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Effects of head rotation on pharyngeal function during normal swallow.

This study quantified the effects of head rotation on pharyngeal swallowing in healthy subjects. Videofluoroscopic and oropharyngeal manometric examinations of pharyngeal swallowing were performed on seven volunteers with the head in neutral and rotated positions. Videofluoroscopic study revealed that head rotation swallow causes the bolus to lateralize away from the direction of head rotation. Pharyngeal manometric study indicated that the pharyngeal peak pressures toward the side of head rotation were significantly increased, whereas the pharyngeal pressures opposite the side of head rotation were not affected. Head rotation swallow produced a significant fall in upper esophageal sphincter (UES) resting pressure and a delay in UES closing. We concluded that the head rotation swallow in normal subjects not only alters the bolus pathway, but also has a useful effect on both pharyngeal clearance and UES dynamics.

Adult↗

Headshake versus whole-body rotation testing of the vestibulo-ocular reflex.

The vestibulo-ocular reflex (VOR) is usually evaluated by whole-body rotary chair oscillation in darkness, but is limited to ambulatory patients. In order to develop a portable method of VOR assessment, eye movements from 10 normal subjects were studied under three conditions: 1. whole-body rotary chair oscillation in the dark and in the light with a head mounted blank field, 2. passive head-on-body rotation in the light with a blank field, and 3. active head-on-body rotation in the light with a blank field. The influence of visual fixation, neck rotation, and volition on VOR gain was to be assessed. Head oscillations were maintained at 0.5 and 1.0 Hz, 50 degrees/s peak velocity. Mean VOR gains with blank field testing were indistinguishable from those obtained in darkness during whole-body rotation. In addition, there were no significant differences in the mean gain between whole-body, passive head rotation or active head rotation. Two vestibulopathic patients (absent calorics bilaterally and oscillopsia) were also studied to illustrate potential clinical utility of the methods. Rotations under all conditions revealed low but variable gains. The evaluation of the VOR in the light with a blank visual surround and passive or active head rotation is a potentially useful clinical method of bedside assessment of the VOR.

Adult↗

Rotation of cells and ion exchange beads in the MHz-frequency range.

Whereas human red blood cells and protoplasts of leaves of Avena sativa show rotation only at discrete frequencies in the kHz-range of a linear alternating electric field, rotation of these cells is observed at practically every frequency in the MHz range (15 to 200 MHz). The cell rotation in the MHz-range can be explained in terms of field induced polarisation and orientation of permanent dipoles within the membrane and the cell. This interpretation is supported by the finding that Chelex beads (polystyrene cross-linked with divinylbenzene and coupled to iminodiacetic acid) do exhibit rotation in the MHz-range, but not in the kHz-range. It is most interesting that the Cu2+- and Ca2+-forms of the Chelex beads show a shift in the rotation frequency spectrum in addition to an increase in the magnitude of the rotation speed with respect to the Na+-form. At frequencies in the MHz-range at which rotation of the Chelex beads is not observed, formation of chains of beads from the electrodes occurs instead. This is due to positive polarisation of the beads leading to positive dielectrophoresis. The results support the view that rotation needs negative polarisability which is determined by the functional groups.

Edible Grain↗

Motion of the ankle in a simulated supination-external rotation fracture model.

