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Effect of Global Postural Re-Education in Individuals With Text Neck Syndrome: A Randomized Controlled Trial.

BACKGROUND AND PURPOSE: This study investigated the effect of Global Postural Re-Education (GPR) versus conventional physical therapy in text neck syndrome (TNS). A prospective, single-blinded, parallel-group randomized controlled trial design was used. METHODS: Sixty participants with TNS (aged 18-40&#xa0;years) were randomly assigned to either conventional treatment or GPR plus conventional treatment. Both groups received supervised therapy for three sessions per week over 4&#xa0;weeks. Outcome measures included craniovertebral and shoulder angles assessed by photogrammetry, pain intensity via Visual Analog Scale, and Cervical Range of Motion via a smartphone application (Clinometer). Measured before and after the intervention. RESULTS: Within-group analyses showed significant improvements in pain and CROM in both groups (p&#xa0;<&#xa0;0.001). However, the between-group analysis revealed no superiority of GPR for pain or CROM (p&#xa0;>&#xa0;0.05). In contrast, GPR demonstrated statistically significant superiority in postural correction, with greater improvements in craniovertebral angle (MD: 2.14&#xb0;; 95% CI: 0.69-3.59; p&#xa0;=&#xa0;0.005) and shoulder angle (MD: 3.2&#xb0;; 95% CI: 0.33-6.07; p&#xa0;=&#xa0;0.03), exceeding MCID thresholds and indicating clinically meaningful benefits. However, these findings should be interpreted with caution because of the longer session duration in the GPR group. DISCUSSION: Incorporating Global Postural Reeducation (GPR) into conventional treatment provided significant additional benefits for postural parameters (craniovertebral and shoulder angles) in individuals with text neck syndrome. However, GPR demonstrated no added superiority over conventional treatment alone regarding pain intensity and cervical range of motion outcomes.

Humans

A transverse loading system applied to a modified Harrington instrumentation.

Observations using standard Harrington Instrumentation revealed that while maximal distractive forces are applied it is possible to produce further correction of spinal deformity by applying a lateral force. Modifications to the standard Harrington Instrumentation by applying a transverse loading system have been made in order to produce this added correction. The transverse load is applied as nearly as possible in the same plane as the bearing points of hooks, i.e., below the axis of the rods. Transverse loading helps to reduce the distance from the apex of the curve to the midline, thereby producing a more stable spine as well as providing additional support on the convex side. The system is ideal for flexible curves with little kyphosis. Photogrammetry reveals that there was no significant rotation occurring after the application of the transverse load. To date, Instrumentation has been used in 10 patients with success.

Adolescent

The effect of oral physiotherapy on dilantin gingival hyperplasia.

Gingival hyperplasia was studied in 13 boys with epilepsy living in a state hospital. Boys were selected on the basis of having gingival hyperplasia, having all teeth between cuspids (upper and lower), having no occlusal abnormality and being cooperative. After gingivectomy, regrowth of gingiva was compared around lateral incisors on one side of the mouth having operator-assisted oral hygiene with that around lateral incisors on the other side of the mouth without operator-assisted oral hygiene. Regrowth of tissue was documented by precise photogrammetry. Oral hygiene, gingival inflammation and crevicular fluid were monitored. Less inflammation, less crevicular fluid and less regrowth of gingival tissues occurred around teeth subjected to good oral hygiene. Precise periodic photographic documentation of the clinical status of patients during studies such as this is considered very valuable.

Adolescent

Multiple-slit illumination of the optic disc.

A modification to a photo slit-lamp illuminator adds detail to the human optic disc surface by projecting onto it a pattern of fine parallel lines. These stripes curve as they traverse the disc, and its surface contour is revealed. Application of this technique may improve the reliability of methods used to quantitate disc topography.

Evaluation Studies as Topic

Classification of human cataracts.

A stereoscopic system of lens photography was developed and was applied in the classification of different forms of cataract. Lenses, after surgical extraction, can be classified by a technician, independent of ophthalmological collaboration. This system meets the needs of the laboratory scientist and has been adopted by the Cooperative Cataract Research Group.

Cataract

Optic disc parameters and onset of glaucomatous field loss. I. Methods and progressive changes in disc morphology.

