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Rider SM, Mizuno S, Kang JD. Molecular Mechanisms of Intervertebral Disc Degeneration. Spine Surg Relat Res 2019; 3:1-11. [PMID: 31435545 PMCID: PMC6690117 DOI: 10.22603/ssrr.2017-0095] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 01/24/2018] [Indexed: 12/25/2022] Open
Abstract
Intervertebral disc degeneration is a well-known cause of disability, the result of which includes neck and back pain with associated mobility limitations. The purpose of this article is to provide an overview of the known molecular mechanisms through which intervertebral disc degeneration occurs as a result of complex interactions of exogenous and endogenous stressors. This review will focus on some of the identified molecular changes leading to the deterioration of the extracellular matrix of both the annulus fibrosus and nucleus pulposus. In addition, we will provide a summation of our current knowledge supporting the role of associated DNA and intracellular damage, cellular senescence's catabolic effects, oxidative stress, and the cell's inappropriate response to damage in contributing to intervertebral disc degeneration. Our current understanding of the molecular mechanisms through which intervertebral disc degeneration occurs provides us with abundant insight into how physical and chemical changes exacerbate the degenerative process of the entire spine. Furthermore, we will describe some of the related molecular targets and therapies that may contribute to intervertebral repair and regeneration.
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Affiliation(s)
- Sean M Rider
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shuichi Mizuno
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - James D Kang
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Influence of Body Composition on Functional Movement Screen™ Scores in College Football Players. J Sport Rehabil 2018; 27:431-437. [DOI: 10.1123/jsr.2015-0080] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Context: The functional movement screen (FMS™) is used to identify movement asymmetries and deficiencies. While obesity has been reported to impede movement, the correlation between body mass index (BMI), body fat percentage (BF%), and FMS™ in athletes is unknown. Objective: To determine if there is a relationship between BMI, BF%, and FMS™ scores in a sample of National Collegiate Athletic Association Division I football athletes. Design: Cross-sectional study. Setting: Biodynamics laboratory. Participants: A total of 38 male freshman football players (18.0 [0.7] y, 185.3 [5.5] cm, and 103.9 [20.3] kg). Interventions: Height, weight, and BF% were collected, and subjects underwent the FMS™ conducted by a certified athletic trainer. Main Outcome Measures: The dependent variables were BMI, BF%, composite FMS™ score, and 7 individual FMS™ test scores. Subjects were grouped as normal BMI (BMI < 30 kg/m2) or obese (BMI ≥ 30 kg/m2). A composite FMS™ score of ≤14 and an individual FMS™ score of ≤1 were classified as cutoffs for poor movement performance. Results: A negative correlation between composite FMS™ score and BMI approached significance (P = .07, ρ = .296). A negative correlation between composite FMS™ score and BF% was significant (P = .01, ρ = −.449). There was a significant difference in the number of obese subjects scoring below the composite FMS™ cutoff (χ2 = 5.179, P = .02) and the individual FMS™ cutoff on the deep squat (χ2 = 6.341, P = .01), hurdle step (χ2 = 9.870, P = .002), and in-line lunge (χ2 = 5.584, P = .02) when compared with normal BMI subjects. Conclusions: Increased BF% and BMI relate to lower composite FMS™ and individual FMS™ test scores, indicating potentially poor movement patterns in larger National Collegiate Athletic Association football athletes. Future research should focus on examining lower extremity–specific FMS™ tasks individually from composite FMS™ scores.
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Vo NV, Hartman RA, Patil PR, Risbud MV, Kletsas D, Iatridis JC, Hoyland JA, Le Maitre CL, Sowa GA, Kang JD. Molecular mechanisms of biological aging in intervertebral discs. J Orthop Res 2016; 34:1289-306. [PMID: 26890203 PMCID: PMC4988945 DOI: 10.1002/jor.23195] [Citation(s) in RCA: 256] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 02/03/2016] [Indexed: 02/04/2023]
Abstract
Advanced age is the greatest risk factor for the majority of human ailments, including spine-related chronic disability and back pain, which stem from age-associated intervertebral disc degeneration (IDD). Given the rapid global rise in the aging population, understanding the biology of intervertebral disc aging in order to develop effective therapeutic interventions to combat the adverse effects of aging on disc health is now imperative. Fortunately, recent advances in aging research have begun to shed light on the basic biological process of aging. Here we review some of these insights and organize the complex process of disc aging into three different phases to guide research efforts to understand the biology of disc aging. The objective of this review is to provide an overview of the current knowledge and the recent progress made to elucidate specific molecular mechanisms underlying disc aging. In particular, studies over the last few years have uncovered cellular senescence and genomic instability as important drivers of disc aging. Supporting evidence comes from DNA repair-deficient animal models that show increased disc cellular senescence and accelerated disc aging. Additionally, stress-induced senescent cells have now been well documented to secrete catabolic factors, which can negatively impact the physiology of neighboring cells and ECM. These along with other molecular drivers of aging are reviewed in depth to shed crucial insights into the underlying mechanisms of age-related disc degeneration. We also highlight molecular targets for novel therapies and emerging candidate therapeutics that may mitigate age-associated IDD. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1289-1306, 2016.
