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Biomedical subjects

H Vanharanta

Publications and source records attributed to H Vanharanta.

At least 55 records · Page 3Linked to original sources
PubMed1995

Pocket-size, portable surface EMG device in the differentiation of low back pain patients.

The relevance of surface EMG of the paraspinal muscles measured by a portable, pocket-size device with a special amplifier was evaluated in different low back pain groups. Patients with only local low back pain had significantly higher EMG activities than those with unilateral radiating pain without verified disc herniation, those with verified disc herniation, and controls, but there were no differences between the latter three groups. Pain clearly modified paravertebral muscle activity, as the patients experiencing pain during the recording showed significantly higher EMG activities than those with no pain. It is concluded that surface EMG is a valid tool for indirectly assessing pain in low back pain patients but not for classification into different diagnostic groups.

Adolescent↗
PubMed1995

Decreased isokinetic trunk muscle strength and performance in long-term survivors of childhood malignancies: correlation with hormonal defects.

OBJECTIVE: To evaluate trunk muscle strength and performance in long-term survivors of childhood malignancies relative to age and sex-matched controls, and to relate the muscle strength observations to the therapeutic agents used and possible hormonal disturbances. DESIGN: Age and sex-matched cohort study. SETTING: Referral center in the northern part of Finland. PATIENTS: Forty-six long-term survivors of childhood cancer. Mean age at examination 19.1 years and median off-therapy time 9.4 years. INTERVENTION: Isokinetic dynamometer testing. MAIN OUTCOME MEASURES: Measurements of trunk muscle peak torque (PT) and total work done (TWD) were performed at angle speeds of 50 degrees/sec and 200 degrees/sec. The results were normalized relative to body fat-free weight (FFW). RESULTS: PT in the trunk muscles was lower in the patients at both angle speeds (mean normalized PT = 5.7Nm/kgFFW vs 7.6Nm/kgFFW for controls at 50 degrees/sec), as also was TWD except for extension TWD at the higher angle speed (mean normalized TWD = 59.9J/kgFFW vs 84.6J/kgFFW for controls at 200 degrees/sec). The normalized PT at 50 degrees/sec and TWD at 200 degrees/sec were lower in the males with testicular damage; also, low age at diagnosis correlated positively with muscle strength and performance. There were no differences in normalized PTs or TWDs between cranial radiation and non-radiation cases, or between growth-hormone-deficient and non-deficient cases, and the patients without cranial radiation or with normal growth hormone secretion still had lower normalized PTs and TWDs than the controls. CONCLUSIONS: Survivors of childhood malignancies have decreased maximal trunk muscle strength and performance. The etiology of this effect remains unclear, but young age at diagnosis, as well as serum testosterone levels in male survivors, evidently influence muscle strength and performance.

Adolescent↗
PubMed1995

Myotonia congenita: quantitation of different aspects of motor performance.

In order to quantitatively assess the motor performance characteristics of 14 patients with congenital myotonia, the reaction time, speed of movement, synergy of different muscle groups and accuracy were measured. The Human Performance Measurement/Basic Elements of Performance device was used for recordings. Warned simple and choice reaction times (SRT, CRT) were significantly longer in the myotonic patients than in the controls. SRTs, consisting of one constant visual stimulus followed by a single movement response of the upper extremities (patients vs. controls) were 218 +/- 48 ms (mean +/- SD) and 172 +/- 12 (p = 0.0038). In the lower extremities the corresponding results were 293 +/- 46 and 239 +/- 24 (p = 0.0018). 1-CRTs, consisting of the upper extremities response to one randomized light signal (patients vs. controls) were 265 +/- 45 and 218 +/- 26 (p = 0.0069), and those of the lower extremities 337 +/- 73 and 279 +/- 39 (p = 0.0107), respectively. 2-CRTs, consisting of two possible visual stimuli in randomized order followed by a movement response of the upper extremities (patients vs. controls), were 308 +/- 54 and 249 +/- 33 (p = 0.0018), and those of the lower extremities 387 /+- 53 and 323 /+- 46 (p = 0.0028), respectively. We did not find any significant difference between the patient and the control groups in speed of movement, synergy of different muscle groups or accuracy. Nor was any significant correlation between the motor performance disability and the disease severity found.

Adult↗
PubMed1994

Reported pain during lumbar discography as a function of anular ruptures and disc degeneration. A re-analysis of 833 discograms.

