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PubMed1998

Soft tissue texture analysis by B-mode-ultrasound in the evaluation of impairment in chronic low back pain.

OBJECTIVE: Patients complaints in chronic low back pain do not always correspond to the results of X-ray and MRI investigations. The paraspinal muscle is very sensitive to all structural disorders of the spine. We used B-mode-ultrasound to investigate the change of the ultrasonic texture of the paraspinal lumbar muscle in people suffering from low back pain. METHODS: The quantitative texture analysis was defined by the ratio of the mean echo level of a unilateral cross-section (L2) of the paraspinal muscle and the level of a central area (L1) of the same cross-section (square 1 x 1 cm, defined by the ultrasonic device). In the lumbar spine there were five cross sections on either side starting at L1 through L5. In the first study healthy males were investigated (n=30). In the second study, 20 males with MRI controlled lumbar disc disorders were investigated. Finally screening was performed with a group of 40 male patients. The last investigation was a pathohistologic cross-check from the ultrasonic findings in five individual shortly after exitus. RESULTS: The ratio showed results >0.6 in the healthy group. The group with lumbar disc disorders showed at the affected levels ratios <0.5. All patients (with one exception) with a lumbar spinal history were detected. Pathohistology confirmed the ultrasonic findings. CONCLUSIONS: The ultrasonic texture analysis of the paraspinal lumbar muscle allows a rapid and easy to perform investigation for relating discal (actually all structural) disorders of the lumbar spine to the reported pain or disability.

Adult↗
PubMed1996

Physical loading and performance as predictors of back pain in healthy adults. A 5-year prospective study.

We investigated muscle strength, aerobic power, and occupational and leisure-time physical loading as predictors of back pain in a 5-year follow-up study. A cohort of 456 adults aged 25, 35, 45 and 55 years, free of back pain, participated in measurements of anthropometric characteristics, aerobic power and muscle strength characteristics at baseline. The subjects' levels and types of physical activity and occupational physical loading were also determined. At 5 years after the baseline examinations 356 of these subjects (78.1%) were reached by mail, and 262 of them (73.6%) properly completed and returned a questionnaire including a detailed back pain history for the 5 years following the baseline measurements. Of this number 56 subjects (21%) who reported back pain (> 30 on a scale from 0 to 100) and functional impairment during the 5-year follow-up composed the marked back pain group. Other subjects (n = 71, 27%) noting lesser symptoms were included in the mild back pain group; 135 subjects (52%) reported having had no back pain. The subjects with marked back pain were on average taller than the subjects without back pain, while no such difference was found in body mass. Heavy occupational musculoskeletal loading (P = 0.005) and high general occupational physical demands (P = 0.036) predicted future back pain. Leisure-time physical activity, aerobic power or muscle strength characteristics were not predictive of future back pain.

Adult↗
PubMed1992

Surface EMG topography and pain distribution in pre-chronic back pain patients.

The relationship between surface EMG recordings from paraspinalis recording sites and subjective pain ratings were examined in a group of pre-chronic back pain patients. thirty-eight back pain patients without major orthopedic diagnosis and a pain duration between 2 to 6 months participated in a three week long subjective pain rating. Following the completion of their pain diary, the paraspinal sites were assessed under the "static" postural conditions of sitting and standing using an EMG scanning procedure. Results of the correlational analysis revealed significant and positive relationships between pain and muscle activity in the upper back (Trapezius, T1 paraspinalis sites) and significant but negative relationships between erector spinae activity (L3 paraspinalis site) and pain. When considering etiological factors of pre-chronic back pain, the results support both the organicity model for upper back, as well as the biomechanical model for the lower back.

Adult↗
PubMed2002

[A monitoring study of electromyography median frequency on fatigue of erector spinalis in drivers working at high altitude].

OBJECTIVE: To evaluate the role of muscle fatigue in the pathogenesis of high prevalence of low back pain(LBP) in drivers who work at high altitude, in order to seek the effective measures for prevention and treatment of LBP. METHOD: The spectral electromyographic(EMG) changes during isometric contraction of erector spinalis to fatigue in 26 drivers in the field were consecutively recorded after daily driving for 5 days. The relationship between the decline of median frequency and the development of the back extensor fatigue were analyzed. RESULTS: The decline rates of EMG median frequency of the erector spinalis on 1-5 working day [(-0.258 +/- 0.087), (-0.248 +/- 0.070), (-0.256 +/- 0.097), (-0.267 +/- 0.093), (-0.274 +/- 0.081)%/s respectively] were significantly different from that of baseline measured before work [(-0.175 +/- 0.114)%/s, P < 0.05 or P < 0.01]. A positive correlation was also found between the decline rate and the working time(r = -0.809, P < 0.05). CONCLUSION: The high prevalence of LBP in the drivers working at high altitude is due to acumulative fatigue of back extensor resulting from long-distance driving, lack of proper rest, decrease of muscle endurance and increase of liability to fatigue, consequently leading to the muscle dysfunction and finally LBP.

