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At least 109 records · Page 6Linked to original sources
PubMed1995

Management of congenital leg length inequality: value of early axis correction.

The principles of treatment of congenital leg length inequality include three strategies: joint stabilization, axis correction, and limb length equalization. We believe that early axis correction is important for normal musculoskeletal development and that residual deformity may be self-perpetuating. Of 97 lower limbs assessed, 14 had PFFD alone, 6 fibula hemimelia alone, and 49 a combination of the two. Seventy-four limb segments were operated on, including 29 joint stabilizations, 65 axis corrections, and 62 lengthenings. Axis correction was the commonest procedure in the under-five age group and may be performed alone or in combination with another treatment strategy. The average lengthening achieved was 4 cm representing a 15.75% length increase. The mean bone healing index was 54.25 days/cm, slightly more in the tibia than in the femur. We recommend early axis correction and joint stabilization prior to lengthening. The choice of lengthening technique depends on the preexisting risk factors and lengthenings should be short and frequent.

Ankle Joint↗
PubMed1998

Body composition and cross-sectional areas of limb lean tissues in Olympic weight lifters.

The cross-sectional area (CSAs) of bone and muscle tissues in the forearm, upper arm, lower leg, and thigh and body composition were determined by B-mode ultrasound and underwater weighing methods, respectively for 56 college Olympic weight lifters and 28 age-matched non-athletes to investigate the magnitude of musculoskeletal development in the strength-trained athletes belonging to the weight-classified sports event. The average value of fat-free mass (FFM) for the weight lifters ranked 12.6 kg above the regression line of FFM on stature for untrained subjects. In the weight lifters, however, the percentage of fat mass to body mass was also highly correlated to body mass index. Bone and muscle CSAs in every site were significantly larger in the weight lifter than in the untrained subjects with relative differences of 22 to 58% and 17 to 56%, respectively. Moreover, as a result of regression analysis for the mixed data from weight lifters and untrained subjects, significant correlation was found between bone and muscle CSAs in every site (r = 0.620 to 0.791, P < 0.05). The differences in lean (bone + muscle) CSA were still significant in all sites except for the lower leg even when the difference in body size was statistically controlled. The comparisons between the weight lifters and untrained subjects on the lean CSA ratios of site to site and muscle CSA ratios of flexors to extensors indicated that the weight lifters had achieved a high relative distribution of lean tissues in the arms and a dominant development in elbow and knee extensors. Thus, the present results suggested that participation in weight lifting exercises for a long period could increase bone CSA as well as muscle CSA, and induce in the participants a noticeable enlargement in given sites and muscle groups responsible for performing the Olympic lifts.

Adipose Tissue↗
PubMed2003

Estimation of musculotendon properties in the human upper limb.

The purpose of this study was to develop and apply a general method for estimating the architectural properties of human muscles in vivo. The method consists of a two-phase, nested optimization procedure in which the values of peak isometric force, optimal muscle-fiber length, and tendon slack length are calculated for each musculotendon actuator, knowing muscle volume and the minimum and maximum physiological lengths of the actuator. In phase I, the positions of the bones and the activation levels of the muscles are found by maximizing the isometric torque developed for each degree of freedom at each joint. In phase II, the architectural properties of each musculotendon actuator are found by matching the strength profile of the model to that measured for subjects. The method is used to estimate the architectural properties of 26 major muscle groups crossing the shoulder, elbow, and wrist. Wherever possible, the model calculations are compared against measurements obtained from anatomical studies reported in the literature. Architectural data obtained from our work should be useful to researchers interested in developing musculoskeletal models of the upper limb.

Adult↗
PubMed1992

Repetitive strain disorder: towards diagnostic criteria.

Thirteen women (mean age 48.2 years; range 25-60 years) all of whom had developed musculoskeletal symptoms during employment in an industrial job with repetitive tasks were referred by their trade unions for adjudication on the cause of symptoms. One had rheumatoid arthritis. A study of the other 12 women provided an opportunity to document the natural history of repetitive strain disorder. Early symptoms of weakness were diffuse but were always relieved by rest. Several months later localisation of symptoms at a tendon, nerve, or enthesis could be predicted from the analysis of the action required in the particular repetitive task. Six of the 12 women required an operation several years later, thus providing histological confirmation of the presence of a lesion. Early loss of grip strength measured by a sphygmomanometer cuff compared with an unaffected control subject and improved by rest may be the most valuable sign in excluding compensation neurosis. The estimated prevalence of repetitive strain disorder defined by these strict criteria was at least 2% in conveyor belt workers.

