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PubMed2003

Evidence for disseminated Mycoplasma fermentans in New Jersey residents with antecedent tick attachment and subsequent musculoskeletal symptoms.

Mycoplasma species are one of nature's most abundant groups of microbes. These bacteria inhabit a wide diversity of insect, plant, and animal species, including humans. Certain mycoplasma species have been identified in blood-sucking arthropods, including Ixodes ticks. Frequent human exposure to this genus of ticks led us to explore the possibility of tick-mediated transmission of these bacteria. We evaluated 7 residents of central New Jersey who developed fatigue, musculoskeletal symptoms, and cognitive disturbance after tick attachment. All 7 of these patients lacked both serological evidence and erythema migrans skin lesions characteristic of Lyme disease. We were able to amplify and quantitate Mycoplasma fermentans-specific DNA from their peripheral blood lymphocytes. After antimicrobial therapy, symptoms subsided, and M. fermentans DNA could no longer be detected in their blood specimens. These findings suggest that a subset of disseminated M. fermentans infections may be a vector-mediated process in humans and should be considered in patients with puzzling musculoskeletal presentations.

Journal Article↗
PubMed1998

Epidemiology of musculoskeletal disorders due to biomechanical overload.

The link between occupation and musculoskeletal disorders has been focused on in numerous research projects, ranging from those simply observing the different pathological findings reported among workers performing particular tasks, down to the latest studies actually quantifying the 'exposure' of workers to physical and psychosocial stimuli. For some disorders and certain tissues, it has been reported that specific types of work-related exposure are associated with the development of musculoskeletal pathologies, and that the relative risks for certain types of occupational exposure can be extremely high. This has been proven in relation to tendinitis of the shoulder and hand-wrist, carpal tunnel syndrome, as well as several localized aspecific musculoskeletal symptoms, such as pain. For other pathologies, the studies reported contradictory results. This is the case for lateral epicondylitis and cervical radiculopathy.

Biomechanical Phenomena↗
PubMed2006

Use of intrathecal baclofen in a child with spastic paraparesis related to human immunodeficiency virus infection: A case report.

This case report describes a 2-year treatment course of a 6-year-old with spastic paraparesis due to human immunodeficiency virus (HIV) encephalopathy. She continued to develop worsening musculoskeletal problems and a decline in mobility despite aggressive antispasticity interventions. In addition to meeting the usual clinical criteria for treatment with continuous intrathecal baclofen (ITB), she was believed to be an appropriate candidate for ITB because of adequate treatment of her HIV infection and associated overall low risk of mortality. For over 12 months, she has been successfully treated with ITB and has not developed any complications related to her HIV infection. To my knowledge, this is the first reported successful treatment of spasticity with ITB in a patient with stable HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Thyroid dysfunction and rheumatic diseases.

Musculoskeletal symptoms developing during the treatment of thyroid disease were studied in 150 patients; 17 developed a symptom complex of early morning stiffness together with shoulder girdle pain and weakness; similar symptoms were seen in only 3 of 100 controls. A prospective study of 16 patients with recent onset rheumatoid arthritis followed during the first 6 months of penicillamine therapy showed no changes in thyroid function tests. It is suggested that changing or abnormal thyroid status may precipitate or exacerbate musculoskeletal disease. Finally, in a retrospective study of 26 patients with both thyroid disease and rheumatoid arthritis, 4 patients had a simultaneous onset of both myxoedema and rheumatoid arthritis, the activity of which was greatly improved by correction of the hypothyroid state.

Adolescent↗
PubMed1996

Musculoskeletal adaptations to weightlessness and development of effective countermeasures.

A Research Roundtable, organized by the American College of Sports Medicine with sponsorship from the National Aeronautics and Space Administration, met in November 1995 to define research strategies for effective exercise countermeasures to weightlessness. Exercise was considered both independently of, and in conjunction with, other therapeutic modalities (e.g., pharmacological nutritional, hormonal, and growth-related factors) that could prevent or minimize the structural and functional deficits involving skeletal muscle and bone in response to chronic exposure to weightlessness, as well as return to Earth baseline function if a degree of loss is inevitable. Musculoskeletal deficits and countermeasures are described with respect to: 1) muscle and connective tissue atrophy and localized bone loss, 2) reductions in motor performance, 3) potential proneness to injury of hard and soft tissues, and 4) probable interaction between muscle atrophy and cardiovascular alterations that contribute to the postural hypotension observed immediately upon return from space flight. In spite of a variety of countermeasure protocols utilized previously involving largely endurance types of exercise, there is presently no activity-specific countermeasure(s) that adequately prevent or reduce musculoskeletal deficiencies. It seems apparent that countermeasure exercises that have a greater resistance element, as compared to endurance activities, may prove beneficial to the musculoskeletal system. Many questions remain for scientific investigation to identify efficacious countermeasure protocols, which will be imperative with the emerging era of long-term space flight.

