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At least 685 records · Page 38Linked to original sources
PubMed1997

Optimization of walking in children.

Previous work demonstrated that adults naturally adopt a walking frequency to optimize physiological cost, symmetry, and stability. Furthermore, the optimal frequency is predictable using the force-driven harmonic oscillator (FDHO) model. However, no studies have established the developmental processes of optimization in children. Thus, the purposes of this study were to examine the predictability of the preferred stride frequency (PSF) and optimization features of 3- to 12-yr-old children using the FDHO model. Forty-five children and nine adults were measured for anthropometric data to calculate the predicted frequency. They later walked at three frequencies (PSF, PSF +25%, and PSF -25%) at a constant speed on a treadmill. The results indicated that the FDHO model was accurate in predicting the preferred frequency of children (prediction error < 0.07 s). We identified three stages of learning in the development of optimization: an early manifestation of sensitivity to resonant frequency, the subsequent development of ability to modulate walking frequency, and the final establishment of an adult optimization form at age seven. Our findings suggest that walking development may be determined by the dynamic cooperation of physiological, neural, and musculoskeletal systems with respect to the environmental context.

Adult↗
PubMed1990

Drug-induced lesions of the musculoskeletal system.

Drugs, whether prescribed by physicians or taken without the knowledge of the physician, may result in profound changes in the musculoskeletal system. Some drugs may produce teratogenic changes in the developing fetus frequently, but not necessarily, in association with anomalies of other systems. Other drugs may have their effects on the child or adult, whereas a number of drugs result in either teratogenic or nonteratogenic abnormalities. In the course of evaluating any diagnostic imaging study, it is essential that the radiologist be aware of any drugs that the patient may be taking and be knowledgeable of the radiologic changes that such drugs may produce in the musculoskeletal system.

Abnormalities, Drug-Induced↗
PubMed1992

Rheumatic manifestations of infective endocarditis.

Rheumatic manifestations are common and varied in infective endocarditis. We performed a retrospective case analysis on 87 patients with 93 episodes of infective endocarditis admitted to Flinders Medical Centre over an 11 year period (1980-1990). Disabling musculoskeletal symptoms and signs were documented in 22 (25%) of the patients. Thirteen patients developed severe or moderately severe low back pain during their illness, two with radiological evidence of a septic discitis or vertebral osteomyelitis. Two patients developed polyarthralgia/arthritis, four had septic arthritis (all with acute Staphylococcus aureus endocarditis), three developed severe loin pain, two acute gout, two had severe buttock pain and sacroiliac joint tenderness and two each developed disabling jaw/facial pain, neck/scapular pain and flank pain respectively. Five patients presented initially to the orthopaedic or rheumatological unit for management of their musculoskeletal symptoms. Four of seven patients with Streptococcus bovis endocarditis demonstrated prominent low back pain supporting a previously noted association between this organism and back symptoms. Furthermore, in one patient who had three separate episodes of endocarditis involving three different organisms, florid back symptoms were only seen in the infective episode involving Streptococcus bovis.

Aged↗
PubMed2005

Development and reliability of the Motivation for Change Questionnaire.

PURPOSE: The purpose of this study was to describe the development of the Motivation for Change Questionnaire (MCQ) and to test its intra-patient reliability on musculoskeletal pain patients in interdisciplinary rehabilitation as a basis for use in rehabilitation planning. METHOD: The MCQ questionnaire was developed from a literature search in the Medline, Cinahl and Psychlit databases concerning motivating factors for change in the life and work situation. Questions covering these factors were developed (item generation). Factor analysis of the questions implied a reduction of the number of questions (item reduction). Inter-item correlation was assessed on the baseline administration of the questionnaire by calculating Cronbach's alpha. When testing the structure of the scales, it was shown that the MCQ questionnaire could be described in two scales, one scale relating to motivation for change in the life situation and the other focusing on motivation for change in the work situation and in total 49 questions. RESULTS: The test -- retest reliability was calculated using the intra-class correlation coefficient (ICC) and 95% confidence intervals were calculated. One question was excluded due to the threshold limit of > 0.5. Seven scales relating to the life situation were accepted by the analysis: social support, mastery in life, challenges in life, control in life, values, self-efficacy and self-confidence. Six scales relating to the work situation were also accepted: co-worker support, supervisory support, challenges in work, job control, interaction and job-satisfaction. CONCLUSIONS: The MCQ questionnaire with 48 questions is reliable for use on musculoskeletal pain patients in interdisciplinary rehabilitation. It can be used to identify each individual's motivating factors for change in life and work situation as a basis for motivational work within rehabilitation and/or to measure within-subject changes in motivation over time. The validity and the responsiveness of the MCQ, need to be studied.

