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Associations between Abdominal Trunk Muscle Weakness and Future Osteoporotic Vertebral Fracture in Middle-Aged and Older Adult Women: A Three-Year Prospective Longitudinal Cohort Study. J Clin Med 2022; 11:jcm11164868. [PMID: 36013104 PMCID: PMC9410457 DOI: 10.3390/jcm11164868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022] Open
Abstract
Potential risk factors associated with future osteoporotic vertebral fracture (OVF) were prospectively investigated in middle-aged and older adult women. We enrolled 197 female patients aged ≥50 years who were scheduled to undergo surgery for lower-extremity degenerative diseases. Patient anthropometric and muscle strength measurements, a bone mineral density measurement of the lumbar spine (L-BMD), and full-spine standing radiographs to examine the presence of old OVFs and spinopelvic sagittal parameters were obtained preoperatively. We evaluated 141 patients who underwent full-spine standing radiographs three years postoperatively to identify new OVFs. We excluded 54 patients who did not undergo a second radiographic examination and 2 with new traumatic OVFs. Univariate and multivariate analyses were performed to identify risk factors associated with new non-traumatic OVF occurrence. Ten (7.1%) patients developed new non-traumatic OVFs during the study period (fracture group). The fracture group had less abdominal trunk muscle strength, lower L-BMD, smaller sacral slopes, and larger pelvic tilt than the non-fracture group. The fracture group showed a higher prevalence of old OVFs preoperatively than the non-fracture group. Abdominal trunk muscle weakness, low L-BMD, and the presence of old OVFs were identified as significant risk factors for OVF occurrence. In middle-aged or older adult women, abdominal trunk muscle weakness, low L-BMD, and old OVFs were associated with future OVF.
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Exposure to Sustained Flexion Impacts Lumbar Extensor Spinae Muscle Fiber Orientation. J Appl Biomech 2021; 37:248-253. [PMID: 33631717 DOI: 10.1123/jab.2020-0238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/25/2020] [Accepted: 01/08/2021] [Indexed: 11/18/2022]
Abstract
The lumbar extensor spinae (LES) has an oblique orientation with respect to the compressive axis of the lumbar spine, allowing it to counteract anterior shear forces. This mechanical advantage is lost as spine flexion angle increases. The LES orientation can also alter over time as obliquity decreases with age and is associated with decreased strength and low back pain. However, it is unknown if LES orientation is impacted by recent exposures causing adaptations over shorter timescales. Hence, the effects of a 10-minute sustained spine flexion exposure on LES orientation, thickness, and activity were investigated. Three different submaximally flexed spine postures were observed before and after the exposure. At baseline, orientation (P < .001) and thickness (P = .004) decreased with increasingly flexed postures. After the exposure, obliquity further decreased at low (pairwise comparison P < .001) and moderately (pairwise comparison P = .008) flexed postures. Low back creep occurred, but LES thickness did not change, indicating that decreases in orientation were not solely due to changes in muscle length at a given posture. Activation did not change to counteract decreases in obliquity. These changes encompass a reduced ability to offset anterior shear forces, thus increasing the potential risk of anterior shear-related injury or pain after low back creep-generating exposures.
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Gruevski KM, Callaghan JP. The effect of age, prolonged seated work and sex on posture and perceived effort during a lifting task. APPLIED ERGONOMICS 2020; 89:103198. [PMID: 32658771 DOI: 10.1016/j.apergo.2020.103198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
The purpose of this investigation was to determine the effect of prolonged seated work, lift task, age and sex on normalized lumbar angles, thoracic angles, perceived effort and duration of lifts. A total of 17 young and 17 mature participants were recruited with an average (standard deviation) age of 23.8 (5.0) years and 63.7 (3.9) years, respectively. Participants completed 3 different floor to knuckle lifts before and following 90 min of seated work. The lifts included; (i) 7 kg symmetrical, (ii) 4.5 kg symmetrical and (iii) 4.5 kg asymmetrical. Prolonged seated work and age interacted to affect normalized peak lumbar angles (p = 0.0469) where older adults adopted 56(15)% flexion after seated work compared to 67(16)% among younger adults. Older adults took significantly longer to complete the lifting tasks compared to younger adults while age did not affect perceived effort across lifting tasks. Older workers may require age specific interventions given age specific responses.
