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Upper crossed syndrome (UCS) refers to the altered muscle activations and movement patterns in scapulae along with some abnormal alignment in the upper quarter, which may contribute to the dysfunction of the cervicothoracic and glenohumeral joints. The present study aimed to investigate the effectiveness of a comprehensive corrective exercise program (CCEP) and subsequent detraining on alignment, muscle activation, and movement pattern in men with the UCS. This randomized controlled trial included 24 men. The intervention group conducted CCEP (8 weeks), followed by four weeks of detraining and the control group maintained normal daily activities. Electromyography of selected muscles, scapular dyskinesis test, head, shoulder, and thoracic spine angle were measured at baseline, post-test, and follow-up. There were significant differences for Group x time interaction and also for within-group from pre-test to post-test and follow-up in all outcomes. Also, significant differences were observed in three outcomes at post-test and follow-up between the CCEP and control group in favor of the CCEP. In Conclusion, the present study demonstrates that the CCEP for individuals with UCS is feasible and effective, improving muscle activation imbalance, movement patterns, and alignment. Importantly, these improvements were maintained after four weeks of detraining, suggesting lasting neuromuscular re-training adaptations.

Many infants admitted to hospital undergo repeated invasive procedures. Oral sucrose is frequently given to relieve procedural pain in neonates on the basis of its effect on behavioural and physiological pain scores. We assessed whether sucrose administration reduces pain-specific brain and spinal cord activity after an acute noxious procedure in newborn infants. In this double-blind, randomised controlled trial, 59 newborn infants at University College Hospital (London, UK) were randomly assigned to receive 0·5 mL 24% sucrose solution or 0·5 mL sterile water 2 min before undergoing a clinically required heel lance. Randomisation was by a computer-generated randomisation code, and researchers, clinicians, participants, and parents were masked to the identity of the solutions. The primary outcome was pain-specific brain activity evoked by one time-locked heel lance, recorded with electroencephalography and identified by principal component analysis. Secondary measures were baseline behavioural and physiological measures, observational pain scores (PIPP), and spinal nociceptive reflex withdrawal activity. Data were analysed per protocol. This study is registered, number ISRCTN78390996. 29 infants were assigned to receive sucrose and 30 to sterilised water; 20 and 24 infants, respectively, were included in the analysis of the primary outcome measure. Nociceptive brain activity after the noxious heel lance did not differ significantly between infants who received sucrose and those who received sterile water (sucrose: mean 0·10, 95% CI 0·04–0·16; sterile water: mean 0·08, 0·04–0·12; p=0·46). No significant difference was recorded between the sucrose and sterile water groups in the magnitude or latency of the spinal nociceptive reflex withdrawal recorded from the biceps femoris of the stimulated leg. The PIPP score was significantly lower in infants given sucrose than in those given sterile water (mean 5·8, 95% CI 3·7–7·8 vs 8·5, 7·3–9·8; p=0·02) and significantly more infants had no change in facial expression after sucrose administration (seven of 20 [35%] vs none of 24; p<0·0001). Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief. Medical Research Council.

Background The influence of sustained spinal loading on flexion relaxation phenomenon (FRP) in erector spinae (ES) in trunk anterior flexion–extension performance has been studied. However, no investigation has been reported on spasm after the loading. The aim of the study is to test if spasm as well as the increase of electromyography ( EMG) intensity of extensors in relaxation period could be found during and/or after prolonged asymmetric static loading. Methods Twenty six male healthy college students participated in the study. Participants finished two 30 min asymmetry load conditions (left load(LL), right load (RL)), randomly with total load 10 kg on the left or the right shoulder, respectively. EMG signals were recorded from the left(l) and the right(r) thoracic erector spinae (lTES, rTES), lumbar erector spinae (lLES, rTES), and hamstring (lHAM, rHAM) muscles in the first 10 min and the last 10 min during the interventions, and also recorded in three trunk anterior flexion–extension exertions before (pre) and after (post) the interventions, respectively. The rhythmic of flexion–extension performance was controlled by a metronome with 5 s flexion and 5 s extension at 60 Hz. Spasms were evaluated and an averaged electromyography (NEMG) was calculated for extensors at the first and last 10 min of 30 min intervention, as well as in the relaxation period of FRP during flexion–extension exertion in both pre and post the intervention. Results During asymmetry spinal loading process, there was no sign of spasms in any of extensors. NEMG of multiple erect spinae had a significant decrease (with the largest -60%, p  = 0.021 in rLES in LL) while that of hamstring increases significantly (the largest value 139%, p  = 0.001 in lHAM in LL). After the interventions, the prevalence of spasms in extensors in relaxation period was found with the value from 8 to 55%. Also, NEMG in multiple extensors had a significant increase (with the largest increase of 114% in lLES in LL, p  = 0.023). Conclusion During sustained asymmetry spinal loading, the NEMG in bilateral HAM has significant increase and the NEMG in bilateral erect spinea has a decrease tendency. After loading, the NEMG has a significant increase, in parallel with spasms elicited in multiple extensors in relation period in flexion–extension performance, with no significant difference between bilateral sides. It may indicate that sustained asymmetry spinal loading could lead to a weakness for tension ability, and/or a micro-damage in spinal bilateral passive tissues in low back area, the risk of developing low back disorder.