UNLABELLED: An experimental study was undertaken with use of axially loaded, unconstrained cadaver ankles to determine the motion patterns seen with progressive stages of the supination-external rotation type of fracture. As described by Lauge-Hansen, these fractures were modeled by transection of the anterior aspect of the capsule and the anterior tibiofibular ligament (stage I), followed by oblique fibular osteotomy ending at the level of the ankle joint (stage II), transection of the posterior aspect of the capsule (stage III), and sequential sectioning of the superficial and deep fibers of the deltoid ligament (stage IV). Thirteen specimens were tested on an apparatus that allowed for controlled loading while the ankle was passed through a physiological range of dorsiflexion and plantar flexion. The ankles were unconstrained about the axial (internal and external rotation) and coronal (varus and valgus angulation) axes. Measurements were made throughout the range of motion in these axes in order to define the kinematic behavior. In the intact specimens, maximum plantar flexion was associated with a mean (and standard deviation) of 1.9 +/- 4.12 degrees of internal rotation of the talus and maximum dorsiflexion, with a mean of 7.2 +/- 3.88 degrees of external rotation. Varus angulation increased slightly with plantar flexion compared with the value in dorsiflexion (2.4 +/- 2.40 compared with 0.3 +/- 1.96 degrees). Internal and external rotation was not affected by fibular osteotomy or by transection of the superficial fibers of the deltoid ligament. Transection of the deep fibers of the deltoid ligament caused a significant (p < 0.02) increase in external rotation of the talus at maximum plantar flexion; this was corrected incompletely by insertion of an anatomical fibular plate. With the numbers available for study, we could not show that varus or valgus angulation was significantly affected by any combination of sectioning of the deltoid ligament and fibular osteotomy. These experiments were repeated with the addition of fixation of the subtalar joint with a talocalcaneal screw. With the number of specimens available, we could detect no significant difference, with respect to axial rotation, due to fixation of the subtalar joint. However, along the coronal axis, increased valgus angulation (p < 0.02) was seen during plantar flexion when either the deep or the superficial fibers of the deltoid ligament had been cut. CLINICAL SIGNIFICANCE: These results indicate that stability of the loaded ankle is primarily due to the deltoid ligament, which exerts a restraining influence on external rotation of the talus. Complete fibular osteotomy did not cause abnormal motion of the ankle in the absence of a medial injury. In the presence of a complete injury, lateral reconstruction only partially restored the mechanical integrity of the ankle. The results provide justification for the non-operative treatment of isolated fractures of the lateral malleolus. The data also suggest that a lateral fracture associated with a major injury of the deltoid ligament should be treated with anatomical lateral fixation followed by immobilization without early motion, to allow adequate healing of the deltoid ligament at its resting length.

Aged↗

The effects of tibial rotation on posterior translation in knees in which the posterior cruciate ligament has been cut.

BACKGROUND: One of the most useful clinical tests for diagnosing an isolated injury of the posterior cruciate ligament is the posterior drawer maneuver performed with the knee in 90 degrees of flexion. Previously, it was thought that internally rotating the tibia during posterior drawer testing would decrease posterior laxity in a knee with an isolated posterior cruciate ligament injury. In this study, we evaluated the effects of internal and external tibial rotation on posterior laxity with the knee held in varying degrees of flexion after the posterior cruciate and meniscofemoral ligaments had been cut. MATERIALS AND METHODS: Twenty cadaveric knees were used. Each knee was mounted in a fixture with six degrees of freedom, and anterior and posterior forces of 150 N were applied. The testing was conducted with the knee in 90 degrees, 60 degrees, 30 degrees, and 0 degrees of flexion with the tibia in neutral, internal, and external rotation. All knees were tested with the posterior cruciate and meniscofemoral ligaments intact and transected. Repeated-measures analysis of variance was used for statistical analysis. RESULTS: At 30 degrees, 60 degrees, and 90 degrees of flexion, there was a significant increase in posterior laxity following transection of the posterior cruciate and meniscofemoral ligaments. At 60 degrees and 90 degrees of flexion, there was significantly less posterior laxity when the tibia was held in internal compared with external rotation. At 0 degrees and 30 degrees of flexion, there was no significant difference in posterior laxity when the tibia was held in internal compared with external rotation. CONCLUSIONS: After the posterior cruciate and meniscofemoral ligaments had been cut, posterior laxity was significantly decreased by both internal and external rotation of the tibia. Internal tibial rotation resulted in significantly less laxity than external tibial rotation did at 60 degrees and 90 degrees of knee flexion.