STUDY DESIGN: This re-analysis was based on 833 computed tomography/discograms collected from 306 candidates for back surgery. OBJECTIVES: The goal was to test the hypothesis that outer anular ruptures are the main determinant of the pain of discography. SUMMARY OF BACKGROUND DATA: Previous analyses indicated univariate associations of pain with disc degeneration and anular ruptures. METHODS: If present, pain was classified as "exact", "similar", or "dissimilar" reproduction of the previously experienced pain. For each disc, ruptures and degeneration were separately evaluated by a four-point scale. Multiple logistic regression with random effects was used in the analysis. RESULTS: Outer anular ruptures were the only predictor of the responses "similar" and "exact". General disc degeneration was the only predictor of the response "dissimilar". There was no effect modification due to gender, age, and spinal level. CONCLUSIONS: During discography, the outer anulus appears to be the origin of pain reproduction.

Adult↗
PubMed1994

Anthropometric variables, self-efficacy beliefs, and pain and disability ratings on the isokinetic performance of low back pain patients.

OBJECTIVES: This study investigated how age, sex, height, body weight, self-efficacy beliefs, pain, and subjective disability predict the performance of low back pain patients on an isokinetic trunk muscle test. METHODS: One hundred and five patients participated in the study. Dependent variables were isokinetic flexion and extension strength measured as total work done at speeds 50, 100, and 150 degrees/second. RESULTS: The anthropometric measures were poor predictors, height being the only significant one. Body weight and age were of no relevance for the performance. Subjective pain and disability had negative effects on the performance of men, but not of women. Self-efficacy beliefs, i.e., the patient's belief in his or her capability to endure physical activities, was the most powerful predictor. CONCLUSION: For the purpose of validation, standardization, and interpretation of isokinetic performance in low back pain patients, these factors should be taken into account.

Adult↗
PubMed1994

Collagens in the injured porcine intervertebral disc.

Spinal pain often is thought to be due to degeneration and mechanical failure of the intervertebral disc. Since the mechanical strength of the tissue depends on collagen fibers, the present study was designed to investigate the reactions in collagen metabolism after an experimentally induced disc injury. Five domestic pigs underwent an incision in the anterior part of the annulus fibrosus of disc L4-L5 through a retroperitoneal approach. The animals were killed 3 months postoperatively, and the injured discs and intact discs (controls) from different animals were removed for chemical analysis. Slices were cut from seven different parts across the disc. The concentration of total collagen (hydroxyproline [Hyp]), the activities of the two key enzymes in collagen biosynthesis (prolyl 4-hydroxylase [PH] and galactosylhydroxylysyl glucosyltransferase [GGT]), and the concentration of mature collagen crosslinks (hydroxypyridinium [HP]) were determined. In all experimental discs, the morphology had changed considerably: the nucleus pulposus was small, fibrous, and yellowish. The annular lamellar structure was partially destroyed and had been replaced by granulation tissue in the region of the injury. Large osteophytes had formed at the ventral edges of the vertebral bodies. In the nucleus pulposus, the Hyp concentration and the activities of PH and GGT were significantly increased, whereas the water content had decreased. The concentration of HP crosslinks was decreased in the anterior annulus fibrosus.

Animals↗
PubMed1994

Neural elements in the normal and experimentally injured porcine intervertebral disk.

There is increasing evidence that-back pain may originate from degenerated or damaged disks, even in the absence of disk herniation. For a study of the pattern of innervation in injured disks, the anterior part of the annulus fibrosus of a lumbar disk in 11 domestic pigs was incised with a scalpel through a retroperitoneal approach. The animals were killed 2 weeks, 1, 2, 3, and 5 months postoperatively, and the whole anterior annulus of each injured disk and corresponding tissue from intact animals were excised. Cryostat sections 20 microns thick were cut from the surface downward, fixed, and stained with different antisera. Antisera to neurofilament triplet protein (R39), protein gene product (PGP) 9.5 and synaptophysin were used as general neural markers. Antiserum to substance P (SP) and calcitonin gene-related peptide (CGRP) were used to localize nerves mainly of the sensory type, and C flanking peptide of neuropeptide Y (CPON) to visualize nerve fibers of the sympathetic type. It was observed that in the intact porcine disk, the outer and middle parts of the anterior annulus were innervated to a depth of 7 mm from the annular surface, but the innermost annular layers showed no immunoreactivity to any of the neural antibodies. Disk injury did not cause any major changes in the nerve topography of the wound area, even though there were granulation tissue and neovascularization in this area.

Animals↗
PubMed1994

Bony vibration stimulation: a new, non-invasive method for examining intradiscal pain.