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Affiliation(s)
- Kristina M Gruevski
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, N2L-3G1, Canada
| | - Jack P Callaghan
- Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, N2L-3G1, Canada.
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Dallaway A, Kite C, Griffen C, Duncan M, Tallis J, Renshaw D, Hattersley J. Age-related degeneration of the lumbar paravertebral muscles: Systematic review and three-level meta-regression. Exp Gerontol 2020; 133:110856. [PMID: 32006635 DOI: 10.1016/j.exger.2020.110856] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Morphological changes of the lumbar spine muscles are not well characterised with ageing. To further the understanding of age-related degeneration of the lumbar spine musculature, normative morphological changes that occur within the paravertebral muscles must first be established. METHODS A systematic review and meta-regressions were conducted adhering to PRISMA guidelines. Searches for published and unpublished data were completed in June 2019. RESULTS Searches returned 4781 articles. 34 articles were included in the quantitative analysis. Three-level meta-analyses showed age-related atrophy (r = -0.26; 95% CI: -0.33, -0.17) and fat infiltration (r = 0.39; 95% CI: 0.28, 0.50) in the lumbar paravertebral muscles. Degenerative changes were muscle-specific and men (r = -0.32; 95% CI: -0.61, 0.01) exhibited significantly greater muscle atrophy than women (r = -0.24; 95% CI: -0.47, 0.03). Imaging modality, specifically ultrasound, also influenced age-related muscle atrophy. Measurements taken across all lumbar levels revealed the greatest fat infiltration with ageing (r = 0.58, 95% CI: 0.35, 0.74). Moderators explained a large proportion of between-study variance in true effects for muscle atrophy (72.6%) and fat infiltration (79.8%) models. CONCLUSIONS Lumbar paravertebral muscles undergo age-related degeneration in healthy adults with muscle, lumbar level and sex-specific responses. Future studies should use high-resolution imaging modalities to quantify muscle atrophy and fat infiltration.
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Affiliation(s)
- A Dallaway
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, Coventry University, Coventry CV1 2DS, United Kingdom; Human Metabolic Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Rd, Coventry CV2 2DX, United Kingdom.
| | - C Kite
- School of Life and Health Sciences, Cell and Tissue Biomedical Research Group, Aston University, Aston Triangle, Birmingham B4 7ET, United Kingdom; Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury SY3 8HQ, United Kingdom
| | - C Griffen
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, Coventry University, Coventry CV1 2DS, United Kingdom; Human Metabolic Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Rd, Coventry CV2 2DX, United Kingdom
| | - M Duncan
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, Coventry University, Coventry CV1 2DS, United Kingdom; School of Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, Coventry University, Coventry CV1 2DS, United Kingdom
| | - J Tallis
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, Coventry University, Coventry CV1 2DS, United Kingdom; School of Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, Coventry University, Coventry CV1 2DS, United Kingdom
| | - D Renshaw
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, Coventry University, Coventry CV1 2DS, United Kingdom
| | - J Hattersley
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, Coventry University, Coventry CV1 2DS, United Kingdom; Human Metabolic Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Rd, Coventry CV2 2DX, United Kingdom
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Kato S, Demura S, Kurokawa Y, Shinmura K, Yokogawa N, Yonezawa N, Shimizu T, Oku N, Kitagawa R, Matsubara H, Kabata T, Tsuchiya H. Correlation between osteoporotic vertebral fracture and abdominal trunk muscle strength in middle-aged and older women. Arch Osteoporos 2019; 14:106. [PMID: 31673807 DOI: 10.1007/s11657-019-0654-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/09/2019] [Indexed: 02/03/2023]
Abstract
We investigated the correlation between abdominal trunk muscle strength and spinal deformities in middle-aged and older women. The results indicated that abdominal trunk muscle weakness, older age, and low lumbar bone mineral density were significant risk factors associated with the presence of OVFs in the lower thoracic and lumbar spine. PURPOSE We developed an innovative exercise device for the abdominal trunk muscles that also measures muscle strength. We investigated the correlation between the strength and thoracolumbar spinal deformity in middle-aged and older women. METHODS This study included 206 consecutive female patients who were 50 years or older and scheduled to undergo surgery for degenerative diseases of the lower extremities. Patients with a history of symptomatic osteoporotic vertebral fractures (OVFs) requiring treatments were excluded. Before surgery, patients underwent physical measurements including abdominal trunk muscle strength using our device, full-spine standing radiography, and bone mineral density measurement of the lumbar spine (L-BMD). According to radiographic findings of the radiogram, patients were divided into four groups: control group (n = 134), listhesis group (n = 29), scoliosis group (n = 19), and fracture group (n = 24). The Tukey-Kramer honestly significant difference test was used to compare all measurements among the four groups. To identify factors associated with the presence of OVFs, a multivariate logistic regression analysis was performed. RESULTS The average abdominal trunk muscle strength in the fracture group was significantly lower than that of the control group. The multivariate analysis revealed that abdominal trunk muscle weakness, older age, and a low L-BMD were associated with OVF findings. CONCLUSIONS Abdominal trunk muscle weakness in middle-aged and older women was associated with OVF. The strength measurement can be a risk assessment of OVF.