Background: Age-related postural misalignment, balance deficits and strength/power losses are associated with impaired functional mobility and an increased risk of falling in seniors. Core instability strength training (CIT) involves exercises that are challenging for both trunk muscles and postural control and may thus have the potential to induce benefits in trunk muscle strength, spinal mobility and balance performance. Objective: The objective was to investigate the effects of CIT on measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility in seniors. Methods: Thirty-two older adults were randomly assigned to an intervention group (INT; n = 16, aged 70.8 ± 4.1 years) that conducted a 9-week progressive CIT or to a control group (n = 16, aged 70.2 ± 4.5 years). Maximal isometric strength of the trunk flexors/extensors/lateral flexors (right, left)/rotators (right, left) as well as of spinal mobility in the sagittal and the coronal plane was measured before and after the intervention program. Dynamic balance (i.e. walking 10 m on an optoelectric walkway, the Functional Reach test) and functional mobility (Timed Up and Go test) were additionally tested. Results: Program compliance was excellent with participants of the INT group completing 92% of the training sessions. Significant group × test interactions were found for the maximal isometric strength of the trunk flexors (34%, p < 0.001), extensors (21%, p < 0.001), lateral flexors (right: 48%, p < 0.001; left: 53%, p < 0.001) and left rotators (42%, p < 0.001) in favor of the INT group. Further, training-related improvements were found for spinal mobility in the sagittal (11%, p < 0.001) and coronal plane (11%, p = 0.06) directions, for stride velocity (9%, p < 0.05), the coefficient of variation in stride velocity (31%, p < 0.05), the Functional Reach test (20%, p < 0.05) and the Timed Up and Go test (4%, p < 0.05) in favor of the INT group. Conclusion: CIT proved to be a feasible exercise program for seniors with a high adherence rate. Age-related deficits in measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility can be mitigated by CIT. This training regimen could be used as an adjunct or even alternative to traditional balance and/or resistance training.

The main objective of this study was to analyze the effect of a resistance training program using outdoor fitness equipment (OFE) on sagittal spine disposition and pelvic tilt in middle-aged and older adults. One hundred and twenty-eight middle-aged and older adults were randomly assigned to the training (TG) or control group (CG). The TG trained for 8 weeks, with 2 weekly sessions of one hour of resistance circuit training with OFE. Before and after the intervention, the sagittal spine disposition and pelvic tilt in the relaxed standing and sitting positions were analyzed. The results showed that the TG obtained a significant reduction (p < 0.001) in all the curvatures of the sagittal spine disposition and pelvic tilt in the standing position after the intervention, in contrast to the CG, which only showed a significant reduction in pelvic tilt (p = 0.005). Regarding the sitting position, only the TG presented a significant decrease in lumbar lordosis (p < 0.001). In conclusion, resistance training with OFE may be useful in improving sagittal spine disposition in middle-aged and older adults. Given the availability of free OFE in parks, the present research provides elders with an accessible and effective training program to curb the effects of ageing on the sagittal spine disposition.

Traffic police riders are exposed to prolonged static postures causing significant angular deviation of the musculoskeletal, including the lumbar angle (L1-L5). This postural alteration contributes to awkward posture, musculoskeletal disorders and spinal injury, especially in the lower back area, as it is one of the most severe modern diseases nowadays. Thus, the study aimed to evaluate the effect of lumbar support with a built-in massager system on spinal angle profiles among traffic police riders. A randomised controlled trial (pre-testpost-test control design) was used to assess spinal angle pattern while riding the high-powered motorcycle for 20 minutes. Twenty-four traffic police riders were randomly selected to participate and 12 riders were assigned to the control group and 12 riders to the experimental group. The pre-test and post-test were conducted at a one-week interval. Each participant was required to wear a TruPosture Smart Shirt (to monitor spinal posture). The TruPosture Apps recorded the spinal angle pattern. The data indicated that the police riders using motorcycle seat with lumbar support and built-in massager system showed a huge improvement in maintaining posture which only involves slight spinal angle deviation changes from the spinal reference angle throughout the 20 minutes ride. The data collected then were analysed using the Mann-Whitney test and Wilcoxon signed-ranked test to verify a statistically significant difference between and within the control and experimental groups. There were significant differences in all sensors between the control group and experimental groups (p<0.05) and within the experimental group. According to the findings, it can be said that the ergonomic intervention prototype (lumbar support with built-in massager system) successfully helps to maintain and improve the natural curve of the spinal posture. This indirectly would reduce the risk of developing musculoskeletal disorders and spinal injury among traffic police riders.

