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At least 343 records · Page 19Linked to original sources
PubMed1998

The musculoskeletal complications of cystic fibrosis.

OBJECTIVE: To determine the spectrum of musculoskeletal complications of cystic fibrosis (CF) in a paediatric population in Australia. METHOD: Clinical assessment followed by serology and bone scan on patients attending a specialized CF clinic. RESULTS: Of 125 patients studied, 21 had musculoskeletal complications, 17 attributable to CF. Eleven had joint involvement (six hypertrophic pulmonary osteoarthropathy (HPOA)), one CF arthropathy, two ciprofloxacin induced arthralgia, one joint contracture following long-line placement, one chest infection associated arthralgia), four kyphosis (two also with HPOA) and two thoracic deformity. HPOA was associated with older age, lower average pulmonary function and lower average Shwachman score. Three patients with HPOA died within 12 months of reporting symptoms. Kyphosis was also associated with older age and lower pulmonary function. CONCLUSION: Increasing age with deteriorating clinical and pulmonary function were associated with a higher incidence of musculoskeletal involvement. The development of symptomatic HPOA is a marker of poor prognosis.

Adolescent↗
PubMedDate not supplied

Skeletal changes after burn injuries in an animal model.

Musculoskeletal deformities can develop after burn injuries. Seventy-five skeletally immature Sprague-Dawley rats were examined after infliction of full-thickness lower extremity scald burns to assess longitudinal growth, joint integrity, and bone composition. Longitudinal bone growth in the immediate postburn period was depressed. However, with the resumption of feeding and activity, normal growth ensued, unless the epiphyseal cartilage had been damaged by septic extension of the wound. Degenerative joint changes occurred in the burned limbs of six animals. Significant soft tissue contractures and collapse of the supporting subchondral bone were present in each of the affected knee joints. There was no evidence of joint sepsis. Large amounts of periosteal new bone consistently formed along the tibia beneath the burn wound. Sequential injections of fluorescent bone markers demonstrated that the stimulus for new bone formation corresponded with the presence of an open granulating burn wound. No further pathologic new bone formed after the wound had healed fully.

Animals↗
PubMed1992

Synovial sarcoma associated with osteofibrous dysplasia. A case report and review of the literature.

We report on a 14-year-old boy who demonstrated an unusual association between osteofibrous dysplasia and synovial sarcoma. This case suggests that a patient who presents with osteofibrous dysplasia of the tibia can eventually develop a malignant musculoskeletal tumor in the same anatomical location (same limb). This experience suggests that a patient who presents with osteofibrous dysplasia should be followed up for the possibility of a coexisting synovial sarcoma in the same leg.

Adolescent↗
PubMed2006

Anatomy and biomechanics of the back muscles in the lumbar spine with reference to biomechanical modeling.

STUDY DESIGN: This article describes the development of a musculoskeletal model of the human lumbar spine with focus on back muscles. It includes data from literature in a structured form. OBJECTIVE: To review the anatomy and biomechanics of the back muscles related to the lumbar spine with relevance for biomechanical modeling. SUMMARY OF BACKGROUND DATA: To reduce complexity, muscle units have been incorporated in an abridged manner, reducing their actions more or less to a single force equivalent. In early models of the lumbar spine, this may have been a necessary step to reduce complexity and, thereby, calculation time. The muscles of the spine are well described in the literature, but mainly qualitatively. Most of the literature provides a description of the structures without precise data of fiber length, muscle length, cross-sectional areas, moment arms, forces, etc. The predicted output of musculoskeletal models is very much dependent on the input parameters. The information needed to improve models consists of better approximations of the attachments to the vertebrae, and more precise data. METHOD: Review of literature. RESULTS: The predicted output of musculoskeletal models is very much dependent on the input parameters. Moderate changes in the assumed muscle line-of-action (i.e., moment arm) could substantially alter the magnitudes of predicted muscle and spinal forces, while the choice of optimization formulation is less sensitive. CONCLUSIONS: Input parameters, moment arms, as well as physiologic cross-sectional areas have a profound effect on the predicted muscle forces. Therefore, it is important to choose the values for moment arm and physiologic cross-sectional area carefully because they are essential input parameters to biomechanical models.

Back↗
PubMed2002

Evolution of behavior and neural control of the fast-start escape response.