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Affiliation(s)
- Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
| | - Satoru Demura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Yuki Kurokawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Kazuya Shinmura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Noriaki Yokogawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Noritaka Yonezawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Takaki Shimizu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Norihiro Oku
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Ryo Kitagawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Hidenori Matsubara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Tamon Kabata
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
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Gruevski KM, Callaghan JP. The effect of age on in-vivo spine stiffness, postures and discomfort responses during prolonged sitting exposures. ERGONOMICS 2019; 62:917-927. [PMID: 30889363 DOI: 10.1080/00140139.2019.1596317] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 03/11/2019] [Indexed: 06/09/2023]
Abstract
Many industrialised working populations are ageing and prolonged sitting exposures are prevalent across occupational sectors. The purpose of this work was to determine the effect of age and sex on passive spine stiffness, postures and discomfort in response to seated work. A total of 34 participants were recruited, with 17 older adults with an average age of (standard deviation) 63.7 (±3.9) years and 17 younger adults aged 23.8 (±5.0) years. Participants were asked to sit continuously for 90 min while typing. Baseline passive spine stiffness was higher in older adults at 40% flexion compared to younger adults (p = .0233). Older adults sat in less normalised flexion, at 33.4% (±16.4) compared to 60.9% (±20.2) in the younger group (p = .0003). Discomfort was higher among older adults in the neck, right shoulder and middle back regions (p < .0086). An understanding of age-specific responses to workplace exposures is essential to determine whether age-specific interventions are warranted. Practitioner summary: Older adults had higher passive spine stiffness and sat with less flexion during prolonged sitting. Discomfort was higher among older adults and occurred earlier in the simulation compared to younger participants, indicating that interventions, such as walking breaks may need to be implemented earlier during sitting for aged workers.
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Affiliation(s)
- Kristina M Gruevski
- a Department of Kinesiology, Faculty of Applied Health Sciences , University of Waterloo , Waterloo , Canada
| | - Jack P Callaghan
- a Department of Kinesiology, Faculty of Applied Health Sciences , University of Waterloo , Waterloo , Canada
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da Silva RA, Vieira ER, Léonard G, Beaulieu LD, Ngomo S, Nowotny AH, Amorim CF. Age- and low back pain-related differences in trunk muscle activation during one-legged stance balance task. Gait Posture 2019; 69:25-30. [PMID: 30658312 DOI: 10.1016/j.gaitpost.2019.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Postural control declines with age and can be affected by low back pain. Poor balance has been reported in people with chronic low back pain (CLBP), which in turn could be explained by the changes in trunk muscle activation. RESEARCH QUESTION Are there differences between younger and older adults with and without chronic low back pain (CLBP) on trunk muscle activity during one-legged stance task? METHODS Twenty (20) with, and 20 subjects without nonspecific CLBP participated in the study. Each group was comprised of 10 younger (50% males; mean age: 31 years) and 10 older adults (50% males; mean age: 71 years). Subjects performed 3 × 30-second trials of one-legged stance, with eyes open, on a force platform, while surface electromyography (EMG) measurements were obtained bilaterally on the multifidus at L5, iliocostalis lumborum at L3, rectus abdominis and biceps femoris muscles.EMG amplitude analysis was processed by the Root Mean Square (250 ms window epochs) and normalized by the peak of activation during the balance tasks, to determine the muscular activity of each muscle. RESULTS Participants with CLBP presented 15% lower lumbar muscle activation (p < 0.05), and 23% higher co-activation (ratio between rectus adominis by multifidus) than participants without CLBP, regardless of age. Significant differences (p < 0.05) between older and young groups were observed only for lower lumbar muscles (mean 24% lower in older than younger adults) and rectus adominis muscles (mean 17% lower in older than younger adults). SIGNIFICANCE CLBP individuals have different trunk muscle activity than those without CLBP, and older adults exhibit lower trunk activation during one-legged stance balance task. The use of the EMG in evaluation of trunk neuromuscular function during one-legged stance may thus be a valuable tool when assessing balance in CLBP and older people.
