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Results for “Cumulative Trauma Disorders”

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At least 1,225 records · Page 68Linked to original sources
PubMed2001

Intersection syndrome in Buriram Hospital: a 4-yr prospective study.

OBJECTIVE: To determine the prevalence, demographic characteristics, symptoms, treatment, and outcome of patients who presented to Buriram Provincial hospital and were diagnosed with intersection syndrome. DESIGN: This was a 4-yr prospective study that included all patients with new complaints of forearm and hand pain who presented to Buriram hospital as inpatients or outpatients. RESULTS: The prevalence of intersection syndrome was found to be 0.37% of all patients (8080) with arm or hand pain. Of the 30 patients presenting with intersection syndrome, all had forearm pain, 22 (73.3%) had swelling, and 12 (40%) had crepitus noted in the intersected region. Fourteen (46.7%) patients reported pain provoked with twisting hand motions with radial deviations, 4 (13.3%) with pulling, and 12 (40%) with combinations of multiple hand movements (threshing, planting, hammering, hand washing, spraying and cementing). The majority of the patients were male (70%) farmers (60%). Twenty-nine patients received nonoperative treatment, including modified work activities to reduce stress on the wrist, nonsteroidal anti-inflammatory, and analgesic medications. One patient received only analgesic medication. One patient additionally required a resting hand splint. Every patient was seen for follow-up within the next 7 days. By 12-18 months posttreatment, there were only 14 patients (46.6%) remaining in follow-up, none with any symptom recurrence. CONCLUSION: Intersection syndrome is a relatively uncommon, overused syndrome that is associated with repeated radial deviation of the wrist and responds favorably to conservative treatment.

Adult↗
PubMed2001

Alternative modes of manual wheelchair ambulation: an overview.

An estimated 90% of all wheelchairs are hand-rim propelled, a physically straining form of ambulation that can lead to repetitive strain injuries in the arms and, eventually, to secondary impairments and disability. Further disability in wheelchair-dependent individuals can lead to a sedentary lifestyle and thereby create a greater risk for cardiovascular problems. Studies on lever-propelled and crank-propelled wheelchairs have shown that these propulsion mechanisms are less straining and more efficient than hand-rim-propelled wheelchairs. This article reviews these studies and substantiates that the frequent use of these alternative propulsion mechanisms may help prevent some of the secondary impairments that are seen among today's wheelchair-user population.

Cumulative Trauma Disorders↗
PubMed2002

Exercise-induced muscle damage in humans.

Exercise-induced muscle injury in humans frequently occurs after unaccustomed exercise, particularly if the exercise involves a large amount of eccentric (muscle lengthening) contractions. Direct measures of exercise-induced muscle damage include cellular and subcellular disturbances, particularly Z-line streaming. Several indirectly assessed markers of muscle damage after exercise include increases in T2 signal intensity via magnetic resonance imaging techniques, prolonged decreases in force production measured during both voluntary and electrically stimulated contractions (particularly at low stimulation frequencies), increases in inflammatory markers both within the injured muscle and in the blood, increased appearance of muscle proteins in the blood, and muscular soreness. Although the exact mechanisms to explain these changes have not been delineated, the initial injury is ascribed to mechanical disruption of the fiber, and subsequent damage is linked to inflammatory processes and to changes in excitation-contraction coupling within the muscle. Performance of one bout of eccentric exercise induces an adaptation such that the muscle is less vulnerable to a subsequent bout of eccentric exercise. Although several theories have been proposed to explain this "repeated bout effect," including altered motor unit recruitment, an increase in sarcomeres in series, a blunted inflammatory response, and a reduction in stress-susceptible fibers, there is no general agreement as to its cause. In addition, there is controversy concerning the presence of sex differences in the response of muscle to damage-inducing exercise. In contrast to the animal literature, which clearly shows that females experience less damage than males, research using human studies suggests that there is either no difference between men and women or that women are more prone to exercise-induced muscle damage than are men.

Adaptation, Physiological↗
PubMed1993

Overexertional lumbar and thoracic back pain among recruits: a prospective study of risk factors and treatment regimens.

A total of 395 male infantry recruits were evaluated in a prospective study of possible risk factors for overexertional back pain and the efficacy of drug treatment regimens for this syndrome. Recruits were classified into subgroups of lumbar or thoracic, and paraspinal or spinous process pain. Recruits were divided into three treatment groups: Ibuprofen, Paracetamol, and no drug treatment. Of the recruits, 18% were diagnosed as having overexertional back pain during the course of 14 weeks of training. By multivariate analysis low body mass index was found to be a risk factor for overexertional lumbar pain (p = 0.005) and increased lumbar lordosis a risk factor for overexertional thoracic pain (p = 0.005). Of recruits with overexertional back pain, 65% were asymptomatic by the end of basic training. There was no statistically significant difference between cure rates according to treatment groups.

Acetaminophen↗
PubMed1988

Unusual stress fracture of the scapula in a jogger.

A case of fracture of the right scapula in the superomedial portion with no history of direct trauma is presented. It is most likely due to jogging with weights in both hands. A brief review of scapular fractures is also reported.

Adult↗
PubMed1992

Osteitis pubis, Tc-99m MDP, and professional hockey players.

Three cases of osteitis pubis detected by bone scanning with Tc-99m MDP in professional ice hockey players are presented. This entity is related to mechanical stress and aggravated by forceful contraction of the adductor and rectus abdominis muscles. The signs, symptoms, and laboratory data are relatively nonspecific, as are radiographic findings in the early stage (pubic symphysitis). The use of bone scanning in the appropriate clinical setting aids in diagnosis.