Fifty-seven patients with low-back pain were evaluated immediately prior to a discography examination by means of an electrical tool which produced bony vibration to the lumbar spinal processes. The vibrator was composed of a standard electric toothbrush shaft (Braun) with a blunt head instead of the brush. The lumbar spinal processes were compressed one by one for a few seconds with this blunt, vibrating tool. The patient's pain experience provoked by vibration was compared with that from injections during discography. A good correlation was found between these two examinations when patients with previously operated backs and painful, prolapsed discs were excluded: sensitivity was 0.96 and specificity 0.72. Prolapsed, but discographically painful discs were always painless in the vibration examination. The local, non-invasive bony vibration stimulation test is an easy, quick, safe, inexpensive and reliable method for examining intradiscal pain.

Adult↗
PubMed1994

Expression of type I, III, and VI collagen mRNAs in experimentally injured porcine intervertebral disc.

Young domestic pigs were incised with a scalpel blade into the anterior part of annulus fibrosus of lumbar discs in order to study the reparative processes in the annulus fibrosus and the secondary reactions in the nucleus pulposus. Northern and slot-blot hybridizations were used to investigate type I, III, and VI collagen gene expression in the disc tissue. For this purpose a method for RNA isolation was modified so as to be applicable to the intervertebral disc, which has a low cell density and a high proteoglycan content in its extracellular matrix. The amount of total RNA was found to be very low, particularly in the nucleus pulposus. Intact RNA could be isolated from most parts of the injured discs, but only from the outer annulus of the control discs. Hybridizations showed that healing of the wound in the annulus fibrosus involves an increase in the synthesis of particularly type I and type III collagens. However, no changes in the collagen gene expression were detectable in the nucleus pulposus two weeks after the injury.

Animals↗
PubMed1994

The intervertebral disc: a biologically active tissue challenging therapy.

The primary role of intervertebral disc as the tissue related to low back pain was confirmed 60 years ago when disc prolapses were described. Recent studies are providing more information on what other types of changes in discs can cause low back pain and how pain and clinical findings are related to disc herniations. This differs greatly from what the scientific community has generally accepted in the past and so it is evident that the new knowledge will change both diagnostic and treatment procedures. These new studies give very little, if any, support to the old methods of physical medicine in treating back pain as being anything more than palliative. However, the increased understanding of how cartilaginous tissues maintain, lose, or even improve their loading capacity supports active, dynamic rehabilitation which has led to good clinical results.

Animals↗
PubMed1994

Proteoglycan chemistry in experimentally injured porcine intervertebral disk.

An animal model of disk degeneration was used to study the concentration levels and types of proteoglycans in the different parts of the intervertebral disk. An annular incision was made with a scalpel blade into the anterior part of the porcine lumbar intervertebral disks via a retroperitoneal approach. Three months after injury the morphology of the injured disk had changed considerably. Disk height was diminished, and in the injured segment osteophytes had formed at the ventral edges of the vertebral body. The nucleus was small, fibrous, and yellowish. The annular lesion had healed by formation of granulation tissue, but the lamellar structure was partially destroyed. The concentration of inorganic [35S]sulfate had decreased across the whole disk, reflecting a decrease in the rate of solute transport. The concentration of incorporated [35S]sulfate had also decreased in the injured disks. The DNA concentration in the anterior annulus and in the nucleus had increased, whereas both the concentration of uronic acid and the ratio of chondroitin-6-sulfate to chondroitin-4-sulfate in the nucleus had decreased. Agarose gel electrophoresis combined with chondroitinase B digestion suggested the presence of dermatan sulfate proteoglycans in the injured annulus fibrosus. The morphology and chemical composition of the disks adjacent to the injured one were normal, and only a slight increase in the concentration of incorporated [35S]sulfate was observed in the disks above the injured one.

Animals↗
PubMed1994

+Gz-related neck pain: a follow-up study.

This epidemiologic study was aimed at detecting determinants of acute inflight neck pain. It followed a cohort of 66 student fighter pilots from 1 to 3 years. These pilots were frequently exposed to high +Gz forces. The number of flight hours, strenuousness of work, job satisfaction, symptoms suggesting psychologic distress, smoking habits, and the frequency of muscle strength, muscle endurance, and aerobic training were investigated by questionnaires at the beginning and end of the follow-up period. Physical examination, consisting of measurement of height, body weight, body mass index, head and neck circumference, passive cervical range of motion, grip strength, and isometric strength of neck muscles was done only at the beginning of the study. The cumulative incidence of acute inflight neck pain was 37.9%. The number of flight hours was found to be the only significant determinant of acute inflight neck pain.

Acute Disease↗
PubMed1994

Cervical disk bulges in fighter pilots.

