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Oliosi E, Júlio A, Probst P, Silva L, Vilas-Boas JP, Pinheiro AR, Gamboa H. Exploring the Real-Time Variability and Complexity of Sitting Patterns in Office Workers with Non-Specific Chronic Spinal Pain and Pain-Free Individuals. SENSORS (BASEL, SWITZERLAND) 2024; 24:4750. [PMID: 39066146 PMCID: PMC11281106 DOI: 10.3390/s24144750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/14/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024]
Abstract
Chronic spinal pain (CSP) is a prevalent condition, and prolonged sitting at work can contribute to it. Ergonomic factors like this can cause changes in motor variability. Variability analysis is a useful method to measure changes in motor performance over time. When performing the same task multiple times, different performance patterns can be observed. This variability is intrinsic to all biological systems and is noticeable in human movement. This study aims to examine whether changes in movement variability and complexity during real-time office work are influenced by CSP. The hypothesis is that individuals with and without pain will have different responses to office work tasks. Six office workers without pain and ten with CSP participated in this study. Participant's trunk movements were recorded during work for an entire week. Linear and nonlinear measures of trunk kinematic displacement were used to assess movement variability and complexity. A mixed ANOVA was utilized to compare changes in movement variability and complexity between the two groups. The effects indicate that pain-free participants showed more complex and less predictable trunk movements with a lower degree of structure and variability when compared to the participants suffering from CSP. The differences were particularly noticeable in fine movements.
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Affiliation(s)
- Eduarda Oliosi
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
- Research Centre in Physical Activity, Health and Leisure (CIAFEL-FADEUP), Faculty of Sport, University of Porto, 4000-000 Porto, Portugal
| | - Afonso Júlio
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
| | - Phillip Probst
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
| | - Luís Silva
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
| | - João Paulo Vilas-Boas
- Centre for Research, Training, Innovation and Intervention in Sport (CIFI2D), Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sport, University of Porto, 4000-000 Porto, Portugal;
| | - Ana Rita Pinheiro
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, 3800-000 Aveiro, Portugal;
| | - Hugo Gamboa
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
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Frasie A, Massé-Alarie H, Bielmann M, Gauthier N, Roudjane M, Pagé I, Gosselin B, Roy JS, Messaddeq Y, Bouyer LJ. Potential of a New, Flexible Electrode sEMG System in Detecting Electromyographic Activation in Low Back Muscles during Clinical Tests: A Pilot Study on Wearables for Pain Management. SENSORS (BASEL, SWITZERLAND) 2024; 24:4510. [PMID: 39065908 PMCID: PMC11280768 DOI: 10.3390/s24144510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 06/30/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND While low back pain (LBP) is the leading cause of disability worldwide, its clinical objective assessment is currently limited. Part of this syndrome arises from the abnormal sensorimotor control of back muscles, involving increased muscle fatigability (i.e., assessed with the Biering-Sorensen test) and abnormal muscle activation patterns (i.e., the flexion-extension test). Surface electromyography (sEMG) provides objective measures of muscle fatigue development (median frequency drop, MDF) and activation patterns (RMS amplitude change). This study therefore assessed the sensitivity and validity of a novel and flexible sEMG system (NSS) based on PEVA electrodes and potentially embeddable in textiles, as a tool for objective clinical LBP assessment. METHODS Twelve participants wearing NSS and a commercial laboratory sEMG system (CSS) performed two clinical tests used in LBP assessment (Biering-Sorensen and flexion-extension). Erector spinae muscle activity was recorded at T12-L1 and L4-L5. RESULTS NSS showed sensitivity to sEMG changes associated with fatigue development and muscle activations during flexion-extension movements (p < 0.05) that were similar to CSS (p > 0.05). Raw signals showed moderate cross-correlations (MDF: 0.60-0.68; RMS: 0.53-0.62). Adding conductive gel to the PEVA electrodes did not influence sEMG signal interpretation (p > 0.05). CONCLUSIONS This novel sEMG system is promising for assessing electrophysiological indicators of LBP during clinical tests.
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Affiliation(s)
- Antoine Frasie
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada; (A.F.); (H.M.-A.); (M.B.); (N.G.); (I.P.); (B.G.); (J.-S.R.); (Y.M.)
| | - Hugo Massé-Alarie
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada; (A.F.); (H.M.-A.); (M.B.); (N.G.); (I.P.); (B.G.); (J.-S.R.); (Y.M.)
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC G1M 2X8, Canada;
| | - Mathieu Bielmann
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada; (A.F.); (H.M.-A.); (M.B.); (N.G.); (I.P.); (B.G.); (J.-S.R.); (Y.M.)
| | - Nicolas Gauthier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada; (A.F.); (H.M.-A.); (M.B.); (N.G.); (I.P.); (B.G.); (J.-S.R.); (Y.M.)
- Department of Computer and Electrical Engineering, Faculty of Science and Engineering, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Mourad Roudjane
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC G1M 2X8, Canada;
- Center for Optics, Photonics and Lasers (COPL), Department of Physics, Faculty of Science and Engineering, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Isabelle Pagé
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada; (A.F.); (H.M.-A.); (M.B.); (N.G.); (I.P.); (B.G.); (J.-S.R.); (Y.M.)
| | - Benoit Gosselin
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada; (A.F.); (H.M.-A.); (M.B.); (N.G.); (I.P.); (B.G.); (J.-S.R.); (Y.M.)
- Department of Computer and Electrical Engineering, Faculty of Science and Engineering, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada; (A.F.); (H.M.-A.); (M.B.); (N.G.); (I.P.); (B.G.); (J.-S.R.); (Y.M.)
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC G1M 2X8, Canada;
| | - Younes Messaddeq
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada; (A.F.); (H.M.-A.); (M.B.); (N.G.); (I.P.); (B.G.); (J.-S.R.); (Y.M.)
- Center for Optics, Photonics and Lasers (COPL), Department of Physics, Faculty of Science and Engineering, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Laurent J. Bouyer
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada; (A.F.); (H.M.-A.); (M.B.); (N.G.); (I.P.); (B.G.); (J.-S.R.); (Y.M.)
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC G1M 2X8, Canada;
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Hejazi HS, Khanmohammadi R, Olyaei G, Qanbari S. The effects of combining sensorimotor training with transcranial direct current stimulation on the anticipatory and compensatory postural adjustments in patients with chronic low back pain. Disabil Rehabil 2024:1-13. [PMID: 38982892 DOI: 10.1080/09638288.2024.2375756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/24/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE To investigate the effects of concurrent sensorimotor training (SMT) and transcranial direct current stimulation (tDCS) on the anticipatory and compensatory postural adjustments (APAs and CPAs) in patients with chronic low back pain (CLBP). METHOD The interventions included (1) SMT plus tDCS and (2) SMT plus sham tDCS. Outcome measures were the normalized integrals of electromyography activity (NIEMG) during the phases of anticipatory and compensatory, and muscle onset latency. The investigated muscles were ipsilateral and contralateral multifidus (MF), transversus abdominus/internal oblique (TrA/IO), and gluteus medius (GM). RESULTS Between-group comparisons demonstrated that ipsilateral TrA/IO NIEMG during CPA1 (p = 0.010) and ipsilateral GM NIEMG during CPA1 (p = 0.002) and CPA2 (p = 0.025) were significantly lower in the SMT combined with tDCS than in the control group. Furthermore, this group had greater NIEMG for contralateral GM during APA1 than the control group (p = 0.032). Moreover, the onset latency of contralateral TrA/IO was significantly earlier after SMT combined with tDCS (p = 0.011). CONCLUSIONS Both groups that received SMT showed positive effects, but anodal tDCS had an added value over sham stimulation for improving postural control strategies in patients with CLBP. Indeed, SMT combined with tDCS leads to stronger APA and less demand for CPA. RCT REGISTRATION NUMBER IRCT20220228054149N1. REGISTRATION DATE 2022-04-04.
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Affiliation(s)
- Hanie Sadat Hejazi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Khanmohammadi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Olyaei
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Qanbari
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
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Ma JY, Wu JJ, Zhang J, Zhao Q, Shen FT, Feng L, Zhang GH, Zhu Y, Xu JG. Integrative rehabilitation in the treatment of lumbosacral muscle strain in elite trampoline athletes: a pilot study. Front Sports Act Living 2024; 6:1383228. [PMID: 39045568 PMCID: PMC11263099 DOI: 10.3389/fspor.2024.1383228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/17/2024] [Indexed: 07/25/2024] Open
Abstract
Background Lumbosacral muscle strain (LMS) is common in Chinese elite trampoline athletes. Advanced lumbar muscle activation is necessary for postural control before upper extremity voluntary movements, called anticipatory postural adjustment to reduce internal postural interference (IPI). The potential of delayed lumbar muscle activation has been reported in patients with non-specific LBP (NLBP) in response to IPI. However, it remains unknown whether this effect exists in elite trampoline athletes. There is also limited literature reporting the rehabilitation of LMS in this population. This study first aimed to explore whether elite trampoline athletes with LMS experience delayed activation of lumbar muscles under IPI. The secondary aim was to preliminarily evaluate an integrative rehabilitation program's effectiveness. Materials and methods Ten elite trampoline athletes with LMS were recruited and received 10 sessions of integrative rehabilitation, including extracorporeal shock wave therapy, acupuncture, Tui-na, and spine function exercises. At baseline and after all sessions, the relative activation time of the lumbar muscles under IPI in a modified rapid arm-rise test was used as a primary outcome measure. The secondary measures included a visual analog scale (VAS) and a questionnaire to assess low back pain (LBP) and athletic training performance. Results The relative activation time of the lumbar muscles under IPI was delayed at baseline, but significantly decreased after the intervention (P < 0.05). The VAS was significantly decreased after the intervention (P < 0.05). There was no significant correlation between the difference in VAS and in activation time of the lumbar muscles before and after the intervention (P > 0.05). Conclusions Elite trampoline athletes with LMS had delayed activation in their lumbar muscles under IPI. Integrative rehabilitation was effective in LBP relief and neuromuscular control of the lumbar muscles, and impacted positively on training performance. Future studies with a larger sample size, a control group, and long-term follow-ups are needed to further examine the efficacy of integrative rehabilitation in elite trampoline athletes with LMS. Additionally, the application of this approach in athletes with LMS or LBP in other sports, particularly those involving IPI, should be explored.
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Affiliation(s)
- Jia-Yin Ma
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Jia Wu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
| | - Jing Zhang
- Department of Traditional Chinese Medicine, General Hospital of Eastern Theater Command, Nanjing, China
| | - Qing Zhao
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Feng-Tao Shen
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ling Feng
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guo-Hui Zhang
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi Zhu
- NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- Institute of Hand Surgery, Fudan University, Shanghai, China
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Jian-Guang Xu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- Institute of Hand Surgery, Fudan University, Shanghai, China
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
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Alshehri MA, van den Hoorn W, Klyne DM, van Dieën JH, Cholewicki J, Hodges PW. Poor lumbar spine coordination in acute low back pain predicts persistent long-term pain and disability. 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 2024; 33:2380-2394. [PMID: 38483640 DOI: 10.1007/s00586-024-08205-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/22/2023] [Accepted: 02/23/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE Sitting balance on an unstable surface requires coordinated out-of-phase lumbar spine and provides sufficient challenge to expose quality of spine control. We investigated whether the quality of spine coordination to maintain balance in acute low back pain (LBP) predicts recovery at 6 months. METHODS Participants in an acute LBP episode (n = 94) underwent assessment of sitting balance on an unstable surface. Seat, hip and spine (lower lumbar, lumbar, upper lumbar, thoracic) angular motion and force plate data were recorded. Coordination between the seat and hip/spine segments to maintain balance was quantified in the frequency domain to evaluate coordination (coherence) and relative timing (phase angle: in-phase [segments move together]; out-of-phase [segments move opposite]). Center of pressure (CoP) and upper thorax motion assessed overall balance performance. Hip and spine coordination with the seat were compared between those who did not recover (increased/unchanged pain/disability), partially recovered (reduced pain/disability) or recovered (no pain and disability) at 6 months. RESULTS In both planes, coherence between the seat and lower lumbar spine was lower (and in-phase-unhelpful for balance) at baseline in those who did not recover than those who recovered. Coherence between the seat and hip was higher in partially recovered in both planes, suggesting compensation by the hip. LBP groups had equal overall balance performance (CoP, upper thorax motion), but non-recovery groups used a less optimal strategy that might have consequences for long-term spine health. CONCLUSION These longitudinal data revealed that individuals with compromised contribution of the lumbar spine to the balance during unstable sitting during acute LBP are less likely to recover.
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Affiliation(s)
- Mansour Abdullah Alshehri
- The University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Wolbert van den Hoorn
- The University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - David M Klyne
- The University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jacek Cholewicki
- Center for Neuromusculoskeletal Clinical Research, Michigan State University, Lansing, MI, USA
- Department of Osteopathic Manipulative Medicine, Michigan State University, East Lansing, MI, USA
| | - Paul W Hodges
- The University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia.
