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Lindquist KA, Shein SA, Hovhannisyan AH, Mecklenburg J, Zou Y, Lai Z, Tumanov AV, Akopian AN. Associations of tissue damage induced inflammatory plasticity in masseter muscle with the resolution of chronic myalgia. Sci Rep 2023; 13:22057. [PMID: 38086903 PMCID: PMC10716154 DOI: 10.1038/s41598-023-49280-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
Gene plasticity during myogenous temporomandibular disorder (TMDM) development is largely unknown. TMDM could be modeled by intramuscular inflammation or tissue damage. To model inflammation induced TMDM we injected complete Freund's adjuvant (CFA) into masseter muscle (MM). To model tissue damage induced TMDM we injected extracellular matrix degrading collagenase type 2 (Col). CFA and Col produced distinct myalgia development trajectories. We performed bulk RNA-seq of MM to generate gene plasticity time course. CFA initiated TMDM (1d post-injection) was mainly linked to chemo-tacticity of monocytes and neutrophils. At CFA-induced hypersensitivity post-resolution (5d post-injection), tissue repair processes were pronounced, while inflammation was absent. Col (0.2U) produced acute hypersensitivity linked to tissue repair without inflammatory processes. Col (10U) generated prolonged hypersensitivity with inflammatory processes dominating initiation phase (1d). Pre-resolution phase (6d) was accompanied with acceleration of expressions for tissue repair and pro-inflammatory genes. Flow cytometry showed that immune processes in MM was associated with accumulations of macrophages, natural killer, dendritic and T-cells, further confirming our RNA-seq findings. Altogether, CFA and Col treatments induced different immune processes in MM. Importantly, TMDM resolution was preceded with muscle cell and extracellular matrix repairs, an elevation in immune system gene expressions and distinct immune cell accumulations in MM.
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Affiliation(s)
- Karen A Lindquist
- Integrated Biomedical Sciences (IBMS) Program, The School of Medicine, The University of Texas Health Science Center at San Antonio (UTHSCSA), 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Sergey A Shein
- Departments of Microbiology, Immunology & Molecular Genetics, The School of Medicine, UTHSCSA, San Antonio, TX, 78229, USA
| | - Anahit H Hovhannisyan
- Departments of Endodontics, The School of Dentistry, The University of Texas Health Science Center at San Antonio (UTHSCSA), 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Jennifer Mecklenburg
- Departments of Endodontics, The School of Dentistry, The University of Texas Health Science Center at San Antonio (UTHSCSA), 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Yi Zou
- Departments of Molecular Medicine, The School of Medicine, UTHSCSA, San Antonio, TX, USA
| | - Zhao Lai
- Departments of Molecular Medicine, The School of Medicine, UTHSCSA, San Antonio, TX, USA
- Greehey Children's Cancer Research Institute, UTHSCSA, San Antonio, TX, 78229, USA
| | - Alexei V Tumanov
- Integrated Biomedical Sciences (IBMS) Program, The School of Medicine, The University of Texas Health Science Center at San Antonio (UTHSCSA), 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
- Departments of Microbiology, Immunology & Molecular Genetics, The School of Medicine, UTHSCSA, San Antonio, TX, 78229, USA.
| | - Armen N Akopian
- Integrated Biomedical Sciences (IBMS) Program, The School of Medicine, The University of Texas Health Science Center at San Antonio (UTHSCSA), 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
- Departments of Endodontics, The School of Dentistry, The University of Texas Health Science Center at San Antonio (UTHSCSA), 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
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Song MX, Yang H, Yang HQ, Li SS, Qin J, Xiao Q. MR Imaging Radiomics Analysis Based on Lumbar Soft Tissue to Evaluate Lumbar Fascia Changes in Patients with Low Back Pain. Acad Radiol 2023; 30:2450-2457. [PMID: 37003877 DOI: 10.1016/j.acra.2023.02.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/21/2022] [Accepted: 02/27/2023] [Indexed: 04/03/2023]
Abstract
RATIONALE AND OBJECTIVES Clinicians must precisely pinpoint the etiology of low back pain as the number of people suffering from it increases to provide targeted care. The purpose of this paper was to use MR imaging radiomics based on lumbar soft tissue to analyze changes in the lumbar fascia of patients with low back pain. MATERIALS AND METHODS We retrospectively analyzed the lumbar MRI of 197 patients with low back pain. Patients were randomly assigned to either the training (n = 138) or validation (n = 59) cohorts. Multivariate logistic regression analysis was used to create radiomics model and combined nomogram model and their predictive performance were evaluated using receiver operating characteristic curves. RESULTS Seven radiomics features based on lumbar soft tissue MRI images were established, which performed well in distinguishing between low back pain patients with fascial changes and normal individuals demonstrated an excellent ability to identify differences, with an Area Under Curve (AUC) of 0.92 (95% CI, 0.88-0.96) in the training cohort and 0.84 (95% CI, 0.73-0.96) in the validation cohort, which performed better than the clinical model significantly only. CONCLUSION The nomogram based on clinical features and radiomics features of MR images had a good predictive ability to differentiate fascial alterations in patients with low back pain from normal subjects. It had the potential to be used as a decision support tool to assist clinicians in determining the etiology of patients with lower back pain and managing patients promptly, particularly in the early stage of the fasciitis when significant abnormalities on imaging were difficult to detect.
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Affiliation(s)
- Ming-Xin Song
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - Hui Yang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - He-Qi Yang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - Shan-Shan Li
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - Jian Qin
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - Qiang Xiao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Shandong First Medical University, No.366 Taishan Street, Tai'an 271000, China.
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Alsubaie AM, Mazaheri M, Martinez-Valdes E, Falla D. Is movement variability altered in people with chronic non-specific low back pain? A systematic review. PLoS One 2023; 18:e0287029. [PMID: 37315096 DOI: 10.1371/journal.pone.0287029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/28/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Variability in spine kinematics is a common motor adaptation to pain, which has been measured in various ways. However, it remains unclear whether low back pain (LBP) is typically characterised by increased, decreased or unchanged kinematic variability. Therefore, the aim of this review was to synthesise the evidence on whether the amount and structure of spine kinematic variability is altered in people with chronic non-specific LBP (CNSLBP). METHODS Electronic databases, grey literature, and key journals were searched from inception up to August 2022, following a published and registered protocol. Eligible studies must investigated kinematic variability in CNSLBP people (adults ≥18 years) while preforming repetitive functional tasks. Two reviewers conducted screening, data extraction, and quality assessment independently. Data synthesis was conducted per task type and individual results were presented quantitatively to provide a narrative synthesis. The overall strength of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation guidelines. FINDINGS Fourteen observational studies were included in this review. To facilitate the interpretation of the results, the included studies were grouped into four categories according to the task preformed (i.e., repeated flexion and extension, lifting, gait, and sit to stand to sit task). The overall quality of evidence was rated as a very low, primarily due to the inclusion criteria that limited the review to observational studies. In addition, the use of heterogeneous metrics for analysis and varying effect sizes contributed to the downgrade of evidence to a very low level. INTERPRETATION Individuals with chronic non-specific LBP exhibited altered motor adaptability, as evidenced by differences in kinematic movement variability during the performance of various repetitive functional tasks. However, the direction of the changes in movement variability was not consistent across studies.
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Affiliation(s)
- Amal M Alsubaie
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Masood Mazaheri
- Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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Lindquist KA, Shein SA, Hovhannisyan AH, Mecklenburg J, Zou Y, Lai Z, Tumanov AV, Akopian AN. Association of inflammation and tissue damage induced biological processes in masseter muscle with the resolution of chronic myalgia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.21.537828. [PMID: 37131723 PMCID: PMC10153356 DOI: 10.1101/2023.04.21.537828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Biological processes linked to intramuscular inflammation during myogenous temporomandibular disorder (TMDM) are largely unknown. We mimicked this inflammation by intra-masseteric muscle (MM) injections of complete Freund’s adjuvant (CFA) or collagenase type 2 (Col), which emulates tissue damage. CFA triggered mechanical hypersensitivity at 1d post-injection was mainly linked to processes controlling chemotactic activity of monocytes and neutrophils. At 5d post-CFA, when hypersensitivity was resolved, there was minimal inflammation whereas tissue repair processes were pronounced. Low dose Col (0.2U) also produced acute orofacial hypersensitivity that was linked to tissue repair, but not inflammatory processes. High dose Col (10U) triggered prolonged orofacial hypersensitivity with inflammatory processes dominating at 1d post-injection. At pre-resolution time point (6d), tissue repair processes were underway and a significant increase in pro-inflammatory gene expressions compared to 1d post-injection were detected. RNA-seq and flow cytometry showed that immune processes in MM were linked to accumulation of macrophages, natural killer and natural killer T cells, dendritic cells and T-cells. Altogether, CFA and Col treatments induced different immune processes in MM. Importantly, orofacial hypersensitivity resolution was preceded with repairs of muscle cell and extracellular matrix, an elevation in immune system gene expression and accumulation of distinct immune cells in MM.
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The Effects of an Acute Maximal Seated Lumbar Spine Flexion Exposure on Low Back Mechanical Pain Sensitivity. J Appl Biomech 2022; 38:12-19. [PMID: 34969008 DOI: 10.1123/jab.2021-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/01/2021] [Accepted: 10/27/2021] [Indexed: 11/18/2022]
Abstract
Viscoelastic creep generated in the lumbar spine following sustained spine flexion may affect the relationship between tissue damage and perceived pain. Two processes supporting this altered relationship include altered neural feedback and inflammatory processes. Our purpose was to determine how low back mechanical pain sensitivity changes following seated lumbar spine flexion using pressure algometry in a repeated-measures, cross-sectional laboratory design. Thirty-eight participants underwent a 10-minute sustained seated maximal flexion exposure with a 40-minute standing recovery period. Pressure algometry assessed pressure pain thresholds and the perceived intensity and unpleasantness of fixed pressures. Accelerometers measured spine flexion angles, and electromyography measured muscular activity during flexion. The flexion exposure produced 4.4° (2.7°) of creep that persisted throughout the entire recovery period. The perception of low back stimulus unpleasantness was elevated immediately following the exposure, 20 minutes before a delayed increase in lumbar erector spinae muscle activity. Women reported the fixed pressures to be more intense than men. Sustained flexion had immediate consequences to the quality of mechanical stimulus perceived but did not alter pressure pain thresholds. Neural feedback and inflammation seemed unlikely mechanisms for this given the time and direction of pain sensitivity changes, leaving a postulated cortical influence.