Adaptation, Physiological↗
PubMed2007

Pinch forces and instrument tip forces during periodontal scaling.

BACKGROUND: The prevalence of upper-extremity musculoskeletal disorders, such as tendinitis, is elevated among dental practitioners. An important risk factor for these disorders is forceful pinching; however, the pinch forces and instrument forces during scaling are unknown. METHODS: Six dentists and six senior-year dental students were recruited to use an instrumented periodontal scaler to perform their usual dental scaling work on patients. Thumb pinch force was measured by a pressure sensor, whereas the forces developed at the instrument tip were measured by a six-axis load cell. RESULTS: Dental students applied greater mean peak pinch force (35.7 +/- 3.8 N) compared to dentists (24.5 +/- 4.1 N) (P = 0.001). On the other hand, the peak forces generated at the instrument tip, which were directly related to the productivity of the dental scaling task, were higher among the dentists. The application of pinch force by dentists was related to the required scaling forces, whereas students applied excessive pinch force to the tools. CONCLUSIONS: Increased experience in periodontal scaling leads to the application of less pinch force to accomplish scaling. Nonetheless, the applied peak pinch forces in both groups are high and may pose a risk for the development of musculoskeletal disorders of the distal upper extremity.

Adult↗
PubMed2004

Musculoskeletal pain in polio survivors and strength-matched controls.

OBJECTIVES: To determine whether a significant difference exists between musculoskeletal symptoms of polio survivors and those of older adults with no history of polio, and to determine if activity level and strength predict pain in either group. DESIGN: Matched research design. SETTING: A research laboratory in a rehabilitation setting. PARTICIPANTS: Fifty-four polio survivors and 54 adults with no history of polio were matched for gender, race, and bilateral knee extensor strength and selected from a cohort of 316 subjects who participated in a study on the relation between activity level and health status. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Location and severity of musculoskeletal pain, activity frequency and intensity level, maximum voluntary isometric strength, and physical performance measures. RESULTS: Polio survivors reported significantly more symptoms than the matched controls ( P <.05). Symptom status among the polio survivors was strongly associated with performance strain, perceived exertion, and activity intensity. Although the polio survivors had activity frequencies and habitual walking speeds that were similar to those from the matched controls, there was evidence that they performed activities at higher intensity levels. CONCLUSIONS: Activity level is a factor in the development of musculoskeletal symptoms in polio survivors. Polio survivors who perform at higher intensity levels are more likely to have moderate to severe pain and more mobility difficulties.

Aged↗
PubMed2005

[Role of provisionality principle in realization of phylembryogeneses].

The analysis of histogenesis of skeletogenic tissues and of organogenesis of the mesonephros and metanephros in higher mammalian animals and man, is presented. The new conception of provisionality is formulated, according to which embryonic primordium and/or its derivatives possess a determined capacity to form, on its course to definitive state, temporary structures (tissues or organs), which fulfil the vital functions in the developing organism and modeling the mechanisms of development and formation of structural and functional units or the whole organ at the level of definitive morphological substrate. Provisionality is regarded as the universal principle in realization of of phylembryogeneses.

Animals↗
PubMed1994

The impact of ergonomic intervention on individual health and corporate prosperity in a telecommunications environment.