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Li X, Lu S, Ge L, Li Z, Chen R, Zu Y, Fu R, Li L, Wang C. Repetitive Transcranial Magnetic Stimulation Combined with Sling Exercise Modulates the Motor Cortex in Patients with Chronic Low Back Pain. Neuroscience 2024; 545:196-206. [PMID: 38518924 DOI: 10.1016/j.neuroscience.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/01/2024] [Accepted: 03/12/2024] [Indexed: 03/24/2024]
Abstract
The study aims to explore the effects of combining repetitive transcranial magnetic stimulation (rTMS) with sling exercise (SE) intervention in patients with chronic low back pain (CLBP). This approach aims to directly stimulate brain circuits and indirectly activate trunk muscles to influence motor cortex plasticity. However, the impact of this combined intervention on motor cortex organization and clinical symptom improvement is still unclear, as well as whether it is more effective than either intervention alone. To investigate this, patients with CLBP were randomly assigned to three groups: SE/rTMS, rTMS alone, and SE alone. Motor cortical organization, numerical pain rating scale (NPRS), Oswestry Disability Index (ODI), and postural balance stability were measured before and after a 2-week intervention. The results showed statistically significant differences in the representative location of multifidus on the left hemispheres, as well as in NPRS and ODI scores, in the combined SE/rTMS group after the intervention. When compared to the other two groups, the combined SE/rTMS group demonstrated significantly different motor cortical organization, sway area, and path range from the rTMS alone group, but not from the SE alone group. These findings highlight the potential benefits of a combined SE/rTMS intervention in terms of clinical outcomes and neuroadaptive changes compared to rTMS alone. However, there was no significant difference between the combined intervention and SE alone. Therefore, our research does not support the use of rTMS as a standalone treatment for CLBP. Our study contributed to optimizing treatment strategies for individuals suffering from CLBP.
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Affiliation(s)
- Xin Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Songwei Lu
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen 9713, the Netherlands
| | - Le Ge
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Zhicheng Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Rong Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Yao Zu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Ruochen Fu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Le Li
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an 710072, PR China.
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China.
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Xiao W, Yang H, Hao Z, Li M, Zhao M, Zhang S, Zhang G, Mao H, Wang C. Relationship between Fear-Avoidance Beliefs and Reaction Time Changes Prior to and following Exercise-Induced Muscle Fatigue in Chronic Low Back Pain. Pain Res Manag 2024; 2024:9982411. [PMID: 38312327 PMCID: PMC10838204 DOI: 10.1155/2024/9982411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/19/2023] [Accepted: 01/17/2024] [Indexed: 02/06/2024]
Abstract
Background Reaction time is a reliable indicator of the velocity and efficiency of neuromuscular control and may be associated with fear-avoidance beliefs. However, the effect of exercise-induced muscle fatigue on reaction time in chronic low back pain (cLBP) and its relationship with fear-avoidance beliefs remains poorly understood. Objectives This study aimed to reveal the relationship between fear-avoidance beliefs and reaction time changes before and after exercise-induced muscle fatigue in cLBP. Methods Twenty-five patients with cLBP were tested by the Biering-Sorensen test (BST) to induce exhaustive muscle fatigue. Total reaction time (TRT), premotor time (PMT), and electromechanical delay (EMD) of dominated deltoid muscle were recorded by surface electromyography during the arm-raising task with visual cues before and after muscle fatigue. The mean difference (MD) of TRT (MDTRT), PMT (MDPMT), and EMD (MDEMD) was calculated from the changes before and after muscle fatigue. Fear-avoidance beliefs questionnaire (FABQ) was applied to evaluate fear-avoidance beliefs before muscle fatigue. In addition, the duration time of BST was recorded for each subject. Results TRT and PMT of dominated deltoid muscle were prolonged after exercise-induced muscle fatigue (Z = 3.511, p < 0.001; t = 3.431, p = 0.001), while there was no statistical difference in EMD (Z = 1.029, p = 0.304). Correlation analysis showed that both the MDTRT and MDPMT were positively correlated with FABQ (r = 0.418, p = 0.042; r = 0.422, p = 0.040). Conclusions These findings suggested that we should pay attention to both muscle fatigue-induced reaction time delay in cLBP management and the possible psychological mechanism involved in it. Furthermore, this study implied that FABQ-based psychotherapy might serve as a potential approach for cLBP treatment by improving reaction time delay. This trial is registered with ChiCTR2300074348.
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Affiliation(s)
- Wenwu Xiao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Huaichun Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Zengming Hao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Menglin Li
- Department of Rehabilitation, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510180, China
| | - Mengchu Zhao
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR 999077, China
| | - Siyun Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Guifang Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Haian Mao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
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Alshehri MA, Alzahrani H, van den Hoorn W, Klyne DM, Vette AH, Hendershot BD, Roberts BWR, Larivière C, Barbado D, Vera-Garcia FJ, van Dieen JH, Cholewicki J, Nussbaum MA, Madigan ML, Reeves NP, Silfies SP, Brown SHM, Hodges PW. Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis. PLoS One 2024; 19:e0296968. [PMID: 38265999 PMCID: PMC10807788 DOI: 10.1371/journal.pone.0296968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Sitting on an unstable surface is a common paradigm to investigate trunk postural control among individuals with low back pain (LBP), by minimizing the influence lower extremities on balance control. Outcomes of many small studies are inconsistent (e.g., some find differences between groups while others do not), potentially due to confounding factors such as age, sex, body mass index [BMI], or clinical presentations. We conducted a systematic review with an individual participant data (IPD) meta-analysis to investigate whether trunk postural control differs between those with and without LBP, and whether the difference between groups is impacted by vision and potential confounding factors. METHODS We completed this review according to PRISMA-IPD guidelines. The literature was screened (up to 7th September 2023) from five electronic databases: MEDLINE, CINAHL, Embase, Scopus, and Web of Science Core Collection. Outcome measures were extracted that describe unstable seat movements, specifically centre of pressure or seat angle. Our main analyses included: 1) a two-stage IPD meta-analysis to assess the difference between groups and their interaction with age, sex, BMI, and vision on trunk postural control; 2) and a two-stage IPD meta-regression to determine the effects of LBP clinical features (pain intensity, disability, pain catastrophizing, and fear-avoidance beliefs) on trunk postural control. RESULTS Forty studies (1,821 participants) were included for the descriptive analysis and 24 studies (1,050 participants) were included for the IPD analysis. IPD meta-analyses revealed three main findings: (a) trunk postural control was worse (higher root mean square displacement [RMSdispl], range, and long-term diffusion; lower mean power frequency) among individuals with than without LBP; (b) trunk postural control deteriorated more (higher RMSdispl, short- and long-term diffusion) among individuals with than without LBP when vision was removed; and (c) older age and higher BMI had greater adverse impacts on trunk postural control (higher short-term diffusion; longer time and distance coordinates of the critical point) among individuals with than without LBP. IPD meta-regressions indicated no associations between the limited LBP clinical features that could be considered and trunk postural control. CONCLUSION Trunk postural control appears to be inferior among individuals with LBP, which was indicated by increased seat movements and some evidence of trunk stiffening. These findings are likely explained by delayed or less accurate corrective responses. SYSTEMATIC REVIEW REGISTRATION This review has been registered in PROSPERO (registration number: CRD42021124658).
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Affiliation(s)
- Mansour Abdullah Alshehri
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Hosam Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Wolbert van den Hoorn
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Albert H. Vette
- Department of Mechanical Engineering, Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, Canada
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Canada
| | - Brad D. Hendershot
- Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, United States of America
| | - Brad W. R. Roberts
- Department of Mechanical Engineering, Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, Canada
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada
| | - David Barbado
- Sport Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernández University of Elche, Alicante, Spain
| | - Francisco J. Vera-Garcia
- Sport Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernández University of Elche, Alicante, Spain
| | - Jaap H. van Dieen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Jacek Cholewicki
- Center for Neuromusculoskeletal Clinical Research, Michigan State University, Lansing, Michigan, United States of America
- Department of Osteopathic Manipulative Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Maury A. Nussbaum
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia, United States of America
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, United States of America
| | - Michael L. Madigan
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia, United States of America
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, United States of America
| | | | - Sheri P. Silfies
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States of America
| | - Stephen H. M. Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Chen Z, Tirosh O, Han J, Adams RD, El-Ansary D, Pranata A. Voluntary postural sway control and mobility in adults with low back pain. Front Neurosci 2024; 17:1285747. [PMID: 38235390 PMCID: PMC10793656 DOI: 10.3389/fnins.2023.1285747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction Low back pain (LBP) is associated with altered somatosensory perception, which is involved in both involuntary and voluntary control of posture. Currently, there is a lack of methods and tools for assessing somatosensory acuity in patients with LBP. The purpose of this study was (1) to assess the reliability of the sway discrimination apparatus (SwayDA) (2) to evaluate the differences in somatosensory acuity between patients with LBP and pain-free individuals, and (3) to examine relationships between somatosensory acuity, severity of LBP, and mobility in patients with LBP. Methods Twenty participants (10 patients with LBP and 10 matched asymptomatic controls) were recruited in a test-retest reliability test. Another 56 participants were recruited for this study with 28 individuals presenting with LBP and a further twenty-eight being asymptomatic. The SwayDA was custom-built to measure somatosensory perception during voluntary anterior-posterior (SwayDA-AP), medial-lateral to the dominant side (SwayDA-ML-D), and non-dominant side (SwayDA-ML-ND) postural sway control. Participants also completed mobility tests, including 10 times and 1-min sit-to-stand tests (10-STS, 1 m-STS). The area under the receiver operating characteristic curve (AUC) was calculated to quantify somatosensory acuity in discriminating different voluntary postural sway extents. Results The ICC (2.1) for the SwayDA-AP, SwayDA-ML-D, and SwayDA-ML-ND were 0.741, 0.717, and 0.805 with MDC95 0.071, 0.043, and 0.050. Patients with LBP demonstrated significantly lower SwayDA scores (tSwayDA-AP = -2.142, p = 0.037; tSwayDA-ML-D = -2.266, p = 0.027) than asymptomatic controls. The AUC values of the SwayDA-AP test were significantly correlated with ODI (rSwayDA-AP-ODI = -0.391, p = 0.039). Performances on the 1 m-STS and the 10-STS were significantly correlated with the AUC scores from all the SwayDA tests (-0.513 ≤ r ≤ 0.441, all p < 0.05). Discussion The SwayDA tests evaluated showed acceptable reliability in assessing somatosensory acuity during voluntary postural sway. Somatosensory acuity was diminished in patients with LBP compared to asymptomatic controls. In patients with LBP, lower somatosensory acuity was associated with increased LBP-related disability. Future research could focus on investigating the factors contributing to the decreased somatosensory perception and mobility in individuals with LBP.
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Affiliation(s)
- Zhengquan Chen
- Shanghai Yangpu District Mental Health Center, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Oren Tirosh
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Jia Han
- Shanghai Yangpu District Mental Health Center, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Roger David Adams
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Doa El-Ansary
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Department of Surgery, Melbourne Medical School, Melbourne, VIC, Australia
| | - Adrian Pranata
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
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Chen BJ, Liu TY, Wu HC, Tsai MW, Wei SH, Chou LW. Effects of sling exercises on pain, function, and corticomuscular functional connectivity in individuals with chronic low back pain- preliminary study. PLoS One 2023; 18:e0288405. [PMID: 38032998 PMCID: PMC10688743 DOI: 10.1371/journal.pone.0288405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/21/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Individuals with chronic low back pain (CLBP) exhibit altered brain function and trunk muscle activation. AIM This study examined the effects of sling exercises on pain, function, and corticomuscular coherence (CMC) in healthy adults and individuals with CLBP. METHODS Eight individuals with CLBP and 15 healthy adults received sling exercise training for 6 weeks. Before and after training, participants performed two motor tasks: rapid arm lifts and repeated trunk flexion-extension tasks, and electromyography of the trunk muscles and electroencephalography of the sensorimotor cortex were recorded. Chi-squared test and Mann-Whitney U tests were used for between group comparison, and Wilcoxon signed-rank tests were used for pre- and post-training comparison. Spearman's Rank Correlation Coefficient (Rs) was used to identify for the relationship between motor performance and Corticomuscular coherence. RESULTS Sling exercises significantly improved pain (median from 3 to 1, p = .01) and Oswestry Disability Index scores (median from 2.5 to 2, p = .03) in the CLBP group. During rapid arm lifts, individuals with CLBP showed lower beta CMC of the transverse abdominis and internal oblique (Tra/IO) (0.8 vs. 0.49, p = .01) and lumbar erector spinae (0.70 vs. 0.38, p = .04) than the control group at baseline. During trunk flexion-extension, the CLBP group showed higher gamma CMC of the left Tra/IO than the control group at baseline (0.28 vs. 0.16 , p = .001). After training, all CMC became statistically non-significant between groups. The training induced improvement in anticipatory activation of the Tra/IO was positively correlated with the beta CMC (rs = 0.7851, p = .02). CONCLUSION A 6-week sling exercises diminished pain and disability in patients with CLBP and improved the anticipatory activation and CMC in some trunk muscles. These improvements were associated with training induced changes in corticomuscular connectivity in individuals with CLBP.
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Affiliation(s)
- Bo-Jhen Chen
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan (R.O.C.)
| | - Tzu-Ying Liu
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chao Tung University, Hsinchu, Taiwan (R.O.C.)
| | - Hsin-Chi Wu
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan (R.O.C.)
- Department of Medicine, Tzu Chi University, Hualien, Taiwan (R.O.C.)
| | - Mei-Wun Tsai
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chao Tung University, Hsinchu, Taiwan (R.O.C.)
| | - Shun-Hwa Wei
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chao Tung University, Hsinchu, Taiwan (R.O.C.)
| | - Li-Wei Chou
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chao Tung University, Hsinchu, Taiwan (R.O.C.)