Cadaver↗

Computed arthrotomography of the shoulder: comparison of examinations made with internal and external rotation of the humerus.

We assessed the best positioning of the humerus for CT scans obtained after air-contrast shoulder arthrography by performing 54 examinations with both external and internal rotation of the humerus. Of the 30 abnormalities of the anterior portion of the labrum, 27 (90%) were identified on the scans obtained with the arm in internal rotation. The other three (10%) were shown best or solely on the scans obtained with the arm in external rotation. All 22 abnormalities of the anterior capsule were shown on the scans obtained with internal rotation. In no case were scans obtained in external rotation superior. Five posterior labral and capsule abnormalities were found; two of them were identified best or only on scans obtained with external rotation. The other three were shown equally well with the arm in either position. The results show that a modest (9%) increase in diagnostic yield can be expected when CT scans obtained with the arm in external rotation are added to studies performed solely with the arm internally rotated.

Adolescent↗

Test-retest reliability of the seated Functional Rotation Test in people with Parkinson's disease: a preliminary study.

This study established the test-retest reliability of a seated Functional Rotation Test monitoring hand-pointing, together with head and trunk-rotation performance, in people with Parkinson's disease. An ancillary purpose was to establish the concurrent validity between the Functional Rotation Test and an electrogoniometer. 10 males with Parkinson's disease (M age=70.5 yr.; Hoehn and Yahr staging severity ranging from II to IV) were recruited. Subjects were fitted with laser-pointing devices, sat in the Functional Rotation room, and were instructed to turn actively and point to their right (or left) as far as they could comfortably manage. Tagged projections were scored (in degrees). Testing was repeated after a brief interval. Electrogoniometer projected locations were compared with Functional Rotation Test scores. Intraclass correlation coefficients (.91 to .97) indicated excellent test-retest reliability. There was also excellent agreement between electrogoniometric and Functional Rotation Test values (Intraclass correlation coefficients=.99). Thus the Functional Rotation Test provides a replicable measure of axial rotation of head, trunk, and hand-pointing in seated subjects with Parkinson's disease.

Aged↗

The immediate effects of soft tissue mobilization with proprioceptive neuromuscular facilitation on glenohumeral external rotation and overhead reach.

STUDY DESIGN: Randomized controlled 2-group. pretest-posttest, multivariate study of patients with shoulder musculoskeletal disorders. OBJECTIVES: The purpose of this study was to evaluate the immediate effect of soft tissue mobilization (STM) with proprioceptive neuromuscular facilitation (PNF) to increase glenohumeral external rotation at 45 degrees of shoulder abduction and overhead reach. BACKGROUND: It is postulated that limitation in glenohumeral external rotation, when measured at 45 degrees of shoulder abduction, represents subscapularis muscle flexibility deficits and is associated with the inability to fully reach overhead. No research, however, is available to demonstrate whether intervention strategies intended to improve subscapularis flexibility and glenohumeral external rotation range of motion at 45 degrees of shoulder abduction will improve a patient's ability to reach overhead. METHODS AND MEASURES: Twenty patients (10 males, 10 females; age range, 21-83 years) with limited glenohumeral external rotation and overhead reach of 1 year duration or less served as subjects. The subjects were randomly assigned to a treatment group, which consisted of soft tissue mobilization to the subscapularis and proprioceptive neuromuscular facilitation to the shoulder rotators, or a control group. Goniometric measurements of glenohumeral external rotation at 45 degrees abduction and overhead reach were taken preintervention and immediately postintervention for the treatment group or at prerest and postrest periods for the control group. RESULTS: The treatment group improved by a mean of 16.4 degrees (95% confidence interval [CI, 12.5 degrees-20.3 degrees) of glenohumeral external rotation, as compared to less than a 1 degree gain (95% CI, -0.2 degrees-2.0 degrees) in the control group (P < .0005). Overhead reach in the treatment group improved by a mean of 9.6 cm (95% CI, 5.2-14.0 cm) in comparison to a mean gain of 2.4 cm (95% CI, -0.8-5.6 cm) for the control group (P = .009). CONCLUSION: These findings suggest that a single intervention session of STM and PNF was effective for producing immediate improvements in glenohumeral external rotation and overhead reach in patients with shoulder disorders.

