72139
Morphological variations of the extrapelvic course and distribution of the obturator nerve in humans.
Kumka, Myroslava
Methods: This study utilized 16 embalmed cadavers (32 upper limbs) of both sexes and of different ages using traditional anatomical macro-micro dissections.
Summary of results: The variant of the Extensor Indicis (EI) muscle: double tendon to index and middle fingers, was found in one female cadaver, bilaterally. The narrow, elongated muscle belly of EI attached to the posterolateral surface of ulna, the adjacent interosseus membrane and the deep antebrachial fascia. The lateral part of the EI muscle belly became tendonous at the inferior third of the forearm while that of the medial part occurred at the superior border of the extensor retinaculum. Both tendons passed deep to the extensor retinaculum to join with the ulnar sides of the tendons of the extensor digitorum forming the extensor expansion for the index and middle fingers. It was observed that the muscle belly of this anomalous muscle was innervated by branches of the deep radial nerve in the inferior third of forearm. The double EI tendon appears to be a developmental variant of the normal migratory pattern of myogenic cells known to occur during embryogenesis of the upper limb.
Conclusion: Our finding supports the hypothesis that the double EI muscle tendon variant may result from early splitting of EI muscle primordium during morphogenesis and may serve to enhance tightness of grip and functional independence to the index and middle fingers.
72153
The willingness of CMCC alumni to participate in a survey of diagnostic competency associated with experience.
Rodine, Rob
Russell et al (2004) determined that response rates among chiropractors for research surveys, not only ranged greatly among publications, but demonstrated a mean of slightly higher than 50%. This creates problems for generalizability of survey research. The purpose of this study is to generate a response rate estimate among a sub-group of chiropractors that would be interested in participating in a study of diagnostic competency among chiropractors.
This estimate will be used to guide future decisions regarding a follow-up study in which a diagnostic competency questionairre will be distributed to chiropractic practitioners.
82001
Test-Retest Reliability of Two Variations of the Global Perceived Recovery Question in Recent Whiplash Patients
Ngo, Trung
The “transition question” is an instrument used to measure improvement in health and is widely used clinically as well as in research. Although there is debate on the transition question’s ability to detect change over time, no study has yet determined whether it is reliable. Because a measurement instrument’s reliability is the first step in determining its value, this study’s purpose is to determine the test-retest reliability of two variations of the Global Perceived Recovery Question in patients with recent whiplash-associated disorders (WAD). A clinical cohort study will be used to test the instrument test-retest reliability. Forty-six adult subjects (age >18) with recent WAD (duration < 2 weeks) from a motor vehicle collision presenting to UHN Rehabilitation Solutions between January 2008 and December 2008 will be recruited in the study. The two Global Perceived Recovery Questions will be administered to the subjects at 6 weeks after the initial visit and again 3 days following that. All statistical analyses will be performed using SAS software (SAS 9.1 for Windows, SAS Institute Inc., Cary, NC, USA).
82008
An ultrasonographical approach to the anatomy of the deep fibular nerve as it appears in neutral and testing positions of the leg and foot of healthy subjects.
Lucaciu, Calin
The deep fibular nerve is one of the most common peripheral nerves impinged at the level of different bony and muscular tunnels that the nerve passes through. However, use of ultrasound to visualize this nerve is sparsely covered. This following study is designed to evaluate the ability of ultrasonography to visualize the deep fibular nerve at the level of its origin as a direct branch of the common fibular nerve and as it courses through the origin of the fibularis longus, the muscle tunnel of the extensor digitorum longus, and at the level of the anterior tarsal tunnel. This study involves 20 asymptomatic human subjects; 10 of each gender will be chosen from the staff and student population at the Canadian Memorial Chiropractic College. The first objective of this study will be to visualize the deep fibular nerve using ultrasound, to determine the proper technique to find the nerve consistently, and to document the characteristics of the nerve (diameter, depth, displacement during movement). Another objective will be to study the behaviour of the nerve during neutral and testing positions such as plantar flexion. Results of this study may have important implications in clinical diagnosis and treatment in the chiropractic setting. Patients experiencing nerve entrapments may have decreased need for decompression surgeries and pharmaceuticals due to increased accuracy in diagnosing and treating nerve entrapments for chiropractors.
82009
Ultrasonography of the Median Nerve at the Level of the Cubital Fossa.
