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PubMed2005

Long-term electromyographic activity in upper trapezius and low back muscles of women with moderate physical activity.

The habitual activity patterns of trapezius and postural back muscles (multifidus, iliocostalis, longissimus) of 23 female subjects with moderate physical activity were studied. Bilateral surface electromyographic (sEMG) recordings from start of work until bedtime were analyzed. The activity level was calibrated as percentage of root mean square-detected muscle activity at maximal voluntary contraction (EMG(max)). Sixty-six previous trapezius recordings of women with moderate physical activity were included in some analyses to pursue the full range of variation in trapezius activity. Twenty-six of these were recorded twice, separated by 16-28 mo. Median activity level and duration of periods with sEMG activity of <0.5% EMG(max) ("rest time"; only trapezius) and exceeding 2 ("burst time"), 10, 30, and 50% EMG(max) was determined. The trapezius median activity level ranged from 0.6 to 8.8% EMG(max), burst time from 9 to 84%, and rest time from 2 to 84%. The activity patterns of the back muscles showed similar large interindividual variation. Repeated trapezius recordings of the same subject showed high consistency; intraclass correlation coefficients ranged from 0.62 to 0.79 for different sEMG variables. Periods with high sEMG amplitude were of short duration; 7% of the trapezius recordings did not present time intervals (0.2-s duration) above 50% EMG(max). The activity patterns of the postural muscles, despite large interindividual variability, were distinctly different from activity patterns of upper and lower limb muscles reported by others (e.g., mean burst time 40-50 vs. 10-20%). We conclude that postural trunk muscles show idiosyncratic activity patterns with large interindividual variation. High-threshold motor units are activated to a very minor extent.

Activities of Daily Living↗
PubMed2004

Longer static flexion duration elicits a neuromuscular disorder in the lumbar spine.

The objective of this study was to assess the impact of two sequential long, static, anterior lumbar flexions on the development of a neuromuscular disorder and to compare it with previously obtained data from a series of short static flexion periods of the same cumulative time (Sbriccoli P, Solomonow M, Zhou BH, Baratta RV, Lu Y, Zhu MP, and Burger EL, Muscle Nerve 29: 300-308, 2004). Static flexions with loads of 20, 40, and 60 N were applied to the lumbar spine over two 30-min periods with a 10-min rest in between. The reflex EMG activity from the multifidus muscles and supraspinous ligament displacement (creep) was recorded during the flexion periods. Creep and EMG were also monitored over 7 h of rest following the work-rest-work cycle. It was found that the creep that developed in the first 30-min flexion period did not recover completely during the following 10 min of rest, giving rise to a large cumulative creep at the end of the work-rest-work session. Spasms were frequently seen within the EMG during the static flexion. Initial and delayed hyperexcitabilities were observed in all of the preparations at any of the three loads explored during the 7-h rest period. ANOVA revealed a significant effect of time (P < 0.0001) on the postloading data. Larger loads elicited larger magnitudes of the initial and delayed hyperexcitabilities, yet were not statistically different. It was concluded that the 3:1 work-to-rest duration ratio resulted in a neuromuscular disorder, regardless of the load magnitude. The conclusions are reinforced in view of the results from a previous study using 60 min of flexion overall but at 1:1 work-to-rest ratio in which only the highest load elicited a delayed hyperexcitability (Sbriccoli et al., Muscle Nerve 29: 300-308, 2004). An optimal dose-to-duration ratio needs to be established to limit, attenuate, or prevent the adverse effects of static load on the lumbar spine while considering the loading duration as a major risk factor.

Animals↗
PubMed1983

Analysis of vertebral muscle obtained during surgery for correction of a lumbar disc disorder.

Biopsies of erector spinae (sacrospinalis) and multifidus muscles were taken, in a precise manner, adjacent to lumbar vertebra 5, from 18 patients aged 28-73, suffering from acute lumbar disc disorders. The respective muscle fiber characteristics were assessed histologically and histochemically using ATPase and NADH staining procedures. A 'strength factor' component was developed for each muscle by combining measurements of fiber area and fiber type, to introduce a functional indication of force. No obvious signs of muscle pathology were evident histologically or histochemically. While a large difference in muscle characteristics may exist on opposite sides of the vertebral column in individual subjects, these differences do not appear to be related to the side of the disc protrusion. It is therefore suggested that muscle obtained from patients suffering from disc protrusion can be used as representative of normal muscle.

