Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Musculoskeletal Development”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 721 records · Page 40Linked to original sources
PubMed1993

Psychosocial factors at work and musculoskeletal disease.

The objective of this review is to establish whether the epidemiologic literature presents evidence of an association between psychosocial work factors and musculoskeletal disease. In a hypothetical model it is suggested that individual characteristics and stress symptoms can modify this relationship. The reviewed studies do not present conclusive evidence due to high correlations between psychosocial factors and physical load and to difficulties in measuring dependent and independent variables. Nevertheless, it is concluded that monotonous work, high perceived work load, and time pressure are related to musculoskeletal symptoms. The data also suggest that low control on the job and lack of social support by colleagues are positively associated with musculoskeletal disease. Perceived stress may be an intermediary in this process. In addition, stress symptoms are often associated with musculoskeletal disease, and some studies indicate that stress symptoms contribute to the development of this disease.

Back Pain↗
PubMed2003

The bone and joint decade. strategies to reduce the burden of disease: the Bone and Joint Monitor Project.

Musculoskeletal conditions are the major cause of morbidity and substantially influence health and quality of life, with enormous costs to health systems. This article describes the Bone and Joint Monitor Project, whose objective is to provide evidence to enable development of policies and strategies to improve the prevention and treatment of musculoskeletal conditions, relevant to their geographic and socioeconomic settings. By identifying the burden of disease and establishing strategies that can be implemented in routine clinical practice, musculoskeletal conditions can be managed more effectively and progress can be demonstrated through the establishment of routine health monitoring. With the interventions currently available, it is feasible that all people will be afforded the right to pain control, mobility, and independence.

Global Health↗
PubMed1994

Bicondylar tibial plateau fractures treated with a hybrid ring external fixator: a preliminary study.

Twenty-three knees in 22 patients with Schatzker type VI tibial plateau fractures were treated with a hybrid ring external fixator using tensioned wires proximally and half-pins distally. All but two injuries were secondary to high-energy trauma. Six were open injuries, and eight patients had other major musculoskeletal trauma. Eight patients were treated with limited open reduction and internal fixation before application of the frame. The remainder received percutaneous cannulated screw fixation to stabilize the articular surface without opening the fracture site. Twenty-three fractures were followed to complete healing. Average time to healing was 4.4 months. Arc of motion averaged 107 degrees, and there were four flexion contractures of 5-15 degrees. Complications consisted of three deep wound infections, one deep venous thrombosis (DVT), one malunion, and one pin tract infection. The average knee score and patient function score were 84.7 and 80.5, respectively (Knee Society Clinical Rating System). There were 13 excellent, three good, one fair, and six poor results. The poor results were in patients who either developed deep wound infections or in those who sustained multiple musculoskeletal trauma compromising the patients' function score and ultimately the average score. This method provides good stabilization and allows early range of motion for complex tibial plateau fractures where extensive dissection and internal fixation are contraindicated due to traumatized soft tissue, osteopenia, and fracture comminution.

Adult↗
PubMed2005

Modeling the effect of non-penetrating ballistic impact as a means of detecting behind armor blunt trauma.

BACKGROUND: According to the National Institute of Justice (NIJ) Standard 0101.04, the maximum deformation a soft armor vest can undergo without penetration is 44 mm. However, this does not take into account the effect of the pressure wave or energy transferred to the organs within the torso due to behind armor blunt trauma (BABT). Therefore, a study was undertaken to develop a finite element model (FEM) to study these effects. METHODS: A finite element model (FEM) of the human thorax; complete with musculoskeletal structure and internal organs (heart, liver, lungs and stomach), intercostal muscle and skin, has been developed in LS-DYNA. A Kevlar vest was modeled on the chest to simulate non-penetrating ballistic impact. RESULTS: Using a projectile modeled with a size and mass equivalent to a 9 mm (124 grain) bullet at 360 and 425 m/s, four impacts were simulated against NIJ Level II and Level IIIa Kevlar vests at the midsternum and right thorax. At the same velocity, the pressures decreased by a factor of 3 and the energy absorbed by the organs decreased by a factor of 6 for the NIJ Level II and Level IIIa vests, respectively. As the projectile velocity increased, the peak pressures increased by a factor of 3 while the energy absorbed by the organs increased by a factor of 4. CONCLUSIONS: The resulting pressure profiles and kinetic energy exhibited by the respective organs indicate this model may be useful in identifying mechanisms of injury as well as organs at an elevated injury risk as a result of BABT.

