Operative injury to the accessory nerve in the posterior cervical triangle; comment upon the abduction test for trapezius muscle paralysis.
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Accessory Nerve↗
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Measurement of muscle strength of the trunk and the lower extremities in subjects with history of low back pain.
STUDY DESIGN: Isokinetically measured muscle strength of the trunk and lower extremities was analyzed. OBJECTIVES: The causes of the weak trunk muscle strength of subjects with low back pain were studied. SUMMARY OF BACKGROUND DATA: Although it is a commonly accepted conclusion that subjects with low back pain have weaker trunk muscles than the normal population, there are no reports concerning muscle strength of the lower extremities in subjects with low back pain. METHODS: Ninety-eight male volunteers were divided into control groups and groups with low back pain. The total trunk strength and total knee strength were defined as the sum of the peak torques of trunk extension, flexion and rotation, and of bilateral knee extension and flexion, respectively. RESULTS: The total trunk and knee strength in the group with low back pain (281 +/- 170 and 301 +/- 132 Nm) were significantly lower than in the control group (543 +/- 124 and 441 +/- 123 Nm). The total trunk and knee strength were linearly correlated in both groups (r = 0.67 and 0.79). CONCLUSIONS: In the group with low back pain, the muscles of the trunk and the lower extremities were similarly affected; this can be attributed to generalized muscular weakness or psychologic factors, such as fear of injury.
Adolescent↗
[Development of fiber type composition and fiber diameter in the longissimus muscle of the domestic pig (Sus scrofa domesticus)].
The development of fiber types composition and fiber diameter in porcine longissimus muscle from birth to the age of 5 years was examined by means of cross-sectional study. The fiber types were classified in the following manner: FTG = fast-twitch-glycolytic, FTO = fast-twitch-oxidative and STO = slow-twitch-oxidative. The percentage on the oxidative fibers decrease from 60.8% on the 1st d to 39.1% on the 100th d of life. On the 1800th d only 26.5% oxidative fibers are present. The average diameters of fiber types increase during the whole examination period, especially to the 100th d of life. The initial gradation of fiber diameter FTG = 63 micron, FTO = 62 micron, STO = 56 micron converts during growth into STO = 112 micron, FTO = 108 micron, FTG = 104 micron. A common representation of muscle fiber diameter growth curve and rump length growth curve demonstrates different growth modes of muscle and skeleton.
Age Factors↗
Muscle training, psychological perception of work and low-back symptoms in nursing aides. The effect of trunk and quadriceps muscle training on the psychological perception of work and on the subjective assessment of low-back insufficiency. A study in a geriatric hospital.
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Adult↗
EMG biofeedback used to reduce standing levels of paraspinal muscle tension in chronic low back pain.
Twenty chronic low back pain (LBP) patients with relatively high standing paraspinal EMG levels (greater than 5 microV) were randomly assigned to 2 groups. One group (N = 10) received EMG biofeedback training to reduce standing paraspinal EMG levels, the other group (N = 10) served as a waiting list control group. Changes in perceived pain (duration X intensity) and paraspinal EMG in standing position were measured at a 3 week pretreatment baseline, during the 3 week treatment period, and at a 3 week post-treatment baseline. Compared to patients in the waiting list control group, those who received EMG biofeedback showed a significant decrease in standing paraspinal EMG from pretreatment to post-treatment baseline. However, no significant differences in reported pain were found during these periods. It is concluded that reduction of standing paraspinal EMG does not lead to reduction in pain.
Adult↗
Is double pedicle TRAM flap reconstruction of a single breast within the standard of care?
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Abdominal Muscles↗
The effect of surgical floor mats in prolonged standing: an EMG study of the lumbar paraspinal and anterior tibialis muscles.
The purpose of this study was to determine whether or not surgical floor mats affect low back and leg muscle activity during prolonged standing. The EMG activity was measured continuously using surface electrodes on the paraspinal muscles of the low back and on the anterior tibialis muscles; the subjects were normal and stood on two different surfaces. Six male subjects were each instructed to stand for two hours on a specially designed surgical floor mat and then, on a separate day, to stand for two hours on a linoleum-covered concrete surface. Six other subjects carried out the same procedure, but stood on the linoleum first. There was no difference in EMG activity obtained from the anterior tibialis muscles and paraspinal muscles of the low back when the subjects stood on the surgical mat, as compared with the linoleum-covered concrete.
Adult↗
Trunk muscle recruitment patterns in patients with low back pain enhance the stability of the lumbar spine.