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Matheve T, Hodges P, Danneels L. The Role of Back Muscle Dysfunctions in Chronic Low Back Pain: State-of-the-Art and Clinical Implications. J Clin Med 2023; 12:5510. [PMID: 37685576 PMCID: PMC10487902 DOI: 10.3390/jcm12175510] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Changes in back muscle function and structure are highly prevalent in patients with chronic low back pain (CLBP). Since large heterogeneity in clinical presentation and back muscle dysfunctions exists within this population, the potential role of back muscle dysfunctions in the persistence of low back pain differs between individuals. Consequently, interventions should be tailored to the individual patient and be based on a thorough clinical examination taking into account the multidimensional nature of CLBP. Considering the complexity of this process, we will provide a state-of-the-art update on back muscle dysfunctions in patients with CLBP and their implications for treatment. To this end, we will first give an overview of (1) dysfunctions in back muscle structure and function, (2) the potential of exercise therapy to address these dysfunctions, and (3) the relationship between changes in back muscle dysfunctions and clinical parameters. In a second part, we will describe a framework for an individualised approach for back muscle training in patients with CLBP.
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Affiliation(s)
- Thomas Matheve
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, 9000 Gent, Belgium;
- REVAL—Rehabilitation Research Center, Faculty of Rehabilitation Sciences, UHasselt, 3500 Diepenbeek, Belgium
| | - Paul Hodges
- NHMRC—Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia;
| | - Lieven Danneels
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, 9000 Gent, Belgium;
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12
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Nishi Y, Osumi M, Morioka S. Anticipatory postural adjustments mediate the changes in fear-related behaviors in individuals with chronic low back pain. Scand J Pain 2023; 23:580-587. [PMID: 36437116 DOI: 10.1515/sjpain-2022-0078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 11/10/2022] [Indexed: 07/21/2023]
Abstract
OBJECTIVES The role(s) of anticipatory postural adjustments (APAs) in changes in subsequent motor and postural controls in response to movement perturbations are unclear in individuals with chronic low back pain (CLBP). This study aimed to clarify the relationships among kinesiophobia, APAs, lumbar kinematic output, and postural control associated with lumbar movement in individuals with CLBP. METHODS CLBP participants (n=48) and healthy controls (HCs) without CLBP (n=22) performed a bend-forward task using their lumbar region on a force platform and returned upright. Each participant's lumbar movements were recorded using an electrogoniometer. We calculated the APA duration, the duration of lumbar direction changes from forward to backward, and the center of pressure (COP) position after lumbar movement tasks completion. RESULTS Compared with the HCs, the duration of direction changes in lumbar movement and the APA duration in CLBP participants were prolonged, and the COP position was shifted forward. The mediation analysis revealed that the duration of lumbar direction changes in the CLBP group was subjected to a significant indirect effect of APAs and a direct effect of kinesiophobia, and the COP position was subjected to a significant indirect effect of kinesiophobia through APAs. CONCLUSIONS APAs partially mediate the relationship between kinesiophobia and changes in lumbar motor control and mediate the relationship between kinesiophobia and postural control in response to movement perturbations. These findings expand our understanding of APAs in altered subsequent movement and postural controls due to kinesiophobia in individuals with CLBP.
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Affiliation(s)
- Yuki Nishi
- Institute of Biomedical Sciences (Health Sciences) , Nagasaki University , Nagasaki, Japan
- Neurorehabilitation Research Center, Kio University, Nara, Japan
| | - Michihiro Osumi
- Neurorehabilitation Research Center, Kio University, Nara, Japan
| | - Shu Morioka
- Neurorehabilitation Research Center, Kio University, Nara, Japan
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Smith JA, Tain R, Sharp KG, Glynn LM, Van Dillen LR, Henslee K, Jacobs JV, Cramer SC. Identifying the neural correlates of anticipatory postural control: A novel fMRI paradigm. Hum Brain Mapp 2023; 44:4088-4100. [PMID: 37162423 PMCID: PMC10258523 DOI: 10.1002/hbm.26332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 04/04/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023] Open
Abstract
Altered postural control in the trunk/hip musculature is a characteristic of multiple neurological and musculoskeletal conditions. Previously it was not possible to determine if altered cortical and subcortical sensorimotor brain activation underlies impairments in postural control. This study used a novel fMRI-compatible paradigm to identify the brain activation associated with postural control in the trunk and hip musculature. BOLD fMRI imaging was conducted as participants performed two versions of a lower limb task involving lifting the left leg to touch the foot to a target. For the supported leg raise (SLR) the leg is raised from the knee while the thigh remains supported. For the unsupported leg raise (ULR) the leg is raised from the hip, requiring postural muscle activation in the abdominal/hip extensor musculature. Significant brain activation during the SLR task occurred predominantly in the right primary and secondary sensorimotor cortical regions. Brain activation during the ULR task occurred bilaterally in the primary and secondary sensorimotor cortical regions, as well as cerebellum and putamen. In comparison with the SLR, the ULR was associated with significantly greater activation in the right premotor/SMA, left primary motor and cingulate cortices, primary somatosensory cortex, supramarginal gyrus/parietal operculum, superior parietal lobule, cerebellar vermis, and cerebellar hemispheres. Cortical and subcortical regions activated during the ULR, but not during the SLR, were consistent with the planning, and execution of a task involving multisegmental, bilateral postural control. Future studies using this paradigm will determine mechanisms underlying impaired postural control in patients with neurological and musculoskeletal dysfunction.
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Affiliation(s)
- Jo Armour Smith
- Department of Physical TherapyChapman UniversityOrangeCaliforniaUSA
| | - Rongwen Tain
- Campus Center for NeuroimagingUniversity of CaliforniaIrvineCaliforniaUSA
| | - Kelli G. Sharp
- Department of Dance, School of ArtsUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Physical Medicine and RehabilitationUniversity of CaliforniaIrvineCaliforniaUSA
| | - Laura M. Glynn
- Department of PsychologyChapman UniversityOrangeCaliforniaUSA
| | - Linda R. Van Dillen
- Program in Physical Therapy, Orthopaedic SurgeryWashington University School of Medicine in St. LouisSt. LouisWashingtonUSA
| | - Korinne Henslee
- Department of Physical TherapyChapman UniversityOrangeCaliforniaUSA
| | - Jesse V. Jacobs
- Rehabilitation and Movement ScienceUniversity of VermontBurlingtonVermontUSA
| | - Steven C. Cramer
- Department of NeurologyUniversity of CaliforniaLos AngelesCaliforniaUSA
- California Rehabilitation InstituteLos AngelesCaliforniaUSA
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Devecchi V, Falla D, Cabral HV, Gallina A. Neuromuscular adaptations to experimentally induced pain in the lumbar region: systematic review and meta-analysis. Pain 2023; 164:1159-1180. [PMID: 36730706 DOI: 10.1097/j.pain.0000000000002819] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/20/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Experimental pain models are frequently used to understand the influence of pain on the control of human movement. In this systematic review, we assessed the effects of experimentally induced pain in the lumbar region of healthy individuals on trunk muscle activity and spine kinematics. Databases were searched from inception up to January 31, 2022. In total, 26 studies using either hypertonic saline injection (n = 19), heat thermal stimulation (n = 3), nociceptive electrical stimulation (n = 3), or capsaicin (n = 1) were included. The identified adaptations were task dependent, and their heterogeneity was partially explained by the experimental pain model adopted. Meta-analyses revealed an increase of erector spinae activity (standardized mean difference = 0.71, 95% confidence interval [CI] = 0.22-1.19) during full trunk flexion and delayed onset of transversus abdominis to postural perturbation tasks (mean difference = 25.2 ms, 95% CI = 4.09-46.30) in the presence of pain. Low quality of evidence supported an increase in the activity of the superficial lumbar muscles during locomotion and during voluntary trunk movements during painful conditions. By contrast, activity of erector spinae, deep multifidus, and transversus abdominis was reduced during postural perturbation tasks. Reduced range of motion of the lumbar spine in the presence of pain was supported by low quality of evidence. Given the agreement between our findings and the adaptations observed in clinical populations, the use of experimental pain models may help to better understand the mechanisms underlying motor adaptations to low back pain.
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Affiliation(s)
- Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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Rum L, Russo Y, Vannozzi G, Macaluso A. "Posture first": Interaction between posture and locomotion in people with low back pain during unexpectedly cued modification of gait initiation motor command. Hum Mov Sci 2023; 89:103094. [PMID: 37148816 DOI: 10.1016/j.humov.2023.103094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 05/08/2023]
Abstract
The ability to adapt anticipatory postural adjustments (APAs) in response to perturbations during single-joint movements is altered in people with chronic low back pain (LBP), but a comprehensive analysis during functional motor tasks is still missing. This study aimed to compare APAs and stepping characteristics during gait initiation between people with LBP and healthy controls, both in normal (without cue occurrence) condition and when an unexpected visual cue required to switch the stepping limb. Fourteen individuals with LPB and 10 healthy controls performed gait initiation in normal and switch conditions. The postural responses were evaluated through the analysis of center of pressure, propulsive ground reaction forces, trunk and whole-body kinematics, and activation onsets of leg and back muscles. During normal gait initiation, participants with LBP exhibited similar APAs and stepping characteristics to healthy controls. In the switch condition, individuals with LBP were characterized by greater mediolateral postural stability but decreased forward body motion and propulsion before stepping. The thorax motion was associated with forward propulsion parameters in both task conditions in people with LBP but not healthy controls. No between-group differences were found in muscle activation onsets. The results suggest that postural stability is prioritized over forward locomotion in individuals with LBP. Furthermore, the condition-invariant coupling between thorax and whole-body forward propulsion in LBP suggests an adaptation in the functional use of the thorax within the postural strategy, even in poor balance conditions.
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Affiliation(s)
- Lorenzo Rum
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy.
| | - Yuri Russo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy; Department of Sport and Health Sciences, University of Exeter, St Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy
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Diplock B, Hing W, Marks D. The long head of biceps at the shoulder: a scoping review. BMC Musculoskelet Disord 2023; 24:232. [PMID: 36978047 PMCID: PMC10044783 DOI: 10.1186/s12891-023-06346-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND This review aimed to explore the available literature to update our understanding of the long head of biceps (LHB) at the shoulder. Synthesise our findings to identify emergent themes and knowledge gaps to inform future research and management directions. METHODS PubMed, Embase, Cinahl, SportDiscus, CENTRAL, and Web of Science were searched from inception to 31st December 2021. Articles were included if they referenced adult participants > 18 years of age and were written in English. RESULTS 214 articles were included in the final analysis, and results were categorised into six emergent themes: (1) Anatomy - Normal anatomical variation of the biceps from aberrant origins, third and fourth accessory heads, and an absence of the LHB tendon (LHBT) are not necessarily benign, with shoulder pain and instability a commonly reported theme. (2) Function - Bicep's role in glenohumeral elevation and stability in healthy shoulders is minimal. In contrast, LHB has a more significant role in shoulder stability and humeral head depression in subjects with rotator cuff failure or an absent LHBT. (3) Pathology - There is an association between LHB tendinopathy, rotator cuff disease, LHBT instability and occult rotator cuff tears. Early recruitment and hyperactivity of the LHB in subjects with symptomatic rotator cuff tears and instability suggest a potential compensatory role. (4) Assessment - The limited diagnostic utility of special orthopaedic tests in assessing LHBT pathology was a consistent theme. The utility of magnetic resonance imaging and ultrasound to identify full-thickness tendon tears and instability of the LHBT was moderate to high. However, the utility of clinical tests and imaging may be underestimated due to arthroscopy's limitations in fully visualising the proximal LHBT. (5) Non-Surgical Management - Ultrasound-guided injections into the biceps sheath show greater accuracy and patient outcomes than blinded injections; however, the entry of injectate into the intraarticular glenohumeral joint may have unwanted complications. (6) Surgical management - For the surgical management of biceps pathology with or without rotator cuff pathology, both biceps tenodesis and tenotomy report similar improvements in pain without any significant adverse effect on strength or function. Tenodesis favoured higher overall constant scores and a lower incidence of Popeye deformity and cramping arm pain, with tenotomy trending to be more cost and time effective. For patients with a healthy LHBT, rotator cuff repair with adjunctive tenodesis or tenotomy fails to provide additional clinical improvements compared to rotator cuff repair in isolation. CONCLUSIONS The scoping review highlights the variability of biceps anatomy, which is not necessarily benign and suggests a minimal role of the LHB in shoulder elevation and stability in healthy individuals. In contrast, individuals with rotator cuff tears experience proximal humeral migration and demonstrate hyperactivity of the LHB, suggesting a potential compensation role. The observed prevalence of LHBT pathology with rotator cuff tears is well established; however, the cause-and-effect relationship between LHBT pathology and rotator cuff disease is undetermined. The diagnostic utility of clinical tests and imaging to exclude LHBT pathology may be understated due to the limitations of arthroscopy to visualise the proximal LHBT fully. Rehabilitation programs for the LHB are understudied. Similar post-surgical clinical outcomes are observed for tenodesis and tenotomy for biceps and rotator cuff-related shoulder pain. Subjects undergoing biceps tenodesis are less likely to have cramping arm pain and a Popeye deformity than patients undergoing biceps tenotomy. The significance of routine surgical removal of the LHBT and sequelae on rotator cuff tear progression to failure and long-term shoulder function is unknown, and further research is required. PRE-REGISTRATION OSF: https://osf.io/erh9m.