Adult↗
PubMed1978

Notalgia paresthetica.

Notalgia paresthetica was described by Astwazaturow in 1934. We have seen six cases in the past year, suggesting that it is not rare. This sensory neuritis affects the posterior rami of several spinal nerves (arising from thoracic segments T2 to T6), causing pruritus, burning, and dysesthesias. Examination reveals hypesthesia. Although the cause is not known, the course seems benign. The posterior rami of these five dorsal roots traverse a 90-degree course through the multifidus spinae muscle, making them unique among the posterior rami.

Adult↗
PubMed2004

Back pain and disability after lumbar laminectomy: is there a relationship to muscle retraction?

OBJECTIVE: Preliminary studies have suggested that prolonged retraction of the paraspinal muscle during spinal surgery may produce ischemic damage. We report the continuous measurement of intramuscular pressure (IMP) during decompressive lumbar laminectomy and its relationship to subsequent back pain and disability. METHODS: Twenty patients undergoing two-level decompressive lumbar laminectomy for lumbar canal stenosis were recruited. Back pain and disability were assessed by use of the Visual Analog Score (VAS), Oswestry Disability Index (ODI), and Short-Form 36 (SF-36) Health Survey. During surgery, IMP was recorded continuously from the multifidus muscle by use of a pressure transducer. The intramuscular perfusion pressure (IPP) was estimated as the difference between the patient's mean arterial pressure and IMP. RESULTS: Two muscle retractors were used: the Norfolk and Norwich (n = 10) and the McCulloch (n = 10). The mean duration of deep muscle retraction was 62.7 +/- 8 minutes (range, 19-133 min). On application of deep muscle retraction, there was a rapid and sustained increase in IMP (P < 0.001), and overall, the calculated mean IPP approached 0 mm Hg or less during this period (P < 0.001). On release of deep muscle retraction, there was a rapid decrease in IMP to preoperative levels. The IPP was greater with the Norfolk and Norwich than the McCulloch retractor (P < 0.001). Compared with preoperative values, there was a decrease in ODI (P < 0.001) and VAS for back pain (P < 0.001) at discharge and 4 to 6 weeks and 6 months after surgery. In addition, there was a decrease in SF-36 scores at 6 months compared with preoperative values (P < 0.001). Total duration of muscle retraction greater than 60 minutes was associated with worse VAS scores for back pain and ODI and SF-36 scores for disability at 6 months after surgery (P < 0.05). There was no relationship between the VAS, ODI, and SF-36 scores and other parameters measured, including the mean IPP, retractor type, operating surgeon, and wound length. CONCLUSION: The McCulloch retractor generates a higher IMP than the Norfolk and Norwich retractor. However, postoperative improvement in VAS, ODI, and SF-36 scores in these patients was associated with a shorter duration of muscle retraction and not the degree of IMP or IPP generated. In this respect, periodic relaxation of the paraspinal muscle retractors during surgery to allow muscle perfusion may help to reduce postoperative back pain and disability.

Adult↗
PubMed2001

Epaxial muscle function in trotting dogs.

One of the features that distinguish mammals from other groups of terrestrial vertebrates is the structure and relative size of their epaxial muscles. Yet we have only a superficial understanding of the role these muscles play in locomotion. To address their locomotor function, we recorded the electrical activity of the iliocostalis, longissimus dorsi and multifidus muscles of trotting dogs. Activity was monitored at both lumbar and thoracic sites. To develop and evaluate hypotheses of epaxial muscle function, we quantified footfall patterns and sagittal trunk kinematics from high-speed videos, and the magnitude and orientation of ground reaction forces from force-plate recordings. All three epaxial muscles tended to exhibit a double-bursting (biphasic) activity pattern, with the exception of the iliocostalis muscle at the thoracic site (which was uniphasic). In general, a large burst of activity in each muscle occurred during the second half of the support phase of the ipsilateral hindlimb, and was active for an average of 30% of the locomotor cycle. A smaller burst of activity occurred during the second half of the support phase of the contralateral hindlimb, and was active for an average of 15% of the locomotor cycle. Analysis of ground reaction forces and sagittal trunk kinematics led us to the hypothesis that the epaxial muscles do not directly stabilize the trunk against the vertical and horizontal components of the ground reaction force. Instead, the epaxial muscles appear to counteract the tendency of the trunk to rebound (flex) in the sagittal plane during the latter half of the support phase. This hypothesis of epaxial muscle function was supported by loading experiments performed on the longissimus dorsi muscle in the lumbar region.