Adult↗

Scapulothoracic and glenohumeral kinematics following an external rotation fatigue protocol.

STUDY DESIGN: Repeated-measures experimental design. OBJECTIVE: To determine the effects of shoulder external rotator muscle fatigue on 3-dimensional scapulothoracic and glenohumeral kinematics. BACKGROUND: The external rotator muscles of the shoulder are important for normal shoulder function. Impaired performance of these muscles has been observed in subjects with impingement syndrome and it is possible that external rotator muscle fatigue leads to altered kinematics of the shoulder girdle. METHODS AND MEASURES: Twenty subjects without a history of shoulder pathology participated in this study. Three-dimensional scapulothoracic and glenohumeral kinematics were determined from electromagnetic sensors attached to the scapula, humerus, and thorax. Surface electromyographic (EMG) data were collected from the upper and lower trapezius, serratus anterior, anterior and posterior deltoid, and infraspinatus muscles. Median power frequency (MPF) values were derived from the raw EMG data and were used to indicate the degree of local muscle fatigue. Kinematic and EMG measures were collected prior to and immediately following the performance of a shoulder external rotation fatigue protocol. RESULTS: After completing the fatigue protocol subjects demonstrated less external rotation of the humerus. Additionally, they had less posterior tilt of the scapula in the beginning phase of arm elevation, and more scapular upward rotation and clavicular retraction in the mid ranges of arm elevation. CONCLUSIONS: Performance of an external rotation fatigue protocol results in altered scapulothoracic and glenohumeral kinematics. Further studies are needed to investigate the effects of external rotator muscle fatigue on scapulothoracic and glenohumeral kinematics in subjects with shoulder pathology.

Adolescent↗

The incidence of rotator cuff disease in smoking and non-smoking patients: a cadaveric study.

The etiology of rotator cuff disease is multifactorial. One theory behind the high incidence of rotator cuff tears in the shoulder is that the supraspinatus/infraspinatus tendon contains a zone of relative avascularity in the area proximal to its insertion at the greater tuberosity. Tobacco smoking is known to contribute to microvascular disease, and it can be hypothesized that smoking tobacco further compromises the vascular supply to the supraspinatus/infraspinatus tendon, thus increasing the incidence of tendinous pathology in the rotator cuff. This article evaluates the rotator cuffs of 72 shoulders in 36 cadavers and compares the incidence of macroscopic and microscopic disease within the rotator cuff tendon. Microscopic evaluation of the accompanying lung tissue from the respective cadaver also was performed. As a result, we were able to determine the presence or absence of a smoking history or emphysema from each cadaver as it related to rotator cuff disease in the shoulder. Of the 36 shoulders that exhibited macroscopic rotator cuff tears, 23 were from cadavers with a history of smoking compared to only 13 from cadavers with no history of smoking. Furthermore, the presence of advanced microscopic rotator cuff pathology (Grade 3 or 4 fibrous degeneration) was more than twice as likely in the cadavers with a history of smoking (22/32) compared to only 10 of 32 shoulders from cadavers with no history of smoking. While none of this data was statistically significant due to the insufficient number of subject cadavers, strong trends were noted in these findings.

Acromion↗

[Deviation and rotation of the larynx in computer tomography].

