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Biomedical subjects

G T Allison

Publications and source records attributed to G T Allison.

At least 19 recordsLinked to original sources
PubMed2006

Critical differences in lateral X-rays with and without a diagnosis of plantar fasciitis.

Plantar fasciitis is a clinical diagnosis and is often combined with some form of imaging to validate the diagnosis. The clinical utility of lateral X-rays lies in the fact that they are relatively inexpensive and may contribute to ruling out other osseous causes of pain. In this study 106 (27 plantar fasciitis (PF) and 79 controls) plain non-weight bearing lateral X-rays were examined by a blind examiner to document the key features of the lateral X-ray between images of individuals with and without plantar fasciitis. As expected calcaneal spurs were observed in both groups (85% PF and 46% controls). However, plantar fascia thickness and fat pad abnormalities resulted in the best group differentiation (p<0.0001) with sensitivity of 85% and specificity of 95% for plantar fasciitis. It was concluded that the key radiological features that differentiate the groups were not spurs but rather changes in the soft tissues. If it is deemed necessary to confirm the diagnosis of typical plantar fasciitis with imaging, a lateral non-weight bearing X-ray should be the first choice investigation especially if these key features are noted.

Adult↗
PubMed2006

Treatment of plantar fasciitis by LowDye taping and iontophoresis: short term results of a double blinded, randomised, placebo controlled clinical trial of dexamethasone and acetic acid.

OBJECTIVES: To determine if, in the short term, acetic acid and dexamethasone iontophoresis combined with LowDye (low-Dye) taping are effective in treating the symptoms of plantar fasciitis. METHODS: A double blinded, randomised, placebo controlled trial of 31 patients with medial calcaneal origin plantar fasciitis recruited from three sports medicine clinics. All subjects received six treatments of iontophoresis to the site of maximum tenderness on the plantar aspect of the foot over a period of two weeks, continuous LowDye taping during this time, and instructions on stretching exercises for the gastrocnemius/soleus. They received 0.4% dexamethasone, placebo (0.9% NaCl), or 5% acetic acid. Stiffness and pain were recorded at the initial session, the end of six treatments, and the follow up at four weeks. RESULTS: Data for 42 feet from 31 subjects were used in the study. After the treatment phase, all groups showed significant improvements in morning pain, average pain, and morning stiffness. However for morning pain, the acetic acid/taping group showed a significantly greater improvement than the dexamethasone/taping intervention. At the follow up, the treatment effect of acetic acid/taping and dexamethasone/taping remained significant for symptoms of pain. In contrast, only acetic acid maintained treatment effect for stiffness symptoms compared with placebo (p = 0.031) and dexamethasone. CONCLUSIONS: Six treatments of acetic acid iontophoresis combined with taping gave greater relief from stiffness symptoms than, and equivalent relief from pain symptoms to, treatment with dexamethasone/taping. For the best clinical results at four weeks, taping combined with acetic acid is the preferred treatment option compared with taping combined with dexamethasone or saline iontophoresis.

Acetic Acid↗
PubMed2006

Effects of abdominal muscle fatigue on anticipatory postural adjustments associated with arm raising.

Anticipatory postural adjustments (APAs) are postulated to ameliorate the effects of the disturbance to posture caused by voluntary movement. The primary hypothesis tested in our study was that the magnitude of anticipatory trunk muscle activity is altered by abdominal muscle fatigue. A subsidiary aim of the present study was to examine the directional nature of APAs and use this information to elucidate the central or peripheral nature of changes in postural muscle activity associated with abdominal muscle fatigue. The present study was a within subject design, where abdominal muscle fatigue was induced by a static abdominal curl. Surface EMG was used to assess postural muscle activity in the following trunk muscles; rectus abdominis, erector spinae and internal oblique. Following abdominal muscle fatigue, the magnitude of muscle activity during APAs was significantly reduced by 20% in both the rectus abdominis (fatigued muscle) and the erector spinae (not fatigued) indicating a central rather than peripheral fatigue effect on muscle activity. Abdominal muscle fatigue also induced a 30% increase in the baseline muscle activity of the internal oblique. The changes in magnitude of APA muscle activity may reflect a change in system gain or a change in postural control perhaps related to a change in perceived postural stability. An increase in baseline muscle activity in the internal oblique may compensate partially for the reduction in APAs.