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Affiliation(s)
- Brendan Diplock
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia.
| | - Wayne Hing
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
| | - Darryn Marks
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
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17
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Effect of Cognitive Load on Anticipatory Postural Adjustment Latency and its Relationship with Pain-Related Dysfunction in Non-specific Chronic Low Back Pain: A Cross-Sectional Study. Pain Ther 2023; 12:723-735. [PMID: 36932302 PMCID: PMC10199985 DOI: 10.1007/s40122-023-00495-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
INTRODUCTION This study aimed to investigate the effect of cognitive load on anticipatory postural adjustment (APA) latency in patients with non-specific chronic low back pain (NCLBP) and its relationship with pain-related functional changes. METHODS A cross-sectional study was conducted from December 15, 2022 to January 25, 2023. Participants were divided into a healthy control group (n = 29) and an NCLBP group (n = 29). Each group was assigned a single task of rapid arm raising and a dual task of rapid arm raising combined with a cognitive load. The cognitive load task was conducted using visual conflict. The APA latency for bilateral trunk muscles was observed using electromyography. The duration of electromyography recording in each task cycle was 28 s. Pain related-functional changes were evaluated using Roland-Morris Disability Questionnaire (RMDQ) before all tasks. RESULTS The APA latency for the right multifidus was significantly delayed in the NCLBP group [25.38, 95% confidence interval (CI) 13.41-37.35] than in the healthy control group (- 5.80, 95% CI - 19.28 to 7.68) during dual task (p = 0.0416). The APA latency for the right multifidus (25.38, 95% CI 13.41-37.35) and transverse abdominis/internal oblique (29.15, 95% CI 18.81-39.50) were significantly delayed compared with on the left side in the NCLBP group during dual task (- 3.03, 95% CI - 15.18-9.13, p = 0.0220; 3.69, 95% CI - 6.81 to 14.18, p = 0.0363). The latency delay of the right and left multifidus APA in the NCLBP group under the dual-task was positively correlated with RMDQ scores (r = 0.5560, p = 0.0017; r = 0.4010, p = 0.0311). CONCLUSIONS Cognitive load could induce APA delay in the right trunk muscles and co-activation pattern changes in bilateral trunk muscle APA in patients with NCLBP. The APA onset delay in multifidus is positively related to pain-related daily dysfunction. Trial Registration ChiCTR2300068580 (retrospectively registered in February 23, 2023).
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18
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Li Y, Xu Z, Xie H, Fu R, Lo WLA, Cheng X, Yang J, Ge L, Yu Q, Wang C. Changes in cortical activation during upright stance in individuals with chronic low back pain: An fNIRS study. Front Hum Neurosci 2023; 17:1085831. [PMID: 36816497 PMCID: PMC9936824 DOI: 10.3389/fnhum.2023.1085831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Postural control deficits are a potential cause of persistent and recurrent pain in patients with chronic low back pain (CLBP). Although some studies have confirmed that the dorsolateral prefrontal cortex (DLPFC) contributes to pain regulation in CLBP, its role in the postural control of patients with CLBP remains unclear. Therefore, this study aimed to investigate the DLPFC activation of patients with CLBP and healthy controls under different upright stance task conditions. Methods Twenty patients with CLBP (26.50 ± 2.48 years) and 20 healthy controls (25.75 ± 3.57 years) performed upright stance tasks under three conditions: Task-1 was static balance with eyes open; Task-2 was static balance with eyes closed; Task-3 involved dynamic balance on an unstable surface with eyes open. A wireless functional near-infrared spectroscopy (fNIRS) system measured cortical activity, including the bilateral DLPFC, pre-motor cortex (PMC) and supplementary motor area (SMA), the primary motor cortex (M1), the primary somatosensory cortex (S1), and a force platform measured balance parameters during upright stance. Results The two-way repeated measures ANOVA results showed significant interaction in bilateral PMC/SMA activation. Moreover, patients with CLBP had significantly increased right DLPFC activation and higher sway 32 area and velocity than healthy controls during upright stance. Discussion Our results imply that PMC/SMA and DLPFC maintain standing balance. The patients with CLBP have higher cortical activity and upright stance control deficits, which may indicate that the patients with CLBP have low neural efficiency and need more motor resources to maintain balance.
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19
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Bussey MD, Pinfold J, Romanchuk J, Salmon D. Anticipatory head control mechanisms in response to impact perturbations: An investigation of club rugby players with and without a history of concussion injury. Phys Ther Sport 2023; 59:7-16. [PMID: 36442352 DOI: 10.1016/j.ptsp.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The primary objective of this study was to examine rugby players anticipatory and compensatory head control during predictable and unpredictable impact events. METHODS An observational cross-sectional study design. Fifty-one (17_healthy 34_concussion) male rugby players were exposed to external predictable and unpredictable impact perturbations at mid-chest level. Surface EMG of the upper-trapezius (UT), splenius-capitis (Spl) and sternocleidomastoid (Scm) was recorded and analysed across three temporal epochs typical for anticipatory and compensatory postural control. Synchronized sagittal head-kinematics were measured from high-speed video (500 fps). Nonparametric tests were used to examine within and between group effects. RESULTS Anticipatory head control was evident in predictable conditions, expressed by early posterior head displacement and activation of the Spl. Compared to unpredictable conditions, muscle amplitudes were significantly lower, as was head acceleration. Compared to Healthy, the Concussion athletes lacked early activation of the Spl, exhibited delayed anticipatory head adjustments and experienced higher head accelerations in predictable conditions. CONCLUSION Rugby players with concussion injuries have significant deficits in cervical spinal motor control. The concussed motor control strategy leads to higher inertial head accelerations and delayed anticipatory head displacements. Effects may persist for two or more years following injury, which may indicate re-injury vulnerability in these athletes.
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Affiliation(s)
- Melanie D Bussey
- School of Physical Education Sport and Exercise Sciences, University of Otago, New Zealand.
| | - Jayden Pinfold
- School of Physical Education Sport and Exercise Sciences, University of Otago, New Zealand; Hawke's Bay Rugby, New Zealand.
| | - Janelle Romanchuk
- School of Physical Education Sport and Exercise Sciences, University of Otago, New Zealand; New Zealand Rugby, New Zealand.
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20
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Adaptive changes in sensorimotor processing in patients with acute low back pain. Sci Rep 2022; 12:21741. [PMID: 36526879 PMCID: PMC9758154 DOI: 10.1038/s41598-022-26174-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
In low back pain (LBP), primary care and secondary prevention of recurrent and persistent LBP are not always successful. Enhanced understanding of neural mechanisms of sensorimotor processing and pain modulation in patients with acute LBP is mandatory. This explorative fMRI study investigated sensorimotor processing due to mechanosensory stimulation of the lumbar spine. We studied 19 adult patients with acute LBP (< 4 weeks of an acute episode) and 23 healthy controls. On a numeric rating scale, patients reported moderate mean pain intensity of 4.5 out of 10, while LBP-associated disability indicated mild mean disability. The event-related fMRI analysis yielded no between-group differences. However, the computation of functional connectivity resulted in adaptive changes in networks involved in sensorimotor processing in the patient group: Connectivity strength was decreased in the salience and cerebellar networks but increased in the limbic and parahippocampal networks. Timewise, these results indicate that early connectivity changes might reflect adaptive physiological processes in an episode of acute LBP. These findings raise intriguing questions regarding their role in pain persistence and recurrences of LBP, particularly concerning the multiple consequences of acute LBP pain. Advanced understanding of neural mechanisms of processing non-painful mechanosensations in LBP may also improve therapeutic approaches.
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21
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Duarte MB, da Silva Almeida GC, Costa KHA, Garcez DR, de Athayde Costa E Silva A, da Silva Souza G, de Melo-Neto JS, Callegari B. Anticipatory postural adjustments in older versus young adults: a systematic review and meta-analysis. Syst Rev 2022; 11:251. [PMID: 36419140 PMCID: PMC9685888 DOI: 10.1186/s13643-022-02116-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/02/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Anticipatory postural adjustments (APAs) are a feedforward mechanism triggered in advance to a predictable perturbation, to help the individual counteract mechanical effects that the disturbance may cause. Whether or not this strategy is compromised in the elderly is not a consensus in the literature. METHODS In this systematic review with meta-analysis, we investigated aging effects on postural control, based on anticipatory postural adjustments (APAs). We selected 11 eligible articles of the following databases: Lilacs, SciELO, PubMed, Cochrane Central, Embase, and CINAHL, involving 324 research participants, assessing their methodological quality and extracting electromyographic, posturographic, and kinematic measurements. We included studies that investigated the occurrence of APAs in healthy younger and older adults, published before 10th August 2022, in English. Studies involving participant with conditions that may affect balance or that did not report measures of onset or amplitude of electromyography (EMG), COP, or kinematics were excluded. To analyze the aggregated results from these studies, we performed the analysis based on the outcome measures (EMG, COP, or kinematic measures) used in individual studies. We calculated differences between younger and older adult groups as the mean differences between the groups and the estimated effect. Egger's test was conducted to evaluate whether this meta-analysis had publication bias. RESULTS Through this review, older adults showed no significant difference in the velocity to perform a movement compared to the younger adults (MD 0.95, 95% CI -0.86, 2.76, I2 = 82%), but both muscle onset and center of pressure (COP) onset were significantly more delayed in older than in younger adults: erector spinae (MD -31.44, 95% CI -61.79, -1.09, I2 = 95%); rectus abdominis (RA) (MD -31.51, 95% CI -70.58, -3.57, I2 = 85%); tibialis anterior (TA) (MD -44.70, 95% CI -94.30, 4.91, I2 = 63%); soleus (SOL) (MD -37.74, 95% CI -65.43, -10.05, I2 = 91%); gastrocnemius (GAS) (MD -120.59, 95% CI -206.70, -34.49, I2 = 94%); quadriceps (Q) (MD -17.42, 95% CI -34.73, -0.12, I2 = 0%); biceps femoris (BF) (MD -117.47, 95% CI -192.55, -42.70, I2 = 97%); COP onset (MD -45.28, 95% CI -89.57, -0.98, I2 = 93%), and COP apa (COPapa) (MD 2.35, 95% CI -0.09, 4.79, I2 = 64%). These changes did not seem to be linked to the speed of movement but possibly to age-related physiological changes that indicated decreased motor control during APAs in older adults. CONCLUSIONS Older adults use different postural strategies that aim to increase the safety margin and stabilize the body to perform the movement, according to the requirements imposed, and this should be considered in rehabilitation protocols. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD420119143198.
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Affiliation(s)
- Manuela Brito Duarte
- Laboratory of Human Motricity Sciences, Federal University of Pará, Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil.,Master's Program in Human Movement Sciences, Federal University of Pará, 448/475 Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil
| | - Gizele Cristina da Silva Almeida
- Laboratory of Human Motricity Sciences, Federal University of Pará, Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil.,Tropical Medicine Center, Federal University of Pará, Av. Generalíssimo Deodoro 92, Belém, Pará, 66050-240, Brazil
| | - Kelly Helorany Alves Costa
- Laboratory of Human Motricity Sciences, Federal University of Pará, Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil.,Tropical Medicine Center, Federal University of Pará, Av. Generalíssimo Deodoro 92, Belém, Pará, 66050-240, Brazil
| | - Daniela Rosa Garcez
- University Hospital Bettina Ferro de Souza, Federal University of Pará, Rua Augusto Corrêa, n 1. Cep 66075-110, Guamá, Belém, Pará, Brazil.,Neuroscience and Cell Biology Graduate Program (PPGNBC), Federal University of Pará, Rua Augusto Corrêa, n 1. Cep 66075-110, Guamá, Belém, Pará, Brazil
| | - Anselmo de Athayde Costa E Silva
- Master's Program in Human Movement Sciences, Federal University of Pará, 448/475 Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil
| | - Givago da Silva Souza
- Tropical Medicine Center, Federal University of Pará, Av. Generalíssimo Deodoro 92, Belém, Pará, 66050-240, Brazil
| | - João Simão de Melo-Neto
- Tropical Medicine Center, Federal University of Pará, Av. Generalíssimo Deodoro 92, Belém, Pará, 66050-240, Brazil
| | - Bianca Callegari
- Laboratory of Human Motricity Sciences, Federal University of Pará, Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil. .,Master's Program in Human Movement Sciences, Federal University of Pará, 448/475 Av. Generalíssimo Deodoro 01, Belém, Pará, 66050-160, Brazil.
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22
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Postural Adjustments in HTLV-1 Infected Patients during a Self-Initiated Perturbation. Viruses 2022; 14:v14112389. [PMID: 36366487 PMCID: PMC9695886 DOI: 10.3390/v14112389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Human T-cell lymphotropic virus type 1 (HTLV-1) infection can be associated with tropical spastic paraparesis (TSP/HAM), which causes neurological myelopathy and sensory and muscle tone alterations, leading to gait and balance impairments. Once trunk perturbation is predicted, the motor control system uses anticipatory and compensatory mechanisms to maintain balance by recruiting postural muscles and displacement of the body's center of mass. METHODS Twenty-six participants (control or infected) had lower limb muscle onset and center of pressure (COP) displacements assessed prior to perturbation and throughout the entire movement. RESULTS Semitendinosus (ST) showed delayed onset in the infected group compared to the control group. The percentage of trials with detectable anticipatory postural adjustment was also lower in infected groups in the tibialis anterior and ST. In addition, COP displacement in the infected group was delayed, had a smaller amplitude, and took longer to reach the maximum displacement. CONCLUSIONS HTLV-1 infected patients have less efficient anticipatory adjustments and greater difficulty recovering their postural control during the compensatory phase. Clinical assessment of this population should consider postural stability during rehabilitation programs.