Animals↗
PubMed2005

Electromyographic functional analysis of the lumbar spinal muscles with low back pain.

The lumbar paraspinal muscles were examined by surface electromyography (EMG) in 22 patients with low back pain and 22 healthy volunteers. Surface electrodes were placed bilaterally on the lumbar multifidus and longissimus muscles at the level of the spinous process of the third lumbar vertebra. Kinesiologic EMG was recorded, in standing resting position, during the following trunk motions: trunk forward flexion and extension, lateral bending and axial rotation. No muscular activity was observed in the full trunk flexion position in the control group. In contrast, continuous muscle activity was observed in the low back pain group. On axial rotation, an intermuscular time lag was observed at the beginning of the motion in the control group. In the low back pain group, there was no such time lag. Paraspinal muscle activities restricted lumbar range of motion, and protect from injury for movement. This suggests their role as stabilizers.

Adult↗
PubMed1983

Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders.

The physiologic replacement of the lower paraspinal muscles by fat was evaluated in 157 patients undergoing computed tomography for reasons unrelated to abnormalities of the locomotor system. Five patients with neuromuscular disorders were similarly evaluated. The changes were graded according to severity at three spinal levels: lower thoracic-upper lumbar, midlumbar, and lumbosacral. The results were analyzed in relation to age and gender. It was found that fatty replacement of paraspinal muscles is a normal age-progressive phenomenon most prominent in females. It progresses down the spine, being most advanced in the lumbosacral region. The severest changes in the five patients with neuromuscular disorders (three with poliomyelitis and two with progressive muscular dystrophy) consisted of complete muscle group replacement by fat. In postpoliomyelitis atrophy, the distribution was typically asymmetric and sometimes lacked clinical correlation. In muscular dystrophy, fatty replacement was symmetric, showing relative sparing of the psoas and multifidus muscles. In patients with neuromuscular diseases, computed tomography of muscles may be helpful in planning a better rehabilitation regimen.

Adipose Tissue↗
PubMed1998

Altered abdominal muscle recruitment in patients with chronic back pain following a specific exercise intervention.

The efficacy of specific exercise interventions that advocate training the co-contraction of the deep abdominal muscles with lumbar multifidus for treating chronic back pain conditions has not been tested. A randomized controlled trial involving 42 subjects with a specific chronic back pain condition investigated whether this form of intervention results in changes to the ratio of activation of the internal oblique relative to the rectus abdominis. Data were collected before and after the intervention, using surface electromyography, while subjects performed different abdominal maneuvers. Subjects were randomly allocated to either a specific exercise group or control group. Following intervention, the specific exercise group showed a significant (p < 0.05) increase in the ratio of activation of the internal oblique relative to the rectus abdominis. The control group showed no significant change. The study findings provide evidence that the conscious and automatic patterns of abdominal muscle activation can be altered by specific exercise interventions.

Abdominal Muscles↗
PubMed2006

Lumbopelvic kinematics and trunk muscle activity during sitting on stable and unstable surfaces.

STUDY DESIGN: A single-group comparative study. OBJECTIVES: To compare lumbopelvic kinematics and muscle activation patterns while sitting on stable and unstable surfaces. BACKGROUND: Unstable surfaces are commonly used during the rehabilitation of certain low back pain disorders. The benefits postulated are increased muscle activity and facilitation of sustainable midrange positions via neuromuscular control. The use of unstable sitting devices in the workplace is controversial, as the postulated increase in muscle activity is thought to lead to a muscle fatigue/pain response. However, little evidence exists for or against the ability of these devices to alleviate or prevent spinal pain. METHODS AND MEASURES: This study included 26 healthy adults (14 male, 12 female). Fastrak 3-dimensional motion analysis detected lumbar curvature, pelvic tilt, and postural sway during sitting on a stable and unstable surface over 5-minute periods. Surface electromyography was used to measure activity in the superficial lumbar multifidus, transverse fibers of internal oblique, and iliocostalis lumborum pars thoracis. RESULTS: Spinal postures were similar for sitting on a stable and unstable surface. Significant increases in postural sway were detected (P = .013) in 3 dimensions of movement during sitting on an unstable surface. Gender differences were noted. No EMG amplitude or variance differences were detected between seating conditions. CONCLUSIONS: Preliminary data show that sitting on unstable surfaces induces greater spinal motion, but does not significantly alter the lumbosacral posture nor the amount of activity in the superficial trunk muscles under investigation.