Many authors described the clinical importance of asymmetry of the laryngeal framework. However, its pathogenesis is generally unknown. In this study, CT images of 315 Japanese subjects were investigated to define the laryngeal position relative to the midline of the cervical vertebra. The CT slice of each subject within 5 mm cephalad of the cricoarytenoid joint was traced. Then, the deviation and rotation angles were measured using our method. Seventy one percent of the subjects' larynges deviated and/or rotated to the right side, while 17% to the left side. Six percent showed neither deviation nor rotation. As to the rest of 6%, deviation and rotation were in opposite directions. Besides, the length of the thyroid alae were measured in 282 subjects. Left ala was longer in 55%, and right was in 23%, and almost equal in 22%. The conclusions are as follows, 1. The majority of the subjects' CT images showed deviation and/or rotation of the laryngeal framework to the right side. 2. So called idiopathic laryngeal deviation is a case which observed in those cases with remarkable deviation and/or rotation of the laryngeal framework. 3. Aging seemed to be an important factor in acceleration of the laryngeal deviation and rotation. 4. The type of diseases and the side of mass lesions had no statistical significance in deviation and rotation of the larynx.

Adult↗

Effects of body orientation and rotation axis on pitch visual-vestibular interaction.

Spatial transformations of the vestibular-optokinetic system must account for changes in head position with respect to gravity in order to produce compensatory oculomotor responses. The purpose of this experiment was to study the influence of gravity on the vestibulo-ocular reflex (VOR) in darkness and on visual-vestibular interaction in the pitch plane in human subjects using two different comparisons: (1) Earth-horizontal axis (EHA) rotation about an upright versus a supine body orientation, and (2) Earth-horizontal versus Earth-vertical (EVA) rotation axes. Visual-vestibular responses (VVR) were evaluated by measuring the slow phase velocity of nystagmus induced during sinusoidal motion of the body in the pitch plane (at 0.2 Hz and 0.8 Hz) combined with a constant-velocity vertical optokinetic stimulation (at +/- 36 degrees/s). The results showed no significant effect on the gain or phase of the VOR in darkness or on the VVR responses at 0.8 Hz between EHA upright and EHA supine body orientations. However, there was a downward shift in the VOR bias in darkness in the supine orientation. There were systematic changes in VOR and VVR between EHA and EVA for 0.2 Hz, including a reduced modulation gain, increased phase lead, and decreased bias during EVA rotation. The same trend was also observed at 0.8 Hz, but at a lesser extent, presumably due to the effects of eccentric rotation in our EVA condition and/or to the different canal input across frequencies. The change in the bias at 0.2 Hz between rotation in darkness and rotation with an optokinetic stimulus was greater than the optokinetic responses without rotation. During EHA, changes in head position relative to gravity preserve graviceptor input to the VVR regardless of body orientation. However, the modifications in VVR gain and phase when the rotation axis is aligned with gravity indicate that this graviceptive information is important for providing compensatory eye movements during visual-vestibular interaction in the pitch plane.

Adult↗

Systematic investigation of physiological correlates of motion sickness induced by viewing an optokinetic rotating drum.

PURPOSE: This study investigated the physiological correlates of motion sickness provoked by viewing an optokinetic rotating drum. METHOD: A total of 52 subjects viewed an optokinetic rotating drum for 16 min. Subjective symptoms of motion sickness (SSMS) and ratings of over-all sickness were measured during the drum rotation. Electrogastrogram (EGG), electroencephalogram (EEG), electrocardiogram, and skin conductance were measured as physiological correlates of motion sickness. RESULTS: Analysis by Pearson's correlation showed that the subjects who had higher scores of SSMS during the drum rotation generated the following: a) a higher rating of over-all sickness (r = 0.76); b) a higher ratio of spectral power of EGG at 4-9 cycles per minute (cpm) between drum rotation and baseline periods (r = 0.63); c) a higher net percent increase of spectral power in the EEG frequency band 0.5-4 Hz between drum rotation and baseline periods on C3 (r = 0.29) and C4 (r = 0.31); d) a higher ratio of spectral power of EEG frequency band 0.5-4 Hz between drum rotation and baseline periods on C3 (r = 0.31); and e) a higher level of net increase in skin conductance from baseline to drum rotation (r = 0.30). CONCLUSION: The increase of EGG at 4-9 cpm activity, gastric tachyarrhythmia, is the most sensitive physiological index of the severity of symptoms of motion sickness.