Altitude↗
PubMed1991

Comparison of muscle strength and bone mineral density in healthy postmenopausal women. A cross-sectional population study.

In this cross-sectional population study with 78 healthy 0.5-5 years postmenopausal, 49-55 year old females a significant simple linear correlation between lumbar spine LII-LIV bone mineral density and adjacent back extensor and flexor isometric muscle strength was found. With the stepwise multiple linear regression analyses the most significant predictors for lumbar spine LII-LIV and femoral neck bone mineral density were weight (partial R2) (R2 = 0.197, p = 0.0001; R2 = 0.157, p = 0.0009) and age (R2 = 0.056, p = 0.0205; R2 = 0.036, p = 0.0708). Height and isometric muscle strength and endurance of muscles were not significant predictors. Weight and age were the most significant predictors also for isometric muscle strength. The mobility of spine, body fat content and anaerobic threshold had no correlation on bone mineral density.

Absorptiometry, Photon↗
PubMed1983

Clinical work posture for the dentist: an electromyographic study.

The results of this study suggest that lumbar support is a significant factor in reducing muscle activity of the upper and lower back for the dentist practicing sit-down dentistry. The importance of lumbar support should be emphasized in any criteria listing correct work posture for the dentist. Under the conditions of this study, stool heights did not influence muscle activity significantly, but did suggest a trend in considering problems of the lower back posture--low stool heights (90 degrees and 75 degrees) produced lower activity than a high stool height (105 degrees) if the back was supported. Therefore, in regard to muscle activity, results of this study suggest that the dental operator should sit low with the lumbar support always in contact with the lower back.

Back↗
PubMed2005

Isokinetic muscle strength of the trunk and bilateral knees in young subjects with lumbar disc herniation.

STUDY DESIGN: Cross-sectional study comparing normal subjects and patients with lumbar disc herniation. OBJECTIVE: To evaluate trunk and knee muscle strength in patients with L4-L5 and/or L5-S1 disc herniation. SUMMARY OF BACKGROUND DATA: Numerous studies have shown that patients with low back pain have weaker trunk muscles. The strength of trunk and knee muscles has not been investigated simultaneously in patients with lumbar disc herniation. METHODS: Forty-one controls and 2 patients were included. Isokinetic strength of the trunk and bilateral knees was tested on a calibrated isokinetic testing machine (Biodex System 3 Pro) regardless of the laterality of the radiculopathy. The testing was carrying out at two different velocities: 60 degrees and 120 degrees per second. RESULTS: Total trunk strength and knee strength were significantly lower in these patients (4.34 +/- 1.06 and 4.06 +/- 1.16 vs. 6.21 +/- 1.05 and 5.83 +/- 1.09 Nm/kg at 60 degrees and 120 degrees per second, respectively, P < 0.001). In patients with unilateral sciatica, there was no significant difference (P > 0.05) in unilateral knee strength between sciatica-involved and -uninvolved limbs (1.89 +/- 0.5, 1.08 +/- 0.45, 1.48 +/- 0.58, 0.93 +/- 0.41 vs. 1.68 +/- 0.45, 0.91 +/- 0.38, 1.41 +/- 0.48, 0.79 +/- 0.39 Nm/kg in sciatica-uninvolved vs. sciatica-involved limbs during extension and flexion at 60 degrees and 120 degrees per second, respectively). Total trunk strength was significantly correlated with total knee strength in both groups. CONCLUSIONS: In the patients with lumbar disc herniation, muscle strength of the trunk and knees was decreased to a similar extent. Weaker knee strength was found on either side of the lower extremity in the patients with unilateral sciatica, regardless of its location.

Adult↗
PubMed1989

[Development of functional stability of the musculoskeletal system in athletes in childhood and adolescence].

Based on the experience gained in sports medicine a review is given on the development of functional stability of the musculoskeletal and locomotive system in actively sporting children and adolescents. Inadequate physical exercise during the growth periods may result in maladaption. Children retarded in their musculoskeletal development exhibit a reduced exercise tolerance. A training system with a high amount of exercises strengthening muscles in general may improve the efficiency of the locomotive system. In school children deficient muscular training results in a progressive reduction of stretching capacity of back and thigh (upper part) muscles. With a view to primary prevention of premature disturbances of the musculoskeletal and articular systems more attention has to be attached to the development of functional stability by adequate physical training both at school and during free-time activities.

Adolescent↗
PubMed2000

[The stiff-man syndrome with diabetes mellitus type 1 and autoimmune thyroiditis].