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Affiliation(s)
- Rubens A da Silva
- Département des Sciences de la Santé, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable - UQAC, Laboratoire de recherche BioNR - UQAC, Saguenay, Québec, Canada; Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), UNOPAR University, Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR, Londrina, PR, Brazil.
| | - Edgar R Vieira
- Florida International University (FIU), Physical Therapy & Neuroscience Departments, Wertheim Colleges of Nursing and Health Sciences & Medicine, 11200 SW 8th St., AHC3-430, Miami, FL, USA
| | - Guillaume Léonard
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louis-David Beaulieu
- Département des Sciences de la Santé, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable - UQAC, Laboratoire de recherche BioNR - UQAC, Saguenay, Québec, Canada
| | - Suzy Ngomo
- Département des Sciences de la Santé, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable - UQAC, Laboratoire de recherche BioNR - UQAC, Saguenay, Québec, Canada
| | - Alexandre H Nowotny
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), UNOPAR University, Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR, Londrina, PR, Brazil
| | - César F Amorim
- Département des Sciences de la Santé, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable - UQAC, Laboratoire de recherche BioNR - UQAC, Saguenay, Québec, Canada; Florida International University (FIU), Physical Therapy & Neuroscience Departments, Wertheim Colleges of Nursing and Health Sciences & Medicine, 11200 SW 8th St., AHC3-430, Miami, FL, USA; Doctoral and Masters Program in Physical Therapy, UNICID, São Paulo, SP, Brazil
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The effect of muscle ageing and sarcopenia on spinal segmental loads. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:2650-2659. [DOI: 10.1007/s00586-018-5729-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/09/2018] [Accepted: 08/09/2018] [Indexed: 12/18/2022]
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Lopes MLV, Santos JPMD, Fernandes KBP, Rogério FRPG, Freitas RQD, Pires-Oliveira DADA. Relação da pressão plantar e amplitude de movimento de membros inferiores com o risco de quedas em idosas. FISIOTERAPIA E PESQUISA 2016. [DOI: 10.1590/1809-2950/14871123022016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivou-se verificar a influência das variáveis de pressão plantar e amplitude de movimento (ADM) de quadril, joelho e tornozelo sobre o risco de quedas em idosas. Participaram 39 idosas, avaliando-se a Pressão Máxima e Média sobre a plataforma de baropodometria. Em seguida, realizou-se o teste Timed Up and Go (TUG) e posteriormente a avaliação da ADM de flexão de quadril e joelho e flexão plantar e dorsal de tornozelo por meio de um goniômetro. As variáveis baropodométricas (Pressão Máxima e Pressão Média) tenderam a influenciar os valores do TUG conforme valor do teste de hipótese (p=0,051), demonstrando correlação moderada (r=0,487), com destaque para a Pressão Máxima, que apresentou correlação significativa com o TUG (p<0,005). Entretanto, a ADM articular de quadril, joelho e tornozelo não apresentaram correlações significativas entre as variáveis baropodométricas e risco de quedas. Sobre a análise da associação entre o TUG, categorizado em baixo e médio risco de quedas, e as quedas, não foram observadas diferenças (p=0,475). O aumento da pressão máxima apresentou relação com o risco de quedas, mas a ADM de quadril, joelho e tornozelo não apresentaram relação sobre o risco de quedas e as variáveis baropodométricas na população investigada.