Biophysical Phenomena↗
PubMed2003

Gene therapy in orthopaedic surgery.

Gene therapy has the potential to revolutionize the treatment of a variety of musculoskeletal disorders. In the past decade, more than 4,000 patients have been enrolled in clinical trials involving gene therapy. Gene therapy is becoming increasingly important in modern orthopaedic clinical practice. It is important to discuss the issues that physicians and scientists face when designing an experiment or clinical trial involving gene therapy, along with the potential clinical applications for gene therapy in the treatment of patients with musculoskeletal problems.

Bone Development↗
PubMed1999

Occupational back disability in U.S. Army personnel.

Musculoskeletal disorders represent a prevalent source of outpatient visits, lost work time, hospitalization, and disability in the military. Recent research has identified patterns among military occupations, gender, and musculoskeletal disability. Although back disorders accounted for a high percentage of all cases, little is known about the relationship between job type and disability in soldiers. The present study analyzed 41,750 disability cases to determine (1) prevalence of work-related back disability diagnoses, (2) specific jobs associated with greater risk of back disability, and (3) association among gender, job type, and disability. The results indicate that (1) lumbosacral strain and intervertebral disc syndrome represent the most prevalent diagnoses for back disability, (2) certain occupations were associated with higher back disability risk, and (3) specific jobs were identified in which females experienced higher rates of back disability than males. The nature of these high-risk jobs, and recent research on work disability factors in U.S. Army soldiers, suggest that a combination of ergonomic and individual/organizational psychosocial factors may play a role in the development, exacerbation, and maintenance of work disability. Future research that identifies specific job factors contributing to increased back disability risk should assist in the development of empirically based work site prevention programs to improve musculoskeletal health and readiness.

Absenteeism↗
PubMed2001

Musculoskeletal model of the upper limb based on the visible human male dataset.

A mathematical model of the human upper limb was developed based on high-resolution medical images of the muscles and bones obtained from the Visible Human Male (VHM) project. Three-dimensional surfaces of the muscles and bones were reconstructed from Computed Tomography (CT) images and Color Cryosection images obtained from the VHM cadaver. Thirteen degrees of freedom were used to describe the orientations of seven bones in the model: clavicle, scapula, humerus, radius, ulna, carpal bones, and hand. All of the major articulations from the shoulder girdle down to the wrist were included in the model. The model was actuated by 42 muscle bundles, which represented the actions of 26 muscle groups in the upper limb. The paths of the muscles were modeled using a new approach called the Obstacle-set Method [33]. The calculated paths of the muscles were verified by comparing the muscle moment arms computed in the model with the results of anatomical studies reported in the literature. In-vivo measurements of maximum isometric muscle torques developed at the shoulder, elbow, and wrist were also used to estimate the architectural properties of each musculotendon actuator in the model. The entire musculoskeletal model can be reconstructed using the data given in this paper, along with information presented in a companion paper which defines the kinematic structure of the model [26].

Adult↗
PubMed1999

Chiropractic intervention in the treatment of joint and soft tissue disorders.

The concept of manual therapy, specifically manipulation of the bodily joints as in the practice of chiropractic, can no longer be deemed an invalid system of health care. Practiced for over 2,000 years by a variety of ancient civilizations, the art of manipulation for the purpose of correcting and restoring joint function has continued to flourish, despite opposition. The climate, however, is changing. The art of chiropractic is increasingly being seen as a uniquely devised and administered technique whereby high velocity, low amplitude thrusting maneuvers are specifically directed by the skilled practitioner toward spinal segments and peripheral articulations in an effort to correct aberrant mechanical function. The corrections are effected while utilizing the transverse and spinal processes of individual vertebrae as contacting levers. Hippocrates is credited with the advice to, "look well to the spine for the cause of disease," as displaced or degenerative vertebrae m! ! ay irritate spinal nerve roots while exiting the intervertebral foramina and, consequently, interfere with normal nerve function. Similarly, it is a fundamental precept of chiropractic philosophy that irritation of the nervous system by mechanical, chemical, or psychogenic means is considered as causative in the development of disease. The scientific evidence associated with chiropractic intervention in the treatment and management of musculoskeletal disorders and visceral diseases is growing. This paper discusses the history, philosophy, and efficacy of joint manipulation and its influence on the development of chiropractic treatment.