STUDY DESIGN: A comparative study of trunk muscle recruitment patterns in healthy control subjects and patients with chronic low back pain was conducted. OBJECTIVE: To assess trunk muscle recruitment in patients with low back pain. SUMMARY OF BACKGROUND DATA: Conflicting evidence has been reported on the level and pattern of trunk muscle recruitment in patients with low back pain. The disparities can be explained partly by methodologic differences. It was hypothesized that trunk muscle recruitment patterns may be altered in patients with low back pain to compensate for reduced spinal stability. METHODS: For this study, 16 patients with low back pain and 16 matched control subjects performed slow trunk motions about the neutral posture and isometric ramp contractions while seated upright. Ratios of electromyographic amplitudes and estimated moment contributions of antagonist over agonist muscles and of segmentally inserting muscles over muscles inserting on the thorax and pelvis only were calculated. In addition, model simulations were performed to assess the effect of changes in muscle recruitment on spinal stability. RESULTS: The ratios of antagonist over agonist, and of lumbar over thoracic erector spinae electromyographic amplitude and estimated moment contributions were greater in the patients than in the control subjects. The simulation model predicted that these changes would effectively increase spinal stability. CONCLUSIONS: Trunk muscle recruitment patterns in patients with low back pain are different from those in healthy control subjects. The differences are likely to be functional with respect to enhancement of spinal stability in the patients.
Adult↗
[Comparative and functional morphology of musculus canalis ani in tetrapod mammals and primates].
Comparative anatomy of structure and function of the M. canalis ani in tetrapode mammals and primates is described for the first time. The muscle itself lies on the sphincter ani internus in the area between the anorectal ("pectinate") and anocutaneal ("white") lines and its circumference is intact around the entire anal canal. The canalis ani muscle orginates from the superior part of the sphincter ani internus and concomitantly receives additional fibers from the longitudinal muscle. Caudally the muscle dips back into the sphincter ani internus and, at the same time, a small portion of the fibers go to the longitudinal muscle and, likewise, a portion also sets itself on the perinaal skin. On the basis of its morphological relationship to the convoluted vessels of the rectal venous plexus, the canalis ani muscle appears to be able to complete the closing of the anus in the continence phase to such an extent that a complete closing of the anal lumen is guaranted.
Anal Canal↗
Fibre type characteristics and function of the human paraspinal muscles: normal values and changes in association with low back pain.
This review focuses on the role of the paraspinal muscles in relation to the development and existence of low back pain. It begins with a discussion of the deficits in paraspinal muscle strength and fatigue-resistance observed in low back pain patients and addresses the issue of 'cause or effect' with respect to muscle dysfunction and back pain. Our current knowledge regarding the 'normal' fibre type characteristics of the human erector spinae is then presented and the influence of these fibre type characteristics on the muscle's performance capacity is discussed. Alterations in the 'microanatomy' of the musculature in connection with low back pain, and the associated implications for the performance capacity of the patient, are then considered. Finally, a number of outstanding issues in relation to the clinical significance of back muscle dysfunction are identified, leading to the proposal of areas for future research.
Electromyography↗
[Action of the dorsal muscle of the leech in the presence of acetylcholine and of eserine and acetylcholine].
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Acetylcholine↗
Spinal mobility and trunk muscle strength in 15-year-old schoolchildren with and without low-back pain.
From a population of 1,503 schoolchildren, 38 15-year-old children suffering from low-back pain and 38 asymptomatic controls were selected for testing of spinal mobility and trunk muscle strength. The asymptomatic controls were matched by age, sex, and school class. In the group with recurrent or continual low-back pain (17 boys and 21 girls), the boys were over 4 cm taller than those in the control group. In both sexes sagittal mobility was decreased in lumbar extension and straight leg raising, and increased in lumbar flexion. Endurance strength in the abdominal and back muscles was decreased compared to the control pupils, who reported no back pain at all in the questionnaire collected 1 year before the testing procedure. The pupils reporting sciatica (n = 7) at some time, in addition to recurrent low-back pain, had decreased lumbar flexion and side bending compared to those with recurrent low-back pain (n = 31) without sciatica. The results of the study indicated that in this growing-age population there was a subgroup with recurrent low-back pain having a different spinal mobility pattern as well as decreased trunk muscle strength.
Adolescent↗
Intramuscular hemodynamics in bilateral erector spinae muscles in symmetrical and asymmetrical postures with and without loading.