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Tenberg S, Nosaka K, Wilke J. The Relationship Between Acute Exercise-Induced Changes in Extramuscular Connective Tissue Thickness and Delayed Onset Muscle Soreness in Healthy Participants: A Randomized Controlled Crossover Trial. SPORTS MEDICINE - OPEN 2022; 8:57. [PMID: 35482217 PMCID: PMC9050985 DOI: 10.1186/s40798-022-00446-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 04/06/2022] [Indexed: 11/10/2022]
Abstract
Background The extramuscular connective tissue (ECT) has been shown to play a significant role in mechanical force transmission between musculoskeletal structures. Due to this and owing to its tight connection with the underlying muscle, the ECT may be vulnerable to excessive loading. The present study aimed to investigate the effect of eccentric elbow flexor exercise on the morphology of the biceps brachii ECT. In view of the high nociceptive capacity of the ECT, an additional objective was to elucidate the potential relationship between ECT damage and the occurrence of delayed onset muscle soreness (DOMS). Methods Eleven healthy participants (♂ = 7; 24 ± 2 years) performed fatiguing dumbbell elbow flexor eccentric exercise (EE) for one arm and concentric exercise (CE) for the other arm in random order and with random arm allocation. Before, immediately after and 24–96 h post-exercise, maximal voluntary isometric contraction torque of the elbow flexors (dynamometer), pressure pain (algometer), palpation pain (100 mm visual analog scale), biceps brachii ECT thickness and ECT/muscle mobility during passive movement (both high-resolution ultrasound) were examined. Results Palpation pain, suggestive of DOMS, was greater after EE than CE, and maximal voluntary isometric contraction torque decreased greater after EE than CE (p < .05). Relative to CE, EE increased ECT thickness at 48 (+ 17%), 72 (+ 14%) and 96 (+ 15%) hours post-exercise (p < .05). At 96 h post-EE, the increase in ECT thickness correlated with palpation pain (r = .68; p < .05). ECT mobility was not different between conditions, but compared to CE, muscle displacement increased at 24 (+ 31%), 72 (+ 31%) and 96 (+ 41%) hours post-EE (p < .05). Conclusion Collectively, these results suggest an involvement of the ECT changes in delayed onset muscle soreness.
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Léger MC, Dion C, Albert WJ, Cardoso MR. The biomechanical benefits of active sitting. ERGONOMICS 2022:1-18. [PMID: 36226515 DOI: 10.1080/00140139.2022.2132298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
This cross-sectional study examined the biomechanical effects of two active chairs (AC1: had the feature to pedal and slide forward on the seat pan; AC2: a multiaxial motion seat pan) compared to a traditional office chair and standing workstation. Twenty-four healthy participants worked at each of the workstations for 60-min. The following equipment was used: Motion Capture, Electromyography, Ratings of Perceived Discomfort Questionnaire, and Exit Survey. The active protocol had positive effects on the body, including increased neuromuscular activity in the gastrocnemius, increased overall movement, and a more open trunk-thigh angle. Greater discomfort in the buttocks due to the lack of seat pan contour was reported for the AC1 which identified a need for a design modification. While standing, participants' shoulders were less flexed than when sitting in any of the three seats, however, greater discomfort was reported in the lower legs after 1 h of computer work. Practitioner summary: A comparison of four different workstations was conducted to further understand the use of active workstations. Active sitting was found to have positive effects on the body, such as allowing sitters to increase movement while sitting without the high activation of muscular activity. Standing can also provide a positive break from sitting.
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Affiliation(s)
- Michelle C Léger
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
| | - Cynthia Dion
- École de Kinésiologie et de Loisir, Université de Moncton, Moncton, Canada
| | - Wayne J Albert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
| | - Michelle R Cardoso
- École de Kinésiologie et de Loisir, Université de Moncton, Moncton, Canada
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8
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Plehuna A, Green DA, Amirova LE, Tomilovskaya ES, Rukavishnikov IV, Kozlovskaya IB. Dry immersion induced acute low back pain and its relationship with trunk myofascial viscoelastic changes. Front Physiol 2022; 13:1039924. [PMID: 36311233 PMCID: PMC9606241 DOI: 10.3389/fphys.2022.1039924] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/26/2022] [Indexed: 08/12/2023] Open
Abstract
Microgravity induces spinal elongation and Low Back Pain (LBP) but the pathophysiology is unknown. Changes in paraspinal muscle viscoelastic properties may play a role. Dry Immersion (DI) is a ground-based microgravity analogue that induces changes in m. erector spinae superficial myofascial tissue tone within 2 h. This study sought to determine whether bilateral m. erector spinae tone, creep, and stiffness persist beyond 2 h; and if such changes correlate with DI-induced spinal elongation and/or LBP. Ten healthy males lay in the DI bath at the Institute of Biomedical Problems (Moscow, Russia) for 6 h. Bilateral lumbar (L1, L4) and thoracic (T11, T9) trunk myofascial tone, stiffness and creep (MyotonPRO), and subjective LBP (0-10 NRS) were recorded before DI, after 1h, 6 h of DI, and 30min post. The non-standing spinal length was evaluated on the bath lifting platform using a bespoke stadiometer before and following DI. DI significantly modulated m. erector spinae viscoelastic properties at L4, L1, T11, and T9 with no effect of laterality. Bilateral tissue tone was significantly reduced after 1 and 6 h DI at L4, L1, T11, and T9 to a similar extent. Stiffness was also reduced by DI at 1 h but partially recovered at 6 h for L4, L1, and T11. Creep was increased by DI at 1 h, with partial recovery at 6 h, although only T11 was significant. All properties returned to baseline 30 min following DI. Significant spinal elongation (1.17 ± 0.20 cm) with mild (at 1 h) to moderate (at 6 h) LBP was induced, mainly in the upper lumbar and lower thoracic regions. Spinal length increases positively correlated (Rho = 0.847, p = 0.024) with middle thoracic (T9) tone reduction, but with no other stiffness or creep changes. Spinal length positively correlated (Rho = 0.557, p = 0.039) with Max LBP; LBP failed to correlate with any m. erector spinae measured parameters. The DI-induced bilateral m. erector spinae tone, creep, and stiffness changes persist beyond 2 h. Evidence of spinal elongation and LBP allows suggesting that the trunk myofascial tissue changes could play a role in LBP pathogenesis observed in real and simulated microgravity. Further study is warranted with longer duration DI, assessment of IVD geometry, and vertebral column stability.
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Affiliation(s)
- Anastasija Plehuna
- King’s College London, Centre of Human & Applied Physiological Sciences, London, United Kingdom
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - David Andrew Green
- King’s College London, Centre of Human & Applied Physiological Sciences, London, United Kingdom
- Space Medicine Team, HRE-OM, European Astronaut Centre, European Space Agency, Cologne, Germany
- KBRwyle Laboratories GmbH, Cologne, Germany
| | - Liubov E. Amirova
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Elena S. Tomilovskaya
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Ilya V. Rukavishnikov
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Inessa B. Kozlovskaya
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
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Marineau Belanger E, Boon DM, Descarreaux M, Abboud J. The effect of low back pain on neuromuscular control in cyclists. J Sports Sci 2022; 40:1255-1264. [PMID: 35389326 DOI: 10.1080/02640414.2022.2061819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study was designed to identify neuromuscular adaptations of low back pain (LBP) cyclists , and the impact of a cycling effort on spinal shrinkage. Forty-eight trained cyclists rode their road bike on a smart trainer for 1-hour. Surface electromyography (EMG) recorded muscle activity of the lumbar erector spinae (LES), 3D motion analysis system recorded kinematic of the trunk, and stadiometry measured spinal height. Statistical comparisons were made using repeated measure ANOVAs. The LBP group presented increase in pain levels throughout the effort (p < 0.001). A significant group difference was only observed for the thoracic angle (p = 0.03), which was less flexed for LBP. The one-hour cycling effort (time effect) significantly increased the trunk flexion (p < 0.001) and thoracic flexion (p < 0.001) for both groups. Significant lower LES activation (35% less) was observed at the end of the effort as well as a decrease in spinal height (p = 0.01) for both groups. Neuromuscular adaptations to cycling effort is identified by a decrease in LES EMG amplitude and an increase flexion of the trunk. Adaptation to pain is seen by an increase in thoracic flexion. Despite these adaptations, LBP cyclists could not ride their bike pain-free.
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Affiliation(s)
- Emile Marineau Belanger
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Dan-Mihai Boon
- parcours neuroscience du mouvement, Université de Paris-Est CréteilFaculté de biologie-santé.,Institut Franco-Européen de Chiropraxie, Campus Paris, France
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Jacques Abboud
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Patterson CS, Lohman E, Asavasopon S, Dudley R, Gharibvand L, Powers CM. The influence of hip flexion mobility and lumbar spine extensor strength on lumbar spine flexion during a squat lift. Musculoskelet Sci Pract 2022; 58:102501. [PMID: 35026497 DOI: 10.1016/j.msksp.2021.102501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 12/02/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]
Abstract
STUDY DESIGN Cross-sectional; Controlled laboratory study. OBJECTIVE To examine the associations among available hip flexion motion, lumbar extensor strength and peak lumbar flexion during a squat lift task. SUMMARY OF BACKGROUND DATA Lumbar spine flexion during lifting can result in increased strain on spinal structures. Although decreased available hip flexion motion and reduced strength of the lumbar extensor muscles has been proposed to contribute to greater lumbar flexion during lifting, direct relationships have not been explored. METHODS Fifty healthy young adults participated (23 males and 27 females). Strength of the lumbar extensors was measured using a motor-driven dynamometer. Available hip flexion was assessed using 3D motion capture. Peak lumbar spine flexion and hip flexion were quantified during the descent phase of the squat lifting task. RESULTS There was a significant negative association between available hip flexion and peak lumbar spine flexion during squat lifting in females (r = -0.407, p = 0.035) but not males (r = -0.341, p = 0.120). Similarly, peak lumbar spine flexion was negatively associated with lumbar extensor strength in females (r = -0.398, p = 0.040) but not males (r = -0.310, p = 0.161). During the squat lift, peak hip motion was positively associated with available hip flexion for both males and females combined (r = 0.774, p < 0.001). CONCLUSION Females with less available hip flexion and lower lumbar extensor strength exhibit greater lumbar flexion when performing a lifting task. Clinicians should be aware of the potential contributions of such impairments when instructing patients into various lifting strategies.