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Affiliation(s)
- Nam V. Vo
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Robert A. Hartman
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Prashanti R. Patil
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Makarand V. Risbud
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Dimitris Kletsas
- Laboratory of Cell Proliferation and Ageing, Institute of Biosciences and Applications, National Centre for Scientific Research “Demokritos”, Athens, Greece
| | - James C. Iatridis
- Leni & Peter W May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Judith A. Hoyland
- Centre for Tissue Injury and Repair, Faculty of Medical and Human Sciences, University of Manchester M13 9PT and NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academic Health Science Centre, Manchester, UK
| | - Christine L. Le Maitre
- Musculoskeletal and Regenerative Medicine Research Group, Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, S1 1WB, UK
| | - Gwendolyn A. Sowa
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - James D. Kang
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Does elite swimming accelerate lumbar intervertebral disc degeneration and increase low back pain? A cross-sectional comparison. 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 2016; 25:2849-55. [PMID: 27289544 DOI: 10.1007/s00586-016-4642-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE The aim was to elucidate elite swimming's possible influence on lumbar disc degeneration (DD) and low back pain (LBP). METHODS Lumbar spine MRI was performed on a group of elite swimmers and compared to a matched Finnish population-based no-sport group. RESULTS One hundred elite swimmers and 96 no-sport adults, mean age 18.7/20.8, respectively, participated. Overall, the two groups had similar prevalence of DD. Swimmers had more DD in the upper lumbar spine but tended to have less DD at the lowest level. Prevalence of bulges and disc herniations were similar, but swimmers had significantly more bulges at L4-5. The swimmers reported less LBP, although not significantly (N.S.). If degenerative findings were present, the association between them and LBP was stronger in the no-sport group. CONCLUSION Elite swimmers and controls had similar prevalence of DD and LBP, although the pattern of DD differed between the groups. In case of DD, swimmers reported less LBP, although N.S.
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Jeon K, Kim S. Effect of unilateral exercise on spinal and pelvic deformities, and isokinetic trunk muscle strength. J Phys Ther Sci 2016; 28:844-9. [PMID: 27134369 PMCID: PMC4842450 DOI: 10.1589/jpts.28.844] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to collect basic data regarding the prevention of spinal and pelvic deformities by investigating the spinal shape and muscular function characteristics of imbalance reduction and functional improvement following asymmetric activities. [Subjects and Methods] The subjects were 14 archery athletes who mostly perform unilateral motion with spinal and pelvic pain, and 19 healthy subjects. All the participants were evaluated using spinal structure analysis and for 60°/sec isokinetic muscular strength of the trunk. [Results] Between the two groups, there were significant differences in the interaction effect of trunk inclination deformities, and flexor and extensor 60°/sec isokinetic muscular strength of the trunk. Also, the main effects of gender comparison showed significant differences in the trunk inclination deformities, pelvic rotation deformities, lordosis angles, and flexor and extensor 60 ˚/sec isokinetic muscular strengths of the trunk. [Conclusion] The basic data obtained in this study can be used to help develop a strategic exercise program for improving unilateral movement and malalignment of the spine and pelvis.
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Affiliation(s)
- Kyoungkyu Jeon
- Sport Science Institute, Incheon National University, Republic of Korea; Sport Science Institute, Incheon National University, Republic of Korea
| | - Soonyoung Kim
- Department of Physical Education, Gachon University, Republic of Korea; Sport Science Institute, Incheon National University, Republic of Korea
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Iosifidis MI, Tsarouhas A, Fylaktou A. Lower limb clinical and radiographic osteoarthritis in former elite male athletes. Knee Surg Sports Traumatol Arthrosc 2015; 23:2528-35. [PMID: 24817165 DOI: 10.1007/s00167-014-3047-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Accepted: 04/27/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the prevalence of lower extremities clinical and radiographic OA in former elite male athletes and referents from the general population and to examine its association with the participants' demographic characteristics. METHODS Two hundred and eighteen former elite male athletes (soccer, volleyball, martial arts, track and field and basketball players, and skiers) and 181 male controls that reported no systematic athletic activity were examined by means of questionnaire, clinical and radiographic evaluation. Exclusion criteria were age younger than 40 years and a positive history of lower extremity surgery, bone or soft tissue trauma and inflammatory arthropathy. RESULTS Overall, the prevalence of clinical OA between former elite athletes (15.6 %) and controls (14.4 %) was similar (n.s.). The prevalence of radiographic OA was significantly higher (p = 0.03) in former elite athletes (36.6 %) compared with controls (23.9 %). All the participants with clinical OA who underwent radiographic examination also had radiographic OA. The prevalence of clinical and radiographic OA was similar (n.s.) between former athletes of different sports. Age, body mass index (BMI) and occupation variably predicted the prevalence of hip, knee and ankle OA in both study groups. CONCLUSIONS In the absence of major bone and soft tissue lower limb trauma during their athletic career, former elite athletes may not be at increased risk of developing clinical OA. Radiographic signs of OA present at a significantly higher incidence and possibly precede the clinical onset of OA. Age, BMI and occupation are identified as strong predictors of the development of OA in former elite athletes.