Adolescent↗

The effect of otolith and semicircular canal convergence on the VOR during eccentric rotation.

VOR gain modulation was systematically investigated in the Rhesus monkey (M. mulatta) during centric and variable eccentric (up to 50 cm) sinusoidal rotation (4 Hz, 0.75 degree) with the nose facing in- or outward to test convergence of otolith and semicircular canal afferences. Earth-stationary lit LED-targets were placed at different distances (12-180 cm) from the monkey. Results were compared to biological demands. During centric rotation at 4 Hz when smooth pursuit mechanisms do not play a role, VOR gain--as expected--was approximately 1 without dependence on target distance. Phase of VOR and centrifuge were shifted by about 180 degrees as was predicted. If the monkey was rotated eccentrically with the nose facing outward the expected gain enhancement for close targets was obtained. Maximal experimental VOR gain during 4 Hz rotation was 4.4 which was close to demand at 50 cm eccentricity and 15 cm target distance (predicted gain: 4.6). If the nose points inward three situations have to be distinguished from simulation: (1) target behind the axis of rotation--VOR gain decrement should occur; (2) target on the axis of rotation--"inverse VOR suppression"; (3) target between monkey and axis of rotation--phase reversal. Experimentally, VOR gain decrement was obtained (situation 1). VOR gain was minimal (but not zero) for targets around the axis of rotation (situation 2). Situation 3 has not been investigated in detail so far.

Acceleration↗

Baselines for three-dimensional perception of combined linear and angular self-motion with changing rotational axis.

The laws of physics explain many human misperceptions of whole-body passive self-motion. One classic misperception occurs in a rotating chair in the dark: If the chair is decelerated to a stop after a period of counterclockwise rotation, then a subject will typically perceive clockwise rotation. The laws of physics show that, indeed, a clockwise rotation would be perceived even by a perfect processor of angular acceleration information, assuming that the processor is initialized (prior to the deceleration) with a typical subject's initial perception - of no rotation in this case. The motion perceived by a perfect acceleration processor serves as a baseline by which to judge human self-motion perception; this baseline makes a rough prediction and also forms a basis for comparison, with uniquely physiological properties of perception showing up as deviations from the baseline. These same principles, using the motion perceived by a perfect acceleration processor as a baseline, are used in the present paper to investigate complex motions that involve simultaneous linear and angular accelerations with a changing axis of rotation. Baselines - motions that would be perceived by a perfect acceleration processor, given the same initial perception (prior to the motion of interest) as that of a typical subject - are computed for the acceleration and deceleration stages of centrifuge runs in which the human carriage tilts along with the vector resultant of the centripetal and gravity vectors. The computations generate a three-dimensional picture of the motion perceived by a perfect acceleration processor, by simultaneously using all six interacting degrees of freedom (three angular and three linear) and taking into account the non-commutativity of rotations in three dimensions. The resulting three-dimensional baselines predict stronger perceptual effects during deceleration than during acceleration, despite the equal magnitudes (with opposite direction) of forces on the subject during acceleration and deceleration. For a centrifuge run with the subject facing tangentially in the direction of motion, the deceleration baseline shows a perception of forward tumble (pitch rotation) beginning with ascent from the earth, while the acceleration baseline does not have analogous pitch and vertical motion. These results give a three-dimensional explanation for certain puzzling acceleration-deceleration perceptual differences observed experimentally by Guedry, Rupert, McGrath, and Oman (Journal of Vestibular Research, 1992.). The present analysis is consistent with, and expands upon, previous analyses of individual components of motion.

Acceleration↗

[Electromyographic activity of human triangularis sterni muscles during thoracic rotation].