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Mokhtarzadeh H, Anderson DE. The Role of Trunk Musculature in Osteoporotic Vertebral Fractures: Implications for Prediction, Prevention, and Management. Curr Osteoporos Rep 2016; 14:67-76. [PMID: 27040104 DOI: 10.1007/s11914-016-0305-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This review examines the current evidence for associations between vertebral fractures (VFx), the most common type of fracture in older adults, and trunk muscles, which are intimately tied to spinal loading and function. Individuals with prevalent VFxs have more fat infiltration in the trunk muscles, lower trunk extension strength, and altered muscle activation patterns. However, no longitudinal studies have examined whether assessment of trunk muscle can contribute to prediction of fracture risk. A few studies report that exercise interventions targeting the trunk muscles can reduce the risk of VFx, improve trunk strength and endurance in patients who have had a VFx, and reduce the risk of falling, a common cause of VFx, but the quality of evidence is low. Trunk muscles likely have an important role to play in prediction, prevention, and management of VFx, but additional longitudinal studies and randomized controlled trials are needed to clarify this role.
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Affiliation(s)
- Hossein Mokhtarzadeh
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 330 Brookline Ave, RN115, Boston, MA, 02215, USA
- Department of Mechanical Engineering, Melbourne School of Engineering, University of Melbourne, Parkville, Australia
| | - Dennis E Anderson
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA.
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 330 Brookline Ave, RN115, Boston, MA, 02215, USA.
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Back muscle fatigue of younger and older adults with and without chronic low back pain using two protocols: A case-control study. J Electromyogr Kinesiol 2015; 25:928-36. [DOI: 10.1016/j.jelekin.2015.10.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/24/2015] [Accepted: 10/07/2015] [Indexed: 12/18/2022] Open
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Shahtahmassebi B, Hebert JJ, Stomski NJ, Hecimovich M, Fairchild TJ. The effect of exercise training on lower trunk muscle morphology. Sports Med 2015; 44:1439-58. [PMID: 25015476 DOI: 10.1007/s40279-014-0213-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Skeletal muscle plays an important role in maintaining the stability of the lumbar region. However, there is conflicting evidence regarding the effects of exercise on trunk muscle morphology. OBJECTIVE To systematically review the literature on the effects of exercise training on lower trunk muscle morphology to determine the comparative effectiveness of different exercise interventions. DATA SOURCE AND STUDY SELECTION A systematic search strategy was conducted in the following databases: PubMed, SportDiscus, CINAHL, the Cochrane Library and PEDro. We included full, peer-reviewed, prospective longitudinal studies, including randomized controlled trials and single-group designs, such as pre- to post-intervention and crossover studies, reporting on the effect of exercise training on trunk muscle morphology. STUDY APPRAISAL AND SYNTHESIS Study quality was assessed with the Cochrane risk-of-bias tool. We classified each exercise intervention into four categories, based on the primary exercise approach: motor control, machine-based resistance, non-machine-based resistance or cardiovascular. Treatment effects were estimated using within-group standardized mean differences (SMDs). RESULTS The systematic search identified 1,911 studies; of which 29 met our selection criteria: motor control (n = 12), machine-based resistance (n = 10), non-machine-based resistance (n = 5) and cardiovascular (n = 2). Fourteen studies (48 %) reported an increase in trunk muscle size following exercise training. Among positive trials, the largest effects were reported by studies testing combined motor control and non-machine-based resistance exercise (SMD [95 % CI] = 0.66 [0.06 to 1.27] to 3.39 [2.80 to 3.98]) and machine-based resistance exercise programmes (SMD [95 % CI] = 0.52 [0.01 to 1.03] to 1.79 [0.87 to 2.72]). Most studies investigating the effects of non-machine-based resistance exercise reported no change in trunk muscle morphology, with one study reporting a medium effect on trunk muscle size (SMD [95 % CI] = 0.60 [0.03 to 1.16]). Cardiovascular exercise interventions demonstrated no effect on trunk muscle morphology (SMD [95 % CI] = -0.16 [-1.14 to 0.81] to 0.09 [-0.83 to 1.01]). LIMITATIONS We excluded studies published in languages other than English, and therefore it is possible that the results of relevant studies are not represented in this review. There was large clinical heterogeneity between the included studies, which prevented data synthesis. Among the studies included in this review, common sources of potential bias were random sequence generation, allocation concealment and blinding. Finally, the details of the exercise parameters were poorly reported in most studies. CONCLUSION Approximately half of the included studies reported an increase in lower trunk muscle size following participation in an exercise programme. Among positive trials, studies involving motor control exercises combined with non-machine-based resistance exercise, as well as machine-based resistance exercises, demonstrated medium to large effects on trunk muscle size. Most studies examining the effect of non-machine-based resistance exercise and all studies investigating cardiovascular exercise reported no effect on trunk muscle morphology. However, these results should be interpreted with caution because of the substantial risk of bias and suboptimal reporting of exercise details in the included studies. Additional research, using methods ensuring a low risk of bias, are required to further elucidate the effects of exercise on trunk muscle morphology.