Adult↗
PubMed2006

Validation of a Spanish version of the Short Musculoskeletal Function Assessment Questionnaire (SMFA).

OBJECTIVES: The purpose of this study was to develop a linguistically appropriate, culturally adapted, and appropriately validated Spanish version of the SMFA (SMFA-Mex). DESIGN: Validation of a survey-based outcome instrument. SETTING: Busy state hospital in southern Mexico. PATIENTS/PARTICIPANTS: Consecutive trauma patients with a variety of orthopedic disorders. INTERVENTION: N/A. MAIN OUTCOME MEASUREMENTS: The SMFA-Mex was forward and back translated, administered to orthopedic trauma patients, and compared against the Spanish version of the SF-36s for criterion validity. Statistical analysis included factor analysis, criterion validation with the SF-36, and internal measures of reliability. RESULTS: Factor analysis demonstrated three separate subscale dimensions: 1) upper-extremity dysfunction, 2) lower-extremity dysfunction, and 3) lifestyle alterations. Item analysis showed a high degree of internal consistency for the three subscales (subscale 1, r = 0.95; subscale 2, r = 0.94; subscale 3, r = 0.92). Test-retest reliability at 7 days was 0.93 for the upper-extremity dysfunction subscale, 0.95 for the lower-extremity dysfunction subscale, and 0.92 for the lifestyle-alterations subscale. Construct validity was established by comparison of the Brazilian version of the SF-36. CONCLUSIONS: The SMFA-Mex was successfully translated and culturally adapted from the English original. The SMFA-Mex demonstrated adequate scale reliability and validity and yielded three distinct subscales using factor analysis.

Adolescent↗
PubMed2005

Cancer survivorship--pediatric issues.

The last three decades have seen tremendous improvements in survival of children diagnosed with cancer, with the 5-year survival rate approaching 80%. This improvement in survival has resulted in a growing population of childhood cancer survivors. Use of cancer therapy at an early age can produce complications that may not become apparent until years later. Approximately two thirds of the survivors of childhood cancer will experience at least one late effect, and about one third will experience a late effect that is severe or life threatening. Long-term complications in childhood cancer survivors, such as impairment in growth and development, neurocognitive dysfunction, cardiopulmonary compromise, endocrine dysfunction, renal impairment, gastrointestinal dysfunction, musculoskeletal sequelae, and subsequent malignancies, are related not only to the specific therapy employed, but may also be determined by individual host characteristics. We review the known late effects of treatment in survivors of childhood cancer in order to suggest reasonable starting points for evaluation of specific long-term problems in this unique but growing population. The Children's Oncology Group (COG) has developed risk-based, exposure-related guidelines for follow-up care that are available at www.surivorshipguidelines.org.

Child↗
PubMed2003

Development of a job-specific FCE protocol: the work demands of hospital nurses as an example.

Musculoskeletal disorders often result in employee disability leaves and sickness-related absenteeism in the workplace. Professional evaluations of an employee's capacity to work require additional support by means of Functional Capacity Evaluation (FCE) methods. However, most FCE methods assess general physical capacity and, because of fixed test procedures, testing times range between 4 and 6 h for up to several days. For return to work (vocational rehabilitation), the tests need to reflect the employees' specific work demands more precisely. This study aims to develop a job-specific FCE protocol on the Ergos Work Simulator for hospital nurses. In developing the contents of this specific protocol, hierarchical task analyses were performed with 20 nurses in four departments of a university medical center. A job-specific test protocol was developed that consisted of five steps. In this process, the original test protocol was analyzed first. Secondly, categorization of physical risk factors for work-related musculoskeletal disorders revealed 16 possible combinations of activity, posture, and load. Finally, duration and frequencies during one working day of these combinations were coupled to the Ergos test panels. The nurse-specific test protocol lasts 90 min. It was possible to develop a job-specific protocol, using on-site observations as the input. Compared to the original Ergos protocol, the external validity of the new job-specific protocol has improved: it simulates the functional capacity that nurses need to perform their job in a realistic way. The testing time of the original Ergos protocol is four times longer compared to the new job-specific protocol.

