LBP might have difficulties standing on short bases. Methods. Subjects stood on either flat surface or short base with different visual inputs. A task was counted as successful if balance was maintained for 70 seconds during bilateral stance and 30 seconds during unilateral stance. The number of successful tasks, horizontal shear force, and center-of-pressure motion were evaluated. Results. The hip strategy was reduced with increased visual dependence in study participants with LBP. The failure rate was more than 4 times that of the controls in the bilateral standing task on short base with eyes closed. Analysis of center-of-pressure motion also showed that they have inability to initiate and control a hip strategy. Conclusions. The inability to control a hip strategy indicates a deficit of postural control and is hypothesized to result from altered muscle control and proprioceptive impairment.