Adult↗
PubMed2002

Bone, muscle, and fat: sex-related differences in prepubertal children.

PURPOSE: To determine whether there are sex-related differences in vertebral cross-sectional dimensions, in paraspinous muscle area, and in the amount of fat in the subcutaneous and visceral compartments of prepubertal boys and girls. MATERIALS AND METHODS: Subcutaneous fat, visceral fat, paraspinous musculature, and vertebral cross-sectional dimensions were studied in 31 pairs of prepubertal healthy white girls and boys 5-10 years of age, rigorously matched for age, height, and weight. Data were analyzed with the Student t test and multiple regression analysis. RESULTS: Sex had a differential effect on fat accumulation and musculoskeletal development. Compared with boys, girls had, on average, 28% greater total fat and 30% higher subcutaneous fat (P <.001 for both), but 10% less paraspinous musculature (P =.002) and 15% smaller vertebral cross-sectional dimensions (P <.001). In contrast, the sexes were monomorphic for visceral fat (P =.24). Stepwise regression analysis indicated that only 22% of the difference in vertebral cross-sectional area could be explained by sex-related differences in paraspinous musculature. CONCLUSION: Together, these data indicate that sex is an important determinant of the morphology in humans well before the beginning of puberty.

Adipose Tissue↗
PubMed2002

The role of physical therapy in the rehabilitation of patients with mastectomy and breast reconstruction.

Women faced with breast cancer may develop musculoskeletal impairments following mastectomy and breast reconstruction. The purpose of this review is to highlight physical therapy considerations with these surgeries. Our experience at a large medical center is described, and suggested exercise guidelines are provided. Close communication between physician and physical therapist is emphasized. Physical therapists facilitate patient education, skillfully evaluate and treat musculoskeletal dysfunctions, and provide individualized patient exercise prescriptions. Physical therapists also serve as valuable members of a multidisciplinary breast cancer team.

Journal Article↗
PubMed2000

Acute response to precision, time pressure and mental demand during simulated computer work.

OBJECTIVES: The electromyographic (EMG) activity of shoulder and forearm muscles was recorded during a standardized computer task with different combinations of time pressure, precision demands, and mental demands to study the interaction of these factors and their effect on muscular response during simulated computer work. METHODS: The computer task lasted 5 minutes, and it was performed by 14 female computer-aided design (CAD) operators during 8 exposure combinations that differed with respect to time pressure, precision demand, and mental demand. Performance (number of produced drawings, mouse clicks, and errors) were recorded. The EMG activity was recorded from the trapezius, infraspinatus, deltoid, and extensor digitorum muscles. An electrogoniometer was used to measure wrist postures and movements. RESULTS: High time pressure (combined with low precision and low mental demands) resulted in higher EMG activity for all the muscles and in a small increase in the number of produced drawings. High precision demands caused a large reduction in the number of produced drawings, but not always a change in EMG activity. High precision demands and high mental demands led to no change or a reduction in muscle activity because the number of drawings was greatly reduced. CONCLUSIONS: The interaction between work pace and other exposure factors must be taken into account when the effects of changes in exposure demands on muscular response are predicted. Only then can it be predicted whether changing demands will constitute a risk of developing musculoskeletal disorders.

Adult↗
PubMed2001

Phase I and pharmacological study of the oral matrix metalloproteinase inhibitor, MMI270 (CGS27023A), in patients with advanced solid cancer.