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23
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Li X, Zhang H, Lo WLA, Ge L, Miao P, Liu H, Li L, Wang C. Sling Exercise Can Drive Cortical Representation of the Transversus Abdominis and Multifidus Muscles in Patients With Chronic Low Back Pain. Front Neurol 2022; 13:904002. [PMID: 35903113 PMCID: PMC9315065 DOI: 10.3389/fneur.2022.904002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe transversus abdominis (TrA) and multifidus (MF) muscles are essential in preventing chronic low back pain (CLBP) recurrence by maintaining segmental stabilization and stiffness. Sling exercise is a high-level core stability training to effectively improve the activities of the TrA and MF muscles. However, the neural mechanism for sling exercise-induced neural plasticity change in the primary motor cortex (M1) remains unclear. This study aimed to investigate the role of sling exercise in the reorganization of the motor cortical representation of the TrA and MF muscles.MethodsTwenty patients with CLBP and 10 healthy individuals were recruited. For map volume, area, the center of gravity (CoG) location (medial-lateral location and anterior-posterior location), and latency, two-way ANOVA was performed to compare the effects of groups (the CLBP-pre, CLBP-post, and healthy groups) and the two muscles (the TrA and MF muscles). The Visual Analog Scale (VAS), the Oswestry Disability Index (ODI), and postural balance stability were assessed at baseline and at the end of 2 weeks of sling exercise. Linear correlations between VAS or ODI and CoG locations were assessed by Pearson's correlation test.Results2 weeks of sling exercise induced both the anterior-medial (P < 0.001) and anterior-posterior (P = 0.025) shifts of the MF muscle representation at the left motor cortex in patients with CLBP. Anterior-medial (P = 0.009) shift of the TrA muscle representation at the right motor cortex was observed in patients with CLBP. The motor cortical representation of the two muscles in patients with CLBP after sling exercise (TrA: 2.88 ± 0.27 cm lateral and 1.53 ± 0.47 cm anterior of vertex; MF: 3.02 ± 0.48 cm lateral and 1.62 ± 0.40 cm anterior of vertex) closely resembled that observed in healthy individuals (TrA: 2.83 ± 0.48 cm lateral and 2.00 ± 0.43 cm anterior of vertex; MF: 2.94 ± 0.43 cm lateral and 1.77 ± 0.48 cm anterior of vertex). The VAS and the ODI were reduced following the sling exercise (VAS: P < 0.001; ODI: P < 0.001).ConclusionThis study provides evidence that sling training can drive plasticity changes in the motor system, which corresponds with the reduction in pain and disability levels in patients with CLBP. This study was registered in the Chinese Clinical Trial Registry (Clinical Trial Registration Number: ChiCTR2100045904, http://www.chictr.org.cn/showproj.aspx?proj=125819).Clinical Trial RegistrationChiCTR2100045904.
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Affiliation(s)
- Xin Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haojie Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Le Ge
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ping Miao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Howe Liu
- School of Health Sciences, Allen College, Waterloo, IA, United States
| | - Le Li
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
- *Correspondence: Le Li
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Chuhuai Wang
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24
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Smith JA, Stabbert H, Bagwell JJ, Teng HL, Wade V, Lee SP. Do people with low back pain walk differently? A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:450-465. [PMID: 35151908 PMCID: PMC9338341 DOI: 10.1016/j.jshs.2022.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/04/2021] [Accepted: 12/17/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls. METHODS A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included if they reported biomechanical characteristics of individuals with and without LBP during steady-state or perturbed walking and running. Biomechanical data included spatiotemporal, kinematic, kinetic, and electromyography variables. The reporting quality and potential for bias of each study was assessed. Data were pooled where possible to compare the standardized mean differences (SMD) between back pain and back-healthy control groups. RESULTS Ninety-seven studies were included and reviewed. Two studies investigated acute pain and the rest investigated persistent pain. Nine studies investigated running gait. Of the studies, 20% had high reporting quality/low risk of bias. In comparison with back-healthy controls, individuals with persistent LBP walked slower (SMD = -0.59, 95% confidence interval (95%CI): -0.77 to -0.42)) and with shorter stride length (SMD = -0.38, 95%CI: -0.60 to -0.16). There were no differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP. During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the persistent LBP groups (SMD = -0.60, 95%CI: -0.90 to -0.30), and individuals with persistent LBP exhibited greater amplitude of activation in the paraspinal muscles (SMD = 0.52, 95%CI: 0.23-0.80). There were no consistent differences in running biomechanics between groups. CONCLUSION There is moderate-to-strong evidence that individuals with persistent LBP demonstrate differences in walking gait compared to back-healthy controls.
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Affiliation(s)
- Jo Armour Smith
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA.
| | - Heidi Stabbert
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA
| | - Jennifer J Bagwell
- Department of Physical Therapy, California State University, Long Beach, CA 90840, USA
| | - Hsiang-Ling Teng
- Department of Physical Therapy, California State University, Long Beach, CA 90840, USA
| | - Vernie Wade
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA
| | - Szu-Ping Lee
- Department of Physical Therapy, University of Nevada, Las Vegas, NV 89154, USA
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25
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Schäfer R, Schäfer H, Platen P. Perturbation-based trunk stabilization training in elite rowers: A pilot study. PLoS One 2022; 17:e0268699. [PMID: 35587490 PMCID: PMC9119454 DOI: 10.1371/journal.pone.0268699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 12/03/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction
Low back pain is a major health issue in elite rowers. High training volume, frequent flexion movements of the lower spine and rotational movement in sweep rowing contribute to increased spinal strain and neuropathological patterns. Perturbation-based trunk stabilization training (PTT) may be effective to treat neuromuscular deficits and low back pain.
Methods
All boat classes (8+, 4+/-, 2-) of the male German national sweep rowing team participated in this non-randomized parallel group study. We included 26 athletes (PTT: n = 12, control group: n = 14) in our analysis. Physical and Sports therapists conducted 16 individualized PTT sessions á 30–40 minutes in 10 weeks, while the control group kept the usual routines. We collected data before and after intervention on back pain intensity and disability, maximum isometric trunk extension and flexion, jump height and postural sway of single-leg stance.
Results
We found less disability (5.3 points, 95% CI [0.4, 10.1], g = 0.42) for PTT compared to control. Pain intensity decreased similar in both groups (-14.4 and -15.4 points), yielding an inconclusive between-group effect (95% CI [-16.3, 14.3]). Postural sway, strength and jump height tend to have no between- and within-group effects.
Conclusion
Perturbation-based trunk stabilization training is possibly effective to improve the physical function of the lower back in elite rowers.
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Affiliation(s)
- Robin Schäfer
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
- * E-mail:
| | - Hendrik Schäfer
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
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26
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Symptomatic individuals with Lumbar Disc Degeneration use different anticipatory and compensatory kinematic strategies to asymptomatic controls in response to postural perturbation. Gait Posture 2022; 94:222-229. [PMID: 33980472 PMCID: PMC9099249 DOI: 10.1016/j.gaitpost.2021.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Lumbar Disc Degeneration (LDD) is associated with recurrent low back pain (LBP) (symptomatic). However, in some instances of LDD, people do not experience LBP (asymptomatic). RESEARCH QUESTION As a step towards understanding why some people with LDD experience LBP and others do not, the primary aim of this study was to examine differences in anticipatory (APA) and compensatory postural adjustments (CPA), between symptomatic LDD patients (LDD pain) and asymptomatic LDD controls (LDD no pain) during postural perturbation. The secondary aim was to determine simultaneous differences in mental health, disability and quality of life status. METHODS 3 T MRI was used to acquire T2 weighted images (L1-S1) from LDD no pain (n = 34) and LDD pain groups (n = 34). In this observational study, responses to predicted and unpredicted forward perturbations were examined using three dimensional motion capture. A Mann Whitney U test was conducted to examine group differences in sagittal spine and lower limb kinematics (integrated angular displacements during four established APA and CPA time intervals), anxiety, depression, disability and quality of life. RESULTS The LDD pain group exhibited lower hip and knee displacements (p = 0.049-0.040) than the LDD no pain group during predicted and unpredicted perturbation. The LDD pain group also exhibited higher compensatory lumbar displacement than the LDD no pain group (p = 0.040-0.005) in the predicted condition but there was no difference observed in the unpredicted condition. The LDD pain group experienced higher levels of depression, anxiety and disability (p < 0.0001) and lower quality of life (p = 0.0001) than LDD controls. SIGNIFICANCE Symptomatic LDD patients are different from LDD controls; they exhibit different kinematic strategies, levels of disability, anxiety, depression and quality of life. Effective care may benefit from evaluating and targeting these differences.
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27
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Castro JBD, Lima VP, Mello DBD, Lopes GC, Peixoto JC, Santos AOD, Nunes RAD, Souza Vale RGD. Effects of Pilates with and without elastic resistance on health variables in postmenopausal women with low back pain. Pain Manag 2022; 12:509-520. [PMID: 35152706 DOI: 10.2217/pmt-2021-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To compare the effects of Pilates with and without accessories on biochemical markers, pain intensity, functional disability and muscle strength in postmenopausal women with nonspecific chronic low back pain. Materials & methods: Twenty-two participants were randomized to a group of Pilates without (PG; n = 11) and with elastic resistance (PAG; n = 11) for 8 weeks, twice a week. We analyzed IGF-1, IGF-binding protein-3 (IGFBP-3), cortisol, creatine kinase, pain intensity, functional disability, abdominal and back strengths. Results: Both groups had lower pain intensity and functional disability and increased lumbar strength postinterventions. PAG exhibited an increase in IGF-1/IGFBP-3 ratio and reduction in creatine kinase compared with PG. Conclusion: Both interventions were effective in the treatment of low back pain. However, PAG presented better responses than PG. Clinical Trial Registration: Brazilian Clinical Trials Registry: ReBEC (RBR-9jwcykc), www.ensaiosclinicos.gov.br/rg/RBR-9jwcykc.
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Affiliation(s)
- Juliana Bp de Castro
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Exercise & Sport (LABEES), Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Vicente P Lima
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Exercise & Sport (LABEES), Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Research Group of Performance, Biodynamics, Exercise & Health (BIODESA), Castelo Branco University, Rio de Janeiro, Brazil
| | - Danielli B de Mello
- Physical Education College of Brazilian Army (EsEFEx), Rio de Janeiro, Brazil
| | - Gustavo C Lopes
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Exercise & Sport (LABEES), Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Andressa Ob Dos Santos
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Exercise & Sport (LABEES), Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Research Group of Performance, Biodynamics, Exercise & Health (BIODESA), Castelo Branco University, Rio de Janeiro, Brazil
| | - Rodolfo Am de Nunes
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Exercise & Sport (LABEES), Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Rodrigo G de Souza Vale
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Exercise & Sport (LABEES), Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Exercise Physiology, Estácio de Sá University, Cabo Frio, RJ, Brazil
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Santos AOBD, Castro JBPD, Nunes RDAM, Silva GCPSMD, Oliveira JGMD, Lima VP, Vale RGDS. Effects of two training programs on health variables in adults with chronic low back pain: a randomized clinical trial. Pain Manag 2022; 12:447-459. [PMID: 35001671 DOI: 10.2217/pmt-2021-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To analyze the effects of two training programs on health variables in adults with low back pain (LBP). Methods: Thirty-eight adults were randomly divided into three groups: resistance training (RG); resistance training with core training (RCG) and control (CG). Results: There were reductions in body mass index (BMI) in RG and RCG, waist circumference in RG and RCG, pain in RG, RCG and CG, CK in RCG, stress in RG and RCG, functional deficiency in RG and RCG and increases in trunk flexor and extensor strength in the RG and RCG. Conclusion: Resistance training, with or without core training exercises, reduced the levels of LBP, functional disability, stress and CK, and increased the strength of trunk flexors and extensors. Trial registration: Brazilian Clinical Trials Registry: ReBEC (RBR-5khzxz).
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Affiliation(s)
- Andressa Oliveira Barros Dos Santos
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil.,Laboratory of Exercise & Sport, Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil
| | - Juliana Brandão Pinto de Castro
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil.,Laboratory of Exercise & Sport, Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil
| | - Rodolfo de Alkmim Moreira Nunes
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil.,Laboratory of Exercise & Sport, Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil
| | - Giullio César Pereira Salustiano Mallen da Silva
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil.,Laboratory of Exercise & Sport, Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil
| | | | - Vicente Pinheiro Lima
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil.,Laboratory of Exercise & Sport, Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil
| | - Rodrigo Gomes de Souza Vale
- Postgraduate Program in Exercise & Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil.,Laboratory of Exercise & Sport, Institute of Physical Education & Sports, Rio de Janeiro State University, Rio de Janeiro, 20550900, Brazil.,Laboratory of Exercise Physiology, Estácio de Sá University, Cabo Frio, Rio de Janeiro, 28909-800, Brazil
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Lin S, Zhu B, Zheng Y, Liu S, Wang C. Effect of RUSI-based core stability exercise on chronic non-specific low back pain patients: study protocol for a randomised controlled trial. BMJ Open 2021; 11:e047317. [PMID: 34907039 PMCID: PMC8671944 DOI: 10.1136/bmjopen-2020-047317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Low back pain (LBP) is one of the most highly prevalent pain both in developed countries and low-income and middle-income countries. Despite increasing healthcare resources and numerous treatment methods for LBP, the efficacy of these therapeutic strategies is still uncertain. Recently, core stability exercise (CSE) is popularly applied as a preventive or rehabilitative method in the treatment of LBP. However, the adequate activation of the local muscle systems of CSE needs further optimisation and quantification. This trial aims to investigate the feasibility and efficacy of CSE monitored by real-time ultrasound image (RUSI) on LBP individuals. METHODS AND ANALYSIS Forty subjects with chronic non-specific LBP (CNLBP), aged from 20 to 50 years, will be randomly allocated into two groups using sealed, consecutively numbered opaque envelopes: (1) study group (SG): CSE monitored by RUSI and (2) control group (CG): identical CSE without monitoring. Interventions will last 30 mins, two times a week for 8 weeks. The primary outcomes include pain intensity, disability and quality of life, and the secondary outcomes will be the postural control static stability, onset timing of trunk muscles activation, ultrasound images of muscle thickness and surface electromyography (sEMG) signal of muscle activities. Outcome measures will be collected at baseline, 4 and 8 weeks during training, and at 6 months follow-up. Data will be collected and analysed by an assessor blinded to group allocation. Effect sizes and mixed-model repeated measures analysis of variance (2 groups×4 time points) will be calculated. ETHICS AND DISSEMINATION This protocol and informed consent has been approved by the Institutional Research Ethics Committee of the First Affiliated Hospital, Sun Yat-sen University (Approval number: [2020] 254-1). The findings of this study will be disseminated to participants through social networks and will be submitted to peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (ChiCTR2000034498).