The fast-start startle behavior is the primary mechanism of rapid escape in fishes and is a model system for examining neural circuit design and musculoskeletal function. To develop a dataset for evolutionary analysis of the startle response, the kinematics and muscle activity patterns of the fast-start were analyzed for four fish species at key branches in the phylogeny of vertebrates. Three of these species (Polypterus palmas, Lepisosteus osseus, and Amia calva) represent the base of the actinopterygian radiation. A fourth species (Oncorhynchus mykiss) provided data for a species in the central region of the teleost phylogeny. Using these data, we explored the evolution of this behavior within the phylogeny of vertebrates. To test the hypothesis that startle features are evolutionarily conservative, the variability of motor patterns and kinematics in fast-starts was described. Results show that the evolution of the startle behavior in fishes, and more broadly among vertebrates, is not conservative. The fast-start has undergone substantial change in suites of kinematics and electromyogram features, including the presence of either a one- or a two-stage kinematic response and change in the extent of bilateral muscle activity. Comparative methods were used to test the evolutionary hypothesis that changes in motor control are correlated with key differences in the kinematics and behavior of the fast-start. Significant evolutionary correlations were found between several motor pattern and behavioral characters. These results suggest that the startle neural circuit itself is not conservative. By tracing the evolution of motor pattern and kinematics on a phylogeny, it is shown that major changes in the neural circuit of the startle behavior occur at several levels in the phylogeny of vertebrates.

Animals↗
PubMed1998

Muscular resistance to varus and valgus loads at the elbow.

Although the contributions of passive structures to stability of the elbow have been well documented, the role of active muscular resistance of varus and valgus loads at the elbow remains unclear. We hypothesized that muscles: (1) can produce substantial varus and valgus moments about the elbow, and (2) are activated in response to sustained varus and valgus loading of the elbow. To test the first hypothesis, we developed a detailed musculoskeletal model to estimate the varus and valgus moment-generating capacity of the muscles about the elbow. To test the second hypothesis, we measured EMGs from 11 muscles in four subjects during a series of isometric tasks that included flexion, extension, varus, and valgus moments about the elbow. The EMG recordings were used as inputs to the elbow model to estimate the contributions of individual muscles to flexion-extension and varus-valgus moments. Analysis of the model revealed that nearly all of the muscles that cross the elbow are capable of producing varus or valgus moments; the capacity of the muscles to produce varus moment (34 Nm) and valgus moment (35 Nm) is roughly half of the maximum flexion moment (70 Nm). Analysis of the measured EMGs showed that the anconeus was the most significant contributor to valgus moments and the pronator teres was the largest contributor to varus moments. Although our results show that muscles were activated in response to static varus and valgus loads, their activations were modest and were not sufficient to balance the applied load.

Adult↗
PubMed2005

Physiological characteristics of top level off-road motorcyclists.

OBJECTIVES: The study aims to analyse the physiological characteristics of top level off-road motocross, enduro, and desert rally motorcyclists to facilitate the design of a specific training program. METHODS: Twenty seven off-road top level riders participated in this study which measured anthropometric data, maximum aerobic power with incremental tests of both arms and legs, isokinetic dynamometry of the knee and elbow, handgrip strength, heart rate, and blood lactate concentrations during competition. RESULTS: The physical demands of the various races appear to influence the development of distinct musculoskeletal characteristics, as well as aerobic and anaerobic metabolism. Motocross riders have more muscle mass, higher isokinetic handgrip strength, and greater aerobic power than enduro and desert rally riders. However, there are no significant anthropometric and physiological differences between desert rally and enduro riders. Desert rally riders tend to be overweight with maximum aerobic power similar to that of healthy individuals. The mechanical characteristics of the motorcycle and the technical and tactical skills of the riders seem to be more important for race success than the metabolic capabilities of the rider. CONCLUSIONS: Desert rally and enduro riders present similar anthropometric and physiological characteristics. Both have a maximum aerobic power similar to that of healthy normal individuals, although desert rally riders tend to be overweight. Motocross riders on the other hand, have more muscle mass, more strength, and greater aerobic power. The differences observed suggest the need for a specific training program to address the requirements of different riders to reduce the possibility of injury.

Adult↗
PubMed2005

Mechanography--a new device for the assessment of muscle function in pediatrics.

The development of the musculoskeletal system in children and adolescents became an important topic in the field of pediatric research when the connections between muscle force and bone diseases were revealed. The present study focused on reference values of ground reaction forces, which derive from muscle forces of the lower limbs. Specifically, the study investigated the relationship between anthropometric characteristics and peak jump force (PJF), and peak jump power (PJP). The parameters were assessed by jumping mechanography using the Leonardo Jumping Platform. The entire study group was comprised of 135 school boys (ages 7-21 y) and 177 girls (ages 6-19 y), who were enrolled in a German primary school and a German high school. The analysis of the parameters revealed that forces deriving from the motor performance of jumping follow an exponential relationship to body size parameters. Therefore, with consideration of anthropometric characteristics, the assessment of ground reaction forces might provide a novel, inexpensive, and accurate approach for the assessment motor performance in children and adolescents.