Adult↗
PubMed2002

Evaluating the point of separation, during carcass fabrication, between the beef wholesale rib and the beef wholesale chuck.

This study determined whether there is a logical point of value change, related to either tenderness or consumer acceptance, at which to separate the beef carcass within the rib/chuck region. Rib/chuck rolls (RCR); (n = 30) consisting of the ribeye roll and chuck eye roll subprimals (2nd through 12th rib locations) were cut into 22 steaks each (two steaks per rib location), and Warner-Bratzler shear force and consumer purchase preference were evaluated for steaks at each rib location. Steaks from different locations of the RCR were composed of differing proportions of several muscles: longissimus muscle (LM), spinalis dorsi and multifidus dorsi (SM), and complexus (CO). The LM (4th to 12th rib) contained three tenderness regions: 7th through 12th rib, 5th and 6th ribs, and 4th rib regions (lowest, intermediate, and highest shear force values, respectively; P < 0.01). Shear force differed (P < 0.05) among rib locations for the SM (2nd to 9th rib), but no logical pattern was evident. The CO (2nd to 7th rib) was more tender toward the anterior end (P < 0.05). The region of the RCR represented by the 4th through 6th rib locations had steaks with higher weighted-average shear force (average shear force of each steak, weighted for surface area of each muscle) values than the remainder of the RCR (P < 0.05). Animal-to-animal variation in shear force was 36% greater than rib-to-rib variation in shear force; thus, statistically significant differences in tenderness among rib locations may be undetectable by consumers. Steaks (n = 330) were offered for sale at a retail supermarket and case time was monitored on each steak to determine consumer purchase preference. Steaks from the 2nd through 4th rib locations required more time to sell (P < 0.01) than steaks from the 5th through 12th rib locations. Two alternative locations for the rib/chuck separation point could be between the 6th and 7th ribs, yielding a ribeye subprimal useful in marketing a "premium quality" product, or between the 4th and 5th ribs, which would yield four more 2.5-cm ribeye steaks per carcass.

Animals↗
PubMed2002

A new technique for exposure of the cervical spine laminae. Technical note.

The author describes a new technique for exposure of the cervical spine laminae in which the attachments of the semispinalis cervicis and multifidus muscles to the spinous processes are left untouched. It provides a conservative exposure through which a diverse range of posterior cervical surgeries can be performed. In contrast to conventional cervical approaches, none of the muscular attachments to the spinous processes is compromised. In this paper the author describes the technical details and discusses the applications of the procedure.

Cervical Vertebrae↗
PubMed1976

The lumbosacral dorsal rami of the cat.

The lumbosacral dorsal rami of the cat were studied by gross dissection. The L1-6 dorsal rami form three discrete branches - lateral, intermediate and medial. The lateral branches supply the iliocostalis lumborum and become cutaneous over the back. The intermediate branches ramify in the longissimus lumborum, and are separated from the lateral branches by the lumbar intermuscular septum. The medial branches supply the multifidus and have a constant branch - the nerve to intertransversarii mediales. The L7 dorsal ramus forms only medial and intermediate branches. The S1 and S2 dorsal rami form three branches, the middle of which form the ascending sacral trunk and accessory ascending sacral trunk. The ascending sacral trunk is derived from S1 and S2, the accessory ascending sacral trunk from S2. Both nerves are the exclusive nerve supply of lumbococcygeus.

Animals↗
PubMedDate not supplied

Lumbosacral interspinous ligament rupture associated with acute intrinsic spinal muscle degeneration.