BACKGROUND: Although attention has been paid to the relationship between the changes in blood circulation in erector spinae muscles and back pain, little is known about their hemodynamics in several various comparable postures with and without loading. Studies on hemodynamics of erector spinae muscles using near-infrared spectroscopy have been performed on subjects and patients mainly in forward flexion positions. METHODS: Two near-infrared spectroscopes were used to measure oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin in bilateral erector spinae muscles at L2-3 in subjects in 9 postures, and holding no load, 10 kg or 20 kg in maximum flexed and lateral bending. Those three values in each posture and loading condition were expressed as a percentage of their corresponding values obtained in the standing upright position, and designated and statistically analyzed as %Oxy-Hb, %Deoxy-Hb and %Total-Hb, respectively. FINDINGS: %Total-Hb and %Oxy-Hb in maximum flexion were the most decreased. In maximum lateral bending, %Oxy-Hb only in the contralateral erector spinae muscles was decreased. When the load was 20 kg, the decreases in %Oxy-Hb were the largest in maximum flexion and lateral bendings. INTERPRETATION: Using two near-infrared spectroscopes allowed us to measure simultaneously the hemodynamics of bilateral muscles. They demonstrated different responses in each side. Asymmetrical posture and loading were accompanied by asymmetrical changes of the bilateral erector spinae muscles. Stretched muscle had less blood volume and oxygenation, both of which decreased with increasing load. These results showed that these postures and conditions might lead to fatigue of the ES muscles.
Adult↗
[The long-term results of surgical treatment of critical lower limb ischemia by autotransplantation using different tissues].
Presented herein is an analysis of the 15-year results of surgical treatment of critical lower limb ischemia (stage IV chronic ischemia according to Fontaine - Pokrovsky classification) in patients suffering from chronic occlusive diseases of lower lirtb arteries (CODLLA) with subtotal and total obliteration of the peripheral arterial system. In total lesion of the talotibial segment when the patients could not be rendered assistance using conventional vascular surgery or when roentgenoendovascular deobliterution was not feasible, use was made of indirect revascularizntion of the ischemized limb by autotransplantation of soft tissue complexes. A flap of the broadest muscle of back (FBMB) was employed as an autotransplant in 56 patients, the greater omentum in 12 patients, and a flap of the anterior dentate muscle (FADM) was used in 9 patients. Twenty-five patients with diffuse lesion of the popliteal talotibial segment were provided combined limb revascularization, when the feasibility of standard bypass graft appeared fairly questionable. The majority of patients were placed under annual observation. It is noteworthy that the monitoring of the ankle/brachial index (ABI), oxygen tension on the foot (TcpO2) and of the proximal-distal temperature gradient as well as the assessment of the number of saved limbs and of the patients' quality of life allow to regard the technique as highly effective in the strategy of the salvage of the terminally inchemized limb from amputation. The technique also makes it possible to solve the problem of patch plasty of the trophically and necrotically changed foot and to maintain its support capacity. Combined revascularization makes it possible to unite the effect of direct and indirect reconstruction of the arterial system and to perform bypass graft in non-conventional situations.
Adult↗
Instability in human forearm movements studied with feed-back-controlled electrical stimulation of muscles.
1. Amplitude-modulated electrical stimulation was applied to the elbow flexors and extensors to produce movements of the forearm in normal subjects. The parameters of the modulating (command) signal were set in isometric trials so as to produce equal and opposite background torques, and equal and supportive torque modulations. 2. Bode plots relating forearm movement to command signal (modulating) frequency showed the muscle-load to have a low-pass characteristic similar to that previously described in the cat, and a slightly larger bandwidth than described previously in man. 3. The transduced forearm signals were fed back to provide the command signal to the stimulators via a filter which mimicked the transfer function of muscle spindle primary endings. In effect this replaced the neural part of the reflex arc with an accessible model, but left the muscle-load effector intact. 4. All six subjects developed forearm oscillations (tremor) when the loop gain exceeded a threshold value. The mean tremor frequency at onset was 4.4 Hz, which was similar to that of the equivalent vibration-evoked tremor (previous paper, Prochazka & Trend, 1988). 5. With the linear spindle model, oscillations tended to grow rapidly in amplitude, and the stimuli became painful. The inclusion of a logarithmic limiting element resulted in stable oscillations, without significant alterations in frequency. This allowed us to study the effect on tremor of including analog delays in the loop, mimicking those associated with peripheral nerve transmission and central reflexes. In one subject, loop delays of 0, 20, 40 and 100 ms resulted in tremor at 4.0, 3.6, 3.0 and 2.1 Hz respectively, as quantified by spectral analysis. 6. By considering separately the phase contributions of the different elements of the reflex arc, including delays, it became clear that muscle-load properties were important in setting the upper limit of tremor frequencies which could conceivably be supported by reflexes. 7. The results support the conclusion of the related vibration study (Prochazka & Trend, 1988), that for moderate levels of background co-contraction, the contribution of stretch reflexes to tremor at the elbow should be sought in the 3-5 Hz range. Exaggerated long-latency reflexes would be expected to reduce these baseline frequencies by 1 or 2 Hz.