Computer Simulation↗
PubMed1999

New vessels, new approaches: angiogenesis as a therapeutic target in musculoskeletal disorders.

Musculoskeletal disorders such as rheumatoid arthritis (RA) and osteoarthritis are a common cause of pain and disability. The vasculature is an important component of the musculoskeletal system, and vascularization is a key event in the development of normal cartilage and bone. By promoting the delivery of nutrients, oxygen and cells, blood vessels help maintain the structural and functional integrity of joints and soft tissue and may facilitate tissue repair and healing. The identification of pro-angiogenic mediators such as vascular endothelial growth factor (VEGF) has led to the development of antiangiogenic therapies for the treatment of neoplastic diseases. The important role of angiogenesis, and especially VEGF, in the pathogenesis of joint disorders such as RA suggests that antiangiogenic therapy may be a useful adjunct to existing approaches in RA.

Arthritis↗
PubMed1997

[Stretching].

Static stretching exercises have become very popular over the past fifteen years both in professional and amateur sports. In the fields of physical therapy and in manual therapy, in particular, static stretching has become part of a standard and successful treatment modality. Together with an appropriate strengthening program, static stretching techniques have become the therapy of choice for treatment of muscle imbalances associated with functional disturbances of the musculoskeletal system. Specific muscle length testing procedures have been developed to determine muscle shortening in clinical practice. In this article, the fundamental principles of the different types of muscle stretching techniques are described, including the dynamic stretching and static stretching techniques. The exercises are organized along the concepts of passive static or neuromuscular stretching principles. The pertaining neurophysiologic fundamentals are discussed, as are the benefits of the individual methods of a functional exercise program. Examples are provided for the most important muscle groups.

Exercise↗
PubMed1999

Body composition by dual-energy X-ray absorptiometry in black compared with white women.

Dual-energy X-ray absorptiometry (DXA) has recently been applied to the measurement of body composition using a three-compartment model consisting of fat, lean and bone mineral. The mass of skeletal muscle may be approximated by measurement of the lean tissue mass of the extremities. In addition, body fat distribution can be estimated by determining the ratio of fat in the trunk to the fat in the extremities. In the current study, DXA was used to compare body composition and fat distribution between black (n = 162) and white women (n = 203). Black women had a higher mineral mass and a higher skeletal muscle mass. The ratio of mineral to muscle mass was higher in black women, even when the data were adjusted for age, height and weight. Both total body bone mineral and muscle mass declined with age in both races, with evidence for an accelerated loss of bone mineral after menopause. Body size (height and weight) was generally a significant variable in developing regressions of each compartment against age. Their higher musculoskeletal mass may lead to misclassification of 12% of black women as obese if body mass index is used as an index of obesity. Body fat distribution (trunk/leg) did not differ between races in the raw data. However, for women of the same age, height and weight, white women have a significantly higher trunk/leg fat ratio. Body composition values for fat, lean and bone mineral obtained from DXA should be adjusted not only for gender but also for age, height, weight and ethnicity.

Absorptiometry, Photon↗
PubMed1980

Arthralgia associated with acute urinary retention. A syndrome of probable viral etiology.

Four patients are described in whom paresthesia and arthralgia developed in association with acute urinary retention. Neurologic and musculoskeletal complaints persisted for varying periods, up to five year, after cessation of urinary symptoms. Significantly elevated titers to Herpes simplex and Herpes zoster viruses were observed in three and four subjects, respectively, although none exhibited cutaneous lesions of herpetic infection. The symptom complex, presumably the result of viral radiculitis, may present in varying patterns that can be confused with lumbar disc protrusion, obstructive uropathy or primary rheumatic disorder. Diagnostic studies requisite for documentation of a viral etiology of the syndrome are discussed.