Abdominal Muscles↗
PubMed1992

Scintigraphic assessment of "effort" axillary-subclavian vein thrombosis.

"Effort" axillary-subclavian vein thrombosis (Paget-Schroetter syndrome) is an uncommon deep venous thrombosis due to repetitive activity of the upper limb. Clinical suspicion is usually confirmed by contrast venography. This report describes a case where the diagnosis was made by radionuclide venography (Tc-99m DTPA). The examination was carried out in the acute phase and clearly demonstrated the presence and the site of the obstruction as well as the collateral vessels. Despite a complete clinical recovery, obtained by medical therapy, further examinations performed in the follow-up period showed persistence of the thrombotic obstruction and a rich development of collateral vessels. In the authors' opinion, radionuclide venography is worth considering as a first-choice procedure when an axillary-subclavian vein thrombosis is suspected, and contrast venography should be performed only when surgical treatment is indicated.

Adult↗
PubMed1995

Detection of increased blood flow to the affected arm in repetitive strain injury with radionuclide and Doppler ultrasound studies. A case report.

A case of clinically diagnosed repetitive strain injury was referred for investigation to rule out the possibility of an occult bone disease. The patient was a female keyboard operator who had pain and tenderness over the flexor muscles of the right hand and arm. The pain was severe and almost constant. The authors observed an increase in Tc-99m MDP delivery to the affected forearm during the dynamic sequence of a three-phase bone scintigram, indicating increased blood flow compared to the contralateral side. The same result was achieved using quantitative blood flow measurements with the Doppler technique and Tc-99m HMPAO perfusion imaging. These findings agree with recent studies that suggest increased total arm blood flow in repetitive strain injury and may provide an easy screening method.

Adult↗
PubMed1996

The three-phase bone scan and exercise induced lower-leg pain. The tibial stress test.

The three-phase bone scan is finding increasing utility in acute and chronic pain syndromes in sports medicine settings. This useful technique may have significant clinical application in assessing the increasing numbers of patients with exercise induced lower leg or medial tibial pain. The authors present a case of exertional lower leg pain or medial tibial pain in which three-phase bone imaging exhibited a dramatic increase in early flow after a simple derived exercise stress. The three-phase bone scan should play a key role in the assessment of exercise pain, and may be enhanced by the addition of simple exercise intervention.

Adult↗
PubMed2001

TI-201 scintigraphy in muscle trauma.

Muscle uptake of Tl-201 thallous chloride in the larger or more major groups, particularly the legs, chest, and upper limb areas, is not uncommonly observed in healthy persons. However, as illustrated in three patients, such uptake, when localized or asymmetric, may provide evidence of unrecognized traumatized muscle, resulting from more chronic or subacute muscle overuse than the acute muscle insult that produces the marked uptake of Tc-99m phosphates associated with frank rhabdomyolysis.

Adult↗
PubMed2002

Longitudinal tibial fatigue fracture: an uncommon stress fracture with characteristic features.

PURPOSE: The author reports three cases of longitudinal tibial fatigue fractures, reviews the literature, and discusses characteristic features that suggest the diagnosis may be made by bone scintigraphy. METHODS: Radiographs and two- or three-phase bone scintigraphs with Tc-99m MDP were obtained in three runners who had exercise-related leg pain and whose clinical symptoms suggested either stress fractures or shin splints. The literature was reviewed and previously reported scintigraphic findings were compared with those seen in these three cases. RESULTS: In contrast to the focal, elliptical, cortex-based abnormal activity usually seen in the upper or middle tibia in patients with tibial stress fractures, all three patients had a long area of abnormal diffusely increased tibial activity that extended from the tibiotalar region proximally. This finding was seen on the 3-hour delayed static images of all three patients and was suggested on the blood-pool (tissue phase) images. The literature also contained reports of these same scan characteristics. Radiographs subsequently disclosed a longitudinal tibial stress fracture in one patient, computed tomography was positive in the second patient, and findings of clinical follow-up and radiographs were consistent with this diagnosis in the third patient. CONCLUSION: In the appropriate clinical setting and with normal or nondiagnostic radiographs, the presence of a long area of diffusely increased activity in the distal tibia extending proximally from the tibiotalar junction is indicative of a longitudinal fatigue fracture.

Adult↗
PubMed1999

Gender and pregnancy affect neuropeptide responses of the rabbit Achilles tendon.

Tendons such as the Achilles tendon are complex structures that are hypocellular, hypovascular, and hyponeural. The development of pathophysiologic function in this tendon because of overuse is relatively common; however, the mechanisms responsible for the development of paratenonitis and tendinosis remain primarily undefined. To understand better a possible regulatory role for neuropeptides (substance P and calcitonin gene related peptide) known to be present in this tissue, the influence of substance P and calcitonin gene related peptide on messenger ribonucleic acid levels for numerous inflammatory molecules, growth factors, and proteinases and inhibitors have been assessed using a semiquantitative reverse transcription-polymerase chain reaction method and explants of paratenon and Achilles tendon midsubstance tissue from adolescent male and female rabbits and tissue from primigravida females. Most of the significant (p < 0.01) changes observed were at the level of the growth factor transcripts and transcripts for proteinases and inhibitors. Twenty-one significant differences in the responsiveness between tissues from male and female rabbits were observed, and 12 significant differences in responsiveness between virgin females and primigravida rabbits were seen. Differences between paratenon and midsubstance responsiveness to the neuropeptides also were observed within each group of animals. The midsubstance tissue from pregnant animals was hyporesponsive to both neuropeptides. These results indicate that neurotransmitter responsiveness of Achilles tendon tissue differs in a gender specific manner and is influenced by pregnancy associated factors.

Achilles Tendon↗