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Affiliation(s)
- Christopher S Patterson
- Loma Linda University Department of Physical Therapy, 24951, N. Circle Dr., A-620, Loma Linda, CA, 92350, USA; Azusa Pacific University, 901 E Alosta Ave. Azusa, CA, 91702, USA.
| | - Everett Lohman
- Loma Linda University Department of Physical Therapy, 24951, N. Circle Dr., A-620, Loma Linda, CA, 92350, USA.
| | - Skulpan Asavasopon
- University of Southern California Division of Biokinesiology and Physical Therapy, 1540 E. Alcazar St. CHP - 155, Los Angeles, CA, 90089, USA
| | - Robert Dudley
- Loma Linda University Department of Physical Therapy, 24951, N. Circle Dr., A-620, Loma Linda, CA, 92350, USA; Azusa Pacific University, 901 E Alosta Ave. Azusa, CA, 91702, USA.
| | - Lida Gharibvand
- Loma Linda University School of Allied Health Professions, 24951 N. Circle Dr., A-620, Loma Linda, CA, 92350, USA.
| | - Christopher M Powers
- University of Southern California Division of Biokinesiology and Physical Therapy, 1540 E. Alcazar St. CHP - 155, Los Angeles, CA, 90089, USA.
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Effects of Core Stabilization Exercise Programs on Changes in Erector Spinae Contractile Properties and Isokinetic Muscle Function of Adult Females with a Sedentary Lifestyle. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study aimed to investigate the effect of core stabilization exercises on the contractile properties and isokinetic muscle function of adult females with a sedentary lifestyle. We enrolled 105 adult females. Tensiomyography was performed on the erector spinae, and the isokinetic muscular functional test was performed on the trunk at an angular velocity of 60°/s and 90°/s. All participants performed the exercise for 60 min per day, 3 times a week, for 7 weeks. A Wilcoxon signed-rank test was performed at a significance level of 0.05. Tensiomyography (TMG) of the erector spinae revealed no significant post-exercise change in the contraction time; however, there was a significant post-exercise increase in the maximum radial displacement and mean velocity until 90% of the TMG was displaced. Additionally, the isokinetic muscular functional test of the trunk revealed a significant post-exercise increase in almost all variables. Our findings demonstrated that the core stabilization exercise reduced stiffness in the erector spinae, increased the velocity of erector spinae contraction, and effectively improved the isokinetic muscular function of the trunk.
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12
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Alcaraz-Clariana S, García-Luque L, Garrido-Castro JL, Carmona-Pérez C, Rodrigues-de-Souza DP, Fernández-de-las-Peñas C, Alburquerque-Sendín F. Influence of Spinal Movements Associated with Physical Evaluation on Muscle Mechanical Properties of the Lumbar Paraspinal in Subjects with Acute Low Back Pain. Diagnostics (Basel) 2022; 12:diagnostics12020302. [PMID: 35204392 PMCID: PMC8870934 DOI: 10.3390/diagnostics12020302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 12/29/2022] Open
Abstract
This research aimed to identify changes in muscle mechanical properties (MMPs) when a standardized sequence of movements is performed and to determine the influence of acute low back pain (LBP) and age on the MMPs. Socio-demographic, clinical variables and MMPs were collected in 33 patients with LBP and 33 healthy controls. A 2 × 2 × 2 (group × age × time) analysis of variance (ANOVA) mixed model was used to determine the effect of the study factors on the different MMPs. There were no significant triple interactions. After the movements, tone and stiffness increased 0.37 Hz and 22.75 N/m, respectively, in subjects <35 years, independent of their clinical status. Relaxation showed differences by age in healthy subjects and creep in LBP subjects. Furthermore, elasticity was higher in <35 years (p < 0.001) without the influence of any other factor. In conclusion, sequenced movements can modify tone and stiffness as a function of age, while age-associated changes in viscoelastic characteristics depends on pain but not on movements. The MMPs should be assessed, not only at the beginning of the physical examination at rest, but also along the patient’s follow-up, depending on their pain and age, in a clinical setting.
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Affiliation(s)
- Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - Juan Luis Garrido-Castro
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, 14071 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
| | - Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
- Correspondence: ; Tel.: +34-914-888-884; Fax: +34-914-888-957
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
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Wachi M, Jiroumaru T, Satonaka A, Ikeya M, Noguchi S, Suzuki M, Hyodo Y, Oka Y, Fujikawa T. Effects of capacitive and resistive electric transfer therapy on pain and lumbar muscle stiffness and activity in patients with chronic low back pain. J Phys Ther Sci 2022; 34:400-403. [PMID: 35527841 PMCID: PMC9057676 DOI: 10.1589/jpts.34.400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/13/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] In this study, we investigated the therapeutic effects of capacitive and
resistive electric transfer therapy in patients with chronic low back pain. [Participants
and Methods] The study included 24 patients with chronic low back pain (12 patients each
in the intervention and sham groups). Pain intensity, superficial and deep lumbar
multifidus stiffness and maximum forward trunk flexion and associated activation level of
the iliocostalis (thoracic and lumbar component) and lumbar multifidus muscles were
measured. [Results] Post-intervention pain intensity and muscle stiffness were
significantly lower than pre-intervention measurements in the intervention group. However,
no between-group difference was observed in the muscle activation level at the end-point
of standing trunk flexion. [Conclusion] Our findings highlight a significant therapeutic
benefit of capacitive and resistive electric transfer therapy in patients with chronic low
back pain and muscle stiffness.
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Affiliation(s)
- Michio Wachi
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi City, Shiga 527-0145, Japan
| | | | - Ayako Satonaka
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi City, Shiga 527-0145, Japan
| | - Masae Ikeya
- Department of Applied Biology, Kyoto Institute of Technology, Japan
| | - Shinichi Noguchi
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi City, Shiga 527-0145, Japan
| | - Mika Suzuki
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi City, Shiga 527-0145, Japan
| | - Yutaro Hyodo
- Department of Applied Biology, Kyoto Institute of Technology, Japan
| | - Yasumasa Oka
- Department of Applied Biology, Kyoto Institute of Technology, Japan
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Cary D, Jacques A, Briffa K. Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PLoS One 2021; 16:e0260582. [PMID: 34847195 PMCID: PMC8631621 DOI: 10.1371/journal.pone.0260582] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 11/14/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Research with a focus on sleep posture has been conducted in association with sleep pathologies such as insomnia and positional obstructive sleep apnoea. Research examining the potential role sleep posture may have on waking spinal symptoms and quality of sleep is however limited. The aims of this research were to compare sleep posture and sleep quality in participants with and without waking spinal symptoms. METHODS Fifty-three participants (36 female) were, based on symptoms, allocated to one of three groups; Control (n = 20, 16 female), Cervical (n = 13, 10 female) and Lumbar (n = 20, 10 female). Participants completed an online survey to collect general information and patient reported outcomes and were videoed over two consecutive nights to determine sleep posture using a validated classification system including intermediate sleep postures. RESULTS Participants in the symptomatic groups also reported a lower sleep quality than the Control group. Compared to Control group participants, those in the Cervical group had more frequent posture changes (mean (SD); 18.3(6.5) versus 23.6(6.6)), spent more time in undesirable/provocative sleep postures (median IQR; 83.8(16.4,105.2) versus 185.1(118.0,251.8)) minutes and had more long periods of immobility in a provocative posture, (median IQR: 0.5(0.0,1.5) versus 2.0 (1.5,4.0)). There were no significant differences between the Control and Lumbar groups in the number of posture changes (18.3(6.5) versus 22.9(9.1)) or the time spent in provocative sleep postures (0.5(0.0,1.5) versus 1.5(1.5,3.4)) minutes. DISCUSSION This is the first study using a validated objective measure of sleep posture to compare symptomatic and Control group participants sleeping in their home environment. In general, participants with waking spinal symptoms spent more time in provocative sleep postures, and experienced poorer sleep quality.
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Affiliation(s)
- Doug Cary
- School of Allied Health, Faculty of Health Science, Curtin University, Bentley, Western Australia, Australia
- Esperance Physiotherapy, Esperance, Western Australia, Australia
- * E-mail:
| | - Angela Jacques
- School of Allied Health, Faculty of Health Science, Curtin University, Bentley, Western Australia, Australia
| | - Kathy Briffa
- School of Allied Health, Faculty of Health Science, Curtin University, Bentley, Western Australia, Australia
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Overactivity in Chronic Pain, the Role of Pain-related Endurance and Neuromuscular Activity: An Interdisciplinary, Narrative Review. Clin J Pain 2021; 36:162-171. [PMID: 31833914 DOI: 10.1097/ajp.0000000000000785] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Decades of research have convincingly shown that fear of pain and pain-related avoidance behavior are important precursors of disability in daily life. Reduced activity as a consequence of avoidance, however, cannot be blamed for chronic disability in all patients. A contrasting behavior, pain-related dysfunctional endurance in a task and overactivity has to be considered. Currently, there is a need to better understand the psychological determinants of overactivity, dysfunctional endurance, and neurobiomechanical consequences. METHODS This is a narrative review. RESULTS The first part of this review elucidates research on self-reported overactivity, showing associations with higher levels of pain and disability, especially in spinal load positions, for example, lifting, bending, or spending too long a time in specific positions. In addition, measures of habitual endurance-related pain responses, based on the avoidance-endurance model, are related to objective assessments of physical activity and, again, especially in positions known to cause high spinal load (part 2). The final part reveals findings from neuromuscular research on motor control indicating the possibility that, in particular, overactivity and dysfunctional endurance may result in a number of dysfunctional adaptations with repetitive strain injuries of muscles, ligaments, and vertebral segments as precursors of pain. DISCUSSION This narrative review brings together different research lines on overactivity, pain-related endurance, and supposed neuromuscular consequences. Clinicians should distinguish between patients who rest and escape from pain at low levels of pain, but who have high levels of fear of pain and those who predominantly persist in activities despite severely increasing pain until a break will be enforced by intolerable pain levels.
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Incidence and Risk Factors of Low Back Pain in Marathon Runners. Pain Res Manag 2021; 2021:6660304. [PMID: 33688384 PMCID: PMC7920723 DOI: 10.1155/2021/6660304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/27/2021] [Accepted: 02/11/2021] [Indexed: 12/15/2022]
Abstract
Purpose The occurrence of low back pain (LBP) in marathon runners has been poorly understood. This study aimed to describe the risk factors and identify whether these factors can cause LBP in these athletes. Methods A self-developed questionnaire was randomly distributed to 850 runners of running a half or a full marathon. Participants responded with the questionnaire focusing on previous training and running conditions after their competitions. Results On the basis of the remaining 800 valid questionnaires, the incidence of LBP was 4.50% (n = 36). A total of 572 (71.5%) males and 228 (28.5%) females, with an average age range of 33.9 ± 9.0 years, came from different occupations with different physical activity characteristics. However, no significant associations between occupation and runners with LBP (p > 0.05) were found. In the final models, risk factors, including warm-up activities (p=0.012, OR = 2.617), fatigue (p = 0.008, OR = 2.680), running gait posture (p=0.041, OR = 2.273), and environmental temperature (p=0.020, OR = 6.584), were significantly associated with LBP in marathoners. Conclusion Although LBP was uncommon in marathoners, it was linked to the factors such as insufficient warm-up activities, fatigue, poor running gait posture, and uncomfortable environmental temperature. Future studies need to validate these results. Nevertheless, these findings could still be useful for protecting the lower back area of runners clinically.