Abdominal Muscles↗
PubMed2004

Non-surgical management of ankle contracture following acquired brain injury.

BACKGROUND AND PURPOSE: The purpose of this study was to document the outcome of non-surgical management of equinovarus ankle contracture in a cohort of patients with acquired brain injury admitted to a specialist Neurosurgical Rehabilitation Unit. METHODS: This prospective descriptive study examined all patients with a new diagnosis of moderate to severe acquired brain injury (Glasgow Coma Scale score </=12) admitted for rehabilitation over a 1 year period. Ankle dorsiflexion range and plantarflexor/invertor muscle activity were evaluated weekly during the period of hospitalization. Contracture was defined as maximal passive range of motion </= 0 degrees dorsiflexion, with the knee extended, on a minimum of two measurement occasions. Patients were retrospectively allocated to one of four treatment outcome categories according to ankle dorsiflexion range, type of intervention required and response to treatment. RESULTS: Ankle contracture was identified in 40 of the 105 patients studied. Contracture resolved with a standard physiotherapy treatment programme, including prolonged weight-bearing stretches and motor re-education, in 23 patients. Contracture persisted or worsened in 17 of 40 cases, all of whom exhibited dystonic muscle overactivity producing sustained equinovarus posturing. Ten of 17 cases required serial plaster casting (+/- injection of botulinum toxin type A) in order to achieve a functional range of ankle motion. Remediation of ankle contracture was not considered a priority in the remaining seven patients due to the severity of their overall disability. CONCLUSION: The incidence of ankle contracture identified in this population was considerably less than previously reported. Reduced dorsiflexion range was remediated with standard physiotherapy treatment in over half of the cases. Additional treatment with serial casting +/- botulinum toxin type-A injection was required to correct persistent or worsening contracture in one quarter of cases. Dystonic extensor muscle overactivity was a major contributor to persistent or progressive ankle contracture.

Adolescent↗
PubMed2003

Velocity dependent passive plantarflexor resistive torque in patients with acquired brain injury.

OBJECTIVES: This study sought to determine whether factors other than stretch reflex excitability contribute to velocity dependent passive plantarflexor resistive torque following brain injury. BACKGROUND: In patients with acquired brain injury increased resistance to passive muscle lengthening commonly results from abnormal muscle contraction, secondary to disinhibition of descending motor pathways, in addition to rheologic changes within the musculo-tendinous unit. Hyper-excitable tonic stretch reflex responses (spasticity) have traditionally been considered to be the main factor influencing resistance that is velocity dependent. METHODS: Ten adults with brain injury and eighteen age matched controls were studied. A computer controlled torque measurement system was utilised to evaluate resistance to dorsiflexion stretches at two velocities (5 degrees and 25 degrees s(-1)). Only stretches which did not evoke muscle contraction were included in the data analysis. The mean difference and 95% confidence limits in passive plantarflexor resistive torque at two stretch velocities, measured over a defined portion of the test movement, were compared between subject groups. RESULTS: A velocity dependent increase in passive plantarflexor resistive torque was evident when the ankle was dorsiflexed past the neutral position in both subjects with brain injury and controls. However, the mean difference was approximately 10 times greater in neurologically impaired limbs compared with control values. CONCLUSIONS: These data indicate that an important component of velocity dependent resistance to passive muscle lengthening in adults with brain injury can be mechanical, and unrelated to stretch induced reflex muscle contraction. RELEVANCE: Increased resistive torque during rapid muscle lengthening may represent a compensatory adaptation for reduced distal motor control following brain injury. A velocity dependent increase in passive plantarflexor resistive torque has the potential to improve stability during gait and provide mechanical resistance to sudden external perturbations.