Adult↗
PubMed1995

Predictive validity of the Nursing Severity Index in patients with musculoskeletal disease. Nurses of University Hospitals of Cleveland.

Prior studies have not examined the validity of severity of illness instruments in patients at low risk for mortality. We, therefore, examined the predictive validity of a newly developed instrument, the Nursing Severity Index in 5347 adult medical and surgical patients with musculoskeletal diagnoses admitted to an academic medical center in 1985-88. The Index is based on aggregating 34 clinical observations which were recorded by primary nurses during patient care; observations reflect biologic, functional, cognitive and psychosocial abnormalities. Other data, including patient demographic data and outcomes were obtained from hospital data bases. We found that, among all study patients, admission Nursing Severity Index scores were highly related (p < 0.001) to in-hospital death rates-which were 0, 0.4, 0.8, 2.6, 6.7 and 23.5% in six hierarchical strata defined by the Index-and to nursing home discharge rates. In multivariate analyses, adjusting for diagnosis and other important covariates, each strata was associated with a 2.5-fold increased risk of mortality and a 1.6-fold increased risk of nursing home discharge. In addition, the Nursing Severity Index was an independent predictor (p < 0.001) of hospital charges and length of stay. We conclude that the Nursing Severity Index assesses multiple dimensions of illness, can be easily recorded during routine patient care, and accurately predicts hospital outcomes in an important 'low risk' group of patients. The validity of the Nursing Severity Index in other clinical subgroups should be further studied.

Adult↗
PubMed2006

Gene therapy in orthopaedics.

Impressive advances in our knowledge of the molecular genetic basis of skeletal disorders and fracture healing have led to the development of novel therapeutics based on ectopic expression of one or more genes in patient cells that can influence repair or regenerative processes in bone. Gene therapy is an attractive new approach to the treatment of bone disorders. Orthopaedics has become one of the most promising areas of research into gene therapy. This is because many potential orthopaedic targets for gene therapy, unlike traditional targets such as cancer and severe genetic disorders, neither present difficult delivery problems nor require prolonged periods of gene expression. Gene therapy offers new possibilities for the clinical management of orthopaedic conditions that are difficult to treat by traditional surgical or medical means. Impaired bone healing, need for extensive bone formation, cartilage repair and metabolic bone diseases are all conditions where alterations of the signalling peptides involved may provide cure or improvement. In orthopaedic oncology, gene therapy may achieve induction of tumour necrosis and increased tumour sensitivity to chemotherapy. An increasing amount of evidence indicates that gene transfer can aid the repair of articular cartilage, menisci, intervertebral disks, ligaments and tendons. These developments have the potential to transform many areas of musculoskeletal care, leading to treatments that are less invasive, more effective and less expensive than existing modalities.

Animals↗
PubMed1986

Sports medicine for the internist.

Because of increasing participation in leisure sports and exercise rehabilitation programs, many patients are developing nonsurgical, soft tissue overuse syndromes. Many of these musculoskeletal problems arise because of underlying biomechanical difficulties, training errors, or improper use of equipment. Epidemiologic observations reveal that these individuals frequently visit a general medical practitioner before seeking the advice of an orthopedic specialist. Prompt diagnosis simply requires an appreciation of anatomy and an analytic understanding of sports biomechanics. Although compulsive about their level of physical activity, many of those affected with overuse syndromes are highly motivated individuals who will predictably improve with the judicious use of NSAIDs, elimination of training errors, and the use of appropriate sports equipment and footwear. Simple orthotics may be needed for correction of biomechanical problems. For many of these localized musculoskeletal disorders, strict adherence to gradual physical rehabilitation activities is advisable.

Ankle↗
PubMed2003

Extracorporeal shock wave therapy for plantar fasciitis. A double blind randomised controlled trial.