This paper is a summary of several papers published in different journals and conference proceedings. The contents deal with the incidence of load related musculoskeletal illness of female workers exposed to various workloads. Furthermore, the changes in workload due to improved workplace design and the effect on the incidence of musculoskeletal illness was evaluated. The sick-leave due to musculoskeletal illness was reduced from 5.3% to 3.1% and the reduction in turn-over from 30.1% to 7.6%. The cost and the benefits of this ergonomic intervention were analysed, and showed that an investment of NOK. 350,000 produced total savings of NOK. 3,200,000. Postural load was assessed by recording electromyography (EMG) on the upper part of musculus trapezius, postural angles of the upper arm and flexion/extension of the head and back. A quantitative relationship was found between the static trapezius load and the development of musculoskeletal sick-leave, related to the length of employment. Indications were found that certain factors were associated with reduced incidence of musculoskeletal illness. These were: increasing the number and total duration of trapezius load below 1% to 2% MVC (Maximum Voluntary Contraction); reducing the magnitude of flexion angle of the upper arm in the sagittal plane and distributing the work between flexors and extensors; and a more dynamic work pattern of the upper arm. The relationship between postural load and musculoskeletal injury was studied in comparable groups of female workers with respect to age, working hours per day and time of employment. Psychosocial problems, spare time activities and living habits of the workers did not show any significant differences across the groups. The results from this study indicate that: the static trapezius load must be kept at a minimum; a median arm flexion should be less than 15 degrees and a median arm abduction less than 10 degrees. These values seem roughly to approach an acceptable arm position; and a forward median flexion of the back of less than 20 degrees seems not to lead to a higher rate of low back pain for workers with long periods of employment.

Biomechanical Phenomena↗
PubMed2004

Postural control in children: implications for pediatric practice.

Based on a systems theory of motor control, reactive postural control (RPA) and anticipatory postural control (APA) in children are reviewed from several perspectives in order to develop an evidence-based intervention strategy for improving postural control in children with limitations in motor function. Research on development of postural control, postural control in children with specific motor disabilities, and interventions to improve postural control is analyzed. A strategy for intervention to improve postural control systems at the impairment and functional activity levels based on a systems theoretical perspective is presented. Suggestions for research to improve evidence for best practice are provided.

Child↗
PubMed2002

Vibration-induced muscle fatigue, a possible contribution to musculoskeletal injury.

Localized muscle fatigue resulting from 30-min sustained and intermittent grip exertions of 5% maximal voluntary contraction (MVC) with and without hand-vibration exposure (10 Hz, 7 mm displacement amplitude) was investigated. Muscle fatigue was quantified by the magnitude of the twitch force elicited in the right flexor digitorum superficialis muscle of the long finger using the low-frequency fatigue (LFF) method. The influence of vibration in the sustained grip exertion condition exacerbates fatigue as seen with the reduction in twitch force 30-60 min post-work task. Intermittent low grip force exertion conditions with and without vibration exposure show negligible fatigue, suggesting the benefit of rest in the work cycle. Perception of muscle fatigue was dissociated from the objective measure of twitch force, suggesting that LFF was not perceived. The presence of LFF and the lack of perception of LFF may increase the risk for the development of musculoskeletal disorders. The findings of this study may apply to the design of the work cycles and tasks that require the use of vibratory tools.

Adult↗
PubMed1989

Risk factors in the psychosocial work environment for neck and shoulder pain in secretaries.

The relationship between psychologic work variables and reported neck and shoulder pain was examined among secretaries. A battery of questionnaires concerning the experienced psychologic work environment as well as musculoskeletal pain symptoms was completed by 420 secretaries at a large medical center. A relatively "poor" psychologic work environment was compared with an environment that was experienced as "good." A "poorly" experienced psychologic work environment was related to a higher frequency of neck and shoulder pain. The relative risk for frequent neck pain was 2.85 (95% confidence interval 1.28 to 6.32) and for frequent shoulder pain 3.32 (95% confidence interval 1.53 to 7.23). Furthermore, the subindexes of work content and social support at work were found to be related to pain, whereas no clear relationship was found for work demands. The results of this study demonstrate the possible importance of the psychologic work environment in the development of musculoskeletal pain disorders. Future investigations should replicate these findings as well as isolate specific mechanisms so that preventive measures may be instituted.

Adult↗
PubMed1999

Physical therapy in a peacekeeping operation: Operation Joint Endeavor/Operation Joint Guard.

This article describes the deployment and utilization of physical therapy services at a combat support hospital during a recent peacekeeping mission in Bosnia. Approximately 17% of all soldiers reporting to the 21st Combat Support Hospital were evaluated and treated by physical therapy. Physical therapy services provided musculoskeletal evaluations, developed field-expedient rehabilitative programs for the deployed soldiers, and provided injury prevention programs for the peace implementation and sustainment forces. Physical therapy helped to provide a high return to duty status and a low rate of air evacuation for deployed troops. The lessons learned from this deployment can help clarify the role of physical therapy in future support operations and sustainment operations.

