Nahid Rahmani

BACKGROUND: Changes in the respiratory system are one of the problems associated with neck pain. The purpose of the present study was to systematically review the previously published studies that have focused on changes in the strength of the respiratory muscles and the diaphragm thickness in individuals with chronic neck pain (CNP). MATERIALS AND METHODS: This systematic review was conducted according to PRISMA guidelines. Articles were retrieved from PubMed, Scopus, Embase, Web of Science, and Google Scholar databases. The keywords used were: “neck pain”, “Respiratory Muscles”, “diaphragm”, “Muscle Strength”, and “ultrasonography”. Among the 160 articles identified, 15 articles were selected that investigated changes in respiratory muscles and diaphragm thickness in patients with chronic neck pain. Study quality was assessed using a validated tool. All studies had a cross-sectional and case-control design. There were some variations among the studies in terms of methodology, musculoskeletal conditions, respiratory parameters, and sample size. RESULTS: A significant difference was reported in maximum inspiratory pressure, maximum expiratory pressure, maximum voluntary ventilation, and diaphragm thickness and excursion in patients with chronic neck pain compared to asymptomatic subjects. Pain score, neck disability index, and neck muscle strength were significantly correlated with respiratory parameters. CONCLUSION: Chronic neck pain is linked to measurable changes in the respiratory system, such as decreased diaphragm thickness and reduced respiratory muscle strength. These changes may impact functional capacity and should be considered in clinical evaluation and rehabilitation planning. These findings support incorporating respiratory assessments into the comprehensive management of CNP.

Background/Objectives: Adverse effects of a sedentary lifestyle on an individual’s overall health are inevitable. With reference to primary-school-aged children, the establishment of effective postural hygiene is critical as it not only promotes optimal musculoskeletal development but also significantly influences their long-term well-being and productivity. This study aimed to develop and internally validate a regularized regression model to predict static postural loading (SPL) in primary school children. Methods: The outcome and predictors of SPL were shortlisted through a systematic review of the literature and expert panels. Data were derived from 258 primary school children. We developed regularized elastic net (EN) and used multiple linear regression (MLR) as a reference. Both models were fitted through five-fold cross-validation with 10 iterations. The grid search technique was used to find the optimal combination of hyperparameters α and λ for the EN. We conducted a permutation importance analysis to obtain and compare predictor rankings for each model. Results: Both models presented a good and comparable fit, with the EN marginally outperforming the MLR in error metrics. Postural risk, sedentary behavior, task duration, and BMI were the most important predictors of SPL in primary school children. Conclusions: The proof of a direct impact of a sedentary lifestyle on children’s overall health is both credible and alarming. Hence, proper identification and management of contributing factors to static postural loading in this age group is critical. In various clinical settings, where the objective is to develop a model that accurately forecasts the outcome, advanced regularized regression methods have evidently shown great performance.

Background and Aims: Using ultrasonography to systematically review all published studies that investigated the association between craniovertebral angle (CVA) and neck muscle size. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Searches were performed in PubMed, Science Direct, OVID, MEDLINE, and Google Scholar databases from January 2000 to October 2024. The keywords used were: “Forward head posture,” “Cranial vertebral angle,” “size,” “thickness,” “weakness,” “enlargement,” “hypertrophy,” “ultrasonography*,” “Diagnostic ultrasound,” “ultrasonic imaging,” “imaging,” “medical sonography,” and “ultrasonic diagnostic”. Results: Of the 329 articles retrieved from the databases, 10 studies fulfilled the inclusion criteria. Four studies investigated the size of neck flexor muscles, four articles investigated the size of neck extensor muscles, and two articles focused on the size of both neck flexor and extensor muscles. Six studies compared participants with and without forward head posture (FHP). Two studies were conducted among asymptomatic subjects, while the other two studies were conducted among participants with and without neck pain. Consistent evidence supported that a significant correlation between the CVA and the thickness of deep neck flexor muscles ( n = 1), a significant correlation between FHP and the thickness of the splenius capitis muscle ( n = 1), an increase in sternocleidomastoid (SCM) muscle thickness ( n = 2) and a decrease in semispinalis capitis (SSC) muscle thickness ( n = 1) in subjects with FHP compared to those without, and a decrease in semispinalis capitis muscle thickness in individuals with FHP accompanied by neck pain compared to those with FHP without neck pain (n = 1). Conclusion: The reviewed studies demonstrated that changes in the CVA are associated with alterations in neck muscle size, particularly affecting the SCM and SSC muscles. Additional research is necessary to investigate the functional implications of alterations in muscle characteristics.

Objective According to the World Health Organization (WHO), more than 1 billion people (approximately 15% of world population) live with disability. Also, about half of these people lack access to healthcare facilities. Therefore, providing timely healthcare services, especially rehabilitation, is of great significance for these people. The goal of the study ...

Context: Defined by several physiological and anatomical contributors, posture is essentially an accurate indicator of health status that is most frequently highlighted by affecting the configuration and operations of internal systems and organs. Quantifying body position has always been highlighted in clinical, academic, and industrial contexts, and various posture analysis approaches have been developed throughout the years. Objectives: This study aims to establish the reliability and validity of several novel observational approaches to postural load assessment and provide an overall view of related trends. Methods: This review was designed and conducted following (PRISMA) guidelines and five databases were surveyed, namely PubMed, Science Direct, CINAHL, Ergonomic Abstracts, and EMBASE, utilizing both generic and specific search terms modified for each database. Articles introducing a novel approach to observational postural load analysis and concepts of reliability and validity of the introduced method were included. Cross-sectional, case-control, experimental, and controlled trial designs were considered. Studies were excluded if they were exclusively based on subjective approaches. The methodological quality of the studies was evaluated using the MacDermid checklist. Similarly, reliability, measurement error, content validity, and criterion validity were assessed using COSMIN (Consensus-based Standards for selecting health Measurement Instruments) boxes B, C, D, and H, respectively. Results: Twenty-five articles were selected for the final review. The studies mainly reported ICC for reliability and r and r2 for validity. The results on the MacDermid quality evaluation tool varied from 38 to 80%, with a mean of 61.60 ± 11.54%. Regarding the COSMIN checklists, the scores were 61.40 ± 10.39%, 59.16 ± 11.35%, 64 ± 16.07%, and 57.12 ± 15.19% for boxes B, C, D, and H, respectively. Some studies did not obtain high scores for specified inclusion and exclusion criteria and appropriate sample size, leading to a moderate quality rating in checklists. Conclusions: Drawing comprehensive conclusions by directly comparing and contrasting observational techniques can be challenging due to their unique strengths, limitations, and inconsistencies. Such variations may arise from the methods’ characteristics, such as the fields, settings, populations, and the evaluated risk factors.