Adult↗
[Tissue reaction to implanted polyurethane designed for parts of the artificial heart].
Experiments on producing polyurethane membranes which could be used for elements of an artificial heart have been carried out in Poland for several years. In the Institute of Biocybernetics and Biomedical Engineering PAN in Warsaw two kinds of polyurethanes with symbols PU 47 and PU 90 have been worked out. They differ in physicochemical properties and they were subjected to investigations of tissue reaction in the Institute of Experimental Surgery and of Biomaterials Investigations of the Medical Academy in Wrocław. The investigations were carried out on 70 rats of the Wistar breed and on 30 rabbits of the New Zealand breed. Polyurethane circles were implanted into subcutaneous tissue, to peritoneal cavity and into muscles of the back in rats; polyurethane oars were implanted into muscles of the back along the backbone of the rabbits. Sections of the animals were carried out 3, 7, 14, 28, 90 and 180 days after the surgery taking 5 animals in each term. Macroscopic and microscopic as well as physicomechanical investigations were carried out. The carried out experimental investigations of the both kinds of polyurethanes showed good tolerance of the animals' organisms on the implanted material. Summing up, we can say that the tested polyurethane foils with symbols PU 47 and PU 90 satisfy the basic requirements made on the materials designed for temporal contact with a living organism.
Abdominal Muscles↗
Intra-abdominal pressure increases stiffness of the lumbar spine.
Intra-abdominal pressure (IAP) increases during many tasks and has been argued to increase stability and stiffness of the spine. Although several studies have shown a relationship between the IAP increase and spinal stability, it has been impossible to determine whether this augmentation of mechanical support for the spine is due to the increase in IAP or the abdominal muscle activity which contributes to it. The present study determined whether spinal stiffness increased when IAP increased without concurrent activity of the abdominal and back extensor muscles. A sustained increase in IAP was evoked by tetanic stimulation of the phrenic nerves either unilaterally or bilaterally at 20 Hz (for 5 s) via percutaneous electrodes in three subjects. Spinal stiffness was measured as the force required to displace an indentor over the L4 or L2 spinous process with the subjects lying prone. Stiffness was measured as the slope of the regression line fitted to the linear region of the force-displacement curve. Tetanic stimulation of the diaphragm increased IAP by 27-61% of a maximal voluntary pressure increase and increased the stiffness of the spine by 8-31% of resting levels. The increase in spinal stiffness was positively correlated with the size of the IAP increase. IAP increased stiffness at L2 and L4 level. The results of this study provide evidence that the stiffness of the lumbar spine is increased when IAP is elevated.
Abdomen↗
Age-related changes in the concentration of hydroxypyridinium crosslinks in functionally different skeletal muscles.
High-performance liquid chromatography methods were developed to measure the concentration of hydroxypyridinium crosslinks in the intramuscular collagen and tendinous parts of functionally different skeletal muscles at different ages. A significant increase in pyridinoline concentration took place during maturation reaching 0.32 +/- 0.07 (mol/mol collagen) in soleus (slow plantar flexor) and 0.28 +/- 0.07 in plantaris (fast "mixed" plantar flexor) at the age of 4 months. In medial and lateral gastrocnemius (fast "mixed" plantar flexors) the pyridinoline concentrations (mol/mol collagen) reached 0.24 +/- 0.06 and 0.19 +/- 0.04, respectively, similar to those in both the extensor digitorum longus (fast "mixed" dorsi flexor) and rectus femoris (fast "mixed" knee extensor) muscles, but higher than in the fast "mixed" dorsi flexor muscle, anterior tibialis (0.11 +/- 0.05 mol/mol). By comparison, pyridinoline concentrations of 0.33 mol/mol collagen (+/- 0.10) was measured from longissimus dorsi, a slow-twitch back posture muscle. After maturation the most significant increase in pyridinoline concentration was measured in soleus and gastrocnemius muscles. No differences in the crosslinking between different parts of muscle belly were noticed at any time-point. However, significantly fewer pyridinoline crosslinks were found in tendinous parts of soleus, extensor digitorum longus and anterior tibialis than in intramuscular collagen. The concentration of pyridinoline crosslinks tended to be highest in slow-twitch postural muscles, soleus and longissimus dorsi, and generally higher in plantar flexors which are exposed to higher stretch than dorsal flexors. The reasons for the unexpectedly low concentrations of pyridinoline crosslinks in the tendinous parts of muscles remain to be clarified.
Aging↗