Relationships between trunk muscle activation and thoraco-lumbar kinematics in non-specific chronic low back pain subgroups during a forward bending task

BACKGROUND

Trunk muscle activity and thoraco-lumbar kinematics can discriminate between non-specific chronic low back pain (NSCLBP) subgroups and healthy controls. However, research commonly focuses on lumbar kinematics, with limited understanding of relationships between kinematics and muscle activity across clinical subgroups. Similarly, the thoracic spine, whilst intuitively associated with NSCLBP, has received less attention and potential relationships between spinal regions and muscle activity requires exploration.

RESEARCH QUESTION

Is there a relationship between trunk muscle activation and regional thoracic and lumbar kinematics in NSCLBP subgroups during a forward bending task?

METHODS

Observational, case-control study. Fifty subgrouped NSCLBP motor control impairment participants (27 Flexion Pattern (FP-MCI), 23 Active Extension Pattern (AEP-MCI)) and 28 pain-free controls were evaluated using 3D motion analysis (Vicon™) and surface electromyography during a forward bending and return to upright task. Mean sagittal angles for the upper-thoracic (UTx), lower-thoracic (LTx), upper-lumbar (ULx) and lower-lumbar (LLx) regions were compared with normalised (% sub-maximal voluntary contraction) mean amplitude electromyography of bilateral transversus abdominis/internal oblique, external oblique, superficial lumbar multifidus and erector spinae (longissimus thoracis) muscles between groups. Pearson correlations were computed to assess relationships (significance p < 0.01).

RESULTS

AEP-MCI individuals demonstrated statistically significant relationships between superficial lumbar multifidus and ULx and LLx kinematics (-.812 to.659). FP-MCI individuals exhibited statistically significant relationships between erector spinae and superficial lumbar multifidus and LLx and LTx kinematics (-.686 to.664) in both task phases, and between external oblique and LTx during forward bending) (-.459 to.572). Correlations were moderate to strong for all significant relationships (-.812 to .664).

SIGNIFICANCE

Relationships between muscle activity and regional spinal kinematics varied between NSCLBP subgroups, suggesting that those with flexion- or extension-related LBP adopt different motor control strategies when performing a bending task. As effectively mechanical biomarkers, these findings may inform treatment by improving understanding of varied motor strategies in subgroups.

Investigating differences in trunk muscle activity in non-specific chronic low back pain subgroups and no-low back pain controls during functional tasks: a case-control study

BACKGROUND

Trunk muscle dysfunction is often regarded as a key feature of non-specific chronic low back pain (NSCLBP) despite being poorly understood and variable with increases, decreases and no change in muscle activity reported. Differences in thoraco-lumbar kinematics have been observed in motor control impairment NSCLBP subgroups (Flexion Pattern, Active Extension Pattern) during static postures and dynamic activities. However, potential differences in muscle activity during functional tasks has not been established in these subgroups to date.

METHODS

A case-control study design recruited 50 NSCLBP subjects (27 Flexion Pattern, 23 Active Extension Pattern) and 28 healthy individuals. Surface electromyography determined muscle activity during functional tasks: reaching upwards, step-down, step-up, lifting and replacing a box, stand-to-sit, sit-to-stand, bending to retrieve (and returning from retrieving) a pen from the floor. Normalised (% sub-maximal voluntary contraction) mean amplitude electromyography of bilateral musculature (transversus abdominis/internal oblique, external oblique, superficial lumbar multifidus and longissimus thoracis) was analysed using Kruskal-Wallis and post-hoc Mann-Whitney U tests.

RESULTS

Transversus abdominis/internal oblique activity was significantly increased in the Flexion Pattern group compared to controls during stand-to-sit (p = 0.009) on the left side only. External oblique activity was significantly greater in the Active Extension Pattern group compared to controls during box lift (p = 0.016) on the right side only. Significantly greater activity was identified in the right Superficial lumbar multifidus during step up (p = 0.029), reach up (p = 0.013) and box replace (p = 0.007) in the Active Extension Pattern group compared to controls. However left-sided superficial lumbar multifidus activity was significantly greater in the Flexion Pattern group (compared to controls) only during stand-to-sit (p = 0.009). No significant differences were observed in longissimus thoracis activity bilaterally during any task. No significant differences between NSCLBP subgroups were observed.