Adolescent↗
PubMed2002

Congenital abnormalities of the urogenital tract in association with congenital vertebral malformations.

There is a close link between the embryological development of the musculoskeletal system and all other main organ systems. We report a prospective series of 202 patients with congenital vertebral abnormalities and document the associated abnormalities in other systems. There were 100 boys and 102 girls. In 153 there were 460 associated abnormalities, a mean of 2.27 abnormalities for each patient. Intravenous pyelography was carried out on 173 patients (85.6%) and ultrasonography on the remaining 29 (14.4%). Patients with genitourinary anomalies were more likely to have musculoskeletal (p = 0.002), gastrointestinal (p = 0.02) and cardiac abnormalities (p = 0.008) than those without genitourinary involvement. A total of 54 (26.7%) had at least one genitourinary abnormality, the most frequent being unilateral renal agenesis. There was urinary obstruction in six (3%). There was no association between genitourinary abnormality and the place of birth, parental age, birth order, level of spinal curvature, or the number, type and side of spinal anomaly. There was, however, a statistically significant association (p = 0.04) between costal and genitourinary abnormalities. The incidence of genitourinary abnormalities (26.7%) was similar to that of previously reported series. The diagnosis of a congenital vertebral abnormality should alert the clinician to a wide spectrum of possible associated anomalies most of which are of clinical importance.

Abnormalities, Multiple↗
PubMed2003

[Evaluative research on occupational rehabilitation: the effectiveness of a health care service subject to dismantlement].

This article deals with the results obtained from 1995 to 1997 by an innovative occupational rehabilitation model for individuals with repetitive strain injury/work related musculoskeletal disorder (RSI/WRMD), developed by the Campinas Occupational Rehabilitation Center under the Brazilian National Institute for Social Security. The study had two objectives: 1) to reconstruct the program as a precondition for evaluation and 2) to evaluate the model's effectiveness in reestablishing the autonomy of individuals with RSI/WRMD. The methodology involved document analysis in order to reconstruct the program's background in terms of problem identification, organizational participation, awareness-raising, staff characteristics and responsibilities, and profile of the clientele. An analysis of 221 patient files provided the basis for constructing an evaluative instrument consisting of different dimensions, variables, and indicators, which was applied to a sample of 47 patient histories prior and subsequent to rehabilitative intervention. High effectiveness was observed in the model, with variations in the different target dimensions.

Adult↗
PubMed1999

Synteny-defined candidate genes for congenital and idiopathic scoliosis.

Idiopathic scoliosis (IS) is a common but poorly understood syndrome. Congenital scoliosis (CS) is less common but comparably unexplored. Previous studies suggest that each has a significant genetic component. However, the occurrence of scoliosis in the presence of other hereditary connective tissue syndromes raises the possibility that IS and CS are in fact a heterogeneous group of disorders with varied pathogenetic mechanisms. Mouse mutations have proven informative in identifying genes that are important in the development of the musculoskeletal system and provided important mechanistic insights regarding their roles in human disease. We sought to identify candidate genes for human IS and CS by reviewing mouse mutations with phenotypes affecting the axial skeleton. We performed a systematic review using the Mouse Genome Database (MGD), the Genome Database (GDB), and the Online Mendelian Inheritance in Man (OMIM) world-wide-web sites with additional searches performed based on the results of this initial search. We identified approximately 400 mouse mutations, reviewed approximately 250 of these for vertebral phenotypes, assessed 45 of these for synteny conservation between mouse and man, and identified 28 mouse mutations for which 29 credible candidates for human scoliosis could be identified based on mouse phenotypic and mapping data. For each of these, we have synthesized information about the mouse mutant phenotype, mapping data, information regarding molecular pathogenesis when a specific causative gene has been identified, and information regarding plausible candidates based on map position when the causative gene has not been identified. Among these were three loci for which the mutant gene had been identified and the human homologue was known. Some of the mouse mutants have phenotypes similar to human syndromes.

Animals↗
PubMed1999

Cellular localization and expression of insulin-like growth factors (IGFs) and IGF binding proteins within the epiphyseal growth plate of the ovine fetus: possible functional implications.