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Affiliation(s)
- Shanshan Lin
- Department of Rehabilitation Medicine, Jiangmen Central Hospital, Jiangmen, Guangdong, China
- Department of Rehabilitation Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Bo Zhu
- Department of Hepatobiliary Surgery, Jiangmen Central Hospital, Jiangmen, Guangdong, China
| | - Yiyi Zheng
- Department of Rehabilitation Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Shufeng Liu
- Department of Rehabilitation Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
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Effects of unilateral and bilateral lower extremity fatiguing exercises on postural control during quiet stance and self-initiated perturbation. Hum Mov Sci 2021; 81:102911. [PMID: 34906841 DOI: 10.1016/j.humov.2021.102911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/29/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022]
Abstract
Postural control can be more difficult during muscle fatigue. Anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) are the two main postural strategies controlled by the central nervous system. Unchanged or early anticipatory onset together with altered activation magnitude during the APAs phase is observed in the trunk and thigh muscles following unilateral and bilateral fatiguing exercises. Thus far, no studies have compared the effect of such exercises on APAs and CPAs. This study compared the effects of these exercises performed at the same relative workload on center of pressure (COP)-based postural stability measures during quiet stance and electromyography (EMG)-based APAs and CPAs during self-initiated perturbation. Fifteen young male subjects completed the two separated fatiguing sessions; 50% of maximal voluntary contraction force obtained from the unilateral (dominant) and bilateral legs with five sets of 20 times lower limb exercise was respectively applied as unilateral and bilateral fatiguing protocols. Spatio-temporal COP parameters (sway velocity, total displacement, and envelope area) were used to evaluate postural stability, and spectral analysis was performed to estimate the distributions in COP power spectrum. EMG activities of transversus abdominis/internal oblique (TrA/IO) and lumbar multifidus (LMF) were recorded and analyzed during the APAs and CPAs phases. Increased sway velocity and total displacements occurred following both unilateral and bilateral fatiguing exercises; however, the envelope area was not affected. Further, early anticipatory onset of TrA/IO was found after bilateral than after unilateral fatiguing exercise. Co-activation index of the TrA/IO-LMF muscle pair during the CPAs phase increased following both fatiguing sessions. The results partly confirmed previously reported fatigue effects induced by unilateral and bilateral exercises on postural stability. It was observed that APAs onsets were altered differently following a unilateral or bilateral fatiguing exercise, whereas the alterations of CPAs were independent of fatigue conditions. Repetitive unilateral or bilateral fatiguing exercises in patients or athletes may differently alter the anticipatory component of postural control.
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A Study on the Relationship between Postural Control and Pain-Related Clinical Outcomes in Patients with Chronic Nonspecific Low Back Pain. Pain Res Manag 2021; 2021:9054152. [PMID: 34765050 PMCID: PMC8577937 DOI: 10.1155/2021/9054152] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/22/2021] [Accepted: 10/16/2021] [Indexed: 11/17/2022]
Abstract
Objectives To explore the relationship between postural control and pain-related clinical outcomes in patients with chronic nonspecific low back pain (cNLBP). Methods Participants with cNLBP and healthy individuals were recruited. Muscle activities were recorded during internal and external perturbation tasks. Postural control capacity was assessed by muscle onset time and integrals of electromyography (iEMGs) of postural muscles during the phases of anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs). Correlation analysis was employed to investigate the relationship between postural control capacity, pain, and disability. Results Twenty-seven patients with cNLBP and 27 healthy participants were recruited. Gastrocnemius (GA) muscle onset time was earlier in the cNLBP group than in the control group in the internal perturbation task. The onset time of GA and erector spinae (ES) of the cNLBP group was later than that of the controls in the external perturbation task. Disability level moderately correlated with the iEMGs of rectus abdominis (RA), GA, and external oblique (EO) during APAs. Pain score moderately correlated with the iEMGs of RA, EO, and ES during CPAs of perturbation tasks. Conclusion cNLBP participants had altered muscle activation strategy to maintain postural stability in response to perturbation. This study further discovered that pain-related disabilities of cNLBP participants were likely related to the APAs capacity, whereas the pain intensity may relate to the CPAs capacity. Pain and disability may therefore be related to the control process of the posture-related muscles.
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Devecchi V, Falla D, Cabral HV, Gallina A. Neuromuscular adaptations to experimentally induced pain in the lumbar region: protocol for a systematic review and meta-analysis. Syst Rev 2021; 10:270. [PMID: 34654481 PMCID: PMC8520254 DOI: 10.1186/s13643-021-01831-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Numerous studies report changes in neuromuscular control in people with low back pain (LBP). However, the relationship between pain and altered neuromuscular control is challenging to unravel given the heterogeneity that exists in clinical populations. One approach commonly adopted to overcome this issue is the use of experimental pain models, but it is currently unclear if the effects of experimental pain are consistent between studies. Therefore, this planned study will systematically evaluate and summarise the effect of experimentally induced pain in the lumbar region on neuromuscular control at sites both locally and remote to the low back. METHODS This protocol has been developed following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). MEDLINE, EMBASE, CINAHL, ZETOC, Web of Science, and grey literature will be searched up to August 31, 2021. Screening processes (title/abstract and full-text), data extraction, and risk of bias assessment will be conducted by two independent reviewers. Studies investigating the effects of exogenous pain models delivered to the low back region on neuromuscular control in healthy individuals will be included. Muscle activity and body kinematics will be the outcomes of interest. The comparisons of interest will be between baseline or control conditions and the experimental pain condition, as well as between the experimental pain and post-pain conditions. Randomised crossover and non-randomised studies of interventions will be included and their risk of bias will be evaluated with the Cochrane Risk-of-Bias tool or with the Risk Of Bias In Non-randomised Studies of Interventions tool, respectively. A random-effect meta-analysis will be conducted for quantitative synthesis when clinical and methodological consistency is ensured. Quality of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation guidelines. DISCUSSION The current review will provide new insights to understand if and what neuromuscular adaptations are caused by pain experimentally induced in the lumbar region. Our findings will reveal which experimental pain model is able to better reproduce adaptations similar to those identified in people with low back pain, possibly contributing to improving our understanding of motor adaptation to low back pain in the long term. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020220130.
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Affiliation(s)
- Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Hélio V. Cabral
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Alessio Gallina
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
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Falla D, Devecchi V, Jiménez-Grande D, Rügamer D, Liew BXW. Machine learning approaches applied in spinal pain research. J Electromyogr Kinesiol 2021; 61:102599. [PMID: 34624604 DOI: 10.1016/j.jelekin.2021.102599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/26/2021] [Accepted: 08/01/2021] [Indexed: 01/13/2023] Open
Abstract
The purpose of this narrative review is to provide a critical reflection of how analytical machine learning approaches could provide the platform to harness variability of patient presentation to enhance clinical prediction. The review includes a summary of current knowledge on the physiological adaptations present in people with spinal pain. We discuss how contemporary evidence highlights the importance of not relying on single features when characterizing patients given the variability of physiological adaptations present in people with spinal pain. The advantages and disadvantages of current analytical strategies in contemporary basic science and epidemiological research are reviewed and we consider how analytical machine learning approaches could provide the platform to harness the variability of patient presentations to enhance clinical prediction of pain persistence or recurrence. We propose that machine learning techniques can be leveraged to translate a potentially heterogeneous set of variables into clinically useful information with the potential to enhance patient management.
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Affiliation(s)
- Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
| | - Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - David Jiménez-Grande
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - David Rügamer
- Department of Statistics, Ludwig-Maximilians-Universität München, Germany
| | - Bernard X W Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, UK
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Larivière C, Preuss R. The effect of extensible and non-extensible lumbosacral orthoses on anticipatory postural adjustments in participants with low back pain and healthy controls. Musculoskelet Sci Pract 2021; 55:102421. [PMID: 34280708 DOI: 10.1016/j.msksp.2021.102421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Wearing a lumbosacral orthosis (LSO) is known to influence spine mechanics, but less is known about how LSOs affect motor control. Whether the use of a LSO can negatively affect motor control of the lumbar spine is still under debate. OBJECTIVE The current study examined the immediate effects of two flexible LSOs (extensible and non-extensible) on the anticipatory postural adjustments that prepare the spine for a predictable perturbation. DESIGN A comparative study using a repeated measures design in a laboratory setting. METHODS Healthy controls (n = 20) and participants with low back pain (n = 40) performed a rapid arm flexion/extension cycle with and without these LSOs. The latency between the activations of the shoulder and different back (iliocostalis lumborum) and abdominal (rectus abdominis, internal and external obliques) muscles, as measured with surface electromyography, was used as the outcome. RESULTS The effects, which were comparable between groups and between LSOs, were mixed, with some muscles showing significantly (p ˂ 0.05) earlier activation and others showing delayed activation with the use of a LSO, relative to the control condition. The corresponding effect sizes were low to average (Hedges's g range: 0.17-0.48). CONCLUSIONS These findings suggest a change in the motor program before task initiation, which might be generalizable to other activities of daily living or work. However, none of the effects were large, making it difficult to provide clear conclusions with regard to their clinical relevance. It remains to be tested whether these immediate adaptations in motor planning can induce long term detrimental effects to the control of lumbar stability.
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Affiliation(s)
- Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada.
| | - Richard Preuss
- School of Physical & Occupational Therapy, McGill University, Montréal, Québec, H3G 1Y5, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
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The Effect of Virtual Reality Training on Anticipatory Postural Adjustments in Patients with Chronic Nonspecific Low Back Pain: A Preliminary Study. Neural Plast 2021; 2021:9975862. [PMID: 34367274 PMCID: PMC8337111 DOI: 10.1155/2021/9975862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/15/2021] [Accepted: 07/12/2021] [Indexed: 01/13/2023] Open
Abstract
Objectives This study is aimed at exploring the effects of virtual reality (VR) training on postural control, measured by anticipatory and compensatory postural adjustments (APAs and CPAs, respectively), in patients with chronic nonspecific low back pain (CNLBP) and the potential neuromuscular mechanism of VR training. Methods Thirty-four patients were recruited and randomly assigned to the VR group (n = 11), the motor control exercise group (MCE, n = 12) and the control group (CG, n = 11). The VR group received VR training using Kinect Xbox 360 systems and magnetic therapy. Besides magnetic therapy, the participants in the MCE group performed real-time ultrasound-guided abdominal drawing-in maneuver (ADIM) and four-point kneeling exercise. The CG only received magnetic therapy. Surface muscle electromyography (sEMG) was used to record the muscle activities of transverse abdominis (TrA), multifidus (MF), lateral gastrocnemius (LG), and tibialis anterior (TA) during ball-hitting tasks. The muscle activation time and integrals of the electromyography activities (IEMGs) during the APA and CPA stages were calculated and used in the data analysis. The visual analogue scale (VAS) and Oswestry dysfunction index (ODI) scores were also recorded. Results A significant interaction effect of time × group was observed on the activation time of TrA (p = 0.018) and MF (p = 0.037). The post-intervention activation time of the TrA was earlier in the VR group (p = 0.029). In contrast, the post-intervention activation time of the MF was significantly delayed in the VR group (p = 0.001). The IEMGs of TrA (p = 0.002) and TA (p = 0.007) during CPA1 significantly decreased only in the VR group after the intervention. The VAS scores of three group participants showed significant decreases after intervention (p < 0.001). Conclusions Patients with CNLBP showed reciprocal muscle activation patterns of the TrA and MF muscles after VR training. VR training may be a potential intervention for enhancing the APAs of the patients with CNLBP.