Serial stereoscopic fundus photographs taken in known relationship to the onset of glaucomatous visual field loss on 12 eyes were intermixed with those from 206 age- and race-matched controls and analyzed in randomized masked fashion. Progressive changes in the size, shape, or contour of the disc, and a newly described parameter, thickness of the nerve fiber layer as it crosses the disc rim, were readily apparent by the time of onset of glaucomatous field loss in all but two abnormal eyes (one case). In the latter instance, direct comparison of stereophotos indicated progressive pallor of the remaining disc tissue. Serial stereophotographs appear superior to fundus drawings for anticipating glaucomatous field loss.

Glaucoma

Optic disc parameters and onset of glaucomatous field loss. II. Static screening criteria.

Stereoscopic fundus photographs of 17 abnormal eyes, taken in known temporal relationship to the onset of glaucomatous visual field loss, and 206 eyes of age- and race-matched controls were examined in randomized masked fashion. Width of the narrowest remaining disc rim, size of the vertical and horizontal physical cups, contour of the temporal and nasal slopes (vertical ovalness), and a newly described parameter, thickness of the nerve fiber layer as it crosses the disc rim, were all useful for distinguishing patients with impending or established visual field loss. None, however, was as effective as defects in the nerve fiber layer, the only parameter displaying sufficient promise as a clinical screening tool to warrant initiation of large-scale prospective evaluation.

Glaucoma

Contour analysis in plastic and reconstructive surgery.

Three-dimensional measurements of living objects may be made using various biostereometric techniques. Moire topography provides one-step contour line maps. It is a potential low-cost adjuvant to current photographic and cephalometric techniques for documentation of surface deformities. A relatively simple apparatus may be used with instant-processing film to produce immediate contour maps superimposed on the object image on the film. There is significant qualitative information highlighted by the fine resolution of the system. This immediate had data may be quantitatively analyzed by hand with ruler and/or caliper. In the future, off-line quantitative analysis may be made by computer. Geometric constraints of the system and examples of use of the technique are provided. Emphasis is placed on facial asymmetries that are difficult to analyze from plain photographs and inaccessible to data analysis from lateral cephalometric roentgenographs.

Adolescent

Morphology of the atrioventricular node, bundle and proximal bundle branches: a study employing computerized reconstruction.

The morphology of the human atrioventricular node, atrioventricular bundle and bundle branches is described. A block of tissue bounded by the ostium of the coronary sinus, the pars membranacea, the septal leaflet of the tricuspid valve and the atrial and ventricular septa is removed. The block is then sectioned serially from the right endocardial surface in the frontal plane of the heart. Sectioning in this way produces fewer sections than from techniques previously described. Outlines of the atrioventricular node, atrioventricular bundle and proximal bundle branches are digitally registered and stored in a computer. Three dimensional reconstructions of the structures are then generated by computer and displayed on an oscilloscope so that the entire three dimensional image can be rotated in any plane. Stereoscopic image pairs are produced to assist perception of the shape of the atrioventricular node, bundle and branching patterns of the bundles. This technique is unique in that it describes a method from which a relatively small number of histologic sections are generated permitting not only a complete histologic examination, but also a study of the morphology of the area.

Adult

Vascular and glomerular changes in the ageing kidney.

Glomerular size, shape and number were examined in 44 human kidneys obtained at necropsy. Intrarenal vascular appearances were assessed histologically and by post-mortem angiography. The mean cross-sectional area of glomeruli varied nearly three-fold and glomerular number varied more than three-fold when kidneys from different adult subjects were compared but kidneys from the same subject resembled one another in glomerular size and number. A significant negative correlation existed in the adult between glomerular number and dimensions. Glomerular numbers in the few immature kidneys studied were similar to those in adult kidneys but glomeruli were smaller. Glomerular numbers tended to decline as age and severity of age-related vascular changes increased but correlation was poor. The possibility remains that glomerular involution in the senescent kidney occurs independently of events in the vessels. In men, but not in women, totally hyalinised glomeruli were observed more frequently with increasing age but their presence did not appear to be related to the degree of vascular change. In the senescent kidney, glomerular lobulations tended to disappear. This, together with glomerular loss, must result in a reduction in the area available for filtration. Assessments of total glomerular surface area should take account of glomerular shape and dimensions as well as numbers.