The insulin-like growth factors (IGFs) are important in the regulation of normal fetal musculoskeletal growth and development, and their actions have been shown to be modulated by IGF binding proteins (IGFBPs). Because the anatomical distribution of IGFBPs is likely to dictate IGF bioavailability, we determined the cellular distribution and expression of IGF-I, IGF-II, and IGFBP-1 to IGFBP-6 in epiphyseal growth plates of the fetal sheep, using immunocytochemistry and in situ hybridization. Little mRNA for IGF-I was detectable within the growth plates, but mRNA for IGF-II was abundant in germinal and proliferative chondrocytes, although absent from some differentiating chondrocytes and hypertrophic cells. Immunohistochemistry for IGF-I and IGF-II showed a presence of both peptides in all chondrocyte zones, including hypertrophic cells. Immunoreactive IGFBP-2 to -5 were localized within the germinal and proliferative zones of chondrocytes, but little immunoreactivity was present within the columns of differentiating cells. IGFBP immunoreactivity again appeared in hypertrophic chondrocytes. IGFBP mRNA in chondrocytes of the epiphyseal growth plate was below the detectable limit of in situ hybridization. However, low levels of mRNAs for IGFBP-2 to -6 were detected by the reverse transcriptase polymerase chain reaction. A co-localization of IGFBPs with IGF peptides in intact cartilage suggests that they may regulate IGF bioavailability and action locally. To test this hypothesis, monolayer cultures of chondrocytes were established from the proliferative zone of the growth plate, and were found to release immunoreactive IGF-II and to express mRNAs encoding IGFBP-2 to -6. Exogenous IGFBP-3, -4, and -5 had an inhibitory action on IGF-II-dependent DNA synthesis. IGFBP-2 had a biphasic effect, potentiating IGF-II action at low concentrations but inhibiting DNA synthesis at equimolar or greater concentrations relative to IGF-II. Long R3 IGF-I, which has a reduced binding affinity for many IGFBPs, was more potent than native IGF-I in promoting DNA synthesis by chondrocytes. Our findings suggest that locally produced IGF-II and IGF-I derived from the circulation can influence fetal epiphyseal chondrogenesis, and that this may be modulated locally by multiple IGFBP expression.

Animals↗
PubMedDate not supplied

[Anomalies of the trunk. An analysis of their prevalence in young athletes].

BACKGROUND: To evaluate the influence of some sports (swimming, tennis, soccer, artistic gym, classical dance, basket, volley) on the development of the musculoskeletal system in prepuberal children. METHODS: From January 1994 to December 1997, 3,765 students of the 4th and 6th class of primary schools in the area of the health district of Cremona, underwent orthopaedic screening. The prevalence of kyphosis, hyperlordosis and back asymmetry in children playing and not playing sports were compared. Statistical analysis was performed using X2-test. RESULTS: The incidence of hyperlordosis was significantly lower in boys playing soccer while the incidence of back asymmetry was higher in girls playing basketball. Tennis was found not to be a suitable sport for either male or female prepuberal children. Swimming was the best sport for females whereas males who swan registered a higher incidence of hyperphosis compared to the control group. In females the incidence of hyperlordosis did not correlate with any of the sports considered whereas the incidence in boys playing soccer and swimming showed a decrease. Hyperkyphosis in females can be reduced by swimming and volleyball, in males by playing basketball. CONCLUSIONS: The results obtained suggest the importance of an orthopaedic evaluation of children who want to take up sports.

Adolescent↗
PubMed2002

The influence of exercise on the composition of developing equine joints.

An overview is given of the direct and long-term effects of exercise on the biochemical characteristics of cartilage and subchondral bone, and on the metabolic activity of chondrocytes in the juvenile horse. In the experimental setup 43 foals were reared until weaning at 5 months of age under similar conditions, except for the type and amount of exercise. Fifteen foals remained at pasture (Pasture group and also control group), 14 foals were kept in box stalls (Box group), and 14 foals were kept in the same box stalls but were subjected daily to an increasing number of gallop sprints (Training group). After weaning 8 foals from each group were euthanised. All remaining 19 animals were housed together in a loose box with access to a small paddock to study a possible reversibility of exercise-induced effects. Post mortem subchondral bone and cartilage samples were collected and analysed for bone morphogenic enzymes, matrix composition, chondrocyte metabolic activity, and bone mineral density. It resulted that lack of exercise leads to a retardation of the normal development of the joint. This is largely compensated for when afterwards a more normal exercise regimen is followed. Most parameters in the Training group approximated those of the pastured foals at age 5 months. However, at age 11 months there were indications for a reduced performance of the investigated tissues in this group. It is concluded that regular, sub-maximal loading, as occurred in the Pasture group, seems best for an optimal development of the musculoskeletal tissues. The combination of short bouts of heavy exercise superimposed on a basic box rest regimen appears to have adverse effects on long-term viability of the tissues and may hence lead to an impaired resistance to injury.

