A method of measuring trunk motion and two related motions using a tape measure and a stepstool was developed by physical therapists at our hospital. The purpose of this study was to assess the reliability of this method. Three repetitions of six motions performed by 24 subjects were each measured by three physical therapist raters on two separate days. The motions were forward bending, backward bending, right side bending, right rotation, right straight leg raising, and right prone knee bending. Reliability, standard deviation, and standard error were calculated for each motion. Only forward bending exhibited good single measurement reliability. Reliability coefficients for all motions were higher for the average of three successive measurements or for the measurement of a motion on successive days by the same rater. Measurements of rotation and straight leg raising, despite the improvement, continued to have low reliability. Analysis of variance was used to determine the significance of the differences between means for each motion across three raters, three repetitions, and two days. By looking at the analysis of variance and reliability estimates together, the authors identified two types of constant error affecting the data.

Normal muscular control of the scapula is important for activities involving upper extremity (UE) elevation. The upper and lower trapezius and the serratus anterior muscles have important and specific roles in upward rotation of the scapula during UE elevation.2,3,18,28 Muscular dysfunction, including weakness of scapulothoracic muscles, 9 has been implicated in disorders such as shoulder (subacromial) impingement and rotator cuff strain. Shoulder pain due to these disorders has been associated with significantly reduced health.

24 patients with chronic low back pain were randomly assigned to three treatment conditions: EMG biofeedback, relaxation training, and a placebo condition. Patients were seen for eight sessions and were evaluated before Session 1 and after Session 8. Eight analyses of covariance which were adjusted for age and pretest scores were computed on the final scores to find which variables could detect significant difference between treatments. Age was included as a covariate because the differences in age between conditions were significant. Four variables with significant and nearly significant differences were chosen for analysis. The second set of analyses identified the nature of the differences among the three conditions. These included a priori planned comparisons among conditions, and paired t tests. Relaxation-trained subjects were significantly superior to subjects in the placebo condition, in decreasing pain during the function test, increasing relaxation, and decreasing Upper Trapezius EMG. They were superior to EMG Biofeedback training in increasing reported activity. Both Relaxation and EMG trained subjects were able to reduce Upper Trapezius EMG by Session 8. Relaxation-trained subjects showed significant change on eight of the 14 possible comparisons for each treatment condition. EMG biofeedback training showed significant favorable results in only one condition; the placebo condition showed no significant results. Relaxation training gave better results in reducing EMG and pain, and in increasing relaxation and activity than either EMG biofeedback alone or a placebo condition.

The objective of this work was to compare laparoscopically assisted vaginal hysterectomy to traditional total abdominal and vaginal hysterectomies in seven critical areas: anesthesia time, surgery time, hospital stay, operative blood loss, total analgesic use, time required to return to work, and total cost of each of these procedures. The first 25 unscreened, consecutive laparoscopically assisted vaginal hysterectomies performed by the senior author were compared with 25 randomly selected traditional total abdominal and 25 randomly selected vaginal hysterectomies performed by the senior author's professional corporation. Laparoscopically assisted vaginal hysterectomy compared favorably to abdominal and vaginal hysterectomy in three areas and was superior to both total abdominal hysterectomy and vaginal hysterectomy in the remaining four areas. Although the use of the endoscopic stapling device and laser made the laparoscopically assisted vaginal hysterectomy a more expensive procedure than traditional vaginal hysterectomy, the expense was not significant and was justified by the decreased surgery time. The results of this comparative study suggest that laparoscopically assisted vaginal hysterectomy is superior or comparable to total abdominal hysterectomy and vaginal hysterectomy, especially for patients who may not have been candidates for vaginal hysterectomy. This procedure has allowed the gynecologic endoscopic surgeon to convert abdominal to vaginal procedures. Laparoscopically assisted vaginal hysterectomy provides an overall cost savings to the patient, has a low complication rate, adapts well to the outpatient setting, causes less patient discomfort, and allows the patient to return rapidly to home and workplace.

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