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Affiliation(s)
- Behnaz Shahtahmassebi
- School of Psychology and Exercise Science, Murdoch University, SS2.015, 90 South Street, Murdoch, Perth, WA, 6150, Australia
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Mawston GA, G. Boocock M. Lumbar posture biomechanics and its influence on the functional anatomy of the erector spinae and multifidus. PHYSICAL THERAPY REVIEWS 2015. [DOI: 10.1179/1743288x15y.0000000014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Figueiredo VF, Amorim JSC, Pereira AM, Ferreira PH, Pereira LSM. Associations between low back pain, urinary incontinence, and abdominal muscle recruitment as assessed via ultrasonography in the elderly. Braz J Phys Ther 2015; 19:70-6. [PMID: 25714438 PMCID: PMC4351610 DOI: 10.1590/bjpt-rbf.2014.0073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 10/02/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Low back pain (LBP) and urinary incontinence (UI) are highly prevalent among elderly individuals. In young adults, changes in trunk muscle recruitment, as assessed via ultrasound imaging, may be associated with lumbar spine stability. OBJECTIVE To assess the associations between LBP, UI, and the pattern of transversus abdominis (TrA), internal (IO), and external oblique (EO) muscle recruitment in the elderly as evaluated by ultrasound imaging. METHOD Fifty-four elderly individuals (mean age: 72±5.2 years) who complained of LBP and/or UI as assessed by the McGill Pain Questionnaire, Incontinence Questionnaire-Short Form, and ultrasound imaging were included in the study. The statistical analysis comprised a multiple linear regression model, and a p-value <0.05 was considered significant. RESULTS The regression models for the TrA, IO, and EO muscle thickness levels explained 2.0% (R2=0.02; F=0.47; p=0.628), 10.6% (R2=0.106; F=3.03; p=0.057), and 10.1% (R2=0.101; F=2.70; p=0.077) of the variability, respectively. None of the regression models developed for the abdominal muscles exhibited statistical significance. A significant and negative association (p=0.018; β=-0.0343) was observed only between UI and IO recruitment. CONCLUSION These results suggest that age-related factors may have interfered with the findings of the study, thus emphasizing the need to perform ultrasound imaging-based studies to measure abdominal muscle recruitment in the elderly.
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Affiliation(s)
- Vânia F Figueiredo
- Centro de Ciências Biológicas e Saúde, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Juleimar S C Amorim
- Departamento de Saúde Pública, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | | | - Paulo H Ferreira
- Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Leani S M Pereira
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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15
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Boocock MG, Mawston GA, Taylor S. Age-related differences do affect postural kinematics and joint kinetics during repetitive lifting. Clin Biomech (Bristol, Avon) 2015; 30:136-43. [PMID: 25576019 DOI: 10.1016/j.clinbiomech.2014.12.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/19/2014] [Accepted: 12/19/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Age is considered a risk factor for manual handling-related injuries and older workers incur higher injury-related costs than younger co-workers. This study investigated the differences between the kinematics and kinetics of repetitive lifting in two groups of handlers of different ages. METHODS Fourteen younger (mean 24.4 yr) and 14 older (mean 47.2 yr) males participated in the study. Participants repetitively lifted a box weighing 13 kg at a frequency of 10 lifts/min for a maximum of 20 min. Postural kinematics (joint and lumbosacral angles and angular velocities) and kinetics (joint moments) were measured throughout the lifting task using motion analysis and ground reaction forces. Muscle fatigue of the erector spinae was assessed using electromyography. FINDINGS Peak lumbosacral, trunk, hip and knee flexion angles differed significantly between age groups over the duration of the task, as did lumbosacral and trunk angular velocities. The younger group increased peak lumbar flexion by approximately 18% and approached 99% of maximum lumbosacral flexion after 20 min, whereas the older group increased lumbar flexion by 4% and approached 82% maximum flexion. The younger group had a larger increase in peak lumbosacral and trunk angular velocities during extension, which may be related to the increased back muscle fatigue observed among the younger group. INTERPRETATION Older participants appeared to control the detrimental effects of fatigue associated with repetitive lifting and limit lumbar spine range of motion. The higher rates of musculoskeletal injury among older workers may stem from a complex interaction of manual handling risk factors.
