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Anthierens A, Thevenon A, Olivier N, Mucci P. Paraspinal muscle oxygenation and mechanical efficiency are reduced in individuals with chronic low back pain. Sci Rep 2024; 14:4943. [PMID: 38418858 PMCID: PMC10901808 DOI: 10.1038/s41598-024-55672-8] [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: 12/14/2022] [Accepted: 02/26/2024] [Indexed: 03/02/2024] Open
Abstract
This study aimed to compare the systemic and local metabolic responses during a 5-min trunk extension exercise in individuals with chronic low back pain (CLBP) and in healthy individuals. Thirteen active participants with CLBP paired with 13 healthy participants performed a standardised 5-min trunk extension exercise on an isokinetic dynamometer set in continuous passive motion mode. During exercise, we used near-infrared spectroscopy to measure tissue oxygenation (TOI) and total haemoglobin-myoglobin (THb). We used a gas exchange analyser to measure breath-by-breath oxygen consumption (V̇O2) and carbon dioxide produced (V̇CO2). We also calculated mechanical efficiency. We assessed the intensity of low back pain sensation before and after exercise by using a visual analogue scale. In participants with CLBP, low back pain increased following exercise (+ 1.5 units; p < 0.001) and THb decreased during exercise (- 4.0 units; p = 0.043). Paraspinal muscle oxygenation (65.0 and 71.0%, respectively; p = 0.009) and mechanical efficiency (4.7 and 5.3%, respectively; p = 0.034) were both lower in participants with CLBP compared with healthy participants. The increase in pain sensation was related to the decrease in tissue oxygenation (R2 = - 0.420; p = 0.036). Decreases in total haemoglobin-myoglobin and mechanical efficiency could involve fatigability in exercise-soliciting paraspinal muscles and, therefore, exacerbate inabilities in daily life. Given the positive correlation between tissue oxygenation and exercise-induced pain exacerbation, muscle oxygenation may be related to persisting and crippling low back pain.
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Affiliation(s)
- Agathe Anthierens
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France.
| | - André Thevenon
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France
- Service de Médecine Physique et de Réadaptation Fonctionnelle, CHRU Lille, Lille, France
| | - Nicolas Olivier
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France
| | - Patrick Mucci
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France
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Langenfeld A, Wirth B, Scherer-Vrana A, Riner F, Gaehwiler K, Valdivieso P, Humphreys BK, Scholkmann F, Flueck M, Schweinhardt P. No alteration of back muscle oxygenation during isometric exercise in individuals with non-specific low back pain. Sci Rep 2022; 12:8306. [PMID: 35585081 PMCID: PMC9117220 DOI: 10.1038/s41598-022-11683-x] [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: 01/10/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of our study was (I) To compare back muscle oxygenation and perfusion as well as Biering–Sorensen muscle endurance (BSME) test holding times between chronic non-specific low back pain (CNSLBP) patients and asymptomatic controls matched for age, body mass index (BMI), sex and physical activity, and (II) to investigate factors associated with BSME holding times. Muscle perfusion (tHb) and oxygenation (SmO2) were measured by near-infrared spectroscopy (NIRS) based oximetry in three back muscles during the BSME. Reliability of tHb and SmO2 was assessed in a separate sample. BSME holding time and SmO2 were compared between patients (n = 45) and controls (n = 45) and factors associated with BSME holding time were assessed using multiple linear regression. Reliability for SmO2 was excellent (ICC = 0.87–0.99). THb showed poor to moderate reliability and was not further used. Groups differed for BSME holding time (P = 0.03), pain intensity (P ≤ 0.0005) and subcutaneous tissue thickness (P = 0.01) but not for NIRS measures. Physical activity and BMI were associated with BSME holding times. Insufficient muscle oxygenation does not seem to be a major factor contributing to CNSLBP. Future investigation should evaluate other determinants of BSME holding times, such as motivation and recruitment of auxiliary muscles.