HISTORY AND ADMISSION FINDINGS: A 54-year-old woman with type 1 diabetes of about 2 years' duration developed painful cramps in the muscles of the abdominal wall, the back and the thighs. On admission physical examination confirmed markedly increased tone of the muscles of the trunk and those proximal to it. INVESTIGATIONS: Markedly increased amounts of anti-GAD (glutamic acid decarboxylase) antibodies were present in both serum and cerebrospinal fluid (CSF). Electroneurography and -myography revealed mild polyneuropathy but no other neurological abnormality. DIAGNOSIS, TREATMENT AND COURSE: Suspected stiff-man syndrome (SMS) was confirmed by the increased anti-GAD antibodies and the marked improvement on gradually increasing doses of clonazepam. The autoimmune syndrome affected several organ systems: central nervous system (SMS), pancreas (diabetes), thyroid (immuno-thyroiditis). Immunosuppressive treatment with azathioprine was begun. The patient remains in good general condition 22 months after the initial diagnosis, and there have been no new organ involvement. CONCLUSION: It is important to include SMS in the differential diagnosis, even though the symptoms are not those of the full-blown picture of this rare disease. Absence of muscle cramps and myoclonus but presence of depressive symptoms can easily result in misdiagnosis, preventing early initiation of effective symptomatic treatment.

Azathioprine↗
PubMed1982

Effects of Latrodectus spider venoms on sensory and motor nerve terminals of muscle spindles.

The effects of the venoms of the spiders Latrodectus mactans tredecimguttatus (black widow) and Latrodectus mactans hasselti (red back) on sensory nerve terminals in muscle spindles were studied in the mouse. A sublethal dose of venom was injected into tibialis anterior and extensor digitorum longus muscles of one leg. After survival from 30 minutes to 6 weeks muscles were examined in serial paraffin sections impregnated with silver or by electron microscopy. Sensory endings became swollen, some within 30 minutes, while over the next few hours there was progressive degeneration of annulospiral endings. By 24 hours every spindle identified by light or electron microscopy was devoid of sensory terminals. Degenerated nerve endings were taken up into the sarcoplasm of intrafusal muscle fibres. Regeneration of sensory axons began within 24 hours, new incomplete spirals were formed by 5 days and by 1 week annulospiral endings were almost all normal in appearance. Intrafusal motor terminals underwent similar acute degenerative and regenerative changes. These experiments show that intrafusal sensory and motor terminals are equally affected by Latrodectus venoms. Sensory nerve fibres possess a capacity for regeneration equal to that of motor fibres and reinnervate intrafusal muscle fibres close to their original sites of innervation.

Animals↗
PubMed2002

Titin--springing back to youth?

Mutations in the muscle protein titin have been linked to dilated cardiomyopathy, a condition in which the heart chambers are enlarged and blood is ineffectively pumped, in humans and in animal models. This protein, which is a component of sarcomeres, provides essential scaffolding for other muscle proteins and acts as a spring to confer passive elasticity on the cardiomyocyte. Several titin isoforms exist, and they display varying size and degrees of elasticity. We review two interesting reports that show how variations in titin isoforms might be implicated in cardiac failure.

Aging↗
PubMed2000

Sclerotomal origin of the ribs.

The somites of vertebrate embryos give rise to sclerotomes and dermomyotomes. The sclerotomes form the axial skeleton, whereas the dermomyotomes give rise to all trunk muscles and the dermis of the back. The ribs were thought to be ventral processes of the axial skeleton and therefore to be derived from the sclerotomes; however, recently a dermomyotomal origin of the distal rib (the costal shaft) was suggested, with only the proximal parts (head and neck of the rib) being of sclerotomal origin. We have re-investigated the development of the ribs in quail-chick chimeras and carried out three experimental series. (1) Single dermomyotomes and (2) single sclerotomes were grafted homotopically, and (3) the ectoderm overlying the unsegmented paraxial mesoderm was removed in the prospective thoracic region. We found that the cells of the dermomyotome gave rise to epaxial and hypaxial trunk muscles, dermis of the back and endothelial cells, but not to ribs. Cells of the sclerotome formed the axial skeleton and all parts of the ribs. Ablation of the ectoderm, which affects dermomyotome development, results in severe malformations of the ribs, probably due to disturbed interactions between dermomyotome and sclerotome. Our results strongly confirm the traditional view of the sclerotomal origin of the ribs.

Animals↗
PubMed1990

[Poor body posture from the aspect of kinesiology].

We investigated the presence of abbreviations of the muscles of the pelvi-femoral muscular tissue, the calf flexors of leg, short back extensors as wall as the muscles strength of the abdominal wall, because the present abbreviation and decrease of muscle strength indicate bad posture of body which is presents the foundation of the lumbal syndrome. All subjects were divided into three groups according to the age (7, 9 and 18 years) and we determined muscular abbreviations regarding decreased strength by means of four tests. All present abbreviations as well as decreased muscular strength point to the necessity of early detection and treatment of these phenomenon in the prevention of lumbal syndrome.

Adolescent↗