This paper reports three cases of bulging cervical disks among fighter pilots flying high-performance aircraft who experienced acute in-flight neck pain during aerial combat maneuvers under high +Gz forces. Radiographic investigations (magnetic resonance imaging/computed tomography/myelography) revealed that disk bulges were the cause of the pain. One pilot underwent decompressive surgery, and two were treated conservatively. Acute in-flight neck pain and related problems, such as bulging cervical disks, may become more common, since the modern fighter aircraft of the future will be better able to create and sustain high +Gz forces than the fighter aircraft in use today. Further, the increasing number of helmet-mounted devices will make flight helmets heavier, thus placing increased stress on cervical structures.

Adult↗
PubMed1993

The relationship of facet tropism to degenerative disc disease.

The role of facet tropism (asymmetry) in the pathogenesis of degenerative disc disease is unknown, and several conflicting reports have been published. We studied this association using CT/discography performed at 324 lumbar levels (108 patients). The stage of disc degeneration as well as the patient's pain response upon discographic injection were scored using a standardized protocol. The facet angles were measured directly from the axial CT/discographic images and defined, in each case, as the angle formed by the facet orientation with respect to the midsagittal plane. The facet tropism angle was defined as the difference between the left and right facet angles at each disc level. The mean and standard deviation (SD) of the tropism angles were calculated. From this calculation, each pair of facet joints was classified as symmetric (within 1 SD of the mean), moderately asymmetric (between 1 and 2 SD), or severely asymmetric (beyond 2 SD of the mean). There were no differences in degree of disc degeneration or pain response with respect to the facet tropism. The total facet angle was also studied. The total facet angle was greater at the more caudal levels. The total angle size was not associated, however, with disc degeneration or pain provocation. These findings do not support the hypothesis that there is an association between facet tropism and degenerative lumbar disc disease.

Adult↗
PubMed1993

Outcome of a multimodal treatment including intensive physical training of patients with chronic low back pain.

A comprehensive 4-week inpatient treatment including intensive physical training was evaluated in 194 chronic low back pain patients of whom 101 were working and 79 were on sick leave. Physical performance was assessed by measurements of spinal mobility, isometric trunk flexion and extension strength, and isokinetic lifting strength. Outcome was evaluated by a functional capacity index and work status changes reported at a 12-month follow-up. There was a 30-50% average increase in physical performance during treatment. At the 12-month follow-up the functional capacity index showed an average increase from 35.4 to 39.3 points (score range 24-48). At follow-up 28% of the sicklisted patients had returned to work and of those employed before treatment 14% were on sick leave. Associations between outcome and the improvement in physical measurements and their level at discharge were determined by stepwise multiple and logistic regression analyses. Among the physical measurements only increase in spinal mobility was associated with functional capacity index in women and return to work in both men and women at the 12-month follow-up. The overall results showed that intensive physical training and improved physical performance did not play crucial roles in the rehabilitation of chronic low back pain patients, at least when return to work was used as the outcome criterion.

Adult↗
PubMed1993

Determinants of +Gz-related neck pain: a preliminary survey.

The aim of the present study was to detect determinants of acute inflight neck pain in a cohort of 27 student fighter pilots frequently exposed to high +Gz forces. Strenuousness of work, job satisfaction, psychological distress, smoking habits, and frequency of muscle strength, muscle endurance, and aerobic training regimens were inquired about by questionnaire. Physical examination determined the subjects' height, body weight, body mass index, head and neck circumference, passive cervical range of motion, grip strength, and isometric strength of neck muscles. The frequency of muscle endurance training was the only possible determinant related to experienced acute inflight neck pain.

Acute Disease↗
PubMed1993

Degeneration of cervical intervertebral disks in fighter pilots frequently exposed to high +Gz forces.

This study investigated the occurrence and the degree of cervical disk degeneration among senior fighter pilots frequently exposed to high +Gz forces, compared with nonexposed controls matched for age and sex. A resistive magnetic resonance (MR) scanner operating at 0.1 T was used to image the cervical intervertebral disks. Sagittal MR images were obtained and disk degeneration was graded 0-6. Both the occurrence and the median degree of disk degeneration were greater among the pilots than among the controls. The greatest difference in the occurrence of disk degeneration (grades 1-6), which also reached statistical significance, was detected for the C3-4 disk: 88% among the fighter pilots and 64% among the controls, respectively. With respect to the moderate degenerative changes (grades 3 and 4) in the C3-4 disk, the difference in the occurrence (88% vs. 36%) was again statistically significant. There was no difference between the other disks. The median disk degeneration between the groups differed (2.0 vs. 1.0), the difference being the most remarkable (3.0 vs. 1.0) for the C3-4 disk. The differences in the median disk degeneration were also statistically significant. These findings suggest that frequent exposure to high +Gz forces may cause premature disk degeneration.

Adult↗