This Phase I study of MMI270, an p.o. administered matrix metalloproteinase inhibitor, assessed toxicity, pharmacokinetics, and tumor response data and investigated markers of biological activity to recommend a dose for Phase II studies. MMI270 was administered continuously at seven dose levels (50 mg once daily to 600 mg three times/day). Patients were evaluated for toxicity and tumor response, and blood and urine samples were taken for pharmacokinetics, bone resorption markers, direct targets of the inhibitor [matrix metalloproteinase-2 (MMP-2), MMP-8, and MMP-9], indirect targets [tissue inhibitor of metalloproteinase-1 (TIMP-1), TIMP-2, basic fibroblast growth factor, vascular endothelial growth factor, vascular cell adhesion molecule-1, soluble urokinase plasminogen activator receptor, and cathepsins B and H] and for a tumor necrosis factor-alpha cytokine release assay. Ninety-two patients were entered. There was no myelotoxicity. Eighteen patients developed a widespread maculopapular rash, which increased in frequency and severity at doses > or = 300 mg bid. Thirty nine patients developed musculoskeletal side effects, which were related to duration of treatment, not to dose level. Pharmacokinetics were linear, and MMI270 was rapidly absorbed and eliminated with minimal accumulation on chronic dosing. Sustained plasma concentrations in excess of 4 x mean IC(50) for the target enzymes were observed at dose levels > or = 150 mg bid. There were no tumor regressions; however, 19 patients had stable disease for > or = 90 days. There was a dose-response increase of MMP-2 and TIMP-1 with MMI270. Transient effects on the bone resorption markers were detected. MMI270 was generally well tolerated, with adequate plasma levels for target enzyme inhibition. The two main toxicities were rash, resulting in a maximum tolerated dose of 300 mg bid and musculoskeletal side effects. Biological marker data indicate drug effects. The rise in TIMP-1 suggests that a reflex rise in inhibitors could modify the effects of MMI270. The recommended Phase II dose is 300 mg bid.

Administration, Oral↗
PubMed2002

Ergonomic risk factors associated with clinical dentistry.

Ergonomics has formed an integral aspect of dental education at the University of British Columbia since the early 1980s. However, studies continued to indicate that dentists are at risk for developing musculoskeletal problems. This provided the impetus for a study of the risk factors associated with these problems. The data analyzed from 421 survey respondents in British Columbia indicate that indeed dentists are experiencing musculoskeletal pain and discomfort. However, the data also suggest that dentists can recognize and identify their own postures, practicing positions, and the equipment usage patterns that are associated with increased risks of experiencing musculoskeletal pain and discomfort. Such recognition is the first critical step to avoiding or neutralizing ergonomic habits and work environment layouts that might otherwise unnecessarily shorten professional clinical careers.

Adult↗
PubMed2002

The effectiveness of ergonomic intervention in the classroom.

OBJECTIVE: To see if an in-service on proper body mechanics and ergonomics for computer workstation usage can increase a student's knowledge regarding these areas. STUDY DESIGN: This was a quasi-experimental design using a questionnaire. Subjects included seventy-three male and forty-four female sixth-grade students enrolled in a word processing class at a New York Middle School. A non-standardized demographic and ergonomic based questionnaire was administered before and after an in-service. An environmental checklist was used to formulate a percentage of ergonomically correct computer workstations. RESULTS: There was a statistically significant difference between pre and post-test scores, indicating that learning took place. Pre-test scores suggest that there exists a need for ergonomic education in classrooms. Results from an environmental checklist support the need for revision of computer workstations in classrooms. CONCLUSION: Ergonomic education is one way to help students to reduce their risks of developing musculoskeletal injury in a classroom environment that impedes correct positioning.

Adolescent↗
PubMedDate not supplied

Bone scintigraphy of skeletal metastasis in hepatoma patients treated by TAE.

BACKGROUND/AIMS: Skeletal metastasis in hepatocellular carcinoma patients has become clinically important as a result of advances in treatment modalities. However, the diagnostic accuracy of bone scintigraphy in hepatocellular carcinoma has been questioned. METHODOLOGY: 99mTc-MDP bone scintigraphy was performed in 63 unresectable hepatocellular carcinoma patients treated by transcatheter arterial embolization who either developed musculoskeletal pain (n = 43) or elevated serum alpha-fetoprotein levels (n = 20) during follow-up. Results were categorized as positive or negative for metastases, and their accuracy was evaluated by radiological studies, biopsy, and clinical follow-up. RESULTS: Bone scintigraphy was positive in 22/43 (51.2%) subjects with pain and 2/20 with alpha-feto-protein elevation. Among 24 bone scintigraphy(+) patients, metastasis was confirmed in 17 and excluded in 6. Frequent sites for metastatic bone scintigraphy lesions were the spine, pelvic bone and ribs. Although 8 metastatic lesions had low or mixed uptake, most had increased uptake on bone scintigraphy. Among 39 bone scintigraphy(-) patients, metastasis was excluded in 32 and confirmed in 1. The sensitivity and specificity of bone scintigraphy in this subset of patients was 94.4% and 84.2%, respectively. CONCLUSIONS: Transcatheter arterial embolization treated hepatocellular carcinoma patients with musculoskeletal pain have a high likelihood of bone metastasis, and bone scintigraphy is a highly reliable method for its detection.