Bosnia and Herzegovina↗
PubMed2000

Neuroimaging of chronic pain: phantom limb and musculoskeletal pain.

New developments in brain imaging lead to a better understanding of cortical and subcortical processes involved in pain perception and the establishment of chronic pain. For different forms of chronic pain long-term changes in cortical structures have been described. In patients with phantom limb pain and back pain alterations in the somatotopic organization of the primary somatosensory (SI) could be observed. The amount of this reorganization is correlated with the subjective pain rating. These changes, which are based on processes of neuronal plasticity, can partially be reversed by analgesic interventions. For the investigation of cortical processes concerning reorganization, EEG and MEG methods are most suitable because of their high temporal and spatial resolution. In conclusion, these findings open a new way for therapeutic interventions to prevent the development of chronic pain.

Back Pain↗
PubMed1995

Methods and applications of stress research.

The major health problems in the industrialized countries have a multifactorial etiology, where stress and other psychosocial factors seem to play an important role. Mental stress is not only induced by high demands, but also by demands that are too low, which happens in many repetitive and monotonous work situations and, e.g., in response to unemployment. For a long time, musculoskeletal disorders were mainly considered to be caused by physical conditions. However, accumulating evidence from several sources now indicate that psychosocial factors are also significantly associated with, e.g., back pain and shoulder problems. Studies of assembly line workers with a high incidence of back pain complaints indicate that the physical load on the spine at work is low, whereas psychophysiological stress levels are high and work satisfaction is low. Female assembly workers were found to have higher physiological arousal than men in traditional assembly line work, whereas their stress levels were lower in a more flexible and autonomous work organisation. In a recent laboratory experiment, both mental and physical stress was found to increase physiological stress levels and muscular tension. It was concluded, that data consistently support the assumption that mental stress is of importance for the development of musculoskeletal symptoms.

Adrenal Medulla↗
PubMed2005

Development of zebrafish (Danio rerio) pectoral fin musculature.

During posthatching development the fins of fishes undergo striking changes in both structure and function. In this article we examine the development of the pectoral fins from larval through adult life history stages in the zebrafish (Danio rerio), describing in detail their pectoral muscle morphology. We explore the development of muscle structure as a way to interpret the fins' role in locomotion. Genetic approaches in the zebrafish model are providing new tools for examining fin development and we take advantage of transgenic lines in which fluorescent protein is expressed in specific tissues to perform detailed three-dimensional, in vivo fin imaging. The fin musculature of larval zebrafish is organized into two thin sheets of fibers, an abductor and adductor, one on each side of an endoskeletal disk. Through the juvenile stage the number of muscle fibers increases and muscle sheets cleave into distinct muscle subdivisions as fibers orient to the developing fin skeleton. By the end of the juvenile period the pectoral girdle and fin muscles have reoriented to take on the adult organization. We find that this change in morphology is associated with a switch of fin function from activity during axial locomotion in larvae to use in swim initiation and maneuvering in adults. The examination of pectoral fins of the zebrafish highlights the yet to be explored diversity of fin structure and function in subadult developmental stages. J. Morphol. (c) 2005 Wiley-Liss, Inc.

Animals↗
PubMed2004

Upper body musculoskeletal symptoms in Sardinian dental students.

PURPOSE: The purpose of this study was to determine how early in a dental career musculoskeletal problems develop, by comparing the prevalence of such symptoms in a dental student population in Sardinia (Italy), a control sample of psychology students from the same university and a sample of dental students in Lebanon. METHODS: One hundred and fourteen dental students from the University of Cagliari (Cagliari, Sardinia, Italy) were surveyed by questionnaire about the presence of several upper body symptoms. Their responses were compared with those of 2 different populations: 114 psychology students from the same university, matched for age and sex, and 178 dental students from the University of Saint Joseph (Beirut, Lebanon). The psychology students were chosen for comparison because of the general dissimilarity of their daily activity to that of dentists. RESULTS: The Italian and Lebanese dental students did not differ with regard to presence of symptoms. The Italian dental students differed from the psychology students in just one respect, with the dental students reporting more lower back pain. Headache was the most prevalent symptom in all 3 groups and was more prevalent among women; however, this difference between the sexes did not reach statistical significance for the psychology students. CONCLUSIONS: The appearance of musculoskeletal symptoms among dental students, even after a relatively short clinical training period, suggests that ergonomics should be covered in the educational system to reduce risks to dental practitioners.

Adolescent↗