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Immediate and short-term effects of mulligan concept positional sustained natural apophyseal glides on an athletic young-adult population classified with mechanical neck pain: an exploratory investigation.

ABSTRACT: Objectives: Mechanical neck pain (MNP) is common in the athletic population. While symptoms may present at the cervical spine for patients complaining of MNP, thoracic spinal alignment or dysfunction may influence cervical positioning and overall cervical function. Clinicians often employ cervical high-velocity low-amplitude (HVLA) thrust manipulations to treat MNP, albeit with a small level of inherent risk. Mulligan Concept positional sustained natural apophyseal glides (SNAGs) directed at the cervicothoracic region are emerging to treat patients with cervical pain and dysfunction, as evidence supporting an interdependent relationship between the thoracic and cervical spine grows. The purpose of this a priori study was to evaluate outcome measures of patients classified with MNP treated with the Mulligan Concept Positional SNAGs. Methods: Ten consecutive young-adult patients, ages ranging from 15 to 18 years (mean = 16.5 ± 1.78), classified with MNP were treated utilizing Mulligan Concept Positional SNAGs. The Numeric Rating Scale (NRS), Patient-Specific Functional Scale (PSFS), Neck Disability Index (NDI), Disablement in the Physically Active (DPAS), and Fear-Avoidance Based Questionnaire-Physical Activity (FABQPA) were collected for inclusion criteria and to identify patient-reported pain and dysfunction. Results: Patients reported decreases in pain on the NRS [5.4 to .16, p = .001], increases in function on the PSFS [5.2 to 10, p = .001], and increases in cervical range of motion (CROM) [ext p = .003, flex p = .009, left rot p = .001, right rot p = .002] immediately post-treatment and between treatments. Discussion: Positional SNAGs directed at the cervicothoracic region may address a variety of patient reported symptoms for MNP, and the number of treatment sessions needed for symptom resolution may be closer to a single session rather than multiple treatments. Level of Evidence: 4.

SUBMITTER: Andrews DP

PROVIDER: S-EPMC6071273 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Immediate and short-term effects of mulligan concept positional sustained natural apophyseal glides on an athletic young-adult population classified with mechanical neck pain: an exploratory investigation.

Andrews Dawn P DP Odland-Wolf Kari B KB May James J Baker Russell R Nasypany Alan A Dinkins Eric M EM

The Journal of manual & manipulative therapy 20180416 4

<b>Objectives:</b> Mechanical neck pain (MNP) is common in the athletic population. While symptoms may present at the cervical spine for patients complaining of MNP, thoracic spinal alignment or dysfunction may influence cervical positioning and overall cervical function. Clinicians often employ cervical high-velocity low-amplitude (HVLA) thrust manipulations to treat MNP, albeit with a small level of inherent risk. Mulligan Concept positional sustained natural apophyseal glides (SNAGs) directed ...[more]

PMID: 30083043

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Project description:BACKGROUND:Pathological muscle activation patterns of the external rotators and periscapular muscles can result in posterior positional functional shoulder instability (PP-FSI). In several patients, physical therapy and surgical treatment are not successful. PURPOSE:The shoulder-pacemaker treatment concept was evaluated prospectively in patients with PP-FSI and previously failed conventional therapy attempt. STUDY DESIGN:Case series; Level of evidence, 4. METHODS:A negative selection of 24 consecutive cases of noncontrollable PP-FSI in 16 patients with previously failed conventional therapy were included in this prospective study. The shoulder-pacemaker treatment consisted of an electrical muscle stimulation-based therapy protocol with 9 to 18 one-hour treatment sessions. Two patients were excluded because of nonadherence to the training schedule, leaving a final study cohort of 21 cases in 14 patients. Follow-up included assessment of clinical function, impairment during daily activities and sports, satisfaction, Western Ontario Shoulder Instability Index (WOSI), Rowe score, and Subjective Shoulder Value at 0 weeks, 2 weeks, 4 weeks, 3 months, 6 months, 12 months, and 24 months after intervention. RESULTS:WOSI, Subjective Shoulder Value, and Rowe score showed a highly significant improvement at all time points of follow-up (P < .001). Young age (P = .005), low weight (P = .019), shoulder activity level (P = .003), unilateral affliction (P = .046), and higher baseline WOSI score (P = .04) were associated with a better treatment effect. Cases with increased glenoid retroversion, posterior scapulohumeral decentering, and dysplastic bony glenoid shape showed a trend toward shorter treatment effect duration. No complications during the intervention or follow-up period were observed. CONCLUSION:The shoulder-pacemaker therapy concept is an effective treatment with rapid improvement and sustained outcome over the course of 2 years in patients with noncontrollable PP-FSI with previously failed conventional treatment. Young and more athletic patients with lower weight and unilateral pathology respond best to the treatment.

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Project description:BackgroundThe concept of health-related quality of life (HRQoL), a patient-reported outcome measure, is poorly defined within the Saudi literature. There is a lack of culturally adapted measures to assess the HRQoL of patients on hemodialysis in Saudi Arabia. Hence, this study aims to explore and define the concept of HRQoL, identify its key domains and develop a conceptual model as perceived by patients with renal failure who are undergoing hemodialysis in Saudi Arabia.MethodsQualitative research methods was used; data were collected in one dialysis center in the Eastern Region of Saudi Arabia. Twenty-two semi structured qualitative interviews were conducted using a topic guide. The data were analyzed using thematic analysis methods as the transcripts were coded, the categories identified, and the themes generated.ResultsSeven definitions of the HRQoL concept emerged from data analysis in terms of health status and psychological wellbeing including the satisfaction with life, socialization and the ability to play the expected social role and having social relationships that are supportive, religiosity and the belief in God and being able to perform religious worships and finally needs satisfaction was used to define HRQoL which included financial needs and the quality of healthcare services. All these themes were utilized to develop one common definition that emphasized the personal satisfaction with health, social, psychological and financial needs in addition to religious performance and the quality of healthcare services provided. The conceptual model was developed using five key domains of HRQoL: physiological, social, psychological, religious and vocational domains that were defined by certain indicators and the relationships between the domains were clarified in the model.ConclusionThe findings of this study could guide the selection of the appropriate HRQoL instrument to assess the HRQoL of patients on hemodialysis in Saudi Arabia, which would ensure the validity of the findings that could be used in healthcare decisions and planning of care.

Dataset Information

Immediate and short-term effects of mulligan concept positional sustained natural apophyseal glides on an athletic young-adult population classified with mechanical neck pain: an exploratory investigation.

Publications

Immediate and short-term effects of mulligan concept positional sustained natural apophyseal glides on an athletic young-adult population classified with mechanical neck pain: an exploratory investigation.

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