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Biomedical subjects

K Lewit

Publications and source records attributed to K Lewit.

At least 19 recordsLinked to original sources

X-ray of trunk rotation.

OBJECTIVE: To establish the mechanism of the thoracolumbar spine during trunk rotation and its restriction. DESIGN: Patients with one-sided rotation restriction were examined seated on a chair with the pelvis fixed in neutral position, at maximum right and left trunk rotations, before and after mobilization of movement restriction; anteroposterior X-rays were taken with a horizontal beam on a vertical X-ray cassette. SETTING: University neurology clinic. MAIN OUTCOME CRITERIA: Assessment of rotation and side bending of the thoracolumbar spine (a) on the normal and the restricted side and (b) after mobilization. RESULTS: In all cases, there was both (coupled) rotation and side flexion during side bending, except that the thoracolumbar junction was frequently near midline; in such cases, the thoracic spine above was bent in the opposite direction. Both rotation and side-bending started at L5 and continued gradually in a cranial direction without a noticeable maximum at any level. CONCLUSIONS: Although it is generally assumed that the configuration of the lumbar zygapophyseal joints precludes axial rotation in the lumbar spine, I find that, during trunk rotation, a coupled movement of side bending and rotation takes place in the lumbar spine and continues without a noticeable break into the thoracic spine. The site of movement restriction, which usually seems to be located at the thoracolumbar junction, cannot be visualized on X-rays.

Adult↗

Myofascial pain: relief by post-isometric relaxation.

The post-isometric relaxation technique begins by placing the muscle in a stretched position. Then an isometric contraction is exerted against minimal resistance. Relaxation and then gentle stretch follow as the muscle releases. This technique was applied to tight, tender muscles that are commonly associated with musculoskeletal pain and was systematically tested on 351 muscle groups in 244 patients. The method produced immediate pain relief in 94%, lasting pain relief in 63%, as well as lasting relief of point tenderness in 23% of the sites treated. Patients who practiced autotherapy on a home program were more likely to realize lasting relief. Pain was relieved in both the muscle itself and at tender insertion points. The technique is useful in addition to, or in place of, local anesthetic injection or dry needling. These results confirm other observations that the increased tension of the affected muscles and the resulting pain and dysfunction are both relieved by restoring the full stretch length of the muscle.

Aged↗

Pain arising in the posterior arch of the atlas.

Headache of cervical origin is by no means an adequate diagnosis. The exact mechanism has to be established for the case in question. A type of cervical headache which arises from the posteriorr arch of the atlas is described. The basic finding is tenderness of this structure on palpation; the technique of palpation is described. In a majority of cases movement restriction (blockage) between the occiput and the atlase is found. The headache as described by the patient is not characteristic, migrainous attacks being present in about one-third of the cases. A frequent feature is pain on retroflexion of the head. Treatment consists of manipulation of the blockage, and infiltration or needling of the posterior arch of the atlas if there is no blockage or if pain continues after the restoration of mobility. In the more complicated cases remedial exercise is indicated. Experience with 64 cases is described.

Atlanto-Occipital Joint↗

[Pathomechanisms of cervical headaches].

Various types of disorders of the cervical region may produce headache. In many of these increased tension of the neck musculature plays an important role. The following mechanisms underlying headache are described and differentiated: 1. Headache due to faulty muscle pattern (stereotype) resulting in overstrain of the upper fixators of the shoulder girdle (upper part of the m.trapezius and levator scapulae); faulty respiration with the aid of the upper auxillary muscles even at rest is pointed out. 2. A forward drawn head position producing static overstrain in the posterior neck muscles and compensatory retroflexion of the cranio-cervical junction resulting in blockage in this region. 3. Anteflexion and ligament pain mainly due to faulty position at work and jolting. 4. Static disturbance in the frontal plain due to obliquity producing asymmetrical strain in the neck musculature. 5. Increased muscular tension due to psychological stress. 6. Blockage in the regions of the cervical spine, shoulder girdle and upper ribs with reflex muscular spasm. 7. Reflex spasm of the neck musculature in visceral disorders causing in addition blockage of the cervico-thoracic junction (heart, gall bladder). 8. Pain arising from the posterior arch of the atlas (here described for the first time). 9. Headache due to vertebral artery involvement. The type of headache seems to be determined rather by the individual mode of reaction than by the mechanism underlying it. As a rule a combination of mechanisms is actually found.

Atlanto-Occipital Joint↗