Chiropractic↗
PubMed2000

Where is imaging going in rheumatology?

Four new approaches to imaging are now becoming available. First is filmless radiology, with flat detectors that 'permit access' to PACS, the picture archiving communication system, and teleteaching. Second is ultrasonography (US), involving three-dimensional volume, harmonic Doppler energy and digital technology techniques, with contrast agents and biopsy needles. Next is computer tomography (CT), using volume acquisition multislices, spiral reconstruction and solid detectors, as well as multidetectors. Finally comes magnetic resonance imaging (MRI). A low magnetic field with an open MRI scan permits interventional radiology in musculoskeletal disease. High magnetic fields are mainly used for clinical research and permit rapid examination, in approximately 10 minutes. In interventional radiology, many procedures can be performed with the guidance of digital radiography, US or MRI. Two areas of localization have to be considered: the spine and the peripheral joints, particularly the shoulder, wrist and foot. Guidelines contribute to good medical practice, but there are other considerations, such as machine accessibility, the nature of the treatment, the personality of the patient and the role of the hospital. Overinvestigation has to be avoided for four reasons: an increase in patient anxiety, the cost of health-care management, the risk of irradiation and sometimes the lack of diagnostic value of these procedures. In rheumatoid arthritis, MRI can detect lesions at an earlier stage of their development and identify subtle lesions and synovitis. Imaging (using x-rays, MRI and US) is important in the assessment of the effectiveness of slow-acting drugs in rheumatoid arthritis, especially since joint damage can progress in spite of a clinical improvement in joint inflammation. In the future, teletransmission, by the Internet or intranet and using PACS, will change our approach to the diagnosis of musculoskeletal disease. Future developments therefore include PACS, filmless radiology, the Internet and intranet, harmonic US, multidetector CT scanning and open MRI on the technical side, as well as the study of cartilage and international radiology on the clinical side.

Arthritis, Rheumatoid↗
PubMed2003

The burden of musculoskeletal conditions at the start of the new millennium.

Musculoskeletal conditions are extremely common and include more than 150 different diseases and syndromes, which are usually associated with pain and loss of function. In the developed world, where these conditions are already the most frequent cause of physical disability, ageing of the most populous demographic groups will further increase the burden these conditions impose. In the developing world, successful care of childhood and communicable diseases and an increase in road traffic accidents is shifting the burden to musculoskeletal and other noncommunicable conditions. To help better prepare nations for the increase in disability brought about by musculoskeletal conditions, a Scientific Group meeting was held to map out the burden of the most prominent musculoskeletal conditions at the start of the Bone and Joint Decade. In particular, the Group gathered data on the incidence and prevalence of rheumatoid arthritis, osteoarthritis, osteoporosis, major limb trauma and spinal disorders. Data were collected and organized by world region, gender and age groups to assist with the ongoing WHO Global Burden of Disease 2000 study. The Group also considered what is known about the severity and course of these conditions, along with their economic impact. The most relevant domains to assess and monitor the consequences of these conditions were identified and used to describe health states for the different stages of the conditions. Instruments that measure these most important domains for the different conditions were recommended. It is clear from data collated that the impact from musculoskeletal conditions and trauma varies among different parts of the world and is influenced by social structure, expectation and economics, and that it is most difficult to measure impact in less developed nations, where the predicted increase is greatest.

Adolescent↗
PubMed2006

Zoledronic acid slows down rat primary chondrosarcoma development, recurrent tumor progression after intralesional curretage and increases overall survival.

