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G Jull

Publications and source records attributed to G Jull.

13 recordsLinked to original sources
PubMed2001

Mid-thoracic tenderness: a comparison of pressure pain threshold between spinal regions, in asymptomatic subjects.

Palpation for tenderness forms an important part of the manual therapy assessment for musculoskeletal dysfunction. In conjunction with other testing procedures it assists in establishing the clinical diagnosis. Tenderness in the thoracic spine has been reported in the literature as a clinical feature in musculoskeletal conditions where pain and dysfunction are located primarily in the upper quadrant. This study aimed to establish whether pressure pain thresholds (PPTs) of the mid-thoracic region of asymptomatic subjects were naturally lower than those of the cervical and lumbar areas. A within-subject study design was used to examine PPT at four spinal levels C6, T4, T6, and L4 in 50 asymptomatic volunteers. Results showed significant (P<0.001) regional differences. PPT values increased in a caudal direction. The cervical region had the lowest PPT scores, that is was the most tender. Values increased in the thoracic region and were highest in the lumbar region. This study contributes to the normative data on spinal PPT values and demonstrates that mid-thoracic tenderness relative to the cervical spine is not a normal finding in asymptomatic subjects.

Adult↗
PubMed2000

Pressure pain thresholds of upper limb peripheral nerve trunks in asymptomatic subjects.

BACKGROUND AND PURPOSE: Palpation of peripheral nerve trunks has been advocated as a method of assessing the presence of hyperalgesic nerve tissue as a contributing factor to pain syndromes in musculoskeletal disorders of the upper quadrant. This study investigated, in the first instance, the pressure pain thresholds of the median, radial and ulnar nerve trunks of the upper limb in healthy, asymptomatic subjects. METHOD: Forty-five male and 50 female healthy volunteer subjects participated in this study which involved measurement of pressure pain thresholds by use of pressure algometry bilaterally over the three peripheral nerve trunks in the upper limbs. RESULTS: Pressure pain thresholds were shown to be lowest in the median nerve (p = 0.001) and lower in female subjects (p = 0.001). Laterality (p = 0.077) or the age of the subject (p = 0.254) did not significantly influence results. CONCLUSIONS: The study demonstrated differences in pressure pain thresholds in the three nerve trunks of the upper limb. These findings should be taken into account when interpreting the findings of nerve palpation in musculoskeletal upper quadrant disorders.

Adolescent↗
PubMed2000

Editorial

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Journal Article↗
PubMed2000

Fads and fashion.

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Education, Professional↗
PubMed1999

Further clinical clarification of the muscle dysfunction in cervical headache.

The Headache Classification Committee of the International Headache Society listed impairments in cervical muscle function as criteria for headaches of cervical spine origin. Fifteen subjects with cervical headache and 15 controls were tested for the frequency of abnormal responses to passive stretching and abnormal muscle contraction. A new test of cranio-cervical flexion was used to assess the contraction of the deep neck flexors. Results indicated a trend towards a higher frequency of abnormal response to passive stretching of the muscles examined in the cervical headache group but only the upper trapezius proved significantly different to the control group. Deep neck flexor muscle contraction was significantly inferior in the cervical headache group. From the perspective of physical characterization of cervical headache, it appears that response from passive stretch of muscle may not be a strong criterion for cervical headache but deep neck flexor performance may have potential to identify musculoskeletal involvement in headache. The finding may also provide positive directions for conservative treatment of cervical headache.

Adult↗
PubMed1999

Lumbar spine kinesthesia in patients with low back pain.

STUDY DESIGN: Single-group, posttest only, using a sample of convenience. OBJECTIVE: To measure the repositioning error of subjects with low back pain for lumbar sagittal movement using a simple kinesthetic test previously described. BACKGROUND: Patients with low back pain are commonly observed to have difficulty in adopting a mid or neutral position of the lumbar spine. METHODS AND MEASUREMENTS: Twenty subjects with low back pain were required to reproduce an upright neutral posture of the lumbar spine following movement into flexion in a sitting position. Trunk positioning accuracy was measured with an electromagnetic tracking device. RESULTS: The mean absolute value of the repositioning error in the sagittal plane was 2.25 degrees +/-0.88 degrees on day 1 and 2.32 degrees +/-1.62 degrees on day 2. The performance of patients with low back pain was similar to that of asymptomatic patients in a previous study, although subjects with low back pain overshot the neutral position more frequently (79%) than did nonimpaired subjects (50%). CONCLUSIONS: Subjects with low back pain may have attempted to use extra mechanoreceptive cues to compensate for some kinesthetic deficit. Nevertheless, the kinesthetic test used was not sensitive enough to detect any repositioning deficits, and reasons for this are explored.