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Affiliation(s)
- Mark G Boocock
- Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand.
| | - Grant A Mawston
- Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand
| | - Steve Taylor
- Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand
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16
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Harriss AB, Brown SH. Effects of changes in muscle activation level and spine and hip posture on erector spinae fiber orientation. Muscle Nerve 2015; 51:426-33. [DOI: 10.1002/mus.24309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Alexandra B. Harriss
- Department of Human Health and Nutritional Sciences; University of Guelph, 50 Stone Road East; Guelph Ontario N1G 2W1 Canada
| | - Stephen H.M. Brown
- Department of Human Health and Nutritional Sciences; University of Guelph, 50 Stone Road East; Guelph Ontario N1G 2W1 Canada
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17
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Shear wave elastography of passive skeletal muscle stiffness: influences of sex and age throughout adulthood. Clin Biomech (Bristol, Avon) 2015; 30:22-7. [PMID: 25483294 PMCID: PMC4298479 DOI: 10.1016/j.clinbiomech.2014.11.011] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/30/2014] [Accepted: 11/24/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Numerous structural and compositional changes - related not only to age, but also activity level and sex - may affect skeletal muscle stiffness across the adult age-span. Measurement techniques available thus far have largely limited passive stiffness evaluations to those of entire joints and muscle-tendon units. Shear wave elastography is an increasingly popular ultrasound technique for evaluating the mechanical properties of skeletal muscle tissue. The purpose of this study was to quantify the passive stiffness, or shear modulus, of the biceps brachii throughout adulthood in flexed and extended elbow positions. We hypothesized that shear modulus would be higher in males relative to females, and with advanced age in both sexes. METHODS Shear wave elastography quantified biceps brachii stiffness at 90° elbow flexion and full extension in a large sample of adults between 21 and 94 years old (n=133; 47 males). FINDINGS Regression analysis found sex and age were significant parameters for older adults (>60 years) in full extension. As expected, shear modulus values increased with advancing age; however, shear modulus values for females tended to be higher than those for males. INTERPRETATION This study begins to establish normative trends for skeletal muscle shear modulus throughout adulthood. Specifically, this work establishes for the first time that the higher passive joint torque often found in males relative to females likely relates to parameters other than muscle shear modulus. Indeed, perhaps increases in skeletal muscle passive stiffness, though potentially altering the length-tension curve, serve a protective role - maintaining the tendon-muscle-tendon length-tension curve within a functional range.
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18
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Zsoldos RR, Krüger B, Licka TF. From maturity to old age: tasks of daily life require a different muscle use in horses. COMPARATIVE EXERCISE PHYSIOLOGY 2014; 10:75-88. [PMID: 28680481 DOI: 10.3920/cep140001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In vertebrates ageing is characterized by reduced viscoelasticity of the ligamentous and tendineous structures and fibre changes in muscle. Also, some vertebral joint degeneration develops with ageing. The aim of this study was to apply dynamic time warping to compare the temporal characteristics of the surface electromyography (sEMG) data and to illustrate the differences in the pattern of muscle use during tasks of daily life in old and mature horses. In vivo kinematics (24 skin markers) and sEMG measurements of neck extensors and flexors were taken in five mature horses (age 10 ± 2 years, half of mean life expectancy) and five old horses (age 25 ± 5 years, older than the mean life expectancy). All horses had the same level of activity in the 12 months prior to the measurement. Tasks measured were neck flexion and neck extension as well as neutral neck position. Muscle activation, minimum and maximum muscle activation were collected. Quartiles of muscle activity based on the maximum observed activity of each muscle were calculated to document the relative increase of activity level during the task. Kinematics as well as overall muscle activity patterns were similar across horses and age groups. However, in the neutral position old horses showed increased extensor activity compared to mature horses, indicating that old equine muscle requires more activity to counteract gravity. Dynamic time warping specified optimal temporal alignments of time series, and different temporal performances were identified. The age groups differed during the flexion task, while extension and neutral were more similar. The results of this study show that even in the second half of life and in the absence of muscle disuse the muscular strategy employed by horses continues to be adapted.