Transcutaneous spinal direct current stimulation (tsDCS) is a safe and convenient method of neuromodulation. It has been proven to alter sensory processing at cervicomedullary level by amplitude changes of the P30 response of tibial nerve somatosensory evoked potentials (TN SEPs). With knowledge that tsDCS affects cortical circuits, we hypothesized that tsDCS may also affect intracortical excitability of the somatosensory cortex assessed by paired stimulation suppression (PSS). Fourteen healthy men were included in this prospective, single-blinded, placebo-controlled crossover study. Single (SS) and paired stimulation (PS) TN SEPs were recorded over the scalp before, immediately as well as 30 and 60 min after applying 15 min of tsDCS over the twelfth thoracic vertebra. Each volunteer underwent three independent and randomized sessions of either cathodal, anodal or sham stimulation. tsDCS showed no effect on peak-to-peak amplitudes or latencies of cortical P40-N50 response after SS. Furthermore, tsDCS failed to induce significant changes on amplitude ratios of PSS, thus showing no impact on intracortical excitability of the somatosensory cortex in healthy subjects. Further research is required to reveal the different mechanisms and to strengthen clinical use of this promising technique.

The optimal management of ankylosis spondylitis (AS) involves a combination of nonpharmacologic and pharmacologic treatment aiming to maximize health-related quality of life. The primary objective of our study was to demonstrate the benefits of an original multimodal exercise program combining Pilates, McKenzie and Heckscher techniques on pulmonary function in patients with AS, while secondary objectives were to demonstrate the benefits of the same program on function and disease activity. This is a randomized controlled study on ninety-six consecutive patients with AS (axial disease subset), assigned on a 1:1 rationale into two groups based on their participation in the Pilates, McKenzie and Heckscher (group I) or in the classical kinetic program (group II). The exercise program consisted of 50-min sessions performed 3 times weekly for 48 weeks. Standard assessments were done at week 0 and 48 and included pain, modified Schober test (mST) and finger–floor distance (FFD), chest expansion (CE) and vital capacity (VC), as well as disease activity Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional Bath Ankylosing Spondylitis Functional Index (BASFI) and metrology index Bath Ankylosing Spondylitis Metrology Index (BASMI). Groups were comparable at baseline; we demonstrated significant improvement between baseline and after 48 weeks of regular kinetic training for all AS-related parameters in both groups. However, significant improvement was found in pain, lumbar spine motility (mST, FFD), BASFI, BASDAI and BASMI in AS performing the specific multimodal exercise program at the end of study ( p  = 0.001). Although there were significant improvements in CE in both groups as compared to baseline (group I, p  = 0.001; group II, p  = 0.002), this parameter increased significantly only in group I ( p  = 0.001). VC measurements were not significantly changed at the end of the study (group I, p  = 0.127; group II, p  = 0.997), but we found significant differences within groups ( p  = 0.011). A multimodal training combining Pilates, McKenzie and Heckscher exercises performed regularly should be included in the routine management of patients with AS for better control of function, disease activity and pulmonary function.

To examine whether objective measures of spine and frontal plane knee motion exhibited during Functional Movement Screen™ (FMS) task performance changed following a movement-guided fitness (MOV) and conventional fitness (FIT) exercise intervention. Secondary analysis of a randomized controlled experiment. Before and after 12 weeks of exercise, participants' kinematics were quantified while performing the FMS and a series of general whole-body movement tasks. Biomechanics laboratory. Fifty-two firefighters were assigned to MOV, FIT, or a control (CON) group. Peak lumbar spine flexion/extension, lateral bend and axial twist, and frontal plane knee motion. The post-training kinematic changes exhibited by trainees while performing the FMS tasks were similar in magnitude (effect size < 0.8) to those exhibited by CON. However, when performing the battery of general whole-body movement tasks, only MOV showed significant improvements in spine and frontal plane knee motion control (effect size > 0.5). Whether graded qualitatively, or quantitatively via kinematic analyses, the FMS may not be a viable tool to detect movement-based exercise adaptations. Amendments to the FMS tasks and/or scoring method are needed before it can be used for reasons beyond appraising the ability to move freely, symmetrically, and without pain. •Post-training changes in spine and knee motion control were similar across groups.•Substantial variation in spine and knee motion was seen amongst the control group.•The FMS did not capture kinematic changes that occurred in response to training.•Low demand movement screens may not challenge control of relevant motions.•The FMS may not be an effective tool to assess the transfer of training.