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Biomedical subjects

K A Lindgren

Publications and source records attributed to K A Lindgren.

29 records · Page 2Linked to original sources
PubMed1992

Cervical rotation lateral flexion test in brachialgia.

The cervical rotation lateral flexion test (CRLF test), developed earlier, was used to examine patients with brachialgia and thoracic outlet syndrome (TOS) symptoms to detect possible restriction of the movement of the first rib. The test was performed for 23 patients, five of them both before and after treatment. The patients were assessed independently by two clinicians to analyze the interobserver reliability. A cineradiographic examination was performed so that any restriction of the movement of the first rib during expiration and inspiration could be detected objectively. The interobserver repeatability of the test was excellent, thus making the cineradiographic examination unnecessary. It is recommended that this test be included in the clinical investigation of all patients with brachialgia with or without radicular pain.

Adult↗
PubMed1991

Recurrent thoracic outlet syndrome after first rib resection.

Seventy-seven patients with 84 operated limbs participated in a follow-up examination on an average of about six years after the resection of the first rib for thoracic outlet syndrome (TOS). Forty-two limbs (50%) were totally asymptomatic one month after the operation and remained so for at least half a year postoperatively. In the follow-up examination, 31 limbs were still asymptomatic, whereas 11 limbs had the same symptoms as before the operation. Of the nine patients with recurrent TOS (two with bilateral resection), seven were women and two were men. These nine patients were on average 38 years old (range = 19 to 51 years) and their jobs consisted of monotonous desk work. Seven of 11 stumps of the first rib were subluxated disclosed by the cervical rotation-lateral-flexion test. The occurrence of a subluxated stump of the first rib in the group of asymptomatic patients was far lower, only 3% (p less than .001). Of the 42 patients with persistent problems, a subluxated stump was encountered in seven (17%). Results of this follow-up examination suggest that monotonous desk work is an important factor causing kinesiologic abnormalities in the thoracic aperture. This abnormal kinesiology contributes to the recurrence of TOS symptoms even after the resection of the first rib.

Adult↗
PubMed1990

Cervical spine rotation and lateral flexion combined motion in the examination of the thoracic outlet.

The axial rotation and simultaneous lateral flexion of the cervical spine is kinesiologically related to the movements of the upper thoracic spine. Five brachialgia patients were found to have a hypomobile first rib on the painful side in a cineradiographic study. The kinesiologic finding was the following: when the neutrally positioned cervical spine was first maximally rotated passively away from the painful side, the passive lateral flexion was restricted in this position. This can be due to the first thoracic transverse process bumping against the subluxated first rib. This test of cervicothoracic mobility is useful in the examination of the thoracic outlet function.

Brachial Plexus Neuritis↗
PubMed1989

Long term outcome after resection of the first rib for thoracic outlet syndrome.

A total of 112 first ribs in 103 patients were resected over 11 years for thoracic outlet syndrome. Seventy-seven patients (84 operations) were followed up for 2.5 years or more to assess the long term results of this procedure and the factors affecting them. One month after surgery 52 per cent of limbs were asymptomatic and 77 per cent were at least improved. A follow-up examination was performed, on average 6.1 years after the operation, by two independent examiners. This evaluation showed a permanent success rate of 37 per cent among 84 limbs examined. These long term results compare unfavourably with previously published data. The reason for the poor final outcome seemed to be difficulty in selecting patients for the operation. This was not aided by any of the preoperative tests. Patients in this study were evaluated by independent examiners, and only a total absence of preceding symptoms was accepted as the criterion for success. We emphasize the importance of unbiased evaluation and long term follow-up.

Adult↗
PubMed1989

Cineradiography of the hypomobile first rib.

A patient with bilateral chronic brachialgia was cineradiographically shown to have hypomobile first ribs bilaterally. This finding can be elicited by the Expiration-Inspiration (E-I) test, in which the patient is palpated just beneath the clavicles while breathing. Right side scalenus muscle activation restored the movement of the right first rib. The cineradiography confirms the validity of the palpatory E-I test which has been previously described.

Cineradiography↗
PubMed1988

Subluxation of the first rib: a possible thoracic outlet syndrome mechanism.

Twenty-two cases of both the thoracic outlet syndrome (TOS) and reflex sympathetic dystrophy (RSD) are described, four in detail. Each case had a hypomobile first rib on the painful side. A simple test was used to evaluate the first rib mobility. After isometric exercises of the scalene muscles, the mobility of the first rib was restored and the symptoms completely relieved in 13 patients. We concluded that the subluxation of the first rib may irritate the neural network and the stellate ganglion in the neighborhood of the first costotransverse joint. This in turn can cause the radiating pain and RSD symptoms.

Adult↗
PubMedDate not supplied

Whiplash injuries in Finland: a prospective 1-year follow-up study.

OBJECTIVES: The aim of the study was to define how many whiplash injuries occur in Finland in traffic accidents and the degree of severity of these injuries using the whiplash-associated disorders (WAD) classification presented by the Quebec Task Force, and to define possible long-term health effects caused by whiplash injury as well as the duration of whiplash-associated sick-leaves. METHODS: This was a prospective one-year-follow-up study. Fourteen insurance companies paving compensations for traffic accidents in Finland sent the accident reports and medical certificates of all neck injuries attributable to traffic accidents to the research team. The material was collected from neck injuries that had occurred in traffic accidents during the year 1998. RESULTS: The majority of those suffering a whiplash injury were women. On the basis of the WAD classification, most whiplash injuries were mild, belonging to grades WAD I and II. At one year from the accident nearly 10% considered that their health had been impaired significantly as a result of their neck injury. Over 10% of those questioned had been on sick-leave for over a month but only 1.5% had been on sick-leave associated with the injury for more than 6 months. The most common symptom after one year was neck pain or neck pain combined with headache and symptoms in the upper extremities. No major changes related to the seasons of the year were found. CONCLUSIONS: The number of reported neck injuries in proportion to all traffic accidents involving physical injuries is small, even in proportion to rear-end collisions. In a considerable proportion of collision patients, whiplash injury does result in significant impairment which can last as long as a year after the accident. The WAD classification predicts the duration of work disability and the long-term health damage caused by the injury. Since the appearance of symptoms and the individual need for rehabilitation due to impaired functional capacity do not depend solely on the tissue damage and biomechanical forces involved in the collision, in the future it will be important to determine which factors are responsible for the differences in coping after a collision.

Accidents, Traffic↗