Lucaciu, Calin
While the cubital fossa is a possible site of median nerve impingement, this region has not been extensively studied by using the ultrasound method. Ultrasound represents a unique modality for visualizing peripheral nerves due to its ability to scan the nerve over a long distance. As a result, this study is designed to evaluate the ability of sonography to visualize the median nerve at the level of the cubital fossa, and to test for correlations between nerve measurements, spatial relationships, and subject characteristics. The study will be using a 5.5-14 MHz linear array transducer (Ultrasonix, BC) in sonographic evaluation of 20 healthy adult volunteers. We will evaluate the anatomical parameters of the median nerve in the cubital fossa, its spatial relationships to bony landmarks and components in the cubital fossa. We will then correlate nerve diameters and the sonographic parameters of Flexor Digitorum Superficialis. The findings of the study lay the groundwork necessary to examine the ultrasonographic appearance of the median nerve in symptomatic patients.
82012
Intra and Inter-Examiner Reliability in Identifying and Grading Vertebral Artery Hypoplasia/Asymmetry on MRI scans.
Peterson, Cynthia
Despite the previous lack of studies linking VA asymmetry to clinical findings, recent research suggests that this anomaly may be a possible risk factor for migraines with aura (Lovrencic-Huzjan et al, 1998; Chuang et al, 2008) and for posterior circulation stroke (Perren et al, 2007; Park, Kim & Roh, 2007; Chuang et al 2006). Although migraine with aura is an important complaint that is encountered by Chiropractors, the more unsettling suggestion of stroke as a possible sequela of vertebral artery hypoplasia is one that should not be taken lightly, especially with the enduring controversy surrounding cervical spine manipulation and stroke (Inamasu & Guiot, 2005). Unfortunately the use of VA asymmetry as a possible screening mechanism for cervical manipulation is not feasible at the present time. Not only is there a need for more research into this issue, but the advanced imaging studies typically used for these explorations are beyond the scope of Chiropractic practice in some countries.
In addition, cost for, access to, and wait times for these techniques outside the research realm makes it an impractical approach for patients in Canada. A current trend, however, is an increase in the number of patients who bring previously acquired MRI or CT imaging to their Chiropractor, often without a corresponding radiologist’s report. As this trend continues, it is imperative that Chiropractors be proficient at reading these advanced imaging techniques. Medical and chiropractic radiologists both report frequently seeing this anomaly, however, this finding is often not included in the radiologist’s written report (C Peterson, DACBR, oral personal communication, 2007). In light of recent studies suggesting a possible link between VA hypoplasia and posterior circulation stroke, evaluating MRI or CT for signs of vertebral artery asymmetry may potentially be important from a medico-legal perspective as a screening method when proper imaging is provided if future studies validate asymmetry as a risk factor for stroke in the absence of manipulation.
While previous studies have mainly utilized ultrasonic and angiographic techniques in their imaging methods as a means of assessing VA asymmetry, there are few studies, if any, existing that solely use MRI. As MRI is frequently available for chiropractic patients, determining if any vertebral artery asymmetry is identifiable on MRI without using advanced measuring techniques would be beneficial in the further investigation of this anomaly. The purpose of this study is to examine the inter and intra-examiner reliability of determining the prevalence of vertebral artery asymmetry on MRI as well as the reliability of assigning a severity grading of mild, moderate or marked hypoplasia/asymmetry. Reliability of this diagnosis must be established before further investigating the clinical relevance.
82014
The effect of clinical experience on cognitive competency in chiropractic interns.
Rodine, Robert
The role of clinical internship within health education is to provide students with practical hands-on training and increase competency through clinical experience and exposure to relevant cases. Over the past decade a standardized questionnaire, termed the basic competency examination (BCE) has been used to evaluate the knowledge, and associated competency of health professionals within the field of musculoskeletal care. Variable data has been reported with mostly unsatisfactory performance and low to moderate passing rates among a variety of clinical professionals. While chiropractic interns have recently been evaluated at the end of their clinic year using this questionnaire, musculoskeletal knowledge at previous time points has not been described in this population. It is the aim of this study to describe the change in scores on the BCE over the course of a chiropractic interns clinical education.
82023
Teaching aids for structural, functional and clinical anatomy of the musculoskeletal system.
Kumka, Myroslava
Description not yet available.