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Affiliation(s)
- Anke Langenfeld
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - Brigitte Wirth
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.,Winterthur Institute of Health Economics, School of Management and Law, University of Applied Sciences, Gertrudstr. 15, 8400, Winterthur, Switzerland
| | - Andrea Scherer-Vrana
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Fabienne Riner
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Kyra Gaehwiler
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Paola Valdivieso
- Laboratory of Muscle Plasticity, Balgrist University Hospital and University of Zurich, Balgrist Campus, Lengghalde 5, 8008, Zurich, Switzerland
| | - B Kim Humphreys
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Felix Scholkmann
- Scholkmann Data Analysis Services, Scientific Consulting and Physical Engineering, Schuppisstr. 5, 8057, Zurich, Switzerland.,Department for Neonatology, University Hospital Zurich and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Martin Flueck
- Laboratory of Muscle Plasticity, Balgrist University Hospital and University of Zurich, Balgrist Campus, Lengghalde 5, 8008, Zurich, Switzerland.,Swiss Federal Institute of Sport Magglingen SFISM, Lärchenplatz building HLP 107, 2532, Magglingen, Switzerland
| | - Petra Schweinhardt
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
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Olkoski MM, Silva MF, Guenka LC, Pelegrinelli AR, Dela Bela LF, Dias JM, Nogueira JF, Pereira GO, Souza DC, Carvalho RG, Facci LM, Cardoso JR. Comparing the effects of aquatic exercises with or without high intensity on the functional status, muscular endurance, and performance of patients with chronic low back pain. J Sports Med Phys Fitness 2020; 61:699-706. [PMID: 33314877 DOI: 10.23736/s0022-4707.20.11265-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The prevalence of low back pain is lower when physical fitness (aerobic and muscular) is higher. Strength exercises are important for subjects with low back pain, but there are few studies on the inclusion of aerobic exercise in low back pain programs. The aim of this study was to compare the effects of aquatic exercises with or without high-intensity component on the functional status, lumbar and abdominal muscle endurance, and performance of subjects with chronic low back pain. METHODS Forty-eight volunteers between 20 and 60 years old were randomly allocated to an experimental group AEDWR (aquatic exercises plus deep-water running group, N.=25) or to a control group AE (aquatic exercises only group, N.=23). The dependent variables included functional status (Repeated Sit-to-Stand test), lumbar (Sorensen test) and abdominal (One Minute Abdominal test) muscle endurance, and physical performance (Maximum Physical Fitness test), which were measured before and after the 9-week intervention and at 21 weeks of follow-up. RESULTS Lumbar endurance was higher in the AEDWR group at the end of the treatment, with a mean difference (MD) of 43.2 seconds, 95% confidence intervals (CI) (9.6; 76.7), P=0.01, d̅=0.74, and better in the follow-up with MD=40.2 seconds, 95% CI (7.1; 73.3), P=0.02, d̅=0.71, than in the AE group. Participant performance also improved on the 9th week in the AEDWR group, with an MD=0.53 kgf, 95% CI (0.008; 0.98), P=0.02, d̅=0.60. CONCLUSIONS The addition of deep-water running exercise to aquatic exercises improved lumbar muscle endurance and performance when compared with aquatic exercises only, and this effect was maintained during the follow-up to lumbar muscle endurance.
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Affiliation(s)
- Mabel M Olkoski
- Department of Production of Animal Alimentary Products, Agro-veterinary Center, Santa Catarina State University, Lages, Brazil
| | - Mariana F Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, State University of Londrina, Londrina, Brazil
| | - Leandro C Guenka
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, State University of Londrina, Londrina, Brazil
| | | | | | - Josilainne M Dias
- School of Medicine, Mato Grosso do Sul State University, Campo Grande, Brazil
| | | | - Gabriele O Pereira
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, State University of Londrina, Londrina, Brazil
| | - Daniella C Souza
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, State University of Londrina, Londrina, Brazil
| | - Rodrigo G Carvalho
- College of Physical Education, Federal University of Vale do São Francisco, Petrolina, Brazil
| | - Ligia M Facci
- Aquatic Physiotherapy Center and Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, State University of Londrina, Londrina, Brazil
| | - Jefferson R Cardoso
- Aquatic Physiotherapy Center and Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, State University of Londrina, Londrina, Brazil -
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Anthierens A, Olivier N, Thevenon A, Mucci P. Benefits of a four-week functional restoration program in chronic low back pain patients and three-month follow-up: focus on paraspinal muscle aerobic metabolism responses to exercise. J Sports Med Phys Fitness 2020; 60:1558-1566. [PMID: 32608937 DOI: 10.23736/s0022-4707.20.11113-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Chronic low back pain (CLBP) is a major health concern characterized by paraspinal muscle fatigability. This can be improved following a functional restoration program. Muscle fatigability can be related to impairment in aerobic metabolism responses. In this study, we investigated paraspinal muscles aerobic metabolism in CLBP patients before and after a functional restoration program, in order to determine if the enhancement in patients' condition following the program is associated to changes in metabolism responses. METHODS Twenty-two CLBP patients (11 women, 11 men; 41.6±1.8 years; 73.7±3.1 kg; 1.74±0.02 m) were evaluated before and after a 4-week functional restoration program, with exercise therapy as the main component. Three months later, 12 patients were seen for a follow-up visit. During each testing session, patients performed a five-minute isokinetic trunk extension exercise in measuring pulmonary gas exchanges and paraspinal muscle oxygenation. Mechanical efficiency and onset V̇O<inf>2</inf> kinetics were also calculated, in addition to usual questionnaires and exercises designed to evaluate psychosocial and physical factors. RESULTS At the end of the program, paraspinal muscle oxygenation, mechanical efficiency, and the V̇O<inf>2</inf> onset kinetics were improved (P<0.05). All measures remained stable during the three-month follow-up except for paraspinal muscle oxygenation, which deteriorated (P<0.05). Return-to-work was associated with the level of workday physical activities and to a decrease in fear-avoidance beliefs. CONCLUSIONS At the end of the program, aerobic metabolism responses were improved in paraspinal muscles in patients. These improvements were not associated with return-to-work, which was primarily influenced by socio-psychological factors.