The triangularis sterni muscles (TS) have been recognized as expiratory muscles, but there is no information on their postural activity or their phasic electromyographic (EMG) activity during thoracic rotation. We examined the EMG activity of the right TS using fine-wire electrodes, in 5 healthy male subjects. With subjects breathing through a mouthpiece, airflow, raw and moving-averaged EMG signals were sampled with a computer during thoracic rotation and resting, accompanied by breathing with or without voluntary thoracic rotation. Maximum EMG (EMGmax) was defined as the greatest moving-averaged EMG activity recorded from each subject during the slow expiratory maneuver from functional residual capacity to residual volume. With leftward thoracic rotation without breathing, the tonic EMG activity of the right TS was observed in all subjects. During resting breathing without thoracic rotation, there were respiration-related phasic activities on TS EMG during expiration in all subjects. With leftward thoracic rotation, the respiration-related phasic activities on TS EMG significantly increased from 8.2 +/- 3.5 (mean +/- SE) %EMGmax to 15.2 +/- 6.1 %EMGmax. On the other hand, with rightward thoracic rotation, it decreased to 3.0 +/- 1.0 %EMGmax. We concluded that 1) TS has a postural function like that of the intercostal muscles, and that 2) the respiratory function of TS is affected by thoracic rotation.

Adult↗

[Two cases of severe vertigo occasioned by neck rotation and its correlation with the direction of vertebral artery at its origin].

We report two cases of severe vertigo with neck rotation. The first case is that of a 54-year-old woman. She suffered from severe vertigo during neck rotation to the right. Angiography demonstrated that the origin of the left vertebral artery (VA) became kinked when she turned her head to the right. The second case is that of a 59-year-old man. He suffered from severe vertigo during neck rotation to the left. Angiography demonstrated that the kink in the right VA at its origin became worse with the patient's turning his head to the left. We resected nerve fibers from the stellate ganglion at the origin of the respective vertebral arteries and corrected the kink in the arteries at their origin. Both patients were relieved of vertigo after the operation the fact that there was vertigo occasioned by neck rotation. The direction of neck rotation was identical with that of a kink in the VA at its origin in both patients. Therefore, the direction of neck rotation is useful information for the diagnosis of vertigo induced by neck rotation. In terms of the treatment, though vascular reconstruction such as vein graft bypass between the VA and the carotid artery or transposition of the VA onto the subclavian artery has been established for VA stenosis and occlusion, the resection of nerve fiber from the stellate ganglion at the origin of VA is also effective and safe, especially when a kink in the VA at its origin accompanies with neck rotation.

Female↗

Magnetic resonance imaging of the rotator cuff muscles after baseball pitching.

AIM: The purposes of present study were to investigate quantitatively using functional MR imaging the effect of a series of throwing activities on rotator cuff muscles and to compare the effect of pitching with that of all-out shoulder external rotator exercise as the targeted external rotator muscle group (the infraspinatus and the teres minor). METHODS EXPERIMENTAL DESIGN: MRI measurements after 135 baseball pitches or all-out shoulder external rotator exercise (concentric mode) in each subject's nondominant shoulder. PARTICIPANTS: 6 amateur baseball pitchers. MEASURES: serial T2-weighted images of rotator cuff muscles were obtained before pitching (or shoulder exercise) and immediately, 30, 60 min, 24, 48, 96 hrs after pitching (or shoulder exercise). T2 relaxation times (T2) at each measurement time were calculated for the rotator cuff muscles. RESULTS: Both the supraspinatus and the external rotator muscle group showed significant T2 elevations until 96 hrs after pitching. The subscapularis also showed significantly increased T2 until postpitching 48 hrs. On the other hand, a significant T2 elevation continued until 60 min after shoulder exercise, but thereafter returned towards the value at rest over the next 24 hrs. CONCLUSION: Long lasting T2 elevations in rotator cuff muscles would be associated with an increase in each intramuscular water content, and may be attributed to the muscle damage that resulted from eccentric contraction during pitching. This information should serve as a useful complement to shoulder injury prevention for baseball pitchers.

Adult↗