Adult

Instability and wear of total hip prostheses determined with roentgen stereophotogrammetry.

A roentgen stereophotogrammetric analysis of hip prostheses was made in four patients with rheumatoid arthritis during a postoperative period of 2 years. Implanted tantalum balls, prosthetic femoral head, and ends of the wire in the acetabular socket were used as measurement points. The migration of the prosthetic head and the acetabular socket in relation to the pelvic bone was determined. The difference between the cranial migration of the head and the socket is a measure of the postoperative instability of the hip joint and deformation of the prosthetic components. This deformation occurs in the plastic acetabular socket and is mainly due to wear. The roentgen stereophotogrammetric method can be applied to standard hip orostheses with a metal femoral head and a plastic or metal acetabular socket to study migration or loosening of the prosthesis in relation to the supporting bone, prosthesis instability, and deformation of the prosthetic components.

Adult

Rapid detection of changes in the optic disc: stereo-chronoscopy.

Easy detection of temporal variations of tissue configurations within the optic disc or other structures is possible by means of stereoscopy: Stereochronoscopy. Photographic pictures of the papilla are taken from time to time at exactly the same angle; when any two of them are paired and viewed with a stereoscope, temporal form changes immediately show up as stereo effects (Schirmer [2]). Since continuing glaucomatous damage cannot be diagnosed either by visual field defects or by actual c/d ratios but only by their temporal changes, this method may prove of diagnostic value.

Adult

Moiré topography--a method for school screening of scoliosis.

The moiré method is tested in school screening of scoliosis. Moiré topography registers a three-dimensional description of the shape of the back. In the straight spine, the moiré shadow pattern is equal on both halves of the back. In structural scoliosis, the moiré pattern differs more with the increasing deformity of the spine. This asymmetry is mainly caused by the rotational component of the scoliosis. These shadow patterns consist of contourlines, which can be compared with those on a relief map. By photographing the moiré shadow lines, the status of the back is documented. In 212 cases, the moiré findings are compared with radiograph observations. A statistically significant correlation is found between the moiré asymmetry (rotational component) and the radiograph findings (lateral deviation according to Cobb). The moiré method seems to fulfil the criteria for a screening method--diagnosis of even minor curves, small risk for false negative findings, simple to handle and can document the back in many children in a short time.

Child

Corneal topography.

This paper explores the many aspects of the nature and measurement of the corneal surface. Its structure and the factors that influence it are described. The traditional techniques of keratometry are summarized and there is an emphasis on new experimental methods of determining corneal topography including moiré, holographic interferometric and profile techniques. The advantages and disadvantages of these procedures are considered.

Adult

Photogrammetric analysis of volume asymmetry of the optic nerve head cup in normal, hypertensive, and glaucomatous eyes.

Recent studies of optic cup volume, depth, and orifice area demonstrated a large overlap of the range of these factors for normal and glaucomatous eyes, suggesting that it is usually not possible to distinguish abnormal disks on the basis of a particualr set of geometric quantifiers. Because of the knowledge that qualitative asymmetry of a person's optic cups may be a sign of glaucoma, calculation of the quantity of cup asymmetry using the aforementioned geometric parameters was undertaken in 90 patients. Results indicated that 90% of the bilaterally normal subjects who were studied and 80% of the ocular hypertensives had less than 0.20 mm3 cup volume asymmetry. In contrast, however, all of the unilateral glaucoma patients in this sample exceeded that value. It therefore appears that measurement of the amount of, volume asymmetry between a person's optic cups may be a useful tool in the diagnosis of glaucoma.

Adult

Comparison of photographic techniques and films used in stereophotogrammetry of the optic disk.

We compared photogrammetric measurements of optic cup volume, area, and depth made from two types of stereophotography and two types of film to determine their effect on the precision of the measurements. We found that measurements from simultaneous stereophotography (Donaldson stereoscopic fundus camera) had a smaller range of values and a smaller mean percent error than measurements from consecutive stereophotography (Zeiss Fundus Flash II camera). However, a Student's t-test for related measures showed no significant difference. The measurements from Kodachrome 25 film and Kodak Photomicrography film varied in range and mean percent error without a pattern. The Student's t-test for related measures showed no significant difference.

Evaluation Studies as Topic