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Affiliation(s)
- Michael I Iosifidis
- 2nd Department of Orthopaedic Surgery, Papageorgiou General Hospital, 21 Filiaton and Ikarou Str, 55438, Thessaloníki, Greece,
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Palmer TB, Thompson BJ, Hawkey MJ, Conchola EC, Adams BM, Akehi K, Thiele RM, Smith DB. The Influence of Athletic Status on the Passive Properties of the Muscle-Tendon Unit and Traditional Performance Measures in Division I Female Soccer Players and Nonathlete Controls. J Strength Cond Res 2014; 28:2026-34. [DOI: 10.1519/jsc.0000000000000332] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hartmann H, Wirth K, Klusemann M. Analysis of the Load on the Knee Joint and Vertebral Column with Changes in Squatting Depth and Weight Load. Sports Med 2013; 43:993-1008. [DOI: 10.1007/s40279-013-0073-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Gombatto SP, Collins DR, Sahrmann SA, Engsberg JR, Van Dillen LR. Patterns of lumbar region movement during trunk lateral bending in 2 subgroups of people with low back pain. Phys Ther 2007; 87:441-54. [PMID: 17374634 DOI: 10.2522/ptj.20050370] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE The movement system impairment (MSI) system is one proposed system for classifying low back pain (LBP) problems. Prior clinical data and observations for the MSI system suggest that different LBP subgroups demonstrate different patterns of movement during clinical tests, such as trunk lateral bending (TLB). The purpose of this study, therefore, was to examine the validity of the observation that lumbar region (LR) movement patterns during TLB are different between 2 subgroups of people with LBP: lumbar rotation with extension (Rotation With Extension) and lumbar rotation (Rotation). SUBJECTS Participants were 44 people (28 men and 16 women; age [X+/-SD], 28.5+/-8.4 years) with chronic or recurrent LBP. METHODS Each participant's LBP problem was classified with the MSI system. Kinematic variables were measured, and LBP symptoms were recorded during the TLB test. RESULTS People in the 2 LBP subgroups demonstrated different patterns of LR movement during TLB. People in the Rotation With Extension subgroup displayed an asymmetric (right versus left) pattern of LR movement across the TLB movement, whereas people in the Rotation subgroup displayed a symmetric pattern of LR movement. Equal proportions of people in the 2 subgroups reported an increase in symptoms with the TLB test. DISCUSSION AND CONCLUSION The patterns of LR movement across the TLB movement were different in 2 subgroups of people with LBP. The difference in the LR movement patterns between subgroups may be an important factor to consider in specifying the details of the interventions for these 2 LBP problems.
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Affiliation(s)
- Sara P Gombatto
- Washington University School of Medicine, Campus Box #8502, 4444 Forest Park Blvd, St Louis, MO 63110, USA.
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Kettunen JA, Kujala UM, Räty H, Videman T, Sarna S, Impivaara O, Koskinen S. Factors associated with hip joint rotation in former elite athletes. Br J Sports Med 2000; 34:44-8. [PMID: 10690450 PMCID: PMC1724139 DOI: 10.1136/bjsm.34.1.44] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To study factors associated with passive hip rotation range of motion (ROM) in former elite male athletes. METHODS Athletes were interviewed about hip pain, disability, lifetime occupational loading, and athletic training. The passive hip rotation was measured with a Myrin inclinometer in 117 former elite male long distance runners, soccer players, weight lifters, and shooters aged 45-68 years. Magnetic resonance imaging was used to detect hip osteoarthritis. RESULTS There were no differences in passive hip rotation ROM between the four athlete groups nor between diverging lifetime loading patterns associated with occupational or athletic activities. Among the subjects without hip osteoarthritis, hip pain, and hip disability according to a stepwise linear regression analysis, the only factor that was associated with the passive hip rotation ROM was body mass index (BMI), explaining about 21% of its variation. Subjects with high BMI had lower passive hip rotation ROM than those with low BMI. There was no right-left difference in the mean passive hip rotation ROM in subjects either with or without hip osteoarthritis as determined by magnetic resonance imaging. Nevertheless, hip rotation ROM was clearly reduced in a few hips with severe caput deformity. CONCLUSIONS Long term loading appears to have no association with passive hip rotation ROM. On the other hand, the hip rotation value was lower in subjects with high BMI than in those with low BMI. A clear right-left difference in hip rotation was found only in those subjects who, according to our magnetic resonance imaging criteria, had severe hip osteoarthritis. These findings should be taken into account when hip rotation ROM is used in the clinical assessment of hip joints.
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Affiliation(s)
- J A Kettunen
- Unit for Sports and Exercise Medicine, University of Helsinki, Finland
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