OBJECTIVE: To demonstrate lumbosacral interspinous ligament rupture, with or without related paraspinal muscle degeneration. SUBJECTS AND METHODS: This study consisted of a prospective imaging analysis of 100 consecutive MRI studies in adult patients (mean age: 56 years) presenting with low back pain. Alterations from the normal in the inter- and perispinal structures of the spine and perispinal soft tissues (e.g. spinal ligaments, perispinal muscles) were sought based upon studies on young volunteers without low back pain (n = 10; mean age: 23 years). RESULTS: Compared to the group without low back pain, many index cases (n = 71: 71%) demonstrated hyperintensity (i.e., sprain or frank ligamentous rupture) of the interspinous ligament(s) on T2-weighted, fat suppressed MRI studies at one (n = 20/71:28%) or multiple (n = 51/71:72%) levels. Associated paraspinal muscle (e.g., interspinalis, multifidus muscles) degeneration was observed in a minority of cases overall (n = 7: 7%), but was only seen in association with cases also demonstrating interspinous ligament degeneration/rupture (n = 7/71:10%). CONCLUSION: Lumbosacral interspinous ligament sprain or frank rupture, as well as related acute-subacute autotraumatic paraspinal muscle rupture/degeneration, may be overlooked by many observers if fat suppressed, T2-weighted MRI is not acquired. These musculoligamentous alterations are on occasion the only abnormalities recognized on MRI of the lumbosacral spine and may theoretically be sources of low back morbidity that potentially may respond to specific therapy. Because this study was an observational one, based solely upon medical imaging, future research must focus upon the correlation of the relevance of these findings with an age-matched asymptomatic control group and longitudinal clinicoradiologic therapeutic trials.

Case-Control Studies↗
PubMed2004

Effect of static stretch on fatigue of lumbar muscles induced by prolonged contraction.

Low back pain (LBP) is believed to be the result of fatigue of the back extensor muscles induced by prolonged contraction. Although static stretch has been considered to promote recovery from such muscle fatigue by relaxation, little is known about the effect of stretch on muscle fatigue, especially in the back extensor muscles. The purpose of this study was to investigate the effect of static stretch on prolonged contraction-inducedfatigue of the back extensor muscles using electromyographic (EMG) spectral analysis in ten healthy volunteers. Bipolar surface electrodes were placed on the longissimus and the multifidus muscles. EMG signals were collected during two trials of a Sorensen trunk-holding test for two minutes, with a five-minute rest period between the two trials (control test). All subjects were asked to perform the same trials, with one-minute of static stretch and a four-minute rest period (stretch test). Maintaining the knees toward the chest in supine position resulted in static stretch. The median frequency (MF) was calculated using a spectrum analysis program, and the MF slope over time was computed by linear regression analysis, and normalized with the y-intercept. The decreasing rate of the normalized MF slope between two trials in two tests was compared. The decreasing rate of the normalized MF slope of the second trial was larger than that of the first trial in the control test (p < 0.05), but no significant difference was observed in the stretch test. The results indicated that static stretch had a significant effect on the recovery from fatigue of the back extensor muscles, since it influenced the decreasing rate of the normalized MF slope.

Adult↗
PubMed2004

[Expression of neuronal nitric oxide synthase and inducible nitric oxide synthase in the erector spinal muscles in idiopathic scoliosis].

OBJECTIVE: To explore the possible mechanism of the erector spinal muscles in idiopathic scoliosis by comparing the expression and localization of neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS) of the thoracic erector spinal muscles on convex side and concave side. METHODS: The patient group comprised 8 females and 2 males who were scheduled for spinal surgery. The apex of scoliotic curve in these patients arose between T6 and T11. The mean age was 14.3 (range 12-17) years, and the mean Cobb angle was 57.7 degrees (range 45 degrees-85 degrees). Muscle biopsies were taken bilaterally during surgery from the superficial multifidus muscle at the apex of the curve between the 6th and 11th thoracic vertebral levels. Part of the tissue was fixed in formalin and stained with hematoxylin and eosin; the remaining tissue was snap frozen and processed for immunohistochemistry and Western blot. Immunocytochemistry for nNOS and iNOS were performed using the EnVision two-step method. Western blot was done with antibodys to nNOS and iNOS. Immunoreactive bands were visualized by enhanced chemiluminescence according to the manufacturer's specifications (Amersham Corp). RESULTS: nNOS protein in the erector spinal muscles was localized at the sarcolemma. Western blot demonstrated that nNOS protein expression in the concave side of erector spinal muscles is more than that in the convex side. A significant decrease in nNOS protein and activity was found on the convex side of erector spinal muscles from idiopathic scoliosis patients; There was a little immunoreactivity to iNOS in erector spinal muscles. There was little difference in iNOS protein expression between both sides of the curve. Western blot detected the same results. CONCLUSION: There is a greater expression of nNOS and iNOS on the concave side than on the convex side, suggesting nNOS and iNOS may play a role in the pathogenesis of idiopathic scoliosis.