Alkaline Phosphatase↗
PubMedDate not supplied

[Early manifestation and dynamics of the development of vertebrobasilar circulation disorder associated with cervicovertebral dysfunction, directions of the prophylaxis and treatment].

206 children and young patients have been observed to diagnose the origin and dynamics of the development of vertebrobasilar circulation disturbances. The great importance was given to detail data collection by questionnairing and studying outpatient medical records of the patients since early childhood. The obtained data were compared with those of healthy people of similar age. Risk factors and the development of symptoms of the disease with age were analyzed in the article. Genetical and constitutional factors are of great importance in the development of vascular and musculoskeletal systems pathologies. The intensity of the pathologic process and dynamics of its development connected directly with the number and pathologic factors duration. Early manifestation of vertebrobasilar disturbances is considered in practice as vegetovascular dystonia. Taking into account a reflex factor in the development of the pathology, reflex therapeutic methods will be pathogenetically justified.

Adolescent↗
PubMedDate not supplied

Traumatic experiences in childhood and the risk of arthritis: a prospective cohort study.

BACKGROUND: Recent data suggest that psychosocial factors, including childhood and adulthood stressors, may play a significant role in the development of chronic musculoskeletal pain and other symptoms. The purpose of this study was to determine if traumatic experiences in childhood are associated with an increased risk of self-reported arthritis later in life. METHODS: We used longitudinal data (N=9,159) from the first 3 cycles of the National Population Health Survey (NPHS) in Canada. New cases of arthritis were identified using an interviewer-administered questionnaire. Psychological trauma in childhood or adolescence was measured by a 7-item questionnaire asking about physical abuse, fearful experiences, hospitalization, being sent away from home, and 3 types of parental disturbance. The effects of trauma were examined in a multivariable discrete-time proportional hazards model. RESULTS: The incidence of self-reported arthritis was 27.1 per 1,000 person-years. We found a relative risk of 1.17 (95% CI=0.92, 1.48) for one traumatic event and 1.27 (95% CI=0.99, 1.62) for two or more traumatic events. Independent effects were observed for prolonged hospitalization (HR=1.33, 95% CI=1.05, 1.68) and being very scared (HR=1.29, 95% CI=1.02, 1.62). In subgroup analyses, no significant interactions were found between trauma and sex, socio-economic status, or baseline health. CONCLUSIONS: In this large prospective study, we found a moderate increase in the risk of arthritis among persons reporting multiple traumatic experiences in childhood.

Adolescent↗
PubMed1980

Musculoskeletal problems in hemophilia.

Spontaneous deep muscle and joint bleeding is a common characteristic of severe hemophilia, often causing damage to the musculoskeletal system. The development of concentrated replacement factors, however, has made home care programs possible, helped prevent deformity, and improved surgical management.

Bone Diseases↗
PubMed1997

Central venous access devices in children with hemophilia: an update.

The most frequent indication for placement of a central venous access device in hemophiliacs is in very young boys (ages 1-2 years) with severe hemophilia who are started on a program of long-term factor prophylaxis designed to eliminate target joint bleeding and the development of chronic musculoskeletal disease. Although expensive, this strategy is extremely successful. It involves intravenous infusion of 25-40 factor units per kg on alternate days (minimum 3 times a week) for boys with severe hemophilia A, and twice a week for boys with severe hemophilia B. To facilitate this prophylaxis regimen some hemophilia clinics routinely recommend placement of a central venous access device; others, more concerned about associated complications such as sepsis, stress the importance of using peripheral veins wherever possible, with central access devices reserved for occasional, selected cases only. A decision to use such a device should only be made after discussion of the risks/benefits with parents (or guardians) and with patients if of an appropriate age. If such a system is to be used, we recommend that a totally implantable device (Port-A-Cath) be placed because of the lower risk of infection, and because totally implantable devices allow children to take part in activities such as swimming. Important complications include catheter-related sepsis, which may occur in 25% or more of devices over time and, much less frequently, catheter-related deep vein thrombosis.

Bacterial Infections↗