Displaying all 6 publications

  1. Kwan MK, Wong KA, Lee CK, Chan CY
    Eur Spine J, 2016 Feb;25(2):401-8.
    PMID: 25962815 DOI: 10.1007/s00586-015-4016-9
    PURPOSE: To introduce a new clinical neck tilt grading and to investigate clinically and radiologically whether neck tilt and shoulder imbalance is the same phenomenon in AIS patients.

    METHODS: 89 AIS Lenke 1 and 2 cases were assessed prospectively using the new clinical neck tilt grading. Shoulder imbalance and neck tilt were correlated with coracoid height difference (CHD), clavicle\rib intersection distance (CRID), clavicle angle (CA), radiographic shoulder height (RSH), T1 tilt and cervical axis.

    RESULTS: Mean age was 17.2 ± 3.8 years old. 66.3 % were Lenke type 1 and 33.7 % were type 2 curves. Strong intraobserver (0.79) and interobserver (0.75) agreement of the clinical neck tilt grading was noted. No significant correlation was observed between clinical neck tilt and shoulder imbalance (0.936). 56.3 % of grade 3 neck tilt, 50.0 % grade 2 neck tilt patients had grade 0 shoulder imbalance. In patients with grade 2 shoulder imbalance, 42.9 % had grade 0, 35.7 % grade 1, 14.3 % grade 2 and only 7.1 % had grade 3 neck tilt. CHD, CRID, CA and RSH correlated with shoulder imbalance. T1 tilt and cervical axis measurements correlated with neck tilt.

    CONCLUSIONS: In conclusion, neck tilt is distinct from shoulder imbalance. Clinical neck tilt has poor correlation with clinical shoulder imbalance. Clinical neck tilt grading correlated with cervical axis and T1 tilt whereas clinical shoulder grading correlated with CHD, RSH CRID and CA.

    Matched MeSH terms: Neck/physiopathology*
  2. Kwan MK, Chan CY
    Eur Spine J, 2016 10;25(10):3065-3074.
    PMID: 27021616
    PURPOSE: To investigate whether an optimal upper instrumented vertebra (UIV) tilt angle would prevent 'lateral' shoulder imbalance or neck tilt (with 'medial' shoulder imbalance) post-operatively.

    METHODS: The mean follow-up for 60 AIS (Lenke 1 and Lenke 2) patients was 49.3 ± 8.4 months. Optimal UIV tilt angle was calculated from the cervical supine side bending radiographs. Lateral shoulder imbalance was graded using the clinical shoulder grading. The clinical neck tilt grading was as follows: Grade 0: no neck tilt, Grade 1: actively correctable neck tilt, Grade 2: neck tilt that cannot be corrected by active contraction and Grade 3: severe neck tilt with trapezial asymmetry >1 cm. T1 tilt, clavicle angle and cervical axis were measured. UIVDiff (difference between post-operative UIV tilt and pre-operative Optimal UIV tilt) and the reserve motion of the UIV were correlated with the outcome measures. Patients were assessed at 6 weeks and at final follow-up with a minimum follow-up duration of 24 months.

    RESULTS: Among patients with grade 0 neck tilt, 88.2 % of patients had the UIV tilt angle within the reserve motion range. This percentage dropped to 75.0 % in patients with grade 1 neck tilt whereas in patients with grade 2 and grade 3 neck tilt, the percentage dropped further to 22.2 and 20.0 % (p = 0.000). The occurrence of grade 2 and 3 neck tilt when UIVDiff was <5°, 5-10° and >10° was 9.5, 50.0 and 100.0 %, respectively (p = 0.005). UIVDiff and T1 tilt had a positive and strong correlation (r2 = 0.618). However, UIVDiff had poor correlation with clavicle angle and the lateral shoulder imbalance.

    CONCLUSION: An optimal UIV tilt might prevent neck tilt with 'medial' shoulder imbalance due to trapezial prominence and but not 'lateral' shoulder imbalance.

    Matched MeSH terms: Neck/physiopathology*
  3. Yuen GK, Clements JB, Ramalingam V, Sundar V
    Clin Ter, 2021 Mar 15;172(2):163-167.
    PMID: 33763681 DOI: 10.7417/CT.2021.2305
    Conclusion: The obtained results conclude piano players are highly prone to the risk of developing PRMSD in the upper body.

    Results: The findings showed piano players have a higher NDI, lower CVA, and RSP when compared with the non-piano players at a statistically significant level of p-value <0.05.

    Objective: Playing-related musculoskeletal disorders (PRMSD) are a common problem for the pianist. The poor upper body ergonomics influences the natural positioning of the neck and shoulders, which involves forward head posture (FHP) and rounded shoulder posture (RSP). This misaligned position could produce a sensation of pain over the upper body, which affects the piano player and computer users with similar ergonomic posture. Recently, photogrammetry methods are commonly applied in a clinical setting to assess posture. The goal of this research is to compare the upper body playing-related muscu-loskeletal disorders between the piano and the non-piano players by applying photogrammetry.