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Knuttinen MG, Zurcher KS, Wallace A, Doe C, Naidu SG, Money SR, Rochon PJ. Ergonomics in IR. J Vasc Interv Radiol 2020; 32:235-241. [PMID: 33358387 DOI: 10.1016/j.jvir.2020.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 12/24/2022] Open
Abstract
Ergonomic research in the field of interventional radiology remains limited. Existing literature suggests that operators are at increased risk for work-related musculoskeletal disorders related to the use of lead garments and incomplete knowledge of ergonomic principles. Data from existing surgical literature suggest that musculoskeletal disorders may contribute to physician burnout and female operators are at a higher risk of developing musculoskeletal disorders. This review article aims to summarize the existing ergonomic challenges faced by interventional radiologists, reiterate existing solutions to these challenges, and highlight the need for further ergonomic research in multiple areas, including burnout and gender.
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Affiliation(s)
| | - Kenneth S Zurcher
- Department of Interventional Radiology, Mayo Clinic, Phoenix, Arizona.
| | - Alex Wallace
- Department of Interventional Radiology, Mayo Clinic, Phoenix, Arizona
| | - Christopher Doe
- Department of Interventional Radiology, University of Colorado School of Medicine, Aurora, Colorado
| | - Sailendra G Naidu
- Department of Interventional Radiology, Mayo Clinic, Phoenix, Arizona
| | - Samuel R Money
- Department of Surgery, Ochsner Clinic, New Orleans, Louisiana
| | - Paul J Rochon
- Department of Interventional Radiology, University of Colorado School of Medicine, Aurora, Colorado
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Robinson M, Lu L, Tan Y, Goonewardena K, Oetomo D, Manzie C. Enabling context aware data analysis for long-duration repetitive stooped work through human activity recognition in sheep shearing. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:87-90. [PMID: 33017937 DOI: 10.1109/embc44109.2020.9175839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is evidence to suggest that changes in kinematics and neuromuscular control in activities that take place over long periods of time lead to increased injury risk. The collection of biometric data over long time periods could provide insight into these injuries. However, it is difficult to analyse long period biometric data for occupations as the analysis depends on the activity being performed, and it is not practical to manually label the amount of data required. A sufficiently accurate human activity recognition algorithm can provide a means to segment the activities and allow this analysis, but the classification must be robust to the inter-individual differences, as well as the intra-individual variations in movement over time that are the target of analysis. This work presents a person-independent human activity recognition algorithm for sheep shearing using a Hidden Markov Model with physical features that are identified to be relevant to spinal movement quality. The classifier achieved an F1 score of 96.47% in identifying the shearing task.
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19
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The pelvic girdle pain deadlock: 1. Would 'deconstruction' help? Musculoskelet Sci Pract 2020; 48:102169. [PMID: 32560871 DOI: 10.1016/j.msksp.2020.102169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Pelvic Girdle Pain (PGP) is an important clinical problem that deserves more attention. Several treatment regimens have been presented that appear to be somewhat promising, but it was reported that about 10% of patients still suffer from the problems 11 years after their inception. This situation should be improved. PURPOSE We present a personalized history, with first the acceptance of the concept of 'PGP', around 2005, and then continued problems in really understanding PGP's nature and causes. We propose to engage in 'deconstruction' of PGP, that is, disentangling the large variety of processes involved. IMPLICATIONS Deconstructing PGP is a venture into the unknown. Still, science should proceed on the basis of what we know already. To understand PGP, experts emphasize the importance of biomechanics or of psychology, and we propose to insert 'inflammation' between these two levels of understanding, that is to say, the full development from low grade local inflammation to systemic inflammation and neuroinflammation. Inflammation is bidirectionally related to biomechanical as well as psychological processes. For clinicians, challenging our "beliefs and understanding of PGP, rather than being 'stuck' with a preferred modus operandi" has major practical implications. It requires continuous monitoring of the patient, and a willingness to change direction. More scientific disciplines are relevant to understanding, and treating, PGP than a single human being can master. Creative flexibility of clinicians would be a promising starting point to improve overall treatment effects in PGP.
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20
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No consensus on causality of spine postures or physical exposure and low back pain: A systematic review of systematic reviews. J Biomech 2020; 102:109312. [DOI: 10.1016/j.jbiomech.2019.08.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/10/2019] [Accepted: 08/09/2019] [Indexed: 12/26/2022]
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Owlia M, Kamachi M, Dutta T. Reducing lumbar spine flexion using real-time biofeedback during patient handling tasks. Work 2020; 66:41-51. [PMID: 32417812 PMCID: PMC7369082 DOI: 10.3233/wor-203149] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/06/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Patient handling activities require caregivers to adopt postures that increase the risk of back injury. Training programs relying primarily on didactic methods have been shown to be ineffective at reducing this risk. The use of real-time biofeedback has potential as an alternative training method. OBJECTIVE To investigate the effect of real-time biofeedback on time spent by caregivers in end-range lumbar spine flexion. METHODS Novice participants were divided into intervention (n = 10) and control (n = 10) groups and were asked to perform a set of simulated care activities eight times on two consecutive days. Individuals in the intervention group watched a training video on safer movement strategies and received real-time auditory feedback from a wearable device (PostureCoach) in four training trials whenever their lumbar spine flexion exceeded a threshold (70% of maximum flexion). Changes in end-range lumbar spine flexion were compared between groups and across trials. RESULTS Participants in the intervention group saw reductions in end-range lumbar spine flexion during the simulated patient handling tasks at the end of the training compared to their baseline trials while there was no change for the control group. CONCLUSIONS The training program including PostureCoach has the potential to help caregivers learn to use safer postures that reduce the risk of back injury.
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Affiliation(s)
- Mohammadhasan Owlia
- Toronto Rehabilitation Institute, University Health Network, ON, Canada
- Department of Mechanical and Industrial Engineering, University of Toronto, ON, Canada
| | - Megan Kamachi
- Toronto Rehabilitation Institute, University Health Network, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, ON, Canada
| | - Tilak Dutta
- Toronto Rehabilitation Institute, University Health Network, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, ON, Canada
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Kett AR, Sichting F. Sedentary behaviour at work increases muscle stiffness of the back: Why roller massage has potential as an active break intervention. APPLIED ERGONOMICS 2020; 82:102947. [PMID: 31514046 DOI: 10.1016/j.apergo.2019.102947] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 06/10/2023]
Abstract
There is increasing evidence that subjects who are exposed to long sitting periods suffer from musculoskeletal discomfort and back pain. The underlying mechanism and effective prevention strategies are still largely unknown. In this study, muscle stiffness of the back was measured in 59 office workers who followed their usual desk work regime for 4.5 h in a sitting posture. The sitting period was either followed by an 8-min roller massage intervention or a controlled standing task. Results showed that muscle stiffness increased significantly after the 4.5 h sitting period. When the sitting period was followed by roller massage, the stiffness values dropped slightly below baseline stiffness. In contrast, the stiffness values remained increased when the sitting period was followed by controlled standing. This study indicates that short-duration tissue manipulation can be an effective active break between prolonged sitting periods to prevent musculoskeletal issues, such as musculoskeletal discomfort and back pain.
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Affiliation(s)
- Alexander Robert Kett
- Department: Human Locomotion, Chemnitz University of Technology, Reichenhainer Straße 31-33, 3. OG, 09126, Chemnitz, Germany.
| | - Freddy Sichting
- Department: Human Locomotion, Chemnitz University of Technology, Reichenhainer Straße 31-33, 3. OG, 09126, Chemnitz, Germany.
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Robinson M, Mayer R, Tan Y, Oetomo D, Manzie C. Effects of varying the rest period on the onset angle of lumbar flexion-relaxation in simulated sheep shearing: a preliminary study. IEEE Int Conf Rehabil Robot 2019; 2019:83-88. [PMID: 31374611 DOI: 10.1109/icorr.2019.8779480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Wool harvesting remains an important industry in Australia, but its workers suffer from extreme rates of injury, in particular, the lower back injuries. Reducing injuries in sheep shearing could be as simple as extending shearer rest periods between sheep, but the effect of this has not previously been studied. The lumbar flexion-relaxation phenomenon is present in sheep shearing and the onset angle of this phenomenon can provide insight into lower back injury risk. The increase in the onset angle of lumbar flexion-relaxation over several work-rest periods for a simulated sheep shearing task is studied. The rate of increase in the onset angle of lumbar flexion-relaxation was higher when shorter breaks were taken for all participants at least unilaterally, indicating that longer rest breaks could reduce back injury risk. Due to the constraints of the sheep shearing occupation, this type of intervention is better suited to learner and novice shearers. Assistive robotic devices would be more suited to reduce injuries in expert shearers, and some insight is provided for the application of these within sheep shearing. Further study of this phenomenon in sheep shearing could provide additional insight to developing an assistive device that could reduce injury.
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Cary D, Briffa K, McKenna L. Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review. BMJ Open 2019; 9:e027633. [PMID: 31256029 PMCID: PMC6609073 DOI: 10.1136/bmjopen-2018-027633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The objectives of this scoping review were to identify (1) study designs and participant populations, (2) types of specific methodology and (3) common results, conclusions and recommendations from the body of evidence regarding our research question; is there a relationship between sleep posture and spinal symptoms. DESIGN Scoping review. DATA SOURCES PEDro, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Medline, ProQuest, PsycINFO, SportDISCUS and grey literature from inception to 10 April 2018. DATA SELECTION Using a modified Arksey and O'Malley framework, all English language studies in humans that met eligibility criteria using key search terms associated with sleep posture and spinal symptoms were included. DATA EXTRACTION Data were independently extracted by two reviewers and mapped to describe the current state of the literature. Articles meeting the search criteria were critically appraised using the Downs and Black checklist. RESULTS From 4186 articles, four articles were identified, of which three were epidemiological and one interventional. All studies examined three or more sleep postures, all measured sleep posture using self-report and one study also used infrared cameras. Two studies examined symptoms arising from the lumbar spine, one the cervical spine and one the whole spine. Waking pain and stiffness were the most common symptoms explored and side lying was generally protective against spinal symptoms. CONCLUSIONS This scoping review highlights the importance of evaluating sleep posture with respect to waking symptoms and has provided preliminary information regarding relationships between sleep posture and spinal symptoms. However, there were not enough high-quality studies to adequately answer our research question. It is recommended future research consider group sizes and population characteristics to achieve research goals, that a validated measure be used to assess sleep posture, that characteristics and location of spinal symptoms are clearly defined and that the side lying posture is subclassified.
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Affiliation(s)
- Doug Cary
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- AAP Education, Esperance, Western Australia, Australia
| | - Kathy Briffa
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Leanda McKenna
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Bauer CM, Kankaanpää MJ, Meichtry A, Rissanen SM, Suni JH. Efficacy of six months neuromuscular exercise on lumbar movement variability - A randomized controlled trial. J Electromyogr Kinesiol 2019; 48:84-93. [PMID: 31252284 DOI: 10.1016/j.jelekin.2019.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 06/11/2019] [Accepted: 06/20/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Lumbar movement variability during heavy, repetitive work may be a protective mechanism to diminish the progression of lumbar disorders and maintain neuromuscular functional integrity. The effect of neuromuscular exercise (NME) on the variability of lumbar movement is still to be determined. METHODS A randomised controlled trial was conducted on a population of nursing personnel with subacute LBP. Following randomization, the NME group participants completed an NME program of six months duration. The participants in the control group only attended the assessment sessions. The outcomes were assessed at: baseline; after six months intervention; 12 months. The primary outcome was lumbar movement variability based on angular displacement and velocity. RESULTS A positive treatment effect on lumbar movement variability was seen after six months of NME intervention. Angular displacement improved, and angular velocity remained constant. At the 12-month follow up, however, the effect faded in the NME group. Lumbar movement variability worsened in the control group over all time periods. CONCLUSION NME may improve lumbar movement variability in the short term and may indicate improved neuromuscular functional integrity. The design of an optimal NME program to achieve long-term improvement in lumbar movement variability is a subject worthy of further research.
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Affiliation(s)
- C M Bauer
- University of Tampere, School of Medicine, Kalevantie 4, 33014 University of Tampere, Finland; Zurich University of Applied Sciences, Department of Health, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland.
| | - M J Kankaanpää
- University of Tampere, School of Medicine, Kalevantie 4, 33014 University of Tampere, Finland; Pirkanmaa Hospital District, Physical and Rehabilitation Medicine Outpatient Clinic, Box 2000, 33521 Tampere, Finland.
| | - A Meichtry
- Zurich University of Applied Sciences, Department of Health, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland.
| | - S M Rissanen
- University of Eastern Finland, Department of Applied Physics, P.O. Box 1627, 70211 Kuopio, Finland.
| | - J H Suni
- UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland.
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Costa Junior JD, de Seixas JM, Miranda de Sá AMFL. A template subtraction method for reducing electrocardiographic artifacts in EMG signals of low intensity. Biomed Signal Process Control 2019. [DOI: 10.1016/j.bspc.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Khan AA, Çarlı AB, Akhlaque U, Kara M, Waheed A, Özçakar L. Ultrasonographic evaluation of the ankle after unilateral traumatic lower limb amputations. Foot Ankle Surg 2018; 24:506-508. [PMID: 29409276 DOI: 10.1016/j.fas.2017.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 03/10/2017] [Accepted: 05/31/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Unilateral lower limb amputation can alter the tissue morphology leading to increase future risk of degenerative secondary disorders. METHODS Thirty-four consecutive male patients with unilateral lower limb amputations of different levels and 34 well matched male controls were included. To explore whether the ankles of traumatic lower limb amputees were undergoing morphological changes, three different tissue types i.e. talar cartilage, plantar fascia and Achilles tendon thicknesses in the intact limb of the lower limb amputee and healthy controls were measured by using ultrasound. RESULTS Plantar fascia was found to be thicker (p=0.013) and talar cartilage was thinner (p<0.001) on the intact sides of the patients than those of the controls. Achilles tendon thickness was found to be similar. In patients group, plantar fascia thickness was positively correlated with age (r=0.601, p<0.001), BMI (r=0.454, p=0.007) and durations of amputation (r=0.443, p=0.009) and prosthetic use (r=0.429, p=0.011). Achilles tendon thickness was positively correlated with durations of amputation (r=0.338, p=0.05) and prosthetic use (r=0.468, p=0.005). In controls group, talar cartilage thickness was negatively correlated with age (r=-0.640, p<0.001) and BMI (r=-0.401, p=0.019). CONCLUSIONS The talar cartilage seemed to be thinner and the plantar fascia to be thicker on the intact sides of the unilateral limb amputees.
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Affiliation(s)
- Atif A Khan
- Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan
| | - Alparslan B Çarlı
- Saglik Bilimleri University, Sultan Abdulhamit Han Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey.
| | - Uzma Akhlaque
- Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan
| | - Murat Kara
- Hacettepe University Medical School, Department of Physical Medicine and Rehabilitation, Ankara, Turkey
| | - Akhtar Waheed
- Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan
| | - Levent Özçakar
- Hacettepe University Medical School, Department of Physical Medicine and Rehabilitation, Ankara, Turkey
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Abboud J, Daneau C, Nougarou F, Dugas C, Descarreaux M. Motor adaptations to trunk perturbation: effects of experimental back pain and spinal tissue creep. J Neurophysiol 2018; 120:1591-1601. [PMID: 29975166 DOI: 10.1152/jn.00207.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In complex anatomical systems, such as the trunk, motor control theories suggest that many motor solutions can be implemented to achieve a similar goal. Although reflex mechanisms act as a stabilizer of the spine, how the central nervous system uses trunk redundancy to adapt neuromuscular responses under the influence of external perturbations, such as experimental pain or spinal tissue creep, is still unclear. The aim of this study was to identify and characterize trunk neuromuscular adaptations in response to unexpected trunk perturbations under the influence of spinal tissue creep and experimental back pain. Healthy participants experienced a repetition of sudden external trunk perturbations in two protocols: 1) 15 perturbations before and after a spinal tissue creep protocol and 2) 15 perturbations with and without experimental back pain. Trunk neuromuscular adaptations were measured by using high-density electromyography to record erector spinae muscle activity recruitment patterns and a motion analysis system. Muscle activity reflex attenuation was found across unexpected trunk perturbation trials under the influence of creep and pain. A similar area of muscle activity distribution was observed with or without back pain as well as before and after creep. No change of trunk kinematics was observed. We conclude that although under normal circumstances muscle activity adaptation occurs throughout the same perturbations, a reset of the adaptation process is present when experiencing a new perturbation such as experimental pain or creep. However, participants are still able to attenuate reflex responses under these conditions by using variable recruitment patterns of back muscles. NEW & NOTEWORTHY The present study characterizes, for the first time, trunk motor adaptations with high-density surface electromyography when the spinal system is challenged by a series of unexpected perturbations. We propose that the central nervous system is able to adapt neuromuscular responses by using a variable recruitment pattern of back muscles to maximize the motor performance, even under the influence of pain or when the passive structures of the spine are altered.
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Affiliation(s)
- Jacques Abboud
- Department of Anatomy, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
| | - Catherine Daneau
- Department of Human Kinetics, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
| | - François Nougarou
- Department of Electrical Engineering, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
| | - Claude Dugas
- Department of Human Kinetics, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
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Changes in Lumbopelvic Movement and Muscle Recruitment Associated with Prolonged Deep Squatting: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15051001. [PMID: 29772741 PMCID: PMC5982040 DOI: 10.3390/ijerph15051001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/07/2018] [Accepted: 05/14/2018] [Indexed: 11/17/2022]
Abstract
This study examined the changes in spinal kinematics and muscle recruitment of the lumbopelvic region associated with prolonged squatting. Eight subjects with chronic nonspecific low back pain (LBP) and eight asymptomatic subjects (AS) performed squat-to-stand and reverse movements, before and immediately after 15 min deep-squatting. Within-group and between-group differences in lumbopelvic kinematics and electromyographic activity acquired in lumbar erector spinae (ES), gluteus maximus (GM), and vastus lateralis (VL) were analyzed. During squat-to-stand after squatting, the LBP group showed slower then faster lumbar movement in the second and third quartiles, respectively. In the second quartile, the AS group moved with a significantly greater lumbar angle. However, significantly greater bilateral GM activity (+4–4.5%) was found in the LBP group only. A more profound decrease in bilateral ES activity (−10%) was also shown in the LBP group, yet this was nonsignificant compared to the AS group (−4%). In the third quartile, only the LBP group moved with a significantly greater lumbar angle, together with a significant increase in bilateral ES (+6–8%) and GM muscle (+2–3%) activity. The findings of the altered pattern of joint kinematics and recruitment of the key lumbopelvic muscles displayed in the LBP group inform on the possible mechanisms that may contribute to the increased risk of developing lumbar dysfunctions for people who work in prolonged squatting postures.
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Shahvarpour A, Preuss R, Sullivan MJL, Negrini A, Larivière C. The effect of wearing a lumbar belt on biomechanical and psychological outcomes related to maximal flexion-extension motion and manual material handling. APPLIED ERGONOMICS 2018; 69:17-24. [PMID: 29477325 DOI: 10.1016/j.apergo.2018.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/18/2017] [Accepted: 01/02/2018] [Indexed: 05/25/2023]
Abstract
Workers with low back pain (LBP) may benefit from wearing a lumbar belt (LB), but the biomechanical and psychological mechanisms involved are not fully understood. Two types of flexible LB (extensible and non-extensible) were compared to a control condition (no LB) regarding pain-related (pain, fear of pain and catastrophizing) and biomechanical (range of motion - ROM) outcomes related to two tasks: maximal trunk flexion-extension and manual material handling. Healthy controls and participants with LBP were tested. During both tasks, the two LBs reduced the lumbar ROM in participants with LBP in the same way as healthy controls. This was observed even at the beginning of the trunk flexion movement, allowing generalization to many work tasks, that is to say tasks performed with small or deep trunk flexion. The two LBs reduced pain, fear of pain and catastrophizing in subjects with LBP. That may help a gradual re-exposure to physical work activities (disability prevention perspective), or maintaining these activities (secondary prevention perspective), following a LBP episode.
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Affiliation(s)
- Ali Shahvarpour
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul. de Maisonneuve O, Montreal, Quebec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada.
| | - Richard Preuss
- School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada.
| | - Michael J L Sullivan
- Department of Psychology, McGill University, 2001 McGill College, Montreal, Quebec, H3A 1G1, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada.
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul. de Maisonneuve O, Montreal, Quebec, H3A 3C2, Canada.
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul. de Maisonneuve O, Montreal, Quebec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada.
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Mousavi-Khatir R, Talebian S, Toosizadeh N, Olyaei GR, Maroufi N. The effect of static neck flexion on mechanical and neuromuscular behaviors of the cervical spine. J Biomech 2018; 72:152-158. [DOI: 10.1016/j.jbiomech.2018.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 02/25/2018] [Accepted: 03/03/2018] [Indexed: 10/17/2022]
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Ayhan C, Tanrıkulu S, Leblebicioglu G. Scapholunate interosseous ligament dysfunction as a source of elbow pain syndromes: Possible mechanisms and implications for hand surgeons and therapists. Med Hypotheses 2018; 110:125-131. [PMID: 29317055 DOI: 10.1016/j.mehy.2017.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 11/02/2017] [Accepted: 12/03/2017] [Indexed: 12/01/2022]
Abstract
Elbow pain syndromes are common upper extremity musculoskeletal disorders, and they are usually associated with repetitive occupational exposure. Ligaments are often one of the sources of musculoskeletal disorders because of their mechanical and neurological properties. The wrist ligaments are some of the ligaments most vulnerable to occupational exposure. Since most occupational tasks require wrist extension for handling tools and loading, the scapholunate interosseous ligament (SLIL) bears greater strain during loading, which results in creep deformation and hysteresis. Ligamentous creep may result in diminished ability to detect signal changes during joint movements, which impairs neuromuscular control established by ligamentomuscular reflex arcs elicited from mechanoreceptors in the ligaments. Changes in muscle activation patterns of forearm muscles due to diminished ligamentomuscular reflexes may initiate a positive feedback loop, leading to musculoskeletal pain syndromes. The relationship between elbow pain syndromes and SLIL injury will be presented through two hypotheses and relevant pain mechanisms: 1. Repetitive tasks may cause creep deformation of the SLIL, which then impairs ligamentomuscular reflexes, leading to elbow pain disorders. 2. Lateral epicondylalgia may increase the risk of SLIL injury through the compensation of the lower extensor carpi radialis muscle activity by higher extensor carpi ulnaris muscle activity, which may alter carpal kinematics, leading to SLIL degeneration over time. The differential diagnosis is usually complicated in musculoskeletal pain disorders. The failure of treatment methods is one of the issues of concern for many researchers. A key element in developing treatment strategies is to understand the source of the disorder and the nature of the injury. We proposed that the differential diagnosis include SLIL injuries when describing elbow pain syndromes, particularly, lateral epicondylalgia.
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Affiliation(s)
- Cigdem Ayhan
- Hacettepe University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Ankara, Turkey.
| | - Seval Tanrıkulu
- Koc University, Faculty of Medicine, Orthopedics and Traumatology Department, Hand Surgery Unit, İstanbul, Turkey
| | - Gursel Leblebicioglu
- Hacettepe University, Faculty of Medicine, Orthopaedics and Traumatology Department, Hand Surgery Unit, Ankara, Turkey
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Bagheri R, Takamjani IE, Dadgoo M, Sarrafzadeh J, Ahmadi A, Pourahmadi MR, Jafarpisheh AS. A protocol for clinical trial study of the effect of core stabilization exercises on spine kinematics during gait with and without load in patients with non-specific chronic low back pain. Chiropr Man Therap 2017; 25:31. [PMID: 29177031 PMCID: PMC5688737 DOI: 10.1186/s12998-017-0162-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 10/23/2017] [Indexed: 11/10/2022] Open
Abstract
Background Non-specific chronic low back pain (NCLBP) is a major public health and global socioeconomic burden with a variety of symptoms such as gait abnormality. Trunk stiffness and deep trunk muscles dysfunction known as guarding mechanism in gait are factors leading to abnormal movement pattern of the spine. Anterior load carriage task during gait is also challenged the trunk stability and its movement pattern. It will be therefore of interest to examine the effect of a Core Stabilization Training Program (CSTP) on the trunk and pelvis kinematics including variability and peak displacement during gait with and without load in NCLBP patients. Methods Patients with NCLBP will participate in a program containing 16 sessions of CSTP and perceived pain, disability and kinematic will be evaluated with 100 mm visual analog scale (VAS), Oswestry Disability Index (ODI) and motion analyzing system respectively before and after the intervention. Participants will be asked to walk with self-selected comfortable speed for 3 times without load and 3 times with caring a load with hands. Discussions We will quantify the effectiveness of CSTP on the kinematic of trunk, lumbar and pelvis during gait. Comparing the kinematic pattern and movement variability using CVo and CVp can contribute to better understand the motor control strategy and movement pattern of the spine during an anterior load carriage task between patients with NCLBP and healthy. Trial registration IRCT number: IRCT2016080829264N1; pre-result.
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Affiliation(s)
- Rasool Bagheri
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Ismail Ebrahimi Takamjani
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran.,School of Rehabilitation Sciences, Nezam St. Shah Nazari Ave. Madar Sq. Mirdamad Biv, P.O Box: 4391-15875, Tehran, Iran
| | - Mahdi Dadgoo
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Javad Sarrafzadeh
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Amir Ahmadi
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Mohammad Reza Pourahmadi
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Amir-Salar Jafarpisheh
- Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Abboud J, Rousseau B, Descarreaux M. Trunk proprioception adaptations to creep deformation. Eur J Appl Physiol 2017; 118:133-142. [DOI: 10.1007/s00421-017-3754-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 10/31/2017] [Indexed: 11/28/2022]
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Trunk kinematics and low back pain during pruning among vineyard workers-A field study at the Chateau Larose-Trintaudon. PLoS One 2017; 12:e0175126. [PMID: 28384277 PMCID: PMC5383154 DOI: 10.1371/journal.pone.0175126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/21/2017] [Indexed: 12/19/2022] Open
Abstract
The prevalence of low back disorders is dramatically high in viticulture. Field measurements that objectively quantify work exposure can provide information on the relationship between the adopted trunk postures and low back pain. The purposes of the present study were three-fold (1) to carry out a kinematics analysis of vineyard-workers’ pruning activity by extracting the duration of bending and rotation of the trunk, (2) to question separately the relationship between the duration of forward bending or trunk rotation with low back pain intensity and pressure pain sensitivity and (3) to question the relationship between the combined duration of forward bending and trunk rotation on low back pain intensity and pressure pain sensitivity. Fifteen vineyard-workers were asked to perform pruning activity for 12 minutes with a wireless triaxial accelerometer placed on their trunk. Kinematic analysis of the trunk showed that vineyard-workers spent more than 50% of the time with the trunk flexed greater than 30° and more than 20% with the trunk rotated greater than 10°. These results show that pruning activity lead to the adoption of forward bended and rotated trunk postures that could significantly increase the risk of work related musculoskeletal disorders in the low back. However, this result was mitigated by the observation of an absence of significant association between the duration of forward bending and trunk rotation with low back pain intensity or pressure pain sensitivity. Even if prospective field measurements and studies assessing the effects of low back pain confounders are needed, this field study provides new genuine information on trunk kinematics during pruning activity.
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Bauer C, Rast F, Ernst M, Meichtry A, Kool J, Rissanen S, Suni J, Kankaanpää M. The effect of muscle fatigue and low back pain on lumbar movement variability and complexity. J Electromyogr Kinesiol 2017; 33:94-102. [DOI: 10.1016/j.jelekin.2017.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 01/20/2017] [Accepted: 02/09/2017] [Indexed: 11/17/2022] Open
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Life history and point prevalence of low back pain in pre-professional and professional dancers. Phys Ther Sport 2017; 25:34-38. [PMID: 28364614 DOI: 10.1016/j.ptsp.2017.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/09/2016] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To investigate lifetime history and point prevalence of low back pain (LBP) in pre-professional and professional dancers and to identify any demographic or physical factors associated with LBP in dancers. DESIGN Cross-sectional study. SETTING One pre-professional ballet school, two pre-professional university dance programs, and a professional nationally touring ballet company. PARTICIPANTS Male and female classical ballet and contemporary dancers aged 12 years old and above. MAIN OUTCOME MEASURES Lifetime history and point prevalence of LBP. RESULTS A total of 110 (n = 19 male) dancers (mean (SD) 17.8 (2.9) years old) participated in the study, which represented 50% of the population invited to participate. A 74% lifetime prevalence of LBP was reported by dancers. Point and 12 month prevalence were 24 and 64%, respectively. No significant association was observed between LBP and any demographic or physical variables. CONCLUSION Pre-professional and professional dancers have an increased vulnerability to LBP. The development of LBP within this population is complex and may not be associated with individual factors measured in this study.
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Voglar M, Wamerdam J, Kingma I, Sarabon N, van Dieën JH. Prolonged Intermittent Trunk Flexion Increases Trunk Muscles Reflex Gains and Trunk Stiffness. PLoS One 2016; 11:e0162703. [PMID: 27768688 PMCID: PMC5096890 DOI: 10.1371/journal.pone.0162703] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/27/2016] [Indexed: 02/03/2023] Open
Abstract
The goal of the present study was to determine the effects of prolonged, intermittent flexion on trunk neuromuscular control. Furthermore, the potential beneficial effects of passive upper body support during flexion were investigated. Twenty one healthy young volunteers participated during two separate visits in which they performed 1 hour of intermittent 60 seconds flexion and 30 seconds rest cycles. Flexion was set at 80% lumbar flexion and was performed with or without upper body support. Before and after intermittent flexion exposure, lumbar range of motion was measured using inertial measurement units and trunk stability was assessed during perturbations applied in the forward direction with a force controlled actuator. Closed-loop system identification was used to determine the trunk translational admittance and reflexes as frequency response functions. The admittance describes the actuator displacement as a function of contact force and to assess reflexes muscle activation was related to actuator displacement. Trunk admittance gain decreased after unsupported flexion, while reflex gain and lumbar range of motion increased after both conditions. Significant interaction effects confirmed a larger increase in lumbar range of motion and reflex gains at most frequencies analysed following unsupported flexion in comparison to supported flexion, probably compensating for decreased passive tissue stiffness. In contrast with some previous studies we found that prolonged intermittent flexion decreased trunk admittance, which implies an increase of the lumped intrinsic and reflexive stiffness. This would compensate for decreased stiffness at the cost of an increase in cumulative low back load. Taking into account the differences between conditions it would be preferable to offer upper body support during activities that require prolonged trunk flexion.
