Responses to a clinical test of mechanical provocation of nerve tissue in whiplash associated disorder

Involvement of nerve tissue may contribute to the persistence of pain following a whiplash injury. This study aimed to investigate responses to the brachial plexus provocation test (BPPT) in 156 subjects with chronic whiplash associated disorder (WAD) with and without associated arm pain and 95 asymptomatic control subjects. The range of elbow extension (ROM) and visual analogue scale (VAS) pain scores were measured. Subjects with chronic WAD demonstrated significantly less ROM and higher VAS scores with the BPPT than the asymptomatic subjects (P

Use of high and low velocity cervical manipulative therapy procedures by Australian manipulative physiotherapists

The use of cervical manipulation presents concerns because of a risk of devastating side effects of trauma to the vertebral artery. Little is known about the frequency of use of cervical manipulation versus passive mobilisation by physiotherapists. A recent national, multi-centre randomised clinical trial of the physiotherapy management of cervicogenic headache provided an opportunity to gain an insight into practices of a sample of manipulative physiotherapists across Australia. The treatment records for the 100 subjects who received only manipulative therapy, or manipulative therapy with exercise as per the trial protocol, were audited. The results revealed that cervical manipulation was used in 20.2% of the 1090 treatments provided to these subjects but cervical joint mobilisation only was used in the vast majority of treatments (77.6%). Nevertheless, 42% of subjects were treated with cervical manipulation at some time. In most instances, manipulation was accompanied by passive mobilisation in the same treatment session. Patients were manipulated on one to six occasions and this occurred predominantly in the latter half of the 12-treatment program. Cervical manipulation was used less frequently in the group who also received exercise. The data suggest that the physiotherapists participating in this study used cervical manipulation selectively and relatively conservatively considering the high use of cervical mobilisation techniques. This may reflect their due regard to safety in the treatment of the cervical region.

The association between auditory memory span and speech rate in children from kindergarten to sixth grade

This study reexamined the association between speech rate and memory span in children from kindergarten to sixth grade (N = 152) in order to potentially account for the inconsistencies within the published literature on this topic. Some of the inconsistencies in past research may reflect the different methods adopted in assessing speech rate. In particular, repeating word triples may itself involve memory demands, contaminating the correlation between speech rate and memory span in younger children. Analyses using composite speech rate and memory span measures showed that speech rate for word triples shared variance with memory span that was independent of speech rate for single words. Moreover, speech rate for word triples was largely redundant with age in explaining additional variation in memory span once the effects of speech rate for single words were controlled. (C) 2002 Elsevier Science.

Kinematic analysis of lingual fatigue in myasthenia gravis

This study describes a preliminary examination of the viability and suitability of the physiologic technique electromagnetic articulography (EMA) in investigating lingual fatigue in myasthenia gravis (MG). A 52.9-year-old female diagnosed with MG at the age of 18 years, but who was in remission, participated in the study with a matched control subject. Changes in the duration, speed, and range of tongue-tip and tongue-back movements during repetition of /taka/ over two minutes were investigated. Results revealed that the MG subject did not exhibit significant changes in duration, maximum velocity, maximum acceleration, or the distance travelled by her tongue as measured by EMA over the task. The kinematic results were, in part, expected since the MG subject was in remission. The results, therefore, may not be representative of the majority of individuals with active MG. The examination of the current case did highlight, however, the potential advantages of EMA in providing detailed, objective information regarding lingual kinematics for future investigations of individuals with MG. It also showed that EMA may be sensitive in detecting subclinical kinematic features of fatigue in individuals who are in remission from MG. Finally, EMA led to the identification of possible physiologic factors underlying the CV transform effect, which was evident for the MG subject's syllable productions. In the past, the effect had been assumed to be a purely perceptual-based phenomenon.

Acoustic signature of the normal swallow: Characterization by age, gender, and bolus volume

Despite growing clinical use, cervical auscultation suffers from a lack of research-based data. One of the strongest criticisms of cervical auscultation is that there has been little research to demonstrate how dysphagic swallowing sounds are different from normal swallowing sounds, In order to answer this question, however, one first needs to document the acoustic characteristics of normal, nondysphagic swallowing sounds, This article provides the first normative database of normal swallowing sounds for the adult population. The current investigation documents the acoustic characteristics of normal swallowing sounds for individuals from 18 to more than 60 years of age over a range of thin liquid volumes. Previous research has shown the normal swallow to be a dynamic event. The normal swallow is sensitive to aging of the oropharyngeal system, and also to the volume of bolus swallowed. The current investigation found that the acoustic signals generated during swallowing were sensitive to an individual's age and to the volume of the bolus swallowed. There were also some gender-specific differences in the acoustic profile of the swallowing sound, It is anticipated that the results will provide a catalyst for further research into cervical auscultation.

Detection of swallowing sounds: Methodology revisited

Cervical auscultation is in the process of gaining clinical credibility. In order for it to be accepted by the clinical community, the procedure and equipment used must first be standardized. Takahashi et al. [Dysphagia 9:54-62, 1994] attempted to provide benchmark methodology for administering cervical auscultation. They provided information about the acoustic detector unit best suited to picking up swallowing sounds and the best cervical site to place it. The current investigation provides contrasting results to Takahashi et al. with respect to the best type of acoustic detector unit to use for detecting swallowing sounds. Our study advocates an electret microphone as opposed to an accelerometer for recording swallowing sounds. However, we agree on the optimal placement site. We conclude that cervical auscultation is within reach of the average dysphagia clinic.