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Affiliation(s)
- Agathe Anthierens
- ULR 7369 - URePSSS, Unité de Recherche Pluridisciplinaire Sport Santé Société, Université Lille, Université Artois, Université Littoral Côte d'Opale, Lille, France -
| | - Nicolas Olivier
- ULR 7369 - URePSSS, Unité de Recherche Pluridisciplinaire Sport Santé Société, Université Lille, Université Artois, Université Littoral Côte d'Opale, Lille, France
| | - Andre Thevenon
- ULR 7369 - URePSSS, Unité de Recherche Pluridisciplinaire Sport Santé Société, Université Lille, Université Artois, Université Littoral Côte d'Opale, Lille, France.,CHRU Lille, Service de Médecine Physique et de Réadaptation Fonctionnelle, Lille, France
| | - Patrick Mucci
- ULR 7369 - URePSSS, Unité de Recherche Pluridisciplinaire Sport Santé Société, Université Lille, Université Artois, Université Littoral Côte d'Opale, Lille, France
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5
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Laird RA, Keating JL, Ussing K, Li P, Kent P. Does movement matter in people with back pain? Investigating 'atypical' lumbo-pelvic kinematics in people with and without back pain using wireless movement sensors. BMC Musculoskelet Disord 2019; 20:28. [PMID: 30658610 PMCID: PMC6339318 DOI: 10.1186/s12891-018-2387-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 12/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Interventions for low back pain (LBP) commonly target ‘dysfunctional’ or atypical lumbo-pelvic kinematics in the belief that correcting aberrant movement improves patients’ pain and activity outcomes. If atypical kinematic parameters and postures have a relationship to LBP, they could be expected to more prevalent in people with LBP compared to people without LBP (NoLBP). This exploratory study measured, defined and compared atypical kinematic parameters in people with and without LBP. Methods Wireless inertial motion and EMG sensors were used to measure lumbo-pelvic kinematics during standing trunk flexion (range of motion (ROM), timing, sequence coordination, and extensor muscle activation) and in sitting (relative sitting position, pelvic tilt range) in a sample of 126 of adults without LBP and 140 chronic LBP subjects. Atypical movement was defined using the 10th/90th centiles of the NoLBP group. Mean differences and prevalence rates for atypical movement were calculated. Dichotomised pain scores for ‘high-pain-on-bending’ and ‘high-pain-on-sitting’ were tested for their association with atypical kinematic variables. Results For standing flexion, significant mean differences, after adjusting for age and gender factors, were seen for the LBP group with (i) reduced ROM (trunk flexion (NoLBP 111o, LBP 93o, p < .0001), lumbar flexion (NoLBP 52o, LBP 46o, p < .0001), pelvic flexion (NoLBP 59o, LBP 48o, p < .0001), (ii) greater extensor muscle activation for the LBP group (NoLBP 0.012, LBP 0.25 p < .0001), (iii) a greater delay in pelvic motion at the onset of flexion (NoLBP − 0.21 s; LBP − 0.36 s, p = 0.023), (iv) and longer movement duration for the LBP group (NoLBP 2.28 s; LBP 3.18 s, p < .0001). Atypical movement was significantly more prevalent in the LBP group for small trunk (× 5.4), lumbar (× 3.0) and pelvic ROM (× 3.9), low FRR (× 4.9), delayed pelvic motion at 20o flexion (× 2.9), and longer movement duration (× 4.7). No differences between groups were seen for any sitting parameters. High pain intensity was significantly associated with small lumbar ROM and pelvic ROM. Conclusion Significant movement differences during flexion were seen in people with LBP, with a higher prevalence of small ROM, slower movement, delayed pelvic movement and greater lumbar extensor muscle activation but without differences for any sitting parameter. Electronic supplementary material The online version of this article (10.1186/s12891-018-2387-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Robert A Laird
- Department of Physiotherapy, Monash University, PO Box 527, Frankston, Victoria, 3199, Australia.
| | - Jennifer L Keating
- Department of Physiotherapy, Monash University, PO Box 527, Frankston, Victoria, 3199, Australia
| | - Kasper Ussing
- Spine Centre of Southern Denmark, Hospital of Lillebaelt, Middelfart, Denmark
| | - Paoline Li
- SuperSpine Physiotherapy, 380 Springvale Rd, Forest Hill, Melbourne, 3131, Australia
| | - Peter Kent
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Sung W, Wong A, Pourshogi A, Pourrezaei K, Silfies S. Near infrared spectroscopy confirms recruitment of specific lumbar extensors through neