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Cazacu IS, Anghelescu A, Onose G. Research on non-invasive monitoring of biomechanical and viscoelastic properties of myotendinous complex in patients with herniated disk with radiculopathy (pre- and post-surgery) in the in order to optimize the neurorehabilitation approach – a systematic literature review. BALNEO AND PRM RESEARCH JOURNAL 2025; 16:794-794. [DOI: 10.12680/balneo.2025.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2025] Open
Abstract
Low back pain is considered to have "epidemic proportions in Western societies", so that it is obvious that discovertebral pathology, especially severe (as is the case with neurosurgical indications), which is our subject research, succita a major and constantly growing interest due to, including to the numerical pressure, which places it among public health problems. This is also reflected by the fact that, for example, in the United States, in recent decades, healthcare costs allocated to prescription drugs to combat lumbosacralgia have risen at a higher rate than in any other category of health services [1]. In our study, we consider that evaluating the viscoelastic properties of muscles provides valuable information about muscle health, function, and progress in recovery. This innovative approach involves assessing the muscle's ability to resist deformation and return to its original shape, which reflects its characteristics of elasticity and viscosity. [2] We previously conducted a systematic review of the related literature using the method of filtering and selecting profile documentary material, a widely accepted and internationally recognized approach: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Thus, we searched using contextually relevant combinations and syntaxes of search keywords in the following international databases: Elsevier, PubMed, PMC, PEDro, and articles published in English in ISI-indexed journals in Web of Knowledge/Science, from January 1, 2021, to December 31, 2023.
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Affiliation(s)
- Ioana-Simona Cazacu
- Neuromuscular Rehabilitation Clinic Division - the Teaching Emergency Hospital “Bagdasar Arseni” Bucharest, Romania
| | - Aurelian Anghelescu
- Neuromuscular Rehabilitation Clinic Division - the Teaching Emergency Hospital “Bagdasar Arseni” Bucharest, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division - the Teaching Emergency Hospital “Bagdasar Arseni” Bucharest, Romania
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Sipko T, Berger-Pasternak B, Paluszak A. Comparative Impact of Kinesio Taping and Post-Isometric Muscle Relaxation on Pain and Myofascial Mechanics in Chronic Low Back Pain: A Randomized Clinical Trial. Med Sci Monit 2025; 31:e945376. [PMID: 39953714 PMCID: PMC11837403 DOI: 10.12659/msm.945376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 11/11/2024] [Indexed: 02/17/2025] Open
Abstract
BACKGROUND This study aimed to evaluate and compare the effects of Kinesio taping (KT), with or without tension (Placebo), and post-isometric muscle relaxation (PIR) on pain intensity and the mechanical properties of myofascial tissues in chronic low back pain (LBP) patients. MATERIAL AND METHODS Study participants (n=64; females, n=34; males, n=30; mean age 41.9 years), were randomly assigned to 1 of the 3 intervention groups. The numerical rating scale (NRS) was used to assess pain intensity at rest, the Oswestry Disability Index was used to estimate the level of disability, and the MyotonPRO© device was used to measure tension, stiffness, and relaxation in the erector spinae on both sides of the lumbar spine. The examinations were performed before the intervention, after interventions, and at 7-day follow-up (RCT Id: ACTRN12624000121561). RESULTS Pain and level of disability were reduced for all groups (P<0.01). In addition, post hoc analysis of the KT group showed significant increases in tension and stiffness of the erector spinae and significantly decreased relaxation between the pre-intervention and follow-up measurements, but only on the contralateral side (P<0.01). CONCLUSIONS KT with or without tape tension and PIR had similar effects in decreasing the level of resting pain and disability. Pain reduction was not related to changes in the mechanical properties of the soft tissue. It can be concluded that the KT with or without tape tension or PIR were mainly analgesic effects, and should be used as a combined therapy in LBP patients.
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Ali MG, Mohammed AA, Ragab WM, Zakaria HM, Alwhaibi RM, Ibrahim ZM, Mamoon RS. Do Lumbar Paravertebral Muscle Properties Show Changes in Mothers with Moderate-Severity Low Back Pain Following a Cesarean Birth? A Case–Control Study. J Clin Med 2025; 14:719. [DOI: -doi:10.3390/jcm14030719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2025] Open
Abstract
Background/Objectives: Cesarean birth (CB) is linked to nonspecific low back pain (NSLBP). Different properties of the muscular tissue, including contractile, biomechanical, and viscous properties, may reflect its physiological or pathological condition. This study aimed to measure these properties of lumbar paravertebral muscles (LPVMs) and their relationship with post-CB mothers with moderate-severity NSLBP and match their measurements to those of the controls. Methods: Sixty women were included in this case–control research. They were divided into two equal groups: Group (A) representing cases, consisted of 30 females who experienced CB and complained of moderate-severity NSLBP, and Group (B) representing controls, consisted of 30 healthy females who had never experienced pregnancy with no or mild-severity NSLBP. Results: The statistical analysis between the two groups yielded significant differences in the right and left LPVMs’ tone (p = 0.002 and 0.015), relaxation time (p = 0.002 and 0.022), and creep (p = 0.013 and 0.008), respectively. On the other side, there were non-significant differences in the right and left LPVMs’ stiffness (p = 0.055 and 0.367) and elasticity (p = 0.115 and 0.231), respectively. The regression analysis’s final model indicated a strong overall performance (Nagelkerke: 1.00). Conclusions: The LPVMs of post-CB mothers with moderate-severity NSLBP showed remarkable changes in both contractile and viscous properties: muscle tone notably decreased, while viscosity increased. However, biomechanical properties like stiffness and elasticity showed negligible changes. This fitted regression analysis illustrated the holistic strong effect of LPVMs’ properties as risk factors contributing to post-CB NSLBP, emphasizing their consideration in diagnosis and intervention strategies for such cases.
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Affiliation(s)
- Mohamed G. Ali
- Department of Physical Therapy for Women’s Health, Faculty for Physical Therapy, South Valley University, Qena 83523, Egypt
| | - Abeer A. Mohammed
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Walaa M. Ragab
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, Taibah University, Medina 42353, Saudi Arabia
| | - Hoda M. Zakaria
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Reem M. Alwhaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Zizi M. Ibrahim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Rehab S. Mamoon
- Department of Physical Therapy for Women’s Health, Faculty for Physical Therapy, South Valley University, Qena 83523, Egypt
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Ali MG, Mohammed AA, Ragab WM, Zakaria HM, Alwhaibi RM, Ibrahim ZM, Mamoon RS. Do Lumbar Paravertebral Muscle Properties Show Changes in Mothers with Moderate-Severity Low Back Pain Following a Cesarean Birth? A Case-Control Study. J Clin Med 2025; 14:719. [PMID: 39941389 PMCID: PMC11818502 DOI: 10.3390/jcm14030719] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2024] [Revised: 12/19/2024] [Accepted: 01/15/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: Cesarean birth (CB) is linked to nonspecific low back pain (NSLBP). Different properties of the muscular tissue, including contractile, biomechanical, and viscous properties, may reflect its physiological or pathological condition. This study aimed to measure these properties of lumbar paravertebral muscles (LPVMs) and their relationship with post-CB mothers with moderate-severity NSLBP and match their measurements to those of the controls. Methods: Sixty women were included in this case-control research. They were divided into two equal groups: Group (A) representing cases, consisted of 30 females who experienced CB and complained of moderate-severity NSLBP, and Group (B) representing controls, consisted of 30 healthy females who had never experienced pregnancy with no or mild-severity NSLBP. Results: The statistical analysis between the two groups yielded significant differences in the right and left LPVMs' tone (p = 0.002 and 0.015), relaxation time (p = 0.002 and 0.022), and creep (p = 0.013 and 0.008), respectively. On the other side, there were non-significant differences in the right and left LPVMs' stiffness (p = 0.055 and 0.367) and elasticity (p = 0.115 and 0.231), respectively. The regression analysis's final model indicated a strong overall performance (Nagelkerke: 1.00). Conclusions: The LPVMs of post-CB mothers with moderate-severity NSLBP showed remarkable changes in both contractile and viscous properties: muscle tone notably decreased, while viscosity increased. However, biomechanical properties like stiffness and elasticity showed negligible changes. This fitted regression analysis illustrated the holistic strong effect of LPVMs' properties as risk factors contributing to post-CB NSLBP, emphasizing their consideration in diagnosis and intervention strategies for such cases.
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Affiliation(s)
- Mohamed G. Ali
- Department of Physical Therapy for Women’s Health, Faculty for Physical Therapy, South Valley University, Qena 83523, Egypt;
| | - Abeer A. Mohammed
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt; (A.A.M.); (W.M.R.); (H.M.Z.)
| | - Walaa M. Ragab
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt; (A.A.M.); (W.M.R.); (H.M.Z.)
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, Taibah University, Medina 42353, Saudi Arabia
| | - Hoda M. Zakaria
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt; (A.A.M.); (W.M.R.); (H.M.Z.)
| | - Reem M. Alwhaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (R.M.A.); (Z.M.I.)
| | - Zizi M. Ibrahim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (R.M.A.); (Z.M.I.)
| | - Rehab S. Mamoon
- Department of Physical Therapy for Women’s Health, Faculty for Physical Therapy, South Valley University, Qena 83523, Egypt;
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Cacciatore TW, Anderson DI, Cohen RG. Central mechanisms of muscle tone regulation: implications for pain and performance. Front Neurosci 2024; 18:1511783. [PMID: 39717699 PMCID: PMC11665217 DOI: 10.3389/fnins.2024.1511783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Accepted: 11/11/2024] [Indexed: 12/25/2024] Open
Abstract
Muscle tone represents a foundational property of the motor system with the potential to impact musculoskeletal pain and motor performance. Muscle tone is involuntary, dynamically adaptive, interconnected across the body, sensitive to postural demands, and distinct from voluntary control. Research has historically focused on pathological tone, peripheral regulation, and contributions from passive tissues, without consideration of the neural regulation of active tone and its consequences, particularly for neurologically healthy individuals. Indeed, simplistic models based on the stretch reflex, which neglect the central regulation of tone, are still perpetuated today. Recent advances regarding tone are dispersed across different literatures, including animal physiology, pain science, motor control, neurology, and child development. This paper brings together diverse areas of research to construct a conceptual model of the neuroscience underlying active muscle tone. It highlights how multiple tonic drive networks tune the excitability of complex spinal feedback circuits in concert with various sources of sensory feedback and in relation to postural demands, gravity, and arousal levels. The paper also reveals how tonic muscle activity and excitability are disrupted in people with musculoskeletal pain and how tone disorders can lead to marked pain and motor impairment. The paper presents evidence that integrative somatic methods address the central regulation of tone and discusses potential mechanisms and implications for tone rehabilitation to improve pain and performance.
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Affiliation(s)
| | - David I. Anderson
- Department of Kinesiology, Marian Wright Edelman Institute, San Francisco State University, San Francisco, CA, United States
| | - Rajal G. Cohen
- Department of Psychology and Communication, University of Idaho, Moscow, ID, United States
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Valenti F, Meden S, Frangež M, Vauhnik R. Intra-rater and inter-rater reliability of a handheld myotonometer measuring myofascial stiffness of lower lumbar myofascial tissue in healthy adults. PeerJ 2024; 12:e18524. [PMID: 39575173 PMCID: PMC11580663 DOI: 10.7717/peerj.18524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Accepted: 10/23/2024] [Indexed: 11/24/2024] Open
Abstract
Background Biomechanical muscle properties, such as stiffness, can be valuable indicators of tissue health and show promise as a diagnostic and treatment measure for chronic low back pain (CLBP). The development of accessible assessment technologies, such as the MyotonPRO portable device, allows for the convenient quantification of muscle tone and stiffness changes. The aim of this study is to assess the reliability of lumbar erector spinae muscle stiffness with the MyotonPRO in healthy adults and to compare stiffness changes between prone and sitting position. Methods Thirty asymptomatic participants (N = 15 women and N = 15 men) aged between 18 and 65 years were recruited to participate in this study. Two examiners tested muscle stiffness at the palpable muscle belly, one finger away from the spinous process at the level of the L4 vertebra, first from the left and then from the right side, both in prone position and after in sitting position. For inter-rater reliability, all participants were tested by two examiners on the same day, and intra-rater reliability was calculated using the same examiner's assessment results with an exact 24-h interval. Intraclass correlation coefficients (ICC), standard error measures (SEM) and minimum detectable change (MDC) with a 95% confidence interval were calculated to assess intra-rater and inter-rater reliability. Results Statistical analysis revealed good intra-rater reliability with an ICC of 0.88 (95% CI [0.76-0.94]) for the stiffness of the left erector spinae and excellent intra-rater reliability with an ICC of 0.91 (95% CI [0.82-0.95]) for the right erector spinae, both in the prone position. Intra-rater reliability in the sitting position was excellent to very good with an ICC of 0.91 (95% CI [0.82-0.96]) for the left side and an ICC of 0.89 (95% CI [0.78-0.95]) for the right side. The results for the left-sided prone position showed good inter-rater reliability with an ICC of 0.87 (95% CI [0.73-0.94]). The prone position on the right side also showed good inter-rater reliability with an ICC of 0.84 (95% CI [0.68-0.92]). The inter-rater reliability for the left and right side in the sitting position was excellent with an ICC of 0.96 (95% CI [0.92-0.98]) for the left side and an ICC of 0.95 (95% CI [0.90-0.97]) for the right side. Conclusion This study demonstrated high reliability in measuring lumbar erector spinae muscle stiffness with the MyotonPRO in healthy adults and the ability of the device to detect even small changes in erector spinae muscle stiffness, testing both the right and left sides and measuring in both prone and sitting positions. The use of the sitting position to assess lumbar tissue tension in individuals may serve as a valuable substitute for the prone position, particularly for patients who experience discomfort in the prone position, and could have additional practical significance in clinical settings.
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Affiliation(s)
- Fabio Valenti
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Sara Meden
- Valdoltra Orthopaedic Hospital, Ankaran, Slovenia
| | - Maja Frangež
- Institute for Medical Rehabilitation, University Medical Centre, Ljubljana, Slovenia
| | - Renata Vauhnik
- Faculty of Health Sciences, Department of Physiotherapy, University of Ljubljana, Ljubljana, Slovenia
- Institute for Joints and Sport Injuries, ARTHRON, Ljubljana, Slovenia
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Sipko T, Barczyk-Pawelec K, Piksa M, Mencel J. Impact of Standing and Sitting Postures on Spinal Curvature and Muscle Mechanical Properties in Young Women: A Photogrammetric and MyotonPro Analysis. Med Sci Monit 2024; 30:e944930. [PMID: 39069714 PMCID: PMC11297353 DOI: 10.12659/msm.944930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/03/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the effect of standing and sitting positions on spinal curvatures evaluated using projection moire and muscle tone and stiffness using the MyotonPRO hand-held device in young women. MATERIAL AND METHODS Thirty-three healthy women, aged 21 to 23 years, volunteered in the study. We used the projection moire method to examine spinal curvatures in both positions and the MyotonPRO device to measure the tone and stiffness of muscles in 3 regions. We evaluated the effects of positions (standing vs sitting), regions (cervical, thoracic, and lumbar), and side factor (right vs left) using multivariate analysis. RESULTS The sitting position significantly decreased the lumbosacral and thoracolumbar angles (P<0.001), but had no effect on the superior thoracic angle. Muscle tension and stiffness were the highest (P<0.001) in the cervical region and did not differ between positions (P>0.05) in this region. We found significantly higher muscle tone and stiffness in the thoracic and lumbar regions during sitting than during standing (P<0.001). There was symmetry in the muscle tone and the stiffness between the right and left sides of the spine. CONCLUSIONS The sitting posture decreased lumbosacral and thoracolumbar angles but increased muscle tension and stiffness in the lumbar and thoracic regions only. The symmetry of muscle tone and transverse stiffness in both positions was the normative value. This study provides insight into the adaptive physiological changes in spinal curvature and muscle mechanical properties in young women and serves as an important reference point for clinical studies of women.
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Affiliation(s)
- Tomasz Sipko
- Department of Kinesiotherapy, Physiotherapy Faculty, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
| | - Katarzyna Barczyk-Pawelec
- Department of Kinesiotherapy, Physiotherapy Faculty, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
| | - Mirela Piksa
- Department of Kinesiotherapy, Physiotherapy Faculty, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
| | - Joanna Mencel
- Department of Kinesiology, Physiotherapy Faculty, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
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Deodato M, Saponaro S, Šimunič B, Martini M, Murena L, Buoite Stella A. Trunk muscles' characteristics in adolescent gymnasts with low back pain: a pilot study on the effects of a physiotherapy intervention including a postural reeducation program. J Man Manip Ther 2024; 32:310-324. [PMID: 37649443 PMCID: PMC11216269 DOI: 10.1080/10669817.2023.2252202] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Trunk muscles' function and characteristics are of great importance for both static and dynamic tasks in different sports, and abnormalities of trunk flexors and extensors might be associated with low back pain (LBP). The aim of this study was to provide a comprehensive evaluation of the functional, morphological and contractile properties in trunk flexors and extensors of young gymnasts with and without LBP. METHODS Young gymnasts (14/25 females, 14-18 y) were screened for the presence of chronic LBP. Abdominal and lumbar muscles were tested for function (McGill's endurance tests), thickness (ultrasound), and contractile responses (tensiomyography). An 8-sessions physiotherapy intervention including postural reeducation was performed by a subsample of 10 subjects with LBP. RESULTS LBP was found to be associated to higher flexors-to-extensors endurance ratio (OR 11.250, 95% CI: 1.647-76.849, p = 0.014), reduced mean lumbar multifidus thickness (OR 16.500, 95% CI: 2.246-121.228, p = 0.006), and reduced mean erector spinae radial displacement (OR 16.500, 95% CI: 2.246-121.228, p = 0.006). The physiotherapy intervention was found to reduce LBP symptoms and it was associated with a significant improvement in the flexors-to-extensors ratio (p < 0.001). CONCLUSIONS This study provides preliminary evidence of functional, morphological, and contractile trunk muscles' alterations associated with chronic LBP in young gymnasts, and presents the effects of a postural reeducation program on symptoms and muscles' functional properties.
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Affiliation(s)
- Manuela Deodato
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- PhD Program in Neural and Cognitive Sciences, Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Serena Saponaro
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Center of Koper, Koper, Slovenia
| | - Miriam Martini
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Luigi Murena
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- Orthopaedics and Traumatology Unit, Cattinara Hospital - ASUGI, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Alex Buoite Stella
- School of Physiotherapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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Lettner J, Królikowska A, Ramadanov N, Oleksy Ł, Hakam HT, Becker R, Prill R. Evaluating the Reliability of MyotonPro in Assessing Muscle Properties: A Systematic Review of Diagnostic Test Accuracy. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:851. [PMID: 38929468 PMCID: PMC11205912 DOI: 10.3390/medicina60060851] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Muscle properties are critical for performance and injury risk, with changes occurring due to physical exertion, aging, and neurological conditions. The MyotonPro device offers a non-invasive method to comprehensively assess muscle biomechanical properties. This systematic review evaluates the reliability of MyotonPro across various muscles for diagnostic purposes. Materials and Methods: Following PRISMA guidelines, a comprehensive literature search was conducted in Medline (PubMed), Ovid (Med), Epistemonikos, Embase, Cochrane Library, Clinical trials.gov, and the WHO International Clinical Trials platform. Studies assessing the reliability of MyotonPro across different muscles were included. A methodological quality assessment was performed using established tools, and reviewers independently conducted data extraction. Statistical analysis involved summarizing intra-rater and inter-rater reliability measures across muscles. Results: A total of 48 studies assessing 31 muscles were included in the systematic review. The intra-rater and inter-rater reliability were consistently high for parameters such as frequency and stiffness in muscles of the lower and upper extremities, as well as other muscle groups. Despite methodological heterogeneity and limited data on specific parameters, MyotonPro demonstrated promising reliability for diagnostic purposes across diverse patient populations. Conclusions: The findings suggest the potential of MyotonPro in clinical assessments for accurate diagnosis, treatment planning, and monitoring of muscle properties. Further research is needed to address limitations and enhance the applicability of MyotonPro in clinical practice. Reliable muscle assessments are crucial for optimizing treatment outcomes and improving patient care in various healthcare settings.
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Affiliation(s)
- Jonathan Lettner
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Tytusa Chalubinskiego 3, 50-368 Wroclaw, Poland;
| | - Nikolai Ramadanov
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Łukasz Oleksy
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Michałowskiego 12, 31-126 Krakow, Poland
- Department of Orthopaedics, Traumatology and Hand Surgery, Faculty of Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Hassan Tarek Hakam
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School, Hochstraße 29, 14770 Brandenburg an der Havel, Germany; (J.L.)
- Faculty of Health Science, Brandenburg Medical School, 14770 Brandenburg an der Havel, Germany
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Scavarelli NT, Sanzo P. The Immediate Effects of Dry Cupping the Lumbar Paraspinals on Range of Motion and Temperature. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2024; 17:551-564. [PMID: 38665683 PMCID: PMC11042842 DOI: 10.70252/ucsb1713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/15/2025]
Abstract
Dry cupping is a therapeutic modality proposed to produce a negative pressure, stretching the skin and underlying tissue. This mechanism is said to promote regional blood flow of oxygenated blood and causing a physiological stretch in the tissue, allowing it to elongate and potentially changing skin temperature. The possible effects of the application to the lumbar spine paraspinal muscles, however, has not been thoroughly examined. The purpose of this pilot study was to explore the immediate effects of dry cupping the lumbar paraspinals on lumbar spine range of motion (ROM) and overlying skin temperature. 30 healthy individuals aged 18-30 years completed the study. The dry cupping was placed on the lumbar paraspinal muscles for 10-minutes. Two plastic cups were placed on the bilateral paraspinals muscles at L1 and L5. Lumbar spine flexion ROM and skin temperature were measured pre- and post-intervention. Descriptive statistics and paired sample t-tests were used to analyze the data (p < .05). There was a statistically significant increase in lumbar spine flexion ROM measured with the Sit and Reach Test, t(29) = 12.62 p = 0.001; d = 2.34, and inclinometry, t(29) = 11.10, p = 0.001; d = 3.86, with a large effect size. There was also a statistically significant decrease in the skin temperature of the lumbar spine paraspinals, t(29) = -2.23, p = 0.034; d = 0.75, with a medium effect size, post-intervention. Dry cupping may be an effective strategy to increase lumbar spine ROM and decrease stiffness, promote recovery, and reduce functional limitations. Future research may examine the difference in effectiveness of static compared to dynamic cupping in a symptomatic population.
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Affiliation(s)
| | - Paolo Sanzo
- Department of Kinesiology, Lakehead University, Thunder Bay, Ontario, CANADA
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Vatovec R, Voglar M. Changes of trunk muscle stiffness in individuals with low back pain: a systematic review with meta-analysis. BMC Musculoskelet Disord 2024; 25:155. [PMID: 38373986 PMCID: PMC10875766 DOI: 10.1186/s12891-024-07241-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Low back pain (LBP) is one of the most common musculoskeletal conditions. People with LBP often display changes of neuromuscular control and trunk mechanical properties, including trunk stiffness. Although a few individual studies have examined back muscle stiffness in individuals with LBP, a synthesis of the evidence appears to be lacking. Therefore, the aim of this systematic review with meta-analysis was to synthesize and evaluate the available literature investigating back muscle stiffness in association with LBP. METHODS We conducted a systematic review of the literature according to the PRISMA guidelines. We searched Pubmed, Scopus, Web of Science and ScienceDirect for studies, that compared back muscle stiffness, measured either by ultrasound-based elastography or myotonometry, between individuals with and without LBP. Pooled data of the included studies were presented descriptively. Additionally, we performed two meta-analyses to calculate the standardized mean difference between the two groups for resting stiffness of the multifidus and erector spinae muscle. For both meta-analyses, the random effect model was used and the weight of individual studies was calculated using the inverse-variance method. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional studies. Furthermore, the certainty of evidence was evaluated using the GRADE approach. RESULTS Nine studies were included in our systematic review. Our results suggest that individuals with LBP have higher stiffness of the multifidus (SMD = 0.48, 95% CI: 0.15 - 0.81, p < 0.01; I2 = 48 %, p = 0.11) and erector spinae at rest (SMD = 0.37, 95% CI: 0.11 - 0.62, p < 0.01; I2 = 39 %, p = 0.14) compared to asymptomatic controls. On the other hand, the evidence regarding muscle stiffness during submaximal contractions is somewhat contradictory. CONCLUSIONS Based on the findings of this systematic review we conclude that people with LBP may have higher back muscle stiffness compared to asymptomatic controls. Addressing muscle stiffness might represent an important goal of LBP treatment. Nevertheless, our findings should be interpreted with extreme caution due to a limited quality of evidence, small number of included studies and differences in measurement methodology.
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Affiliation(s)
- Rok Vatovec
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310, Izola, Slovenia
| | - Matej Voglar
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310, Izola, Slovenia.
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Assessing reliability and validity of different stiffness measurement tools on a multi-layered phantom tissue model. Sci Rep 2023; 13:815. [PMID: 36646734 PMCID: PMC9842673 DOI: 10.1038/s41598-023-27742-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023] Open
Abstract
Changes in the mechanical properties (i.e., stiffness) of soft tissues have been linked to musculoskeletal disorders, pain conditions, and cancer biology, leading to a rising demand for diagnostic methods. Despite the general availability of different stiffness measurement tools, it is unclear as to which are best suited for different tissue types and the related measurement depths. The study aimed to compare different stiffness measurement tools' (SMT) reliability on a multi-layered phantom tissue model (MPTM). A polyurethane MPTM simulated the four layers of the thoracolumbar region: cutis (CUT), subcutaneous connective tissue (SCT), fascia profunda (FPR), and erector spinae (ERS), with varying stiffness parameters. Evaluated stiffness measurement tools included Shore Durometer, Semi-Electronic Tissue Compliance Meter (STCM), IndentoPRO, MyotonPRO, and ultrasound imaging. Measurements were made by two independent, blinded examiners. Shore Durometer, STCM, IndentoPRO, and MyotonPRO reliably detected stiffness changes in three of the four MPTM layers, but not in the thin (1 mm thick) layer simulating FPR. With ultrasound imaging, only stiffness changes in layers thicker than 3 mm could be measured reliably. Significant correlations ranging from 0.70 to 0.98 (all p < 0.01) were found. The interrater reliability ranged from good to excellent (ICC(2,2) = 0.75-0.98). The results are encouraging for researchers and clinical practitioners as the investigated stiffness measurement tools are easy-to-use and comparatively affordable.
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Asymmetries of the Muscle Mechanical Properties of the Pelvic Floor in Nulliparous and Multiparous Women, and Men: A Cross-Sectional Study. Symmetry (Basel) 2022. [DOI: 10.3390/sym14102124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aimed to identify if the muscle mechanical properties (MMPs) of both sides of pelvic floor muscles (PFMs) are symmetrical in different populations of both sexes. Between-sides comparisons of MMPs of PFMs, assessed with manual myotonometry, were performed in three groups, with 31 subjects each, composed of healthy nulliparous women (without any type of delivery or pregnancy), multiparous women (with at least two vaginal deliveries), and healthy adult men. Intra-group correlations between MMPs and age, body mass index (BMI), or clinical state of pelvic floor were also obtained. The nulliparous women and the men showed no between-sides differences in any MMP of PFMs. However, the multiparous women showed that the right side displayed less frequency (−0.65 Hz, 95% CI = −1.01, −0.20) and decrement (0.5, 95% CI = 0.11, 0.01), and more relaxation (1.00 ms, 95% CI = 0.47, 1.54) and creep (0.07 De, 95% CI = 0.03, 0.11), than the left side. Further, MMPs were related to age, sex, and BMI, also depending on the population, with the multiparous women being the only group with some between-sides asymmetries, which in this case were positive and of fair intensity for the left side of the PFMs, between BMI, and frequency and stiffness (rho Spearman coefficient: 0.365 and 0.366, respectively). The symmetry of MMPs of the PFMs could depend on the subject’s condition. Multiparous women show a higher tendency to asymmetries than nulliparous women and men, which should be considered in research and clinical settings.
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