Adult↗
PubMed1989

Magnetic resonance imaging of the musculoskeletal system in children.

Pediatric applications of magnetic resonance imaging (MRI) differ from those in adults primarily with respect to the focus on congenital and developmental abnormalities and those pathologic conditions that are unique to children. Sedation is often required for younger children to avoid motion. Quality diagnostic images also require the use of appropriate sizes of surface and planar coils. MRI is an excellent method to evaluate bone marrow involvement and soft-tissue extension of osteosarcoma and Ewing's sarcoma. In children, it is important to be aware of the changes in normal bone marrow signal that occur with maturation and with the normal progression of the replacement of red marrow by yellow marrow. Aplastic and hypercellular anemias have differing MRI features. The high-contrast resolution of the soft tissues, including the spinal cord, and the capability for direct imaging in any plane make MRI an excellent modality for the evaluation of the spine, including congenital malformations.

Bone Marrow↗
PubMed1996

Development of a musculoskeletal extremity health status instrument: the Musculoskeletal Function Assessment instrument.

Despite an increasing reliance on the use of health status measures to assess and evaluate medical care, no single instrument is currently available for use with the broad range of patients with musculoskeletal disorders of the extremities that is commonly seen in clinical practice. In this paper, we report on the development of the Musculoskeletal Function Assessment instrument, a 100-item self reported health status instrument that is designed to meet this need. The instrument was developed in two phases. During the first phase, items were selected on the basis of interviews with 135 patients and 12 clinicians and from reviews of existing health status instruments. The items then were grouped into categories. During the second phase, the instrument was tested for reliability and content validity using a sample of 327 patients with one of five musculoskeletal disorders of the upper and lower extremities (fractures, soft-tissue injuries, repetitive motion disorders, osteoarthritis, and rheumatoid arthritis). The patients were selected from both community and academic sites. Content validity also was demonstrated, based on a review of item selection procedures, expert opinion, and the distribution of scores on the instrument.

Adolescent↗
PubMed2002

Measuring the experiences of health care for patients with musculoskeletal disorders (MSD): development of the Picker MSD questionnaire.

Analysis of data from a survey of patients with musculoskeletal problems (mainly back and neck pain) to develop a core measure of patients' experiences of health care. A secondary purpose was to determine whether a single summary index figure could be generated from the instrument. The data reported here comes from a postal survey of patients attending a spine clinic in Stockholm, Sweden. After attending the clinic patients were mailed a questionnaire. Up to two reminders were sent to nonresponders. Questionnaires were sent to 342 patients. Totally 173 (51%) questionnaires were returned, of which 38.1% respondents were male and 61.2% female. The mean age of patients was 54 years (SD 13.84), ranging from 16 to 88. Sixteen items on the questionnaire were found to constitute a reliable index of patient experience and which seem to be tapping the most important aspects of patient experience. The index score was found to have high construct validity. The instrument provides a core set of issues that should be covered when assessing the quality of care patients attending clinics for musculoskeletal disorders.

Adolescent↗
PubMed1999

The young athlete.

BACKGROUND: It is very much part of the Australian lifestyle to encourage children and adolescents to participate in sport and exercise. As a result the general practitioner is often presented with injuries in younger patients. OBJECTIVE: This article presents an overview of the growth and development of the musculoskeletal system, and discusses relevant aspects of conditioning and training and the nature of injuries seen in the younger athlete. DISCUSSION: The range of common musculoskeletal problems seen in young children and adolescents is outlined with some recommendations made for an approach to management of the commoner conditions.

Adolescent↗