Adult↗
PubMed1996

Evaluation of the relationship between laboratory and clinical tests of transversus abdominis function.

A clinical test of the function of the deep abdominal muscles was compared to a laboratory electromyographic (EMG) investigation of the contribution of transversus abdominis (TrA) to stability of the lumbar spine during limb movement. The two different functions of TrA were evaluated in 15 subjects. The subject group included six subjects with chronic low back pain and nine subjects with no history of low back pain so that the resultant recordings were spread over a wide range for each test. The clinical test involved quantification of the ability of the subjects to specifically displace the anterior abdominal wall in a way consistent with the function of the muscle. This was evaluated by use of a device designed to measure pressure reduction as the abdomen lifted off a transducer in the prone position. The laboratory test involved determination of the onset of contraction of TrA associated with rapid upper limb movement, measured using fine-wire EMG electrodes. The parameter evaluated was the latency between the contraction of TrA and the prime mover of the limb. Data were analysed both as absolute values and as ordinal data of a three-rating scale derived from criteria based on current knowledge of the response to both tests. No significant correlation was found between the absolute magnitudes of the pressure and timing data, however, comparison of the rating scale data indicated a significant relationship between the tests and associated high level of agreement between the two measures. The results of the study indicate that a reduction in the ability to draw in the abdominal wall is related to changes in the coordination of TrA, although the magnitude of the changes were not correlated. The degree of causality between these co-varying but independent manifestations of the function of TrA is uncertain.

Abdominal Muscles↗
PubMed1996

Toward a clinical test of lumbar spine kinesthesia.

Poor lumbar spine kinesthetic awareness is often observed in low back pain patients and is usually evaluated qualitatively in the clinical situation. The purpose of this study was to investigate a simple, kinesthetic test for the lumbar spine. The experimental protocol utilized a 3Space Fastrak to determine the error, within and between days, of 10 healthy subjects in reproducing a neutral lumbopelvic (T10-S2) position following movement into flexion. The mean value of the repositioning error for the sagittal plane movement (flexion/extension) over the three repetitions within day 1 was 2.6 +/- 1.2 degrees and for day 2 was 2.6 +/- 1.7 degrees. No statistically significant difference existed between days. These repositioning errors were well within the ranges described by other authors for various asymptomatic joint complexes. These results provide a basis for further evaluation of this test on patients with low back pain to investigate its ability to detect any kinesthetic deficit.

Adult↗
PubMed1994

Cervical musculoskeletal dysfunction in post-concussional headache.

Persistent headache is a common symptom following a minor head injury or concussion, possibly related to simultaneous injury of structures of the cervical spine. This study measured aspects of cervical musculoskeletal function in a group of patients (12) with post-concussional headache (PCH) and in a normal control group. The PCH group was distinguished from the control group by the presence of painful upper cervical segmental joint dysfunction, less endurance in the neck flexor muscles and a higher incidence of moderately tight neck musculature. Active range of cervical motion and postural attitude were not significantly different between groups. As upper cervical joint dysfunction is a feature of cervicogenic causes of headache, the results of this study support the inclusion of a precise physical examination of the cervical region in differential diagnosis of patients suffering persistent headache following concussion.

Adolescent↗
PubMed1988

The accuracy of manual diagnosis for cervical zygapophysial joint pain syndromes.

The ability of a manipulative therapist to diagnose symptomatic cervical zygapophysial joint syndromes accurately was evaluated in a series of 20 patients. In 11 patients the presence, or absence, of a symptomatic joint was established by means of radiologically-controlled diagnostic nerve blocks. These patients were assessed by the manipulative therapist, without knowledge of the medical diagnosis. Another nine patients were first seen by the manipulative therapist whose diagnosis was then evaluated by means of diagnostic blocks. The manipulative therapist identified correctly all 15 patients with proven symptomatic zygapophysial joints, and specified correctly the segmental level of the symptomatic joint. None of the five patients with asymptomatic joints was misdiagnosed as having symptomatic zygapophysial joints. Thus, manual diagnosis by a trained manipulative therapist can be as accurate as can radiologically-controlled diagnostic blocks in the diagnosis of cervical zygapophysial syndromes. However, before generalized claims about the reliability of manual diagnosis can be made, further studies of this nature are required to validate intertherapist reliability and the ability of manual techniques to diagnose other spinal pain syndromes.

Cervical Vertebrae↗