    Materials and Methods: This causal-comparative study includes 70 participants with 35 piano and 35 non-piano players. The participant's FHP was assessed using a digitized photo to record the Craniovertebral angle (CVA) with the support of Kinovea software. Besides, digital Vernier Calliper used to assess the scapular index on the RSP and Neck disability indices (NDI) used to measure neck pain and functional disability of the participants.

    Matched MeSH terms: Neck/physiopathology
  4. Dhillon MK, Leong YP
    Singapore Med J, 1991 Apr;32(2):177-8.
    PMID: 2042085
    An 8-year old boy presented with a right neck swelling which appeared only intermittently. The swelling was well demonstrated by the Valsalva manoeuvre. The differential diagnosis include a laryngocele, a superior mediastinum tumour or cyst and a venous aneurysm. Plain radiography, computerized tomography, ultrasonography and venography were performed. A diagnosis of venous aneurysm was confirmed. Ultrasonography was the best modality for imaging of this rare condition. It is non-invasive and it will also delineate the extent of the lesion. The treatment is expectant. Surgery is reserved for cosmesis and symptomatic aneurysms.
    Matched MeSH terms: Neck/physiopathology*
  5. Chee WS, Suriah AR, Chan SP, Zaitun Y, Chan YM
    Osteoporos Int, 2003 Oct;14(10):828-34.
    PMID: 12915959
    Dietary studies often report low calcium intake amongst post-menopausal Malaysian women and calcium deficiency has been implicated as part of the etiology of age-related bone loss leading to osteoporosis. Therefore, the objective of this study was to examine the effectiveness of high calcium skimmed milk (Anlene Gold, New Zealand Milk, Wellington, New Zealand) to reduce bone loss in Chinese postmenopausal women. Two hundred subjects aged 55-65 years and who were more than 5 years postmenopausal were randomized to a milk group and control group. The milk group consumed 50 g of high calcium skimmed milk powder daily, which contained 1200 mg calcium (taken as two glasses of milk a day). The control group continued with their usual diet. Using repeated measures ANCOVA, the milk supplement was found to significantly reduce the percentage of bone loss at the total body compared to the control group at 24 months (control -1.04%, milk -0.13%; P<0.001). At the lumbar spine, the percentage of bone loss in the control group was significantly higher (-0.90%) when compared to the milk (-0.13%) supplemented group at 24 months (P<0.05). Similarly, milk supplementation reduced the percentage of bone loss at the femoral neck (control -1.21%, milk 0.51%) (P<0.01) and total hip (control -2.17%, milk -0.50%) (P<0.01). The supplemented group did not experience any significant weight gain over the 24 months. The serum 25-hydroxy vitamin D level improved significantly (P<0.01) from 69.1 +/- 16.1 nmol/l at baseline to 86.4 +/- 22.0 nmol/l at 24 months in the milk group. In conclusion, ingestion of high calcium skimmed milk was effective in reducing the rate of bone loss at clinically important lumbar spine and hip sites in postmenopausal Chinese women in Malaysia. Supplementing with milk had additional benefits of improving the serum 25-hydroxy vitamin D status of the subjects.
    Matched MeSH terms: Femur Neck/physiopathology
  6. Thu WPP, Logan SJS, Cauley JA, Kramer MS, Yong EL
    Arch Osteoporos, 2019 07 19;14(1):80.
    PMID: 31324992 DOI: 10.1007/s11657-019-0631-0
    Chinese Singaporean middle-aged women have significantly lower femoral neck bone mineral density and higher lumbar spine bone mineral density than Malays and Indians, after adjustment for age, body mass index, and height.

    PURPOSE: Information regarding mediators of differences in bone mineral density (BMD) among Asian ethnicities are limited. Since the majority of hip fractures are predicted to be from Asia, differences in BMD in Asian ethnicities require further exploration. We compared BMD among the Chinese, Malay, or Indian ethnicities in Singapore, aiming to identify potential mediators for the observed differences.

    METHODS: BMD of 1201 women aged 45-69 years was measured by dual-energy X-ray absorptiometry. We examined the associations between ethnicity and BMD at both sites, before and after adjusting for potential mediators measured using standardized questionnaires and validated performance tests.

    RESULTS: Chinese women had significantly lower femoral neck BMD than Malay and Indian women. Of the more than 20 variables examined, age, body mass index, and height accounted for almost all the observed ethnic differences in femoral neck BMD between Chinese and Malays. However, Indian women still retained 0.047 g/cm2 (95% CI, 0.024, 0.071) higher femoral neck BMD after adjustment, suggesting that additional factors may contribute to the increased BMD in Indians. Although no crude ethnic differences in lumbar spine BMD were observed, adjusted regression model unmasked ethnic differences, wherein Chinese women had 0.061(95% CI, - 0.095, 0.026) and 0.065 (95% CI, - 0.091, 0.038) g/cm2 higher lumbar spine BMD compared to Malay and Indian women, respectively.

    CONCLUSION: BMD in middle-aged Asian women differ by ethnicity and site. Particular attention should be paid to underweight women of Chinese ethnic origin, who may be at highest risk of osteoporosis at the femoral neck and hence hip fractures.

    Matched MeSH terms: Femur Neck/physiopathology
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