Sureeporn Uthaikhup

Validation of thai versions of the neck disability index and neck pain and disability scale in patients with neck pain

Study Design. Cross-cultural validation of the Neck Disability Index (NDI) and Neck Pain and Disability Scale (NPDS). Objective. To translate and test the psychometric properties of Thai versions of the NDI and NPDS questionnaires. Summary of Background Data. The NDI and NPDS are questionnaires commonly used to measure neck pain and disability. The original versions of the NDI and NPDS have been translated into many languages but there are no validated Thai versions. Methods. Translation and cross-cultural adaptation of the original English versions of the NDI and NPDS were performed according to published guidelines. A total of 185 patients with neck pain participated in the study and were asked to complete the Neck Disability Index-Thai version (NDI-TH), Neck Pain Disability Scale-Thai version (NPDS-TH), and a visual analogue scale (VAS; 0–10). Psychometric evaluation included factor analysis, internal consistency, test-retest reliability, agreement, and convergent validity. Test-retest reliability for the NDI-TH was examined in 20 patients and in 17 for the NPDS-TH. Patients completed the questionnaires twice with an interval of 48 hours. Results. Factor analysis revealed a single-factor solution for the NDI-TH and three factor solution for the NPDS-TH. Cronbach &agr; values for the NDI-TH and NPDS-TH were excellent (0.85 and 0.96, respectively). The three NPDS-TH subscales ranged from 0.90 to 0.94. Good to excellent test-retest reliability was demonstrated for all measurements (Intraclass Correlation Coefficient range = 0.74–0.91, P < 0.001). The NDI-TH, NPDS-TH, and NPDS-TH subscales were moderately correlated with the VAS (range, r = 0.61–0.76, P < 0.001). The minimal detectable change was 16.1 points for the NDI-TH (scale range = 0–100) and 21.8 points for NPDS-TH (scale range = 0–100). Conclusion. The NDI-TH and NPDS-TH seem to be reliable instruments to measure functional limitation and disability in Thai patients with neck pain. However, further research is still needed to determine responsiveness and validity of these questionnaires.

Improvements in tissue blood flow and lumbopelvic stability after lumbopelvic core stabilization training in patients with chronic non-specific low back pain.

[Purpose] This study investigated the effects of lumbopelvic stabilization training on tissue blood flow changes in the lumbopelvic region and lumbopelvic stability compared to placebo treatment and controlled intervention among patients with chronic non-specific low back pain. [Subjects and Methods] A total of 25 participants (7 males, 18 females; mean age, 33.3 ± 14.4 years) participated in this within-subject, repeated-measures, double-blind, placebo-controlled comparison trial. The participants randomly underwent three types of interventions that included lumbopelvic stabilization training, placebo treatment, and controlled intervention with 48 hours between sessions. Lumbopelvic stability and tissue blood flow were measured using a pressure biofeedback device and a laser Doppler flow meter before and after the interventions. [Results] The repeated-measures analysis of variance results demonstrated a significant increase in tissue blood flow over the lumbopelvic region tissues for post- versus pre-lumbopelvic stabilization training and compared to placebo and control interventions. A significant increase in lumbopelvic stability before and after lumbopelvic stabilization training was noted, as well as upon comparison to placebo and control interventions. [Conclusion] The current study supports an increase in tissue blood flow in the lumbopelvic region and improved lumbopelvic stability after core training among patients with chronic non-specific low back pain.

Altered Pain Sensitivity in Elderly Women with Chronic Neck Pain

Background Age-related changes occur in both the peripheral and central nervous system, yet little is known about the influence of chronic pain on pain sensitivity in older persons. The aim of this study was to investigate pain sensitivity in elders with chronic neck pain compared to healthy elders. Methods Thirty elderly women with chronic neck pain and 30 controls were recruited. Measures of pain sensitivity included pressure pain thresholds, heat/cold pain thresholds and suprathreshold heat pain responses. The pain measures were assessed over the cervical spine and at a remote site, the tibialis anterior muscle. Results Elders with chronic neck pain had lower pressure pain threshold over the articular pillar of C5-C6 and decreased cold pain thresholds over the cervical spine and tibialis anterior muscle when compared with controls (p < 0.05). There were no between group differences in heat pain thresholds and suprathreshold heat pain responses (p > 0.05). Conclusion The presence of pain hypersensitivity in elderly women with chronic neck pain appears to be dependent on types of painful stimuli. This may reflect changes in the peripheral and central nervous system with age.

Lumbopelvic Core Stabilization Exercise and Pain Modulation Among Individuals with Chronic Nonspecific Low Back Pain.

Lumbopelvic stabilization training (LPST) may provide therapeutic benefits on pain modulation in chronic nonspecific low back pain conditions. This study aimed to examine the effects of LPST on pain threshold and pain intensity in comparison with the passive automated cycling intervention and control intervention among patients with chronic nonspecific low back pain.