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Baek S, Ki SY, Chung SW, Lee SJ, Cho YC, Oh KS. Delayed Anticipatory Muscle Activation in Rotator Cuff Tendinopathy. Orthop J Sports Med 2021; 9:23259671211019360. [PMID: 34377717 PMCID: PMC8330462 DOI: 10.1177/23259671211019360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/18/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Previous research investigating rotator cuff (RC) tendinopathy has usually focused on pathoanatomy. The pathologic response to anticipatory postural adjustments (APAs) has not yet been investigated. PURPOSE/HYPOTHESIS To explore changes in APAs as detected by pre-emptive activation of shoulder muscles during ball catching. It was hypothesized that anticipatory muscle activation (AMA) would be present in the unaffected shoulder but delayed or absent in the affected shoulder in patients with RC tendinopathy. STUDY DESIGN Controlled laboratory study. METHODS This study included 21 RC tendinopathy patients with a mean age of 49.5 years. Patients were required to grab a ball embedded with an electromyography sensor when it dropped on their hand, and surface electromyography signals were recorded from the infraspinatus, upper trapezius, anterior deltoid, and biceps. The trials utilized 2 balls, weighing 200 g and 500 g. Each ball was used in 2 trials, 1 involving a number count preceding the ball drop (predictable) and the other involving a sudden drop (unpredictable). The onsets of AMA between the affected and unaffected limbs were compared. RESULTS Regardless of the experimental condition, significantly delayed AMA onsets were identified in all investigated muscles of the affected side compared with those of the unaffected side, except for the biceps muscle in the 500-g predictable trial. For the infraspinatus, the mean onset time in the 200-g predictable trial was -141.0 ± 60.2 ms on the affected side and -211.9 ± 67.1 ms on the unaffected side (P < .001); in the 200-g unpredictable trial this value was -139.5 ± 54.9 ms on the affected side and -199.5 ± 56.2 ms on the unaffected side (P < .001). CONCLUSION Delayed AMA was observed in the affected shoulder compared with the unaffected shoulder in patients with RC tendinopathy, not only in the RC muscle but also in the periscapular and upper arm muscles. This may indicate that central hypoexcitability is partly responsible. CLINICAL RELEVANCE The basis for RC tendinopathy treatment should not be limited to the tendon pathoanatomy. Delayed AMA around the shoulder joint could provide insight into potential mechanisms related to the central nervous system.
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Affiliation(s)
- Samuel Baek
- Department of Orthopaedic Surgery, Seoul Red Cross Hospital, Seoul, Republic of Korea
| | - Se-Young Ki
- Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Seok Won Chung
- Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Seoung-Joon Lee
- Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Young Chang Cho
- Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Kyung-Soo Oh
- Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
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Caña-Pino A, Espejo-Antúnez L, Carmona Del Barco P, Montanero-Fernández J, Lluch-Girbés E, Roussel NA, Apolo-Arenas MD. Energy spectral density as valid parameter to compare postural control between subjects with nonspecific chronic low back pain vs healthy subjects: A case-control study. Musculoskelet Sci Pract 2021; 53:102370. [PMID: 33836396 DOI: 10.1016/j.msksp.2021.102370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/08/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Nonspecific chronic low back pain (NSCLBP) is one of the most common and frequent health problems. OBJETIVE: to compare postural control (i.e. center of pressure (CoP) displacement and energy spectral density (ESD)) using technological devices (accelerometers and pressure platform) between subjects with NSCLBP and healthy subjects. METHODS A cross-sectional case-control study was conducted. Observational study (STROBE). The final sample consisted of 60 subjects (30 NSCLBP subjects and 30 healthy subjects). Triaxial accelerometer and pressure platform were used in order to obtain ESD and CoP displacement measurements during four balance tasks (i.e. with and without vision and on stable versus unstable surface). Independent t tests were used to compare participants with NSCLBP and healthy controls in the two clinical measurements (i.e., CoP displacement and ESD) for the four balance tests. A multivariate analysis of variance (MANOVA) together with a Fisher's linear discrimination was applied in order to categorize NSPLBP. RESULTS Patients with NSCLBP showed greater CoP migration in the positions eyes open, stable surface on the anteroposterior axis (p = 0.012), eyes closed, stable surface on the mediolateral axis (p = 0.025), eyes closed, stable surface on the anteroposterior axis (p = 0.001), eyes open, unstable surface on the anteroposterior axis (p = 0.040), eyes closed, unstable surface on the anteroposterior axis (p = 0.015). Also the ESD was significantly greater for the four situations described (p ≤ 0.01) in subjects with NSCLBP. CONCLUSIONS Accelerometer appears to be a technological device that could offer a potential benefit within the battery of tests on physical performance among subjects with NSCLBP and healthy subjects.
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Affiliation(s)
- Alejandro Caña-Pino
- Department of Medical Surgical-Therapy, Medicine Faculty, Extremadura University, Badajoz, Spain
| | - Luís Espejo-Antúnez
- Department of Medical Surgical-Therapy, Medicine Faculty, Extremadura University, Badajoz, Spain.
| | - Pablo Carmona Del Barco
- Department of Computer and Telematic Systems Engineering, Area of Languages and Computer Systems, School of Industrial Engineering, Extremadura University, Badajoz, Spain
| | | | - Enrique Lluch-Girbés
- Department of Physical Therapy, University of Valencia, 46010, Valencia, Spain; Pain in Motion" International Research Group, 1090, Brussels, Belgium; Department of Human Physiology and Rehabilitation Sciences, Faculty of Physiotherapy, Vrije University Brussels, B-1050, Brussels, Belgium
| | - Nathalie A Roussel
- Rehabilitation Sciences and Physiotherapy (REVAKI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ma Dolores Apolo-Arenas
- Department of Medical Surgical-Therapy, Medicine Faculty, Extremadura University, Badajoz, Spain
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Are neuromuscular adaptations present in people with recurrent spinal pain during a period of remission? a systematic review. PLoS One 2021; 16:e0249220. [PMID: 33793608 PMCID: PMC8016280 DOI: 10.1371/journal.pone.0249220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/14/2021] [Indexed: 12/11/2022] Open
Abstract
A plethora of evidence supports the existence of neuromuscular changes in people with chronic spinal pain (neck and low back pain), yet it is unclear whether neuromuscular adaptations persist for people with recurrent spinal pain when in a period of remission. This systematic review aimed to synthesise the evidence on neuromuscular adaptations in people with recurrent spinal pain during a period of remission. Electronic databases, grey literature, and key journals were searched from inception up to the 4th of September 2020. Eligibility criteria included observational studies investigating muscle activity, spine kinematics, muscle properties, sensorimotor control, and neuromuscular performance in adults (≥ 18 years) with recurrent spinal pain during a period of remission. Screening, data extraction, and quality assessment (Newcastle-Ottawa Scale) were conducted independently by two reviewers. Data synthesis was conducted per outcome domain. A meta-analysis with a random-effects model was performed where possible. The overall strength of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation guidelines (GRADE). From 8292 records, 27 and five studies were included in a qualitative and quantitative synthesis, respectively. Very low level of evidence supports muscle activity changes in people with recurrent low back pain, especially greater co-contraction, redistribution of muscle activity, and delayed postural control of deeper trunk muscles. Reduced range of motion of the lumbar spine was also found. Meaningful conclusions regarding other outcome domains or people with recurrent neck pain could not be drawn. In conclusion, people with recurrent low back pain during a period of remission show muscle activity and spine kinematics adaptations. Future research should investigate the long-term impact of these changes, as well as adaptations in people with recurrent neck pain.
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Deane JA, Lim AKP, McGregor AH, Strutton PH. Understanding the impact of lumbar disc degeneration and chronic low back pain: A cross-sectional electromyographic analysis of postural strategy during predicted and unpredicted postural perturbations. PLoS One 2021; 16:e0249308. [PMID: 33793605 PMCID: PMC8016216 DOI: 10.1371/journal.pone.0249308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/16/2021] [Indexed: 11/17/2022] Open
Abstract
People with chronic low back pain (LBP) exhibit changes in postural control. Stereotypical muscle activations resulting from external perturbations include anticipatory (APAs) and compensatory (CPAs) postural adjustments. The aim and objective of this study was to determine differences in postural control strategies (peak amplitude, APAs and CPAs) between symptomatic and asymptomatic adults with and without Lumbar Disc Degeneration (LDD) using surface electromyography during forward postural perturbation. Ninety-seven subjects participated in the study (mean age 50 years (SD 12)). 3T MRI was used to acquire T2 weighted images (L1-S1). LDD was determined using Pfirrmann grading. A bespoke translational platform was designed to deliver horizontal perturbations in sagittal and frontal planes. Electromyographic activity was analysed bilaterally from 8 trunk and lower limb muscles during four established APA and CPA epochs. A Kruskal-Wallis H test with Bonferroni correction for multiple comparisons was conducted. Four groups were identified: no LDD no pain (n = 19), LDD no pain (n = 38), LDD pain (n = 35) and no LDD pain (n = 5). There were no significant differences in age or gender between groups. The most significant difference between groups was observed during forward perturbation. In the APA and CPA phases of predictable forward perturbation there were significant differences ankle strategy between groups (p = 0.007–0.008); lateral gastrocnemius and tibialis anterior activity was higher in the LDD pain than the LDD no pain group. There were no significant differences in the unpredictable condition (p>0.05). These findings were different from the remaining groups, where significant differences in hip strategy were observed during both perturbation conditions (p = 0.004–0.006). Symptomatic LDD patients exhibit different electromyographic strategies to asymptomatic LDD controls. Future LBP electromyographic research should benefit from considering assessment of both lower limbs in addition to the spine. This approach could prevent underestimation of postural control deficits and guide targeted rehabilitation.
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Affiliation(s)
- Janet A Deane
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.,Department of Health Sciences, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Adrian K P Lim
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.,Department of Imaging, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Alison H McGregor
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Paul H Strutton
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Sever J, Babič J, Kozinc Ž, Šarabon N. Postural Responses to Sudden Horizontal Perturbations in Tai Chi Practitioners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052692. [PMID: 33800052 PMCID: PMC7967416 DOI: 10.3390/ijerph18052692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 12/03/2022]
Abstract
Tai Chi has been shown to elicit numerous positive effects on health and well-being. In this study, we examined reactive postural control after sudden unloading horizontal perturbations, which resembled situations encountered during Tai Chi. The study involved 20 participants, 10 in the Tai Chi group (age: 37.4 ± 7.8 years), who had been regularly training the push-hand technique for at least 7 years, and 10 in the control group, consisting of healthy adults (age: 28.8 ± 5.0). Perturbations were applied at three different positions (hips, shoulders, and arms) via the load-release paradigm. Twenty measurements were carried out for each perturbation position. We measured peak vertical and horizontal forces on the ground (expressed percentage of body mass (%BM)), peak center of pressure displacement and peak horizontal and vertical velocities at the knee, hip and shoulder joints. The Tai Chi group exhibited smaller increases in vertical ground reaction forces when perturbations were applied at the hips (11.5 ± 2.1 vs. 19.6 ± 5.5 %BW; p = 0.002) and the arms (14.1 ± 4.2 vs. 23.2 ± 8.4 %BW; p = 0.005). They also responded with higher horizontal force increase after hip perturbation (16.2 ± 3.2 vs. 13.1 ± 2.5 %BW; p < 0.001). Similar findings were found when observing various outcomes related to velocities of vertical movement. The Tai Chi group also showed lower speeds of backward movement of the knee (p = 0.005–0.009) after hip (0.49 ± 0.13 vs. 0.85 ± 0.14 m/s; p = 0.005) and arm perturbations (0.97 ± 0.18 vs. 1.71 ± 0.29 m/s; p = 0.005). Center of pressure displacements were similar between groups. Our study demonstrated that engaging in Tai Chi could be beneficial to reactive postural responses after sudden perturbations in a horizontal direction; however, future interventional studies are needed to directly confirm this. Moreover, because of the age difference between the groups, some confounding effects of age cannot be ruled out.
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Affiliation(s)
- Jernej Sever
- Center Premik, Ltd., Center for Psychophysical Development, 1000 Ljubljana, Slovenia;
| | - Jan Babič
- Laboratory for Neuromechanics and Biorobotics, Jožef Stefan Institute, 1000 Ljubljana, Slovenia;
| | - Žiga Kozinc
- Andrej Marusic Institute, Department of Health Study, University of Primorska, 6000 Koper, Slovenia;
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia
| | - Nejc Šarabon
- Andrej Marusic Institute, Department of Health Study, University of Primorska, 6000 Koper, Slovenia;
- Human Health Department, InnoRenew CoE, 6310 Izola, Slovenia
- Laboratory for Motor Control and Motor Behavior, S2P, Science to Practice, Ltd., 1000 Ljubljana, Slovenia
- Correspondence:
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Postural adjustments impairments in elderly people with chronic low back pain. Sci Rep 2021; 11:4783. [PMID: 33637810 PMCID: PMC7910566 DOI: 10.1038/s41598-021-83837-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 02/09/2021] [Indexed: 11/08/2022] Open
Abstract
Chronic low back pain (CLBP) is associated with postural control impairments and is highly prevalent in elderly people. The objective of this study is to verify whether anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) are affected by CLBP in elderly people by assessing their postural control during a self-initiated perturbation paradigm induced by rapid upper arm movement when pointing to a target. The participants’ lower limb muscle onset and center of pressure (COP) displacements were assessed prior to perturbation and throughout the entire movement. T0 moment (i.e., the beginning of the movement) was defined as the anterior deltoid (DEL) onset, and all parameters were calculated with respect to it. The rectus femoris (RT), semitendinosus (ST), and soleous (SOL) showed delayed onset in the CLBP group compared with the control group: RF (control: − 0.094 ± 0.017 s; CLBP: − 0.026 ± 0.012 s, t = 12, p < 0.0001); ST (control: − 0.093 ± 0.013 s; CLBP: − 0.018 ± 0.019 s, t = 12, p < 0.0001); and SOL (control: − 0.086 ± 0.018 s; CLBP: − 0.029 ± 0.015 s, t = 8.98, p < 0.0001). In addition, COP displacement was delayed in the CLBP group (control: − 0.035 ± 0.021 s; CLBP: − 0.015 ± 0.009 s, t = 3; p = 0.003) and presented a smaller amplitude during APA COPAPA [control: 0.444 cm (0.187; 0.648); CLBP: 0.228 cm (0.096; 0.310), U = 53, p = 0.012]. The CLBP group required a longer time to reach the maximum displacement after the perturbation (control: 0.211 ± 0.047 s; CLBP 0.296 ± 0.078 s, t = 3.582, p = 0.0013). This indicates that CLBP elderly patients have impairments to recover their postural control and less efficient anticipatory adjustments. Our results suggest that people with CLBP have altered feedforward hip and ankle muscle control, as shown from the SOL, ST, and RT muscle onset. This study is the first study in the field of aging that investigates the postural adjustments of an elderly population with CLBP. Clinical assessment of this population should consider postural stability as part of a rehabilitation program.