Adolescent↗
PubMed2004

[Expression of calmodulin and nNOS in the paraspinal muscles in idiopathic scoliosis].

OBJECTIVE: The aim of this study was to identify whether one side of the apex of the scoliotic curve showed greater muscular abnormalities than the other. This investigation sought to compare directly the expression and localization of Calmodulin (CaM) and nNOS of the thoracic spinal musculature on convex side with those on the concave side in the scoliosis patients attending for spinal surgery. METHODS: The patient group comprised 8 females and 2 males, scheduled for spinal surgery, in whom the apex of the scoliotic curve arose between T6 and T11. Muscle biopsies were taken bilaterally during surgery from the superficial multifidus muscle at the apex of the curve between the 6th and 11th thoracic vertebral levels. Part of the tissue was fixed in Formalin and stained with hematoxylin and eosin; the remaining tissue was snap frozen and processed for immunohistochemistry and western blot. The following antibodies were used for the immunohistochemistry at dilutions optimized in preliminary experiments. Goat polyclonal anti-human-CaM and mouse monoclonal anti-human-nNOS were used as primary antibodies. CaM and nNOS were detected by immunohistochemical method and Western-blot. Western blotting was done with antibodies to CaM. RESULTS: Compared with control muscle and the muscle on the concave side of the scoliotic curve, A significant decrease in CaM and nNOS was found on the convex side of paraspinal muscle from idiopathic scoliosis patients, Western blotting with an CaM antibody and nNOS antibody shows that there are more CaM and nNOS protein in the concave side of paraspinal muscle in these patients with adolescent idiopathic scoliosis than in the convex side. CONCLUSION: This asymmetry of CaM and nNOS in the paraspinal muscle may play a role in the pathogenensis of IS.

Adolescent↗
PubMed2005

An ergonomics intervention program to prevent worker injuries in a metal autoparts factory.

An ergonomics intervention program (EIP) was conducted with male employees working in the pressing and storage sections of a metal autoparts factory in Samut Prakan Province, Thailand. The objectives of this study were to assess the causes of injuries in the pressing and storage sections of that factory, and to improve working conditions by reducing worker injuries from accidents and low back muscular discomfort, using an EIR The study design used a participatory research approach which was quasi-experimental with pretest-posttest evaluations, with a non-equivalent control group. A total of 172 male participants working in Building A were the target group for assessing causes of injury. A retrospective study of official accident information, and questionnaires for general information, health and muscular discomfort, injury frequency rate (IFR), injury severity rate (ISR), medical expenses, and EIP design. Two groups of employees volunteered for the study on muscular back discomfort. The first group of 35 persons volunteered to participate in the EIP (EIP group), and the second 17 persons from Building B did not (non-EIP group). The EIP was composed of 4 major categories: (1) engineering improvement, (2) change in personal protective equipment, (3) environmental improvement, (4) administrative intervention, training, and health education. Low back muscular discomfort was measured through questionnaires on subjective feelings of muscular discomfort, and by surface electromyography (sEMG). Muscle activities were measured by sEMG of the left and right erector spinae and multifidus muscles, and evaluated by multivariate test for dependent samples (paired observation), and multivariate test for two independent samples. After EIP, IFR decreased 65.46%, ISR decreased 41.02%, and medical expenses decreased 42.79%. The low back muscular loads of the EIP group were significantly reduced, with a 95% confidence level (p < 0.05) while those of the non-EIP group were not. Subjective feelings of muscular discomfort, determined by Wilcoxon Signed Ranks test, showed that after applying the EIP to the EIP group, the mean scores for general bodily discomfort and low back muscular discomfort in the EIP group had significantly reduced, while those of the non-EIP group increased, (p < 0.05).

Accidents, Occupational↗