Chondrosarcoma is a difficult musculoskeletal tumor to treat. Surgical treatment leads to severe disability, with high rates of local recurrence and life threat. No adjuvant therapy is effective in differentiated chondrosarcomas. Bisphosphonates (BPs) are a class of molecules which is effective in malignant bone diseases. The aim of the present study was to determine the effects of zoledronic acid (ZOL) on chondrosarcoma tumor progression. ZOL was tested in vivo (s.c. 100 microg/kg, twice a week) in a rat chondrosarcoma model and in vitro (10(-7)-10(-4) M) on cells derived from this model. Two types of animal models were assessed, the first simulated development after intralesional curettage, the second nonoperative development of the tumor. Cell proliferation, caspase-1, -3 activities and cell cycle analysis were studied. The results revealed that ZOL slows down primary tumor development, tumor progression after intralesional curretage and increases overall survival. ZOL inhibits cell proliferation and increases cell death, with no significant variation of caspase-1 and -3 activities and cell cycle profiles. The present study demonstrates for the first time that in addition to surgery, the therapy of chondrosarcoma with BPs might be beneficial. Because of these first results, new therapeutic approaches of chondrosarcoma must be considered, mainly for low grade chondrosarcoma when disabling operation is planned and when only intralesional resection can be undertaken.

Animals↗
PubMed1994

Exercise and the musculoskeletal system.

1. Normal joints in individuals of all ages may tolerate prolonged and vigorous exercise without adverse consequences or accelerated development of OA. 2. Individuals who have underlying muscle weakness or imbalance, neurological abnormalities, anatomical variances, and who engage in significant amounts of exercise that stress the lower extremities, may accelerate the development of OA. 3. Individuals who have suffered injuries to supporting structures may also be susceptible to accelerated development of OA in weight-bearing joints, even without increased stress to the joint from exercise. 4. Certain individuals with established degenerative or inflammatory arthritis may benefit from supervised exercise programmes. 5. Still more information is needed so that physicians can identify subjects at risk for the development of OA, advise the millions of participants about the beneficial and deleterious effects of regular exercise and sports participation, and develop successful rehabilitation programmes for injured joints.

Exercise↗
PubMed1998

Development and validation of an exercise performance support system for people with lower extremity impairment.

OBJECTIVE: To identify innovative strategies to support appropriate, self-directed exercise that increase physical activity levels of people with arthritis. This article reports on one interactive, multimedia exercise performance support system (PSS) for people with lower extremity impairments in strength or flexibility. METHODS: An interdisciplinary team developed the PSS using self-report of lower extremity musculoskeletal impairments (flexibility and strength) to produce an individualized exercise program with video and print educational materials. Initial evaluation has investigated the validity and reliability of program assessments and recommendations. RESULTS: PSS self-report and professional assessments were similar, with more impairments indicated by self-report. PSS exercise recommendations were similar to those made by 3 expert physical therapists using the same exercise data base. Results of PSS impairment assessments were stable over a 1-week period. CONCLUSION: PSS exercise recommendations appear to be reliable and a valid reflection of current exercise knowledge in rheumatology. Furthermore, users were able to complete the computer-based program with minimal assistance and reported it to be enjoyable and informative.

Exercise Therapy↗
PubMed2006

Participatory ergonomic processes to reduce musculoskeletal disorders: summary of a Québec experience.

This article critically reviews 11 participatory ergonomic interventions carried out in Québec by the Occupational Health and Safety Research Institute (IRSST). In the introduction, the characteristics of the approach used are situated in relation to the literature on this subject. Based on the "Ergo team" formula, the approach aims to provide company personnel with the skills to analyze and correct hazardous workstations in relation to musculoskeletal disorders (MSD), using an analysis process that the researchers developed. Although isolated workstations were corrected, the process aims for more general impacts on the company. In the 11 interventions, 40 work situations were analyzed, and in 31 cases, changes were implemented to reduce MSD risks. The most common changes dealt with the tools/equipment (77.4% and physical layouts (84%); changes involving work methods (29% and work organization (12.9%) were less common. The difficulties encountered in the interventions are summarized, and the possible impacts of the interventions on the organization and psychosocial factors are discussed. The authors then address the limitations of the paper and the factors that should be considered in evaluating such a participatory process. The authors conclude that the participatory process was successful in implementing changes in companies and that other studies are necessary for a better understanding of the process and its impacts.

Ergonomics↗
PubMed1999

Craniofacial pain and motor function: pathogenesis, clinical correlates, and implications.