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Impact of load expectations on neuromuscular and postural strategies during a freestyle lifting task in individuals with and without chronic low back pain. PLoS One 2021; 16:e0246791. [PMID: 33556146 PMCID: PMC7870001 DOI: 10.1371/journal.pone.0246791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 01/26/2021] [Indexed: 11/19/2022] Open
Abstract
Objective This study aimed to investigate how load expectations modulate neuromuscular and postural strategies in the anticipation of a freestyle lifting task with varying expected loads in individuals with and without chronic low back pain (cLBP). Methods Forty-seven participants, 28 with cLBP pain and 19 without, were recruited and completed a series of freestyle lifting trials (3 sets of box lifted for a total of 36 lifts). Verbal cues were used to modulate their expectations about the boxes’ weight: no expectation, lighter or heavier load expectations. Following each set, participants rated their perceived exertion on a visual analog scale. During the lifting protocol, kinematics (time to maximal flexion, angular velocity and joint angles), electromyography muscle activity (erector spinae and quadriceps) and center of pressure displacement were simultaneously recorded. Results Results showed that time to maximal knee flexion was modulated by load expectations in both groups (mean lighter load expectations = 1.15 ± 0.32 sec.; mean heavier load expectations = 1.06 ± 0.31 sec.). Results also showed a load expectations X group interaction for that time to maximal hip and lumbar flexion. Time to maximal hip flexion decreased with heavier load expectations (mean lighter load expectations = 1.20 ± 0.36; mean heavier load expectations = 1.16 ± 0.33) for cLBP only. Time to maximal lumbar flexion increased with heavier load expectation (mean lighter load expectations = 1.41 ± 0.27 sec.; mean lighter load expectations = 1.46 ± 0.29 sec.) for participants without LBP. However, no difference in lumbar, hip nor knee angles were observed between groups or conditions. Results highlighted significant load expectation effects for erector spinae electromyography activity, as lower muscle activations was observed for both groups with heavier load expectations (mean = 0.32 ± 0.15), compared to lighter load expectations (mean = 0.52 ± 0.27). Force plates analyses did not reveal any significant load expectation effects. Conclusion Present findings showed that load expectations modulate movement strategies and muscle activation similarly but not identically in individuals with chronic low back pain and healthy adults during freestyle lifting. Results of the present study partially differ from previous studies and suggest only minor differences in lifting strategies between healthy individuals and individuals with cLBP experiencing low level of pain and disability. More studies are needed to investigate the potential role of load expectations in the development and persistence of chronic low back pain.
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Maurer C, Holzgreve F, Erbe C, Wanke EM, Kopp S, Groneberg DA, Ohlendorf D. Influence of dental occlusion conditions on plantar pressure distribution during standing and walking - A gender perspective. Med Eng Phys 2021; 88:47-53. [PMID: 33485513 DOI: 10.1016/j.medengphy.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/17/2020] [Accepted: 12/31/2020] [Indexed: 12/01/2022]
Abstract
The aim of this study was to investigate gender-specific influences of different symmetric and asymmetric occlusion conditions on postural control during standing and walking. The study involved 59 healthy adult volunteers (41 f/19 m) aged between 22 and 53 years (30.2 ± 6.3 years). Postural control measurements were carried out using a pressure plate by measuring plantar pressure distribution during standing and walking test conditions. Seven different occlusion conditions were tested. Prior to a MANOVA model analysis, the relationship between the two test conditions were checked using a factor analysis with a varying number of factors (between 2 and 10). The plantar pressure distributions during walking and standing are independent test conditions. The coefficient of variance across all variables between the conditions and genders was not significant: t(46) = 1.51 (p = 0.13). No statement can be made whether, or not, the influence of gender is greater than the influence of the conditions. Healthy male and female test subjects did not show any difference between seven occlusion conditions on the plantar pressure distribution while standing or walking. No differences between the genders were found for any of the investigated variables. In contrast to custom-made occlusion splints, simple cotton rolls appear not to influence the neuromuscular system in a systematic manner.
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Affiliation(s)
- C Maurer
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany
| | - F Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany
| | - C Erbe
- Department for Orthodontics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - E M Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany
| | - S Kopp
- School of Dentistry, Department of Orthodontics, Goethe-University Frankfurt, Germany
| | - D A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany
| | - D Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt am Main 60590, Germany.
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Crasto C, Montes AM, Carvalho P, Carral JC. Abdominal muscle activity and pelvic motion according to active straight leg raising test results in adults with and without chronic low back pain. Musculoskelet Sci Pract 2020; 50:102245. [PMID: 32919292 DOI: 10.1016/j.msksp.2020.102245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/29/2020] [Accepted: 08/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Active Straight Leg Raise (ASLR) is a clinical test that challenges lumbopelvic stability and have been used in low back pain patients. There are reports of positive tests in asymptomatic individuals, however, it is not clear if they are false positives or a consequence of performing the test differently. OBJECTIVES To compare abdominal muscles activity and pelvic motion during an ASLR between adults with chronic low back pain and asymptomatic participants with a positive and negative ASLR test. DESIGN Cross-sectional study design. METHOD Nineteen volunteers with chronic nonspecific low back pain (LBP) and 19 asymptomatic, 12 with a negative ASLR (AG-) and 7 with a positive ASLR test (AG+) were assessed while performing an ASLR (dynamic postural challenge). Pelvic rotation and medio-lateral center of pressure displacement (COPml), as well as bilateral EMG abdominal muscles activity were assessed. Muscles asymmetry index were also analyzed. Kruskal-wallis test was used to compare groups (α = 0.05). RESULTS Both LBP and AG + displayed significantly less contralateral internal oblique/transversus abdominis (IO/TrA) muscle activation than AG- (p = 0.003 and p = 0.005, respectively) and also more asymmetry between sides in the IO/TrA than AG- (p = 0.022 and p = 0.004, respectively). No significant differences between LBP and AG+ were found (p > 0.05). CONCLUSION A positive ASLR test in an asymptomatic person could be more than a false positive, since IO/TrA muscle activation appears to be lower and more asymmetrical in people with a positive ASLR test, both with and without low back pain. Future studies may consider removing asymptomatic individuals with a positive ASLR.
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Affiliation(s)
- Carlos Crasto
- Department of Physiotherapy and Activity and Human Movement Study Center (CEMAH), School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal; Department of Physiotherapy, Santa Maria Health School, Porto, Portugal.
| | - António Mesquita Montes
- Department of Physiotherapy and Activity and Human Movement Study Center (CEMAH), School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal; Department of Physiotherapy, Santa Maria Health School, Porto, Portugal.
| | - Paulo Carvalho
- Department of Physiotherapy and Activity and Human Movement Study Center (CEMAH), School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal.
| | - Jm Cancela Carral
- Faculty of Education and Sports Science, University of Vigo, Pontevedra, Spain.
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Viseux FJF, Mora A, Villeneuve P, Charpentier P, Martins DF, Lemaire A. Contribution of the sensory innervation of the spine in low back pain: review and clinical commentary. Somatosens Mot Res 2020; 38:27-33. [PMID: 33108934 DOI: 10.1080/08990220.2020.1840344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Few validated tests allow a precise aetiological diagnosis of Low Back Pain (LBP), and the difficulty of clinical evaluations could be one of the reasons to explain the lack of effectiveness in the therapeutic management of chronic LBP. However, an implication of a sensory impairment in the control of sensorimotor circuits could be suggested. Interactive and specific responses between nociceptive nerve fibres and the paraspinal musculature motor control could have clinical implications, in particular through kinematic evaluation. Following an introduction to the link between the sensory innervation of the spine and pain, we then summarise the maladaptive movement in LBP at the kinematic and neuropathological level. A clinical objectification of these kinematic adaptations at the lumbar spine level, would clarify the aetiological diagnosis causes of chronic LBP, and so help optimising therapeutic strategies by proposing a relevant and precise clinical model of this painful condition.
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Affiliation(s)
- Frederic J F Viseux
- Centre d'évaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France.,Service de Neurochirurgie, Centre Hospitalier de Valenciennes, Valenciennes, France.,Posture Lab, Paris, France
| | - Annarita Mora
- Centre d'évaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France.,Service de Neurochirurgie, Centre Hospitalier de Valenciennes, Valenciennes, France
| | | | - Pascal Charpentier
- Centre d'évaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France
| | - Daniel F Martins
- Experimental Neuroscience Laboratory (LaNEx), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Santa Catarina, Brazil
| | - Antoine Lemaire
- Centre d'évaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France
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Physical or Cognitive Exertion Does Not Influence Cortical Movement Preparation for Rapid Arm Movements. Motor Control 2020; 24:473-498. [DOI: 10.1123/mc.2019-0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/04/2020] [Accepted: 05/14/2020] [Indexed: 11/18/2022]
Abstract
The contribution of central factors to movement preparation (e.g., the contingent negative variation [CNV]) and the influence of fatigue on such factors are still unclear, even though executive cognitive functions are regarded as key elements in motor control. Therefore, this study examined CNV amplitude with electroencephalography in 22 healthy humans during a rapid arm movement task prior to and following three experimental conditions: (a) a no exertion/control condition, (b) a physical exertion, and (c) a cognitive exertion. CNV amplitude was affected neither by a single bout of physical/cognitive exertion nor by the control condition. Furthermore, no time-on-task effects of the rapid arm movement task on the CNV were found. Exertion did not affect cortical movement preparation, which is in contrast to previous findings regarding time-on-task effects of exertion on CNV. Based on the current findings, the rapid arm movement task is deemed suitable to measure cortical movement preparation, without being affected by learning effects and physical/cognitive exertion.
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Aoki O, Otani Y, Morishita S. Immediate changes in anticipatory muscle activity after unexpected muscle contraction training. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Osamu Aoki
- Faculty of Rehabilitation Shijonawate Gakuen University Daito Japan
| | - Yoshitaka Otani
- Faculty of Rehabilitation Kobe International University Kobe Japan
| | - Shinichiro Morishita
- Faculty of Medical Technology Niigata University of Health and Welfare Niigata Japan
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Amerijckx C, Goossens N, Pijnenburg M, Musarra F, van Leeuwen DM, Schmitz M, Janssens L. Influence of phase of respiratory cycle on ultrasound imaging of deep abdominal muscle thickness. Musculoskelet Sci Pract 2020; 46:102105. [PMID: 32217268 DOI: 10.1016/j.msksp.2019.102105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/20/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND It is difficult to evaluate the transversus abdominis (TrA) and internal oblique (IO) due to their dual role in both trunk control and breathing. OBJECTIVES To investigate whether TrA and IO thickness as measured by ultrasound differs across the respiratory cycle in upright standing. DESIGN Observational study. METHODS Thickness of TrA and IO was measured with ultrasound in 67 subjects in upright standing. Measures were performed 3 times and by 2 assessors, at the end of relaxed expiration, at the end of a full inspiration, and at the end of full expiration. Differences were assessed by ANOVA. Intra- and inter-rater reliability (of a single measure and the average of 3 measures) were assessed by intra-class correlation (ICC). RESULTS Thickness of the TrA and IO was higher at full expiration than at the end of relaxed expiration (p < 0.001), and in turn compared to at full inspiration (p < 0.001). Intra-rater reliability was excellent at all respiratory phases (ICC 0.76-0.87). Whereas inter-rater reliability for a single measure was only fair to good for TrA (ICC 0.52-0.71) and good to excellent for IO (ICC 0.61-0.78), the inter-rater reliability of the average was excellent at all respiratory phases (ICC 0.75-0.90). CONCLUSIONS Thickness of TrA and IO increases when lung volume decreases. The intra- and inter-rater reliability of an average measure were excellent at the end of relaxed expiration, full inspiration and full expiration. This provides new opportunities to evaluate the deep abdominal muscles, and their role in respiration, in a physiotherapeutic setting.
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Affiliation(s)
- Charlotte Amerijckx
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590, Diepenbeek, Belgium.
| | - Nina Goossens
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590, Diepenbeek, Belgium.
| | - Madelon Pijnenburg
- Department of Allied Health Professions, Fontys University of Applied Sciences, 5600, AH,Eindhoven, the Netherlands.
| | - Frank Musarra
- PhysioMusarra, Physiotherapy Rehabilitation Center, 61121, Pesaro, Italy.
| | - Daniel M van Leeuwen
- Department of Allied Health Professions, Fontys University of Applied Sciences, 5600, AH,Eindhoven, the Netherlands; The Hague University of Applied Sciences, 2501 EH, The Hague, the Netherlands.
| | - Marc Schmitz
- SonoSkills-SonoScience, 6041, KG, Roermond, the Netherlands.
| | - Lotte Janssens
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590, Diepenbeek, Belgium.
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Larivière C, Preuss R, Ludvig D, Henry SM. Is postural control during unstable sitting a proxy measure for determinants associated with lumbar stability? J Biomech 2020; 102:109581. [DOI: 10.1016/j.jbiomech.2019.109581] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/27/2019] [Accepted: 12/10/2019] [Indexed: 01/29/2023]
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50
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Does experimentally induced pain-related fear influence central and peripheral movement preparation in healthy people and patients with low back pain? Pain 2020; 161:1212-1226. [DOI: 10.1097/j.pain.0000000000001813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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