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Affiliation(s)
- Matej Voglar
- University of Primorska, Andrej Marušič Institute, Koper, Slovenia
| | - Jeffrey Wamerdam
- MOVE Research Institute Amsterdam, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Idsart Kingma
- MOVE Research Institute Amsterdam, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nejc Sarabon
- University of Primorska, Andrej Marušič Institute, Koper, Slovenia.,S2P Ltd., Laboratory for Motor Control and Motor Learning, Ljubljana, Slovenia
| | - Jaap H van Dieën
- MOVE Research Institute Amsterdam, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Mendrin N, Lynn SK, Griffith-Merritt HK, Noffal GJ. Progressions of Isometric Core Training. Strength Cond J 2016. [DOI: 10.1519/ssc.0000000000000233] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ebenbichler GR, Leitgeb J, Amtmann G, König F, Schernthaner M, Resch KL, Kainberger F. Degeneration and Instability and the Relation to Patients' Function Late After Lumbar Disc Surgery: Data from a 12-Year Follow-Up. Am J Phys Med Rehabil 2016; 95:871-879. [PMID: 27149592 DOI: 10.1097/phm.0000000000000522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the excess risk of degeneration and segmental instability in operated segments late after lumbar disc surgery in patients with presurgically stable segments, and whether local pathological findings relate to patients' back health. DESIGN This retrospective analysis reports on 69 patients 12 years after first-time, uncomplicated lumbar disc surgery. Two independent radiologists evaluated the patients' lumbar functional x-rays; the Back Pain Rating Score (LBP-RS) assessed back-specific function. RESULTS At 12 years after lumbar disc surgery, degenerative changes as well as segmental instability occurred significantly more frequently in the operated than nonoperated lumbar segments, but there was no association between increased degeneration and segmental instability rates. The risk for acquiring segmental instability was significantly associated with surgery (odds ratio, 6.5; 95% confidence interval, 1.5-28.8). Prevalence of segmental instabilities was associated with better LBP-RS scores. Analyses of LBP-RS subscores revealed a clear association of segmental instability with physical function, but not with pain or activities of daily living. CONCLUSIONS Lumbar disc surgery seems to be associated with an increased risk of degeneration and segmental instability in the long term. This structural impairment, however, seems functionally well compensated and does not seem to be a relevant causal factor for a chronic back pain syndrome. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Describe the impact of lumbar disc surgery on segmental instability and degenerative changes; (2) Recognize the lack of association between degenerative changes and segmental instability after lumbar disc surgery; and (3) State the value of lumbar spinal functional tests in the evaluation of patients after lumbar disc surgery. LEVEL Advanced ACCREDITATION:: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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Affiliation(s)
- Gerold R Ebenbichler
- From the Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria (GRE); Vienna Medical University, Vienna, Austria (JL, GA); Section for Medical Statistics, Institute for Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria (F König); Department of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria (MS, F Kainberger); and German Institute of Health Research, Bad Elster and Dresden, Germany (KLR)
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The Influence of Centralization and Directional Preference on Spinal Control in Patients With Nonspecific Low Back Pain. J Orthop Sports Phys Ther 2016; 46:258-69. [PMID: 26813757 DOI: 10.2519/jospt.2016.6158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Prospective cohort, test-retest design. BACKGROUND Directional preference (DP) with centralization (CEN) and DP without CEN are common pain-pattern responses assessed by Mechanical Diagnosis and Therapy (MDT). Although there is evidence that MDT can reduce pain and disability in the short term by treating the patient with direction-specific exercises concordant with the patient's DP, the mechanism responsible for this is unclear. OBJECTIVE To determine whether clinical signs of impaired spinal control improve immediately after eliciting a DP-with-CEN response or a DP-without-CEN response in patients with nonspecific low back pain. METHODS Participants underwent a standardized MDT assessment and were classified into the following pain-pattern subgroups: DP with CEN, DP without CEN, or no DP. Clinical signs of impaired spinal control were assessed pre-MDT assessment and post-MDT assessment by an independent examiner. Four spinal control tests were conducted: aberrant lumbar movements while bending forward, the active straight leg raise (ASLR) test, the Trendelenburg test, and the prone instability test. Differences in spinal control pre-MDT assessment and post-MDT assessment were calculated for the 3 pain-pattern subgroups and compared with chi-square tests. We hypothesized that a larger proportion of patients in the DP-with-CEN subgroup would exhibit improved spinal control than patients categorized as DP without CEN or no DP. RESULTS Of 114 patients recruited, 51 patients (44.7%) were categorized as DP with CEN, 23 (20.2%) as DP without CEN, and 40 (35.1%) as no DP. Before MDT assessment, between 28.9% (Trendelenburg test) and 63.7% (ASLR test) of patients showed impaired spinal control. After MDT assessment, a larger proportion of patients in the DP-with-CEN subgroup (43%) showed improvement than those in the no-DP subgroup (7%) on aberrant lumbar movements (P = .02). Likewise, more patients in the DP-with-CEN subgroup (50%) improved on the ASLR test than those in the no-DP subgroup (8%, P<.01) or the DP-without-CEN subgroup (7%, P = .01). Changes in Trendelenburg test and prone instability test outcomes did not reach statistical significance. CONCLUSION Immediately following MDT assessment, a larger proportion of patients with a DP-with-CEN pain pattern showed improvement in clinical signs of spinal control compared to patients with a DP-without-CEN or no-DP pain pattern. The current study was registered in the Dutch trial registry at http://www.trialregister.nl/trialreg/index.asp (NTR4246). LEVEL OF EVIDENCE Therapy, level 2b.
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Suni JH, Rinne M, Kankaanpää M, Taulaniemi A, Lusa S, Lindholm H, Parkkari J. Neuromuscular exercise and back counselling for female nursing personnel with recurrent non-specific low back pain: study protocol of a randomised controlled trial (NURSE-RCT). BMJ Open Sport Exerc Med 2016; 2:e000098. [PMID: 27900169 PMCID: PMC5117067 DOI: 10.1136/bmjsem-2015-000098] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2016] [Indexed: 12/19/2022] Open
Abstract
Introduction Nursing personnel have high risk for incidence of low back pain (LBP) followed by development of chronic pain and disability. Multiple risk factors such as patient handling, night shift work and lack of supporting work culture have been identified. In subacute LBP, high-fear avoidance is prognostic for more pain, disability and not returning to work. Lack of leisure-time physical activity predicts long-term sickness absence. The purpose of this study is to compare effectiveness of 6-month neuromuscular exercise and counselling in treating back pain in female nursing personnel with recurrent non-specific LBP pain compared with either (exercise or counselling) alone and a non-treatment control group. Methods and analysis The design is of a double-blinded four-arm randomised controlled trial with cost-effectiveness evaluation at 12 and 24 months. The study is conducted in 3 consecutive substudies. The main eligibility criteria are experience of LBP during the past 4 weeks with intensity of at least 2 (Numeric Rating Scale 0–10) and engagement in patient handling. Sample size was estimated for the primary outcome of pain intensity (visual analogue scale). Study measurements are outlined according to the model of International Classification of Functioning, Disability and Health, which incorporates the biopsychosocial processes assessed. Ethics and dissemination This study is carried out conforming to the guidelines of good scientific practice and provisions of the declaration of Helsinki. Increasing physical and mental capacity with interventions taking place immediately after working hours near the worksite may reduce development of chronic LBP and work disability in female nursing personnel with recurrent non-specific LBP. Trial registration number NCT04165698.
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Affiliation(s)
- Jaana H Suni
- UKK Institute for Health Promotion Research , Tampere , Finland
| | - Marjo Rinne
- UKK Institute for Health Promotion Research , Tampere , Finland
| | - Markku Kankaanpää
- Pirkanmaa Hospital District, Physical and Rehabilitation Medicine Outpatient Clinic , Tampere , Finland
| | | | - Sirpa Lusa
- Finnish Institute of Occupational Medicine , Helsinki , Finland
| | - Harri Lindholm
- Finnish Institute of Occupational Medicine , Helsinki , Finland
| | - Jari Parkkari
- UKK Institute for Health Promotion Research , Tampere , Finland
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Abboud J, Nougarou F, Descarreaux M. Muscle Activity Adaptations to Spinal Tissue Creep in the Presence of Muscle Fatigue. PLoS One 2016; 11:e0149076. [PMID: 26866911 PMCID: PMC4750977 DOI: 10.1371/journal.pone.0149076] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/26/2016] [Indexed: 12/02/2022] Open
Abstract
Aim The aim of this study was to identify adaptations in muscle activity distribution to spinal tissue creep in presence of muscle fatigue. Methods Twenty-three healthy participants performed a fatigue task before and after 30 minutes of passive spinal tissue deformation in flexion. Right and left erector spinae activity was recorded using large-arrays surface electromyography (EMG). To characterize muscle activity distribution, dispersion was used. During the fatigue task, EMG amplitude root mean square (RMS), median frequency and dispersion in x- and y-axis were compared before and after spinal creep. Results Important fatigue-related changes in EMG median frequency were observed during muscle fatigue. Median frequency values showed a significant main creep effect, with lower median frequency values on the left side under the creep condition (p≤0.0001). A significant main creep effect on RMS values was also observed as RMS values were higher after creep deformation on the right side (p = 0.014); a similar tendency, although not significant, was observed on the left side (p = 0.06). A significant creep effects for x-axis dispersion values was observed, with higher dispersion values following the deformation protocol on the left side (p≤0.001). Regarding y-axis dispersion values, a significant creep x fatigue interaction effect was observed on the left side (p = 0.016); a similar tendency, although not significant, was observed on the right side (p = 0.08). Conclusion Combined muscle fatigue and creep deformation of spinal tissues led to changes in muscle activity amplitude, frequency domain and distribution.
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Affiliation(s)
- Jacques Abboud
- Département d’Anatomie, Université du Québec à Trois-Rivières, Québec, Canada
- * E-mail:
| | - François Nougarou
- Département de Génie Électrique, Université du Québec à Trois-Rivières, Québec, Canada
| | - Martin Descarreaux
- Département des Sciences de l’Activité Physique, Université du Québec à Trois-Rivières, Québec, Canada
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Mense S, Hoheisel U. Evidence for the existence of nociceptors in rat thoracolumbar fascia. J Bodyw Mov Ther 2016; 20:623-8. [PMID: 27634088 DOI: 10.1016/j.jbmt.2016.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/20/2015] [Indexed: 12/28/2022]
Abstract
Recently, the existence of nociceptive fibers in fascia tissue has attracted much interest. Fascia can be a source of pain in several disorders such as fasciitis and non-specific low back pain. However, little is known about the properties of fascia nociceptors and possible changes of the fascia innervation by nociceptors under pathological circumstances. In this histologic study, the density of presumably nociceptive fibers and free nerve endings was determined in the three layers of the rat TLF: inner layer (IL, covering the multifidus muscle), middle layer (ML) and outer layer (OL). As markers for nociceptive fibers, antibodies to the neuropeptides CGRP and SP as well as to the transient receptor potential vanilloid 1 (TRPV1) were used. As a pathological state, inflammation of the TLF was induced with injection of complete Freund's adjuvant. The density of CGRP- and SP-positive fibers was significantly increased in the inner and outer layer of the inflamed fascia. In the thick middle layer, no inflammation-induced change occurred. In additional experiments, a neurogenic inflammation was induced in the fascia by electrical stimulation of dorsal roots. In these experiments, plasma extravasation was visible in the TLF, which is clear functional evidence for the existence of fascia nociceptors. The presence of nociceptors in the TLF and the increased density of presumably nociceptive fibers under chronic painful circumstances may explain the pain from a pathologically altered fascia. The fascia nociceptors probably contribute also to the pain in non-specific low back pain.