CONCLUSIONS

Muscle activity in these NSCLBP subgroups appears to be highly variable during functional tasks with no clear pattern of activity identified. The findings reflect inconsistencies and variability in trunk muscle activity previously observed in these NSCLBP subgroups. Further work evaluating ratios of muscle activity and changes in muscle activity throughout task duration is warranted.

Modificación Diluída de Colores en Ovinos Shetland y Ouessant

Ovinos de la raza Shetland mostraban vellones de varios colores, los cuales variaban de oscuro a claro en un grupo basado en el negro (negro, negro cálido, café oscuro, y estaño) y otro basado en café (café, café claro, miel). Los ovinos produjeron 257 crias. Entre los colores mas diluidos, apareamientos de miel con miel solamente produjeron crias de color miel. Parejas estaño por estaño solamente produjeron crias de miel o estaño. Estos dos colores diluidos apereados con colores más oscuros, produjeron varios colores que concuerdan con un sistema de dos loci. En el cual el negro es dominante sobre el café en un locus (B), y los colores diluidos fueron recesivos respectos a los colores completamente intensos en un segundo locus (Mod que significa Modificado). Ambos loci tienen algún grado de dominancia incompleta, que representa la gama completa de colores de vellóon. Los resultados de la raza Ouessant incluyeron 41 crías, todos de colores del grupo basado en el negro. Los resultados de Ouessant son similares a ellos de Shetland, e indican que el mecanismo para la dilución del color de los vellones ocurre en varias razas.

Comparison of gait, functional activities, and patient-reported outcome measures in patients with knee osteoarthritis and healthy adults using 3D motion analysis and activity monitoring: an exploratory case-control analysis

Objective

To examine functional performance differences using kinematic and kinetic analysis between participants with and without knee osteoarthritis (OA) to determine which outcomes best characterize persons with and without knee OA.

Methods

Participants with unilateral moderate knee OA (Kellgren–Lawrence grades 2 or 3) and controls without knee pain were matched for age, gender, and body mass index. Primary outcomes included temporal parameters, joint rotations and moments, and ground reaction forces assessed via 3D motion capture during walking and ascending/descending stairs. Secondary outcomes included timed functional activities (sit to stand; tying shoelaces), 48 hrs lower limb activity monitoring, and patient-reported outcome measures (Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, European Quality of Life–5 Dimensions).

Results

Eight matched pairs were analyzed. Compared with controls, OA participants exhibited significant reductions in peak frontal hip and sagittal knee moments, and decreased peak anterior ground reaction force with the affected limb while walking. Ascending stairs, OA participants had slower speed, fewer strides per minute, longer cycle and stance times, and increased trunk range of motion (ROM) in assessments of both limbs; longer swing time and reduced ankle ROM in the affected limb; and increased knee frontal ROM in the unaffected limb. Descending stairs, OA participants had fewer strides per minute and decreased trunk transverse ROM in assessments of both limbs; increased knee frontal ROM in the affected limb; and longer strides, shorter stance and cycle times, increased trunk sagittal and decreased knee transverse ROMs in the unaffected limbs vs controls. Compared with controls, OA participants had slower walking cadence (120–130 vs 100–110 steps/min, respectively), took significantly longer on timed functional measures, and had significantly worse scores in patient-reported outcomes.

Conclusion

Several objectives and patient-reported measures examined in this study could potentially be considered as outcomes in pharmacologic or physical therapy OA trials.

Intrasubject repeatability of in vivo intervertebral motion parameters using quantitative fluoroscopy

PURPOSE

In vivo quantification of intervertebral motion through imaging has progressed to a point where biomarkers for low back pain are emerging. This makes possible deeper study of the condition's biometrics. However, the measurement of change over time involves error. The purpose of this prospective investigation is to determine the intrasubject repeatability of six in vivo intervertebral motion parameters using quantitative fluoroscopy.

METHODS

Intrasubject reliability (ICC) and minimal detectable change (MDC) of baseline to 6-week follow-up measurements were calculated for six lumbar spine intervertebral motion parameters in 109 healthy volunteers. A standardised quantitative fluoroscopy (QF) protocol was used to provide measurements in the coronal and sagittal planes using both passive recumbent and active weight-bearing motion. Parameters were: intervertebral range of motion (IV-RoM), laxity, motion sharing inequality (MSI), motion sharing variability (MSV), flexion translation and anterior disc height change during flexion.

RESULTS

The best overall intrasubject reliability (ICC) and agreement (MDC) were for disc height (ICC 0.89, MDC 43%) and IV-RoM (ICC 0.96, MDC 60%), and the worst for MSV (ICC 0.04, MDC 408%). Laxity, MSI and translation had acceptable reliability (most ICCs > 0.60), but not agreement (MDC > 85%).

CONCLUSION

Disc height and IV-RoM measurement using QF could be considered for randomised trials, while laxity, MSI and translation could be considered for moderators, correlates or mediators of patient-reported outcomes. MSV had both poor reliability and agreement over 6 weeks. These slides can be retrieved under Electronic Supplementary Material.

Can different seating aids influence a sitting posture in healthy individuals and does gender matter?

This study determined differences in spinal-pelvic kinematics sitting on (i) mat (ii) block and (iii) novel 10º forward inclined wedge (Buttafly^TM) in a same-subject repeated measures cross-over design in 60 healthy individuals (34 females). Repeated measures ANOVA revealed statistically significant differences between sitting conditions and lumbar and pelvic sagittal angles. Both, the inclined wedge and the block seating aids reduced overall flexion, but the inclined wedge had a greater influence in the lumbar region whilst the block induced the greatest change in the pelvis. This may be relevant for seating aid design personalised to posture type. Statistically significant gender differences were identified in all 3 seating conditions with males adopting more flexed lumbar spine and posteriorly tilted pelvis. Females flexed less in thoracic spine when sitting on an inclined wedge and a block. These statistically significant differences between males and females may provide first explorative direction for bespoke seating aids design.

Non-specific chronic low back pain: differences in spinal kinematics in subgroups during functional tasks

PURPOSE

A multidimensional classification approach suggests that motor control impairment subgroups exist in non-specific chronic low back pain (NSCLBP). Differences in sitting lumbar posture have been identified between two such subgroups [flexion pattern (FP) and active extension pattern (AEP)] and healthy individuals; however, functional spinal movement has not been explored. This study will evaluate whether NSCLBP subgroups exhibit regional spinal kinematic differences, compared to healthy individuals, during functional tasks.

METHODS

Observational, cross-sectional study design. Spinal kinematics of 50 NSCLBP subjects (27 FP, 23 AEP) and 28 healthy individuals were investigated using 3D motion analysis (Vicon™) during functional tasks [reaching upwards, step down, step up, lifting, and replacing a box, stand-to-sit, sit-to-stand, bending to retrieve (and returning from retrieving) a pen from the floor]. Mean sagittal angle for the total thoracic, total lumbar, upper thoracic, lower thoracic, upper lumbar, and lower lumbar regions between groups was compared.

RESULTS

Significant differences were observed in lower thoracic and upper lumbar regions between NSCLBP subgroups during most tasks. Significant differences were observed between the FP and healthy group in the lower thoracic region during stand-to-sit-to-stand tasks and bending (and returning from) to retrieve a pen from the floor. All significant results demonstrated the FP group to operate in comparatively greater flexion.

CONCLUSIONS

The thoraco-lumbar spine discriminated between FP and AEP, and FP and healthy groups during functional tasks. FP individuals demonstrated more kyphotic thoraco-lumbar postures, which may be pain provocative. No significant differences were observed between AEP and healthy groups, suggesting that alternative mechanisms may occur in AEP.

Human growth factor receptor bound 14 binds the activated insulin receptor and alters the insulin-stimulated tyrosine phosphorylation levels of multiple proteins

To identify proteins interacting in the insulin-signaling pathway that might define new pathways or regulate existing ones, we have employed the yeast two-hybrid system. In a two-hybrid screen of a human liver cDNA library, we identified the human growth factor receptor bound 14 (hGrb14) adaptor protein as a partner of the activated insulin receptor. Additional analysis of the insulin receptor--hGrb14 interaction in the yeast two-hybrid system revealed that the SH2 domain of hGrb14 was not the sole region involved in binding the activated insulin receptor. The insulin-stimulated interaction between hGrb14 and the insulin receptor was also observed in different mammalian cultured cell lines. This association was detected at 1 min of insulin stimulation and was maximal at 10 nM and greater concentrations of insulin. Chinese hamster ovary cells stably expressing the insulin receptor (CHO-IR) and hGrb14 were used to examine the effects of hGrb14 overexpression on insulin-stimulated tyrosine phosphorylation of proteins; in general, increasing levels of hGrb14 expression resulted in a reduction in tyrosine phosphorylation. This decrease was demonstrated for the specific proteins src homology-containing and collagen-related protein (Shc), insulin receptor substrate-1 (IRS-1), and Downstream of tyrosine Kinase (Dok). The broad effects of hGrb14 overexpression on insulin-stimulated tyrosine phosphorylation suggest that it acts early in the insulin-signaling pathway.

Ultrastructural localization of CMPase, TPPase, and NADPase activity in neurons, satellite cells, and Schwann cells in frog dorsal root ganglia

Sections of bullfrog dorsal root ganglia were analyzed for cytidine monophosphatase (CMPase), thiamine pyrophosphatase (TPPase), and nicotinamide adenine dinucleotide phosphatase (NADPase) activity, and the distributions of these enzymatic activities were compared with those traditionally found in other cell types (e.g., CMPase: Golgi trans-sacculotubular network; TPPase: trans-Golgi saccule(s); NADPase: intermediate Golgi saccules). In the present study, CMPase activity in neurons was localized mainly to the Golgi trans-sacculotubular network and lysosomes, but sometimes also occurred at the ends of the trans and most distal intermediate Golgi saccules. A similar distribution was found in satellite and Schwann cells. TPPase activity in neurons occurred not only in the trans-Golgi saccule but also in the trans-sacculotubular network, lysosomes, and scattered tubular elements. In satellite and Schwann cells, activity was found in both the trans saccule and trans-sacculotubular network, and substantial activity often appeared in the more distal of the intermediate saccules. NADPase activity in neurons was usually absent from the intermediate Golgi saccules and was confined to the trans-sacculotubular network and lysosomes; however, activity was sometimes also found in the intermediate and/or trans-Golgi saccules. In satellite and Schwann cells, activity appeared consistently in both the trans-sacculotubular network and intermediate saccules, as well as in lysosomes. These distributions, especially in the case of TPPase and NADPase, differ substantially from the most frequently reported localizations of the above enzymes, indicating that the Golgi complex may exhibit considerable plasticity of structure and function in different cell types.

Presence of glycoproteins in the cell nucleus as shown by radioautographic studies after administration of [3H]fucose and [3H]galactose

Dorsal root ganglia were removed from adult bullfrogs and incubated with [3H]fucose for intervals from 15 min to 1 h, followed by fixation. Some ganglia were post-incubated in the absence of [3H]fucose for up to 17 h. In additional in vivo experiments, young frogs were injected with [3H]fucose, and killed 30 min or 1 h later, and then ganglia were removed and fixed. Electron microscope radioautographs of the ganglia revealed an intense radioautographic reaction over the nuclei of Schwann and satellite cells as early as 5 min after initial exposure to [3H]fucose. At time intervals up to 2 h after initial exposure to [3H]fucose, the silver grains were evenly distributed over both the periphery and internal regions of the nucleus, while at 18 h they were localized to the cell periphery. In occasional cells, the perinuclear space was expanded in some areas and was the site of reaction. In young rats, injected with [3H]galactose and killed 15 min to 5 h later, electron microscope radioautographs revealed heavy reaction over the nuclei of duodenal villous and crypt columnar cells, in which the grains were evenly distributed over both the peripheral and internal regions. In mitotic cells, grains appeared to be associated with the condensed chromatin of forming chromosomes. These results provide strong evidence that glycoproteins exist in the nuclei of the above cell types and that they are actively renewed. The rapid appearance of nuclear reaction after initial exposure to [3H]fucose or [3H]galactose indicates that either these sugars are added to glycoproteins within the nucleus itself or that they migrate rapidly to this site after having been glycosylated elsewhere.

Vanadium exposure enhances lipid peroxidation in the kidney of rats and mice

Vanadium (V) as sodium orthovanadate induces an increase in lipid peroxidation in the kidneys after a single subcutaneous or intraperitoneal injection to rats or mice. The rate of malondialdehyde (MDA) formation, an index of lipid peroxidation, by kidney homogenates increased by more than 100% 1 h after injection. Chronic exposure of rats to vanadium sulfate, initially through maternal milk and later in the drinking water, resulted after 10 weeks in a significant increase in MDA formation by kidney but not by other tissues. In both acute and chronic studies in rats and mice, no significant increase in lipid peroxidation by V treatment was detected in brain, heart, lung, spleen, or liver. In mice, administration of ascorbate prior to acute exposure to V diminished both toxicity, i.e., respiratory depression and limb paralysis, and the formation of MDA in kidney.