Many structural, behavioral, and pharmacological interventions imply that favorable treatment effects in musculoskeletal pain states are mediated through the correction of muscle function. The common theme of these interventions is captured in the popular idea that structural or psychological factors cause muscle hyperactivity, muscle overwork, muscle fatigue, and ultimately pain. Although symptoms and signs of motor dysfunction can sometimes be explained by changes in structure, there is strong evidence that they can also be caused by pain. This new understanding has resulted in a better appreciation of the pathogenesis of symptoms and signs of the musculoskeletal pain conditions, including the sequence of events that leads to the development of motor dysfunction. With the improved understanding of the relationship between pain and motor function, including the inappropriateness of many clinical assumptions, a new literature emerges that opens the door to exciting therapeutic opportunities. Novel treatments are expected to have a profound impact on the care of musculoskeletal pain and its effect on motor function in the not-too-distant future.

Facial Muscles↗
PubMedDate not supplied

Clinical trial of photodynamic therapy using acridine orange with/without low dose radiation as new limb salvage modality in musculoskeletal sarcomas.

Most patients with musculoskeletal sarcoma do not recover satisfactory limb function after limb salvage surgery. To achieve satisfactory improvement of limb function, we developed a unique surgical modality of photodynamic therapy using acridine orange (AO-PDT) and clinically applied it to patients with musculoskeletal sarcomas. Ten patients with primary musculoskeletal sarcomas were enrolled in the study. Of these, 6 had primary malignant soft tissue sarcoma and 4 had primary malignant bone tumor. In the AO-PDT procedure, intralesional or partially marginal tumor excision was initially conducted and microscopic curettage of the remnant tumor, which emitted green fluorescence under blue excitation after local administration of 1microg/ml AO solution, was performed using a fluorescence surgical microscope. Subsequently, blue light illuminated there for 10 minutes. The surgical wound was closed, followed by immediate X-ray irradiation of the resected area with 5 Gy in 5 out of 10 patients to enhance the effect of AO-PDT. The follow-up of the patients ranged from 24 to 48 months. All the patients (AO-PDT alone: 5, AO-PDT with 5-Gy radiation: 5) are alive; only one patient showed local recurrence of the tumor. The recurrence rate was 10%. None of the 5 patients treated by AO-PDT with radiation developed local tumor recurrence. The limb function in all the patients, except for one, recovered to the level before surgery. None of the patients clinically showed any local or systemic complications. AO-PDT may be a promising new limb salvage modality for preservation of excellent limb function in patients with musculoskeletal sarcoma.

Acridine Orange↗
PubMed2007

Decreased up-regulation of the interleukin-12Rbeta2-chain and interferon-gamma secretion and increased number of forkhead box P3-expressing cells in patients with a history of chronic Lyme borreliosis compared with asymptomatic Borrelia-exposed individuals.

Lyme borreliosis (LB) can, despite adequate antibiotic treatment, develop into a chronic condition with persisting symptoms such as musculoskeletal pain, subjective alteration of cognition and fatigue. The mechanism behind this is unclear, but it has been postulated that an aberrant immunological response might be the cause. In this study we investigated the expression of the T helper 1 (Th1) marker interleukin (IL)-12Rbeta2, the marker for T regulatory cells, forkhead box P3 (FoxP3) and the cytokine profile in patients with a history of chronic LB, subacute LB, previously Borrelia-exposed asymptomatic individuals and healthy controls. Fifty-four individuals (12 chronic LB, 14 subacute LB, 14 asymptomatic individuals and 14 healthy controls) were included in the study and provided a blood sample. Mononuclear cells were separated from the blood and stimulated with antigens. The IL-12Rbeta2 and FoxP3 mRNA expression was analysed with real-time reverse transcription-polymerase chain reaction (RT-PCR). The protein expression of IL-12Rbeta2 on CD3(+), CD4(+), CD8(+) and CD56(+) cells was assessed by flow cytometry. Furthermore, the secretion of interferon (IFN)-gamma, IL-4, IL-5, IL-10, IL-12p70 and IL-13 was analysed by enzyme-linked immunospot (ELISPOT) and/or enzyme-linked immunosorbent assay (ELISA). Chronic LB patients displayed a lower expression of Borrelia-specific IL-12Rbeta2 on CD8(+) cells and also a lower number of Borrelia-specific IFN-gamma-secreting cells compared to asymptomatic individuals. Furthermore, chronic LB patients had higher amounts of Borrelia-specific FoxP3 mRNA than healthy controls. We speculate that this may indicate that a strong Th1 response is of importance for a positive outcome of a Borrelia infection. In addition, regulatory T cells might also play a role, by immunosuppression, in the development of chronic LB.

Adult↗