BACKGROUND: Extracorporeal shock wave therapy (ESWT) is an increasingly popular therapeutic approach in the management of a number of tendinopathies. Benefit has been shown in calcific tendinitis of the rotator cuff, but evidence for its use in non-calcific disorders is limited. AIMS: To perform a double blind randomised controlled trial of moderate dose shock wave therapy in plantar fasciitis. METHODS: Adults with plantar fasciitis for at least 3 months were randomised to receive either active treatment (0.12 mJ/mm(2)) or sham therapy, monthly for 3 months. Pain in the day, nocturnal pain and morning start-up pain were assessed at baseline, before each treatment and 1 and 3 months after completion of therapy. RESULTS: Eighty-eight subjects participated and no differences existed between the groups at baseline. At 3 months, 37% of the subjects in the ESWT group and 24% in the sham group showed a positive response (50% improvement from baseline) with respect to pain. Positive responses in night pain occurred in 41% and 31% in the ESWT and sham groups, respectively. Positive responses in start-up pain occurred in 37% and 36% in the ESWT and sham groups, respectively. Both groups showed significant improvement over the course of the study, but no statistically significant difference existed between the groups with respect to the changes were seen in any of the outcome measures over the 6-month period. CONCLUSIONS: There appears to be no treatment effect of moderate dose ESWT in subjects with plantar fasciitis. Efficacy may be highly dependent upon machine types and treatment protocols. Further research is needed to develop evidence based recommendation for the use ESWT in musculoskeletal complaints.

Adult↗
PubMed2003

Mechanical influences on cells, tissues and organs - 'Mechanical Morphogenesis'.

Cells can sense changes in their mechanical environment and promote alterations and adaptations in tissue structure and function. Mechanical stimuli regulate such fundamental processes as cell division and differentiation and determine tissue form. The current editorial outlines the general scope of a subject area we have called 'mechanical morphogenesis'. We are promoting it as an area of special interest for future issues of the European Journal of Morphology. Clearly, mechanical loading is of pivotal importance to the development, function and repair of all tissues in the musculoskeletal system, including bone, ligament, tendon, skeletal muscle, intervertebral disc and meniscus. Bone in particular has attracted special interest and mechanical strain is central to both Wolff 's law and Frost's 'mechanostat' model of bone behaviour. But it is skeletal muscle that shows the most obvious and rapid response to altered load, with striated muscle fibres hypertrophing with strength-training programmes, and atrophing in the absence of adequate mechanical stimulation. Articular cartilage, together with tendons and ligaments is also responsive to changing exercise levels, and either abnormally high or low loads are detrimental. However, the influence of mechanical forces extends to many other organ systems, including the respiratory, cardiovascular, nervous and integumentary systems. The bronchial mucosa and the alveoli are subject to tensile and compressive loading during the volume changes that occur in respiration, and surface tension is also of paramount importance. The whole form of the cardiovascular system is driven by the haemodynamic influences of blood, and atherosclerosis has an underlying mechanical basis. The characteristic plaques tend to occur at sites of obvious mechanical significance - regions of arterial branching and curvature, where shear stress on the vessel wall may be low, but tensile stress high. Sensory perception by the nervous system has a well known mechanical basis and the cochlea is perhaps the most elaborate example of a site where sensory cells transduce mechanical forces and relay information to the brain. Mechanical force has also been proposed as a regulating factor in controlling axonal growth. Finally, the integumentary system has several structural adaptations that obviously relate to the influence of mechanical forces. The thickened layer of keratinised squames in the palms and soles is directly related to the high levels of shear at these locations.

Animals↗
PubMed2005

Computer system for definition of the quantitative geometry of musculature from CT images.

The computer system for quantitative determination of musculoskeletal geometry from computer tomography (CT) images has been developed. The computer system processes series of CT images to obtain three-dimensional (3D) model of bony structures where the effective muscle fibres can be interactively defined. Presented computer system has flexible modular structure and is suitable also for educational purposes.

Arthrography↗
PubMed1984

Competencies in biomechanics for the physical therapist. Suggestion for entry-level curricula.

The purpose of this paper is to identify competencies needed in the area of biomechanics for physical therapists. The discussion is divided into the following three areas: prevention of movement dysfunction, patient evaluation, and patient treatment. Clinical examples for each area are included. Physical therapists must understand normal biomechanical development, pathomechanical development, biomechanics of normal movement, and pathomechanics of the musculoskeletal system. In addition, physical therapists should be experts in biomechanics of exercise and be able to analyze biomechanically various types of activities.

Back Pain↗