Immedicate Effects of Core Stabilization Exercise on β-Endorphin and Cortisol Levels Among Patients With Chronic Nonspecific Low Back Pain: A Randomized Crossover Design

Objective The main objective of the study was to measure the levels of plasma &bgr;‐endorphin (PB) and plasma cortisol (PC) under lumbar core stabilization exercise (LCSE), placebo and control conditions in patients with chronic nonspecific low back pain. Methods Twenty‐four participants with chronic nonspecific low back pain participated in a randomized, placebo‐controlled, crossover design study. There were 3 experimental exercise conditions: control condition (positioning in crook lying and rest), placebo condition (passive cycling in crook lying using automatic cycler), and LCSE on a Pilates device tested with a 48‐hour interval between sessions by concealed randomization. A blood sample was collected before and after the exercise conditions. Plasma &bgr;‐endorphin and PC were measured through enzyme‐linked immunosorbent assay and electrochemiluminescence in a Cobas E411 auto analyzer. Results A significant difference in PB level was identified before and after the LCSE condition (P < .05), whereas no significant differences were noted in control and placebo exercise conditions. Also, the trend of elevation of PB under the LCSE was significantly different compared with the placebo and control conditions (P < .01). In contrast, the PC level remained unchanged in all 3 conditions. Conclusion The findings of this study indicate that LCSE could possibly influence PB but not PC level among patients with chronic nonspecific low back pain. The mechanism of action of the pain‐relieving effect of LCSE might be related to an endogenous opioid mechanism as part of its effects and might not be involved with a stress‐induced analgesia mechanism.

Effectiveness of physiotherapy for seniors with recurrent headaches associated with neck pain and dysfunction: a randomized controlled trial

BACKGROUND CONTEXT A previous study demonstrated that in seniors, the presence of cervical musculoskeletal impairment was not specific to cervicogenic headache but was present in various recurrent headache types. Physiotherapy treatment is indicated in those seniors diagnosed with cervicogenic headache but could also be adjunct treatment for those with cervical musculoskeletal signs who are suspected of having transitional headaches. PURPOSE This study aimed to determine the effectiveness of a physiotherapy program for seniors with recurrent headaches associated with neck pain and cervical musculoskeletal dysfunction, irrespective of the headache classification. STUDY DESIGN This is a prospective, stratified, randomized controlled trial with blinded outcome assessment. PATIENT SAMPLE Sixty-five participants with recurrent headache, aged 50-75 years, were randomly assigned to either a physiotherapy (n=33) or a usual care group (n=32). OUTCOME MEASURES The primary outcome was headache frequency. Secondary outcomes were headache intensity and duration, neck pain and disability, cervical range of motion, quality of life, participant satisfaction, and medication intake. METHODS Participants in the physiotherapy group received 14 treatment sessions. Participants in the usual care group continued with their usual care. Outcome measures were recorded at baseline, 11 weeks, 6 months, and 9 months. This study was funded by a government research fund of

Decreased thickness of the lower trapezius muscle in patients with unilateral neck pain.

6,850. No conflict of interest is declared. RESULTS There was no loss to follow-up for the primary outcome measure. Compared with usual care, participants receiving physiotherapy reported significant reductions in headache frequency immediately after treatment (mean difference -1.6 days, 95% confidence interval [CI] -2.5 to -0.6), at 6-month follow-up (-1.7 days, 95% CI -2.6 to -0.8), and at 9-month follow-up (-2.4 days, 95% CI -3.2 to -1.5), and significant improvements in all secondary outcomes immediately posttreatment and at 6- and 9-month follow-ups, (p<.05 for all). No adverse events were reported. CONCLUSIONS Physiotherapy treatment provided benefits over usual care for seniors with recurrent headache associated with neck pain and dysfunction.

Effects of gender and hand dominance on size of the lower trapezius muscle

Thickness of the lower trapezius muscle in patients with neck pain has not been established. We examined the thickness of the lower trapezius muscle in patients with and without unilateral neck pain.

Impaired Standing Balance in Individuals with Cervicogenic Headache and Migraine

Introduction: The influence of gender and hand dominance on the size of the lower trapezius muscle has not been studied. We aimed to identify the effects of gender and hand dominance on thickness of this muscle. Methods: Thirty healthy subjects (15 men and 15 women) were recruited for the study. The thickness of the lower trapezius muscles was measured bilaterally at the level of T8 at rest and with contraction at 130° of shoulder abduction using ultrasound imaging. Results: Men had significantly greater thickness of the lower trapezius muscle than women, both at rest and with contraction (P < 0.01). Greater lower trapezius muscle thickness was found on the dominant side compared with the non‐dominant side (P < 0.05). Conclusion: Gender and side dominance differences should be controlled for when investigating lower trapezius muscle thickness. Muscle Nerve 52: 576–579, 2015

Recommended Rice Intake Levels Based on Average Daily Dose and Urinary Excretion of Cadmium in a Cadmium-Contaminated Area of Northwestern Thailand

AIMS To determine whether a difference in standing balance exists among individuals with cervicogenic headache, those with migraine, and asymptomatic controls. METHODS A total of 24 participants with cervicogenic headache, 24 with migraine, and 24 asymptomatic controls of similar age, gender, and body mass index were included. Standing balance was assessed with a swaymeter under the conditions of eyes open and closed; on firm and soft surfaces; and in comfortable and narrow stances (for a total of eight testing conditions). Each condition was tested for 30 seconds. The outcome measures were sway area and displacement. Multivariate analysis of variance with Bonferroni post hoc test were used to analyze between-group differences in the postural sway variables. RESULTS Both headache groups had significantly larger sway areas than the control group during comfortable stance with eyes open and with eyes closed on a soft surface (P < .05) and during narrow stance with eyes closed on firm and soft surfaces (P < .05). The overall results demonstrated significantly greater sway in the anterior-posterior direction and less sway in the medial-lateral direction in selected tests in the cervicogenic headache group compared to the migraine group. CONCLUSION Individuals with cervicogenic headache and those with migraine have impaired balance during standing, but possibly to a different extent and pattern. Assessment of balance in patients with cervicogenic headache and migraine should be considered in clinical practice.