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Affiliation(s)
- Siegfried Mense
- Department of Neurophysiology, Center for Biomedicine and Medical Technology Mannheim, Ruprecht-Karls-University Heidelberg, D 68167, Mannheim, Germany.
| | - Ulrich Hoheisel
- Department of Neurophysiology, Center for Biomedicine and Medical Technology Mannheim, Ruprecht-Karls-University Heidelberg, D 68167, Mannheim, Germany.
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45
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Bishop JH, Fox JR, Maple R, Loretan C, Badger GJ, Henry SM, Vizzard MA, Langevin HM. Ultrasound Evaluation of the Combined Effects of Thoracolumbar Fascia Injury and Movement Restriction in a Porcine Model. PLoS One 2016; 11:e0147393. [PMID: 26820883 PMCID: PMC4731465 DOI: 10.1371/journal.pone.0147393] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 01/04/2016] [Indexed: 12/15/2022] Open
Abstract
The persistence of back pain following acute back "sprains" is a serious public health problem with poorly understood pathophysiology. The recent finding that human subjects with chronic low back pain (LBP) have increased thickness and decreased mobility of the thoracolumbar fascia measured with ultrasound suggest that the fasciae of the back may be involved in LBP pathophysiology. This study used a porcine model to test the hypothesis that similar ultrasound findings can be produced experimentally in a porcine model by combining a local injury of fascia with movement restriction using a "hobble" device linking one foot to a chest harness for 8 weeks. Ultrasound measurements of thoracolumbar fascia thickness and shear plane mobility (shear strain) during passive hip flexion were made at the 8 week time point on the non-intervention side (injury and/or hobble). Injury alone caused both an increase in fascia thickness (p = .007) and a decrease in fascia shear strain on the non-injured side (p = .027). Movement restriction alone did not change fascia thickness but did decrease shear strain on the non-hobble side (p = .024). The combination of injury plus movement restriction had additive effects on reducing fascia mobility with a 52% reduction in shear strain compared with controls and a 28% reduction compared to movement restriction alone. These results suggest that a back injury involving fascia, even when healed, can affect the relative mobility of fascia layers away from the injured area, especially when movement is also restricted.
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Affiliation(s)
- James H. Bishop
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America
| | - James R. Fox
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America
| | - Rhonda Maple
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America
| | - Caitlin Loretan
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America
| | - Gary J. Badger
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, United States of America
| | - Sharon M. Henry
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, United States of America
| | - Margaret A. Vizzard
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America
| | - Helene M. Langevin
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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Hartman RA, Yurube T, Ngo K, Merzlak NE, Debski RE, Brown BN, Kang JD, Sowa GA. Biological responses to flexion/extension in spinal segments ex-vivo. J Orthop Res 2015; 33:1255-64. [PMID: 25865090 DOI: 10.1002/jor.22900] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 03/10/2015] [Indexed: 02/04/2023]
Abstract
Mechanical loading is a salient factor in the progression of spinal disorders that contribute to back pain. Biological responses to loading modes like flexion/extension (F/E) in relevant spinal tissues remain unstudied. A novel, multi-axial experimental system was developed to subject viable functional spinal units (FSUs) to complex, in-situ loading. The objective was to determine biological effects of F/E in multiple spinal tissues-annulus fibrosus, nucleus pulposus, facet cartilage, and ligamentum flavum. Rabbit lumbar FSUs were mounted in a bioreactor within a robotic testing system. FSUs underwent small (0.17/0.05 Nm) and large (0.5/0.15 Nm) range-of-motion F/E for 1 or 2 h of cycling. Outcomes in each tissue, compared to unloaded FSUs, included (i) relative mRNA expression of catabolic (MMP-1, 3 and ADAMTS-5), pro-inflammatory (COX-2), and anabolic (ACAN) genes and (ii) immunoblotting of aggrecan degradation. Total energy applied to FSUs increased in groups subject to large range-of-motion and 2-h cycling, and moment relaxation was higher with large range-of-motion. F/E significantly modulated MMP1,-3 and COX-2 in facet cartilage and MMP-3 and ACAN in annulus fibrosus. Large range-of-motion loading increased MMP-mediated aggrecan fragmentation in annulus fibrosus. Biological responses to complex loading ex vivo showed variation among spinal tissues that reflect tissue structure and mechanical loading in F/E.
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Affiliation(s)
- Robert A Hartman
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, 3471 5th Avenue, Pittsburgh, Pennsylvania, 15213.,Department of Bioengineering, University of Pittsburgh, 300 Technology Drive, 360B Center for Bioengineering, Pittsburgh, Pennsylvania, 15219
| | - Takashi Yurube
- Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Kevin Ngo
- Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Nicolas E Merzlak
- Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Richard E Debski
- Department of Bioengineering, University of Pittsburgh, 300 Technology Drive, 360B Center for Bioengineering, Pittsburgh, Pennsylvania, 15219.,Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Bryan N Brown
- Department of Bioengineering, University of Pittsburgh, 300 Technology Drive, 360B Center for Bioengineering, Pittsburgh, Pennsylvania, 15219.,McGowan Institute for Regenerative Medicine, 450 Technology Drive, Suite 300, Pittsburgh, Pennsylvania, 15219
| | - James D Kang
- Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Gwendolyn A Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, 3471 5th Avenue, Pittsburgh, Pennsylvania, 15213.,Department of Bioengineering, University of Pittsburgh, 300 Technology Drive, 360B Center for Bioengineering, Pittsburgh, Pennsylvania, 15219.,Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
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Asgari M, Sanjari MA, Mokhtarinia HR, Moeini Sedeh S, Khalaf K, Parnianpour M. The effects of movement speed on kinematic variability and dynamic stability of the trunk in healthy individuals and low back pain patients. Clin Biomech (Bristol, Avon) 2015; 30:682-8. [PMID: 26021879 DOI: 10.1016/j.clinbiomech.2015.05.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 05/03/2015] [Accepted: 05/07/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Comparison of the kinematic variability and dynamic stability of the trunk between healthy and low back pain patient groups can contribute to gaining valuable information about the movement patterns and neuromotor strategies involved in various movement tasks. METHODS Fourteen chronic low back pain patients with mild symptoms and twelve healthy male volunteers performed repeated trunk flexion-extension movements in the sagittal plane at three different speeds: 20 cycles/min, self-selected, and 40 cycles/min. Mean standard deviations, coefficient of variation and variance ratio as variability measures; maximum finite-time Lyapunov exponents and maximum Floquet multipliers as stability measures were computed from trunk kinematics. FINDINGS Higher speed significantly reduced the kinematic variability, while it increased short-term Lyapunov exponents. Long-term Lyapunov exponents were higher at self-selected speed and lower in low back pain patients as compared to control volunteers. Floquet multipliers were larger at self-selected speed and during higher pace trunk movements. INTERPRETATION Our findings suggest that slower pace flexion-extension trunk movements are associated with more motor variation as well as local and orbital stability, implying less potential risk of injury for the trunk. Individuals with and without low back pain consistently recruited a closed-loop control strategy towards achieving trunk stability. Chronic low back pain patients exhibited more stable trunk movements over long-term periods, indicating probable temporary pain relief functional adaption strategies. These results may be used towards the development of more effective personalized rehabilitation strategies and quantitative spinal analysis tools for low back pain detection, diagnosis and treatment, as well as improvement of workspace and occupational settings.
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Affiliation(s)
- Morteza Asgari
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
| | - Mohammad Ali Sanjari
- Biomechanics Lab, Rehabilitation Research Center, Faculty of Rehabilitation, Department of Rehabilitation Basic Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Hamid Reza Mokhtarinia
- Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Samaneh Moeini Sedeh
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
| | - Kinda Khalaf
- Department of Biomedical Engineering, Khalifa University of Science Technology and Research, Abu Dhabi, United Arab Emirates.
| | - Mohamad Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
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48
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Hoheisel U, Rosner J, Mense S. Innervation changes induced by inflammation of the rat thoracolumbar fascia. Neuroscience 2015; 300:351-9. [PMID: 26003735 DOI: 10.1016/j.neuroscience.2015.05.034] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 05/12/2015] [Accepted: 05/14/2015] [Indexed: 12/20/2022]
Abstract
Recently, the fascia innervation has become an important issue, particularly the existence of nociceptive fibers. Fascia can be a source of pain in several disorders such as fasciitis and non-specific low back pain. However, nothing is known about possible changes of the fascia innervation under pathological circumstances. This question is important, because theoretically pain from the fascia cannot only be due to increased nociceptor discharges, but also to a denser innervation of the fascia by nociceptive endings. In this histological study, an inflammation was induced in the thoracolumbar fascia (TLF) of rats and the innervation by various fiber types compared between the inflamed and intact TLF. Although the TLF is generally considered to have proprioceptive functions, no corpuscular proprioceptors (Pacini and Ruffini corpuscles) were found. To obtain quantitative data, the length of fibers and free nerve endings were determined in the three layers of the rat TLF: inner layer (IL, adjacent to the multifidus muscle), middle layer (ML) and outer layer (OL). The main results were that the overall innervation density showed little change; however, there were significant changes in some of the layers. The innervation density was significantly decreased in the OL, but this change was partly compensated for by an increase in the IL. The density of substance P (SP)-positive - presumably nociceptive - fibers was significantly increased. In contrast, the postganglionic sympathetic fibers were significantly decreased. In conclusion, the inflamed TLF showed an increase of presumably nociceptive fibers, which may explain the pain from a pathologically altered fascia. The meaning of the decreased innervation by sympathetic fibers is obscure at present. The lack of proprioceptive corpuscular receptors within the TLF does not preclude its role as a proprioceptive structure, because some of the free nerve endings may function as proprioceptors.
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Affiliation(s)
- U Hoheisel
- Chair of Neurophysiology, Centre for Biomedicine and Medical Technology Mannheim, Ruprecht-Karls-University Heidelberg, 68167 Mannheim, Germany.
| | - J Rosner
- Chair of Neurophysiology, Centre for Biomedicine and Medical Technology Mannheim, Ruprecht-Karls-University Heidelberg, 68167 Mannheim, Germany
| | - S Mense
- Chair of Neurophysiology, Centre for Biomedicine and Medical Technology Mannheim, Ruprecht-Karls-University Heidelberg, 68167 Mannheim, Germany
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49
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Mawston GA, G. Boocock M. Lumbar posture biomechanics and its influence on the functional anatomy of the erector spinae and multifidus. PHYSICAL THERAPY REVIEWS 2015. [DOI: 10.1179/1743288x15y.0000000014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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50
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Rethinking design parameters in the search for optimal dynamic seating. J Bodyw Mov Ther 2015; 19:291-303. [DOI: 10.1016/j.jbmt.2014.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 07/07/2014] [Accepted: 07/10/2014] [Indexed: 11/22/2022]
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