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Affiliation(s)
- R R Zsoldos
- Movement Science Group Vienna, Clinical Department of Small Animals and Horses, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria
| | - B Krüger
- Multimedia, Simulation and Virtual Reality Group, Institute of Computer Science II, University of Bonn, Friedrich-Ebert-Allee 144, 53113, Bonn, Germany
| | - T F Licka
- Movement Science Group Vienna, Clinical Department of Small Animals and Horses, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria.,Large Animal Hospital, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, Scotland, United Kingdom
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19
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Singh DKA, Bailey M, Lee R. Decline in lumbar extensor muscle strength the older adults: correlation with age, gender and spine morphology. BMC Musculoskelet Disord 2013; 14:215. [PMID: 23875830 PMCID: PMC3723547 DOI: 10.1186/1471-2474-14-215] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 07/12/2013] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Muscle morphology, age and gender may be determinants of muscle strength in older adults. However, very few research studies have directly examined such correlation in the ageing spine. The aim of the study was to examine the correlation between lumbar extensor muscle strength, its muscle fibre angles, thoracolumbar curvature, age and gender in the older and younger adults. METHODS Muscle fibre angles of lumbar extensor muscles, thoracolumbar curvature and lumbar extensor muscle strength were examined in 26 young (mean age 27.9, SD 5.2) and 26 older (mean age 72.1, SD 5.9) participants. Pearson's correlation was employed to determine the association among lumbar extensor muscle fibre angle, thoracolumbar curvature, age, gender and lumbar extensor muscle strength. Multiple stepwise linear regression analysis was used to identify significant determinants of lumbar extensor muscle strength. RESULTS The results demonstrated a significant correlation between lumbar extensor muscle strength, muscle fibre angle, age and gender. In the step wise regression analysis, both gender and age were identified as the most robust determinant for lumbar extensor muscle strength in older adults. However, gender was the only determinant of muscle strength in the young. CONCLUSION These results suggest that the decline in the lumbar extensor muscle strength in older adults was more dependent on age when compared to younger adults.
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Affiliation(s)
- Devinder Kaur Ajit Singh
- Faculty of Health Sciences, Jalan Raja Muda Aziz, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Martin Bailey
- Chelsea School, University of Brighton, Hillbrow Denton Road, Eastbourne BN20 7SR, UK
| | - Raymond Lee
- Roehampton University, Roehampton Lane, SW15 5PU, London, UK
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20
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Williams JM, Haq I, Lee RY. The effect of pain relief on dynamic changes in lumbar curvature. MANUAL THERAPY 2013; 18:149-154. [PMID: 23058448 DOI: 10.1016/j.math.2012.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 08/31/2012] [Accepted: 09/12/2012] [Indexed: 06/01/2023]
Abstract
Lumbar curvature is important in the assessment of low back pain (LBP). It is often reported that changes in curvature seen in LBP sufferers are an adaptive response to pain. Studies investigating this hypothesis employing an experimental pain relief model have failed to isolate pain relief in their interventions. Therefore the purpose of this study was to investigate the immediate effects of pain relief on dynamic lumbar curvature. Twenty acute and 20 chronic LBP sufferers had their dynamic curvature measured using a novel fibre-optic device during flexion, extension and lifting before and after administration of oral analgesics. Peak curvature changes were examined using paired t-tests, numbers of responders to pain relief and changes in lumbar curvature sequencing were compared between groups using Chi-squared testing. A significant reduction in movement evoked pain was achieved. A significant reduction in kyphosis at end range flexion and lifting was identified for the acute LBP group following pain relief. No significant differences were observed for the chronic low back pain (CLBP) group. Neither the acute nor chronic LBP group were more likely to respond to pain relief by demonstrating alterations in peak curvature or in lumbar sequencing behaviour. These results demonstrate simple targeted pain relief did not result in gains in peak curvature challenging the assumption of movement alteration being possible through pain relief. Dynamic changes in curvature as displayed by sequencing showed that neither acute nor chronic LBP sufferers were more likely to respond to pain relief.
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Affiliation(s)
- Jonathan M Williams
- School of Health and Social Care, Bournemouth University, Royal London House, Christchurch Road, Bournemouth, Dorset BH1 3LT, UK.
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