Adult↗
PubMed2003

Trunk muscle onset detection technique for EMG signals with ECG artefact.

The timing of trunk muscle activation has become an important element in the understanding of human movement in normal and chronic low back pain populations. The detection of anticipatory postural adjustment via trunk muscle onsets from electromyographic (EMG) signals can be problematic due to baseline noise or electro-cardiac (ECG) artefact. Shewhart protocols or whole signal analyses may show different degrees of sensitivity under different conditions. Muscle activity onsets were determined from surface EMG of seven muscles for five trials before and after fatigue were examined in four subjects (n=280). The objective of this study was to examine two detection methods (Shewhart and integrated protocol (IP)) in determining the onsets of trunk muscles. The variability of the baseline amplitude and the impact of added Gaussian noise on the detected onsets were used to test for robustness. The results of this study demonstrate that before and after fatigue there is a large degree of baseline variance in the trunk muscles (coefficients of variation between 40-65%) between trials. This could be normal response to body sway. The IP method was less susceptible to false onsets (detecting onsets in the baseline window) 3 vs. 51%. The findings suggest the IP method is robust with large variance in the baseline if the signal to noise ratio is greater than six. In spite of the robustness of the algorithm, the findings would suggest that statistical assessments should be used to target trials for selective visual inspection for subtle trunk muscle onsets.

Abdominal Muscles↗
PubMed2003

Malondialdehyde oxidation of cartilage collagen by chondrocytes.

OBJECTIVE: The damage to cartilage collagen is a central event in the pathogenesis of cartilage aging and osteoarthritis (OA). We have previously developed an in vitro model of cartilage degradation which shows that chondrocyte-dependent lipid peroxidation mediates cartilage collagen degradation. The goal of our study was to investigate the role of vitamin C in this degradation model and to investigate effect of chondrocyte-dependent lipid peroxidation in the oxidation of cartilage collagen. METHODS: We studied primary articular chondrocytes. Effect of vitamin C was investigated in the previously described model. Serum-free stimulated and unstimulated chondrocyte-matrix extracts were subjected to SDS-PAGE and immunoblot analysis. Malondialdehyde (MDA)-protein oxidation of cartilage proteins was demonstrated by the reactivity of chondrocyte extracts to a monoclonal antibody, MDA2, which detects MDA-lysine adducts. RESULTS: Vitamin C treatment of chondrocyte cultures resulted in significant enhanced incorporation of 3H-proline label in cell-matrix. Cells treated with vitamin C, as compared to control untreated cells showed decreased spontaneous release of labeled matrix. Vitamin C treated or not treated chondrocytes responded comparably to stimulation with the agonist calcium ionophore A23187. The serum-free in vitro culture of chondrocytes resulted in MDA-protein oxidation. The treatment of chondrocytes with A23187 resulted in the enhancement of MDA-protein oxidation. The immunoblot reactivity pattern of extracts to MDA2 antibody and to polyclonal anti-type II collagen antibody was somewhat similar, which suggests that these two different types of antisera exhibit a crossreaction to chondrocyte proteins. Chondrocyte extracts were pretreated both with and without pure collagenase, and then subjected to immunoblot analysis. Only collagenase treated extracts showed a disappearance, or significant reduction, of larger than 60 kDa size MDA2 immunoreactive proteins. This suggests that the proteins that disappeared after the enzyme treatment were collagen proteins and which had also been modified by MDA oxidation. CONCLUSIONS: These observations suggest that collagen hydroxylation of matrix by vitamin C does not play a role in this model of chondrocyte-dependent collagen degradation. Also, this study demonstrates that chondrocyte-derived lipid peroxidation product MDA mediates oxidation of cartilage collagens. Oxidative modification of cartilage collagen in vivo could result in alteration of biochemical and biophysical properties of cartilage collagen fibrils, making them prone to degradation, thus initiating the changes observed in aging and OA.

Animals↗
PubMed2003

Evaluation of extensibility, passive torque and stretch reflex responses in triceps surae muscles following serial casting to correct spastic equinovarus deformity.

PRIMARY OBJECTIVE: Spastic equinovarus deformity of the ankle in adults with acquired brain injury can severely limit the achievement of rehabilitation goals. This study examined changes in triceps surae muscle extensibility, passive resistive torque and soleus stretch reflex responses in 10 adult brain injured subjects undergoing serial casting to correct ankle equinovarus deformity. METHOD: Goniometric measurement of maximal passive dorsiflexion was used to evaluate extensibility of the triceps surae muscles. Computer controlled ankle dynamometry and surface electromyography were used to identify passive resistive torque and soleus stretch reflex onset angle in response to stretches at two velocities. RESULTS: The mean casting period was 5 weeks. Casting was discontinued in one subject due to failure to achieve measurable gain in ankle range over three consecutive cast changes. Median improvements in maximal ankle dorsiflexion, with the knee flexed or extended, of 30 degrees and 15 degrees, respectively, were achieved in the remaining nine subjects (p < 0.0001). The median passive ankle range in response to a displacing torque of 10 Nm increased 4.3 degrees over the intervention period (p < 0.0001). Consistent soleus reflex activity in response to passive stretches at 25 degrees x s(-1) was elicited in only four subjects. A trend for the stretch reflex onset to move further into the available range was demonstrated in these subjects. CONCLUSION: In the present study, serial casting contributed to significant change in triceps surae extensibility and passive resistive torque, corresponding with improved maximal passive ankle dorsiflexion range and an increase in the angle achieved with a displacing torque of 10 N.m. Increased stretch reflex threshold was observed in some subjects. The use of pre-determined outcome criteria and careful measurement of responses to this intervention were important to prevent premature discontinuation of casting when gains were slower than expected.

Adolescent↗
PubMed2002

The influence of fatigue on trunk muscle responses to sudden arm movements, a pilot study.

OBJECTIVE: To examine fatigue induced changes in trunk muscle latencies following trunk muscle fatigue. DESIGN: A repeated measures within subject design.Background. Trunk muscle responses to sudden movements is of interest in clinical biomechanics and motor control. METHODS: Electromyographic profiles were recorded from transversus abdominis (finewire), internal oblique, rectus abdominis and external oblique and longissimus at the level of the 3rd lumbar vertebrae bilaterally. Four asymptomatic subjects performed arm-raising task using a visual cue before and after an isometric fatiguing trunk extension task. RESULTS: Feed-forward responses were not detected in all muscles for every trial. In general, following fatigue trunk muscle onset latencies occur earlier (left, P=0.0016; right, P=0.0475). CONCLUSIONS: Trunk muscle fatigue alters anticipatory postural adjustments in normal subjects. It remains unclear if there is a pattern for specific muscles changes between individuals and if these are reflected in individuals with low back pain. RELEVANCE: Trunk muscle fatigue and altered trunk muscles latencies to movement perturbations have been associated with low back pain. These findings suggest that there may be a link between centrally mediated response to isometric muscle fatigue and anticipatory motor control strategies.

Abdominal Muscles↗
PubMed2002

The relationship between EMG median frequency and low frequency band amplitude changes at different levels of muscle capacity.

OBJECTIVE: To test the validity of high and low frequency band amplitudes of the surface electromyography (EMG) profile as representation of muscle fatigue. DESIGN: A within subjects (n=10) repeated measures design was used to collect surface EMG signals from the biceps during an isometric contraction under two levels of fatigue status. BACKGROUND: The use of the shift in the median frequency of the surface EMG power spectrum is a well known method of assessing muscle fatigue. Fatigue also results in amplitude changes of the specific frequency bands. The use of frequency band analysis may be an alternative option for the assessment of muscle fatigue in specific experimental settings. METHODS: Surface EMG profiles of the biceps were recorded at 1024 Hz during a sustained isometric hold at 60% of the individuals fresh and fatigued maximal voluntary isometric torque. The median frequency of the power spectrum was compared with changes in the low frequency (15-45 Hz) and high frequency (>95 Hz) bands.Results. There was a close association between median frequency shift and the amplitude of the 15-45 Hz bandwidth and the high-low frequency amplitude ratio. The association was similar for performance under different muscle capacity states. CONCLUSIONS: Frequency band amplitude analysis provides similar information to median frequency shift under isometric conditions and may be suited to specific experimental protocols in workplace fatigue studies. RELEVANCE: The use of amplitude band analysis that closely approximates the standard median frequency changes allows greater possibility of assessing muscle fatigue in different experimental settings and the use of lower sampling rates.

Adult↗
PubMed2002

A randomized clinical trial of manual therapy for cervico-brachial pain syndrome -- a pilot study.

Cervico-brachial pain syndrome is an upper quarter pain condition in which mechanosensitive neural tissue is considered a primary feature. A single-blind randomized controlled trial was conducted to determine the clinical effect of two manual therapy interventions. Thirty subjects (20 females and 10 males) were randomly allocated to one of three groups - one of two manual therapy intervention groups or a control group. One manual therapy intervention group consisted of passive techniques aimed at mobilizing neural tissue structures and the cervical spine. The other involved indirect manual therapy techniques with a focus on articular components of the gleno-humeral joint and thoracic spine. The treatment period lasted 8 weeks in total and was combined with a home exercise programme. Following the 8-week baseline period the control group were crossed over into the specific neural tissue manual therapy group. Pain visual analogue scale (VAS), the short-form McGill pain and Northwick Park neck pain questionnaires were completed before, midway and after the treatment period. The findings suggest that both manual physiotherapy interventions combined with home exercises are effective in improving pain intensity, pain quality scores and functional disability levels. A group difference was observed for the VAS scores at 8 weeks with the neural manual therapy technique having a significantly lower score.

Adult↗
PubMed2001

Pain and muscular responses to a neural tissue provocation test in the upper limb.

Pain and muscular responses to a Neural Tissue Provocation Test with bias to median nerve were examined in 20 asymptomatic subjects. The test was performed on both arms with the cervical spine in a neutral position and in contralateral sideflexion as a sensitizing manoeuvre. The angle of elbow extension at the time of onset of pain and muscle activity in trapezius, biceps and triceps muscles was measured using an electrogoniometer. Muscle activity was recorded by surface electromyography. Results indicate that pain responses and muscle activity of trapezius are present in the majority of normal subjects. The onset of pain was highly reliable and compared favourably with detection of muscle activity onset. There was no significant difference of the angle of the elbow with the onset of pain between arms. Hence in patients with unilateral neck or upper limb pain a difference between sides might be indicative of a possible neural tissue involvement. Pain and muscular responses were influenced by the position of the cervical spine. This finding suggests that cervical contralateral sideflexion has a sensitizing effect on neural tissues. There was an association between the onset of pain and onset of trapezius muscle activity in all painful trials. However, muscle activity was also present in subjects with no pain.

Adult↗
PubMed2001

Trunk muscle fatigue during a back extension task in standing.

There is some evidence that the fatiguing characteristics during isometric back extension tasks may assist in identifying differences between individuals with and without low back pain (LBP). During these tasks, especially in standing, other abdominal trunk muscles are also active. The abdominal trunk muscles acting across multiple segments of the lumbar spine function in isolation or in synergy to create flexion torques. It is suggested that co-activation patterns of the trunk muscles are able to control the axis of rotation of the extension torque and also provide multi-segmental stability of the spine. The purpose of this study was to examine the fatigue responses in 4 asymptomatic individuals to a sustained isometric extension task of the trunk muscles evaluating the shifts in the median frequency of the electromyographic (EMG) signal. This study suggests that in asymptomatic subjects, the more superficial abdominal muscles (External Oblique and Rectus Abdominis) increased in activity as the test progressed. There was large inter-individual variation in both amplitude and median frequency changes. Rectus abdominis and the back extensors demonstrated characteristics of fatigue during the task. Studies to test for any characteristic trends in whether specific trunk muscles fatigue in standing is a feature in chronic LBP, invites a formal investigation.

Abdominal Muscles↗
PubMed2000

Evidence linking chondrocyte lipid peroxidation to cartilage matrix protein degradation. Possible role in cartilage aging and the pathogenesis of osteoarthritis.

Reactive oxygen species (ROS) are implicated in both cartilage aging and the pathogenesis of osteoarthritis. We developed an in vitro model to study the role of chondrocyte-derived ROS in cartilage matrix protein degradation. Matrix proteins in cultured primary articular chondrocytes were labeled with [(3)H]proline, and the washed cell matrix was returned to a serum-free balanced salt solution. Exposure to hydrogen peroxide resulted in oxidative damage to the cell matrix as established by monitoring the release of labeled material into the medium. Calcium ionophore treatment of chondrocytes, in a dose-dependent manner, significantly enhanced the release of labeled matrix, suggesting a chondrocyte-dependent mechanism of matrix degradation. Antioxidant enzymes such as catalase or superoxide dismutase did not influence matrix release by the calcium ionophore-activated chondrocytes. However, vitamin E, at physiological concentrations, significantly diminished the release of labeled matrix by activated chondrocytes. The fact that vitamin E is a chain-breaking antioxidant indicates that the mechanism of matrix degradation and release is mediated by the lipid peroxidation process. Lipid peroxidation was measured in chondrocytes loaded with cis-parinaric acid. Both resting and activated cells showed constitutive and enhanced levels of lipid peroxidation activity, which were significantly reduced in the presence of vitamin E. In an immunoblot analysis, malondialdehyde and hydroxynonenal adducts were observed in chondrocyte-matrix extracts, and the amount of adducts increased with calcium ionophore treatment. Furthermore, vitamin E diminished aldehyde-protein adduct formation in activated extracts, which suggests that vitamin E has an antioxidant role in preventing protein oxidation. This study provides in vitro evidence linking chondrocyte lipid peroxidation to cartilage matrix protein (collagen) oxidation and degradation and suggests that vitamin E has a preventive role. These observations indicate that chondrocyte lipid peroxidation may have a role in the pathogenesis of cartilage aging and osteoarthritis.

Aldehydes↗
PubMed2000

Peroneal latency in normal and injured ankles at varying angles of perturbation.

The aim of this study was to determine whether there was a difference in latency of the peroneus longus muscle at varying amplitudes of ankle inversion perturbation and between individuals with and without a history of ankle injury. Thirty-four male athletes from different football codes (soccer, rugby) received four random tilts to their left ankles at 5 degrees, 10 degrees, and 15 degrees in the frontal plane on a dual platform trap door. Peroneal latency was defined as the time difference between onset of the trap door movement, as detected by an accelerometer, and the onset of muscle activation above a resting baseline, as recorded using surface electromyography. Latency was determined using an algorithm. A series of repeated measures analyses of variance indicated that the latency was reliable between trials. There was no statistical evidence that history of injury or subjective ankle instability influenced the latency; however, there was a systematic difference between dominant and nondominant legs (dominant, 6.3 ms faster), and there was a small systematic effect (3 ms) for the angle of inversion perturbation. Muscle latency responses in male football players are thought to be influenced more by dominance than by history of injury or amplitude of perturbation.

Adolescent↗