Purpose of Review Forward head posture (FHP) is the most common cervical postural fault in the sagittal plane that is found with different severity levels in almost all populations. Despite claims that FHP may be related to neck pain, this relation seems to be controversial. Thus, our purpose is to determine whether FHP differs between asymptomatic subjects and those with neck pain and to investigate if there is a relationship between head posture and neck pain. Recent Findings A total of 15 cross-sectional studies were eligible for inclusion for this systematic review and meta-analysis. Ten studies compared FHP between a group of asymptomatic participants and a group of participants with neck pain and an overall mean difference (MD) of 4.84 (95% CI = 0.14, 9.54), indicating a significant between-group difference, contrary to adolescent (MD = − 1.05; 95% CI = − 4.23, 2.12). Eight studies showed significant negative correlations between FHP and neck pain intensity (r = − 0.55; 95% CI = − 0.69, − 0.36) as well as disability (r = − 0.42; 95% CI = − 0.54, − 0.28) in adults and older adults, while in adolescents, only lifetime prevalence and doctor visits due to neck pain were significant predictors for FHP. Summary This systematic review found that age played an important role as a confounding factor in the relation between FHP and neck pain. Also, the results showed that adults with neck pain show increased FHP when compared to asymptomatic adults and that FHP is significantly correlated with neck pain measures in adults and older adults. No association was found between FHP and most of neck pain measures in adolescents.

IntroductionTensioning neural mobilization (NM) is accomplished through increasing the distance between nerve bed ends via elongation. NM techniques have different biomechanical effects on the nervous system. Evidence for their use in treating certain upper-quarter conditions like cervicobrachial pain is limited. The study was to determine tensioning NM efficacy on unilateral chronic cervical radiculopathy regarding mechanosensitivity of the affected nerve roots and intensity of neck and arm pain.MethodsForty participants with chronic unilateral cervical radiculopathy were randomly assigned to group A (<i>n</i> = 20), receiving traditional physical therapy (manual traction and infrared irradiation), and group B (<i>n</i> = 20), receiving traditional physical therapy in addition to tensioning NM of brachial plexus. Mechanosensitivity of the affected brachial nerve roots and intensity of neck and arm pain were evaluated at baseline and after a 3-week program with the upper limb tension test-1 and visual analogue scale. The normal (Z) test, paired and unpaired t-test, Wilcoxon signed-rank test, and Wilcoxon rank-sum test (Mann-Whitney) were used in data analysis.ResultsThere were significant within-group differences in both groups regarding mechanosensitivity and pain intensity (mechanosensitivity: <i>p</i> = 0.001 for group A, <i>p</i> = 0.001 for group B; pain: <i>p</i> < 0.01 for group A, <i>p</i> < 0.01 for group B). There was no statistically significant between-group difference regarding mechanosensitivity (<i>p</i> = 0.07) or pain intensity (<i>p</i> = 0.838).ConclusionsThe addition of tensioning NM to traditional physical therapy had no significant benefits, although both groups showed decreased post-treatment mechanosensitivity and pain intensity.

The role of oral contraceptives (OC) in the aetiology of cutaneous malignant melanoma (CMM) has been controversially discussed over the last two decades. In an extensive literature search we identified 18 case-control studies, published between 1977 and 1996, offering information on this relationship. Using a meta-analytical approach we combined the study-specific risk estimates and derived a summary odds ratio of 0.95 (95% confidence interval: 0.87-1.04). Based on the data of 3796 cases and 9442 controls, we thus found no evidence for an aetiological role of OC use in the development of CMM.

Background Complex regional pain syndrome (CRPS) is a chronic condition following inciting events such as fractures or surgeries with sensorimotor and autonomic manifestations and poor prognosis. This review aimed to provide conclusive evidence about the sensory phenotype of CRPS based on quantitative sensory testing (QST) to understand the underlying pain mechanisms and guide treatment strategies. Databases Eight databases were searched based on a previously published protocol. Forty studies comparing QST outcomes (thermal, mechanical, vibration, and electric detection thresholds, thermal, mechanical, pressure, and electric pain thresholds, wind-up ratio, mechanical pain sensitivity, allodynia, flare area, area after pinprick hyperalgesia, pleasantness after C-tactile stimulation, and pain ratings) in chronic CRPS (adults and children) versus healthy controls were included. Results From 37 studies (14 of low quality, 22 of fair quality, and 1 of good quality), adults with CRPS showed: (i) significant loss of thermal, mechanical, and vibration sensations, significant gain of thermal and mechanical pain thresholds, significant elevation of pain ratings, and no difference in wind-up ratio; (ii) significant reduction of pleasantness levels and increased area of pinprick hyperalgesia, in the affected limb. From three fair-quality studies, adolescents and children with CRPS showed loss of cold detection with cold hyperalgesia in the affected limb. There was moderate to substantial overall heterogeneity. Conclusion Diffuse thermal and mechanical hypoesthesia with primary and secondary hyperalgesia, enhanced pain facilitation evidenced by increased area of pinprick hyperalgesia, and elevated pain ratings are dominant in adults with CRPS. Adolescents and children with CRPS showed less severe sensory abnormalities.

The purpose of this study was to determine normal and abnormal patterns of activation of gluteus maximus (GM), hamstring (HAM), contralateral erector spinae (CES), and ipsilateral erector spinae (iES) muscles during a prone hip extension test in healthy or asymptomatic subjects and those with non-specific chronic low back pain through a systematic review. Studies were recognized by searching electronic databases (Embase, MEdLiNE/PubMed, Cochrane Library, PEdro [Physiotherapy Evidence database], and CiNAHL) and scanning articles reference lists from the beginning until July 2018. Limits involved studies in the English language and performed among humans. of 2112 citations and reference lists scanned, 15 articles were determined to be relevant to this review. From these studies, 4 investigated 157 subjects (88 asymptomatic and 69 with low back pain), and 11 investigated 257 healthy subjects. The results of the moderate and weak quality studies indicate that the HAM and ES muscles are activated early and almost simultaneously, but GM is consistently delayed in relation to leg movement and the other 3 muscles in healthy individuals. in low back pain subjects, CES are delayed and GM is significantly delayed in individuals who showed abnormal lumbar motions when compared with healthy ones.