METHODS: MEDLINE, EMBASE, PubMed, Cochrane Controlled Trials Register, Web of Science, ProQuest, and the WHO Clinical Trials Registry were searched. Studies were included if they randomized adults with orthostatic hypotension to droxidopa or to control, and outcomes related to symptoms, daily activity, blood pressure, or adverse events. Data were extracted independently by two reviewers. Risk of bias was judged against the Cochrane risk of bias tool and quality of evidence measured using Grading of Recommendations Assessment, Development and Evaluation criteria. A fixed-effects model was used for pooled analysis.
RESULTS: Of 224 identified records, four studies met eligibility, with a pooled sample size of 494. Study duration was between 1 and 8 weeks. Droxidopa was effective at reducing dizziness [mean difference -0.97 (95% confidence interval -1.51, -0.42)], overall symptoms [-0.52 (-0.98, -0.06)] and difficulty with activity [-0.86 (-1.34, -0.38)]. Droxidopa was also effective at improving standing SBP [3.9 (0.1, 7.69)]. Rates of adverse events were similar between droxidopa and control groups, including supine hypertension [odds ratio 1.93 (0.87, 4.25)].
CONCLUSION: Droxidopa is well tolerated and effective at reducing the symptoms associated with neurogenic orthostatic hypotension without increasing the risk of supine hypertension.
REGISTRATION: PROSPERO ID CRD42015024612.
METHODS: In experiment 1 (n = 10), we tested the direction of force exerted in an isometric aiming task before and after 40 repetitions of 2-s maximal-force ballistic contractions toward a single directional target. In experiment 2 (n = 12), each participant completed three training conditions in a counterbalanced crossover design. In two conditions, both the aiming task and the training were conducted in the same (neutral) forearm posture. In one of these conditions, the training involved weak forces to determine whether the level of neural drive during training influences the degree of bias. In the third condition, high-force training contractions were performed in a 90° pronated forearm posture, whereas the low-force aiming task was performed in a neutral forearm posture. This dissociated the extrinsic training direction from the pulling direction of the trained muscles during the aiming task.
RESULTS: In experiment 1, we found that aiming direction was biased toward the training direction across a large area of the work space (approximately ±135°; tested for 16 targets spaced 22.5° apart), whereas in experiment 2, we found systematic bias in aiming toward the training direction defined in extrinsic space, but only immediately after high-force contractions.
CONCLUSION: Our findings suggest that bias effects of training involving strong neural drive generalize broadly to untrained movement directions and are expressed according to extrinsic rather than muscle-based coordinates.
OBJECTIVE: The three main objectives are to analyze published pen-and-paper observational methods, to extract and understand the risk levels of each method and to identify their associated health effects.
METHODOLOGY: The authors searched scientific databases and the Internet for materials from 1970 to 2013 using the following keywords: ergo, posture, method, observational, postural angle, health effects, pain and diseases. Postural assessments of upper arms, lower arms, wrists, neck, back and legs in six pen-and-paper-based observational methods are highlighted, extracted in groups and linked with associated adverse health effects.
RESULTS: The literature reviewed showed strengths and limitations of published pen-and-paper-based observational methods in determining the work activities, risk levels and related postural angles to adverse health effects. This provided a better understanding of unsafe work postures and how to improve these postures.
CONCLUSION: Many pen-and-paper-based observational methods have been developed. However, there are still many limitations of these methods. There is, therefore, a need to develop a new pen-and-paper-based observational method for assessing postural problems.
OBJECTIVE: The aim of this study was to analyze the proximal thoracic (PT) flexibility and its compensatory ability above the "potential UIV."
SUMMARY OF BACKGROUND DATA: Shoulder and neck imbalance can be caused by overcorrection of the main thoracic (MT) curve due to inability of PT segment to compensate.
METHODS: Cervical supine side bending (CSB) radiographs of 100 Lenke 1 and 2 patients were studied. We further stratified Lenke 1 curves into Lenke 1-ve: PT side bending (PTSB) 80.0% of cases of the PT segment were unable to compensate at T3-T6. In Lenke 1+ve curves, 78.4% were unable to compensate at T6, followed by T5 (75.7%), T4 (73.0%), T3 (59.5%), T2 (27.0%), and T1 (21.6%). In Lenke 1-ve curves, 36.4% of cases were unable to compensate at T6, followed by T5 (45.5%), T4 (45.5%), T3 (30.3%), T2 (21.2%), and T1 (15.2%). A significant difference between Lenke 1-ve and Lenke 1+ve was observed from T3 to T6. The difference between Lenke 1+ve and Lenke 2 curves was significant only at T2.
CONCLUSION: The compensation ability and the flexibility of the PT segments of Lenke 1-ve and Lenke 1+ve curves were different. Lenke 1+ve curves demonstrated similar characteristics to Lenke 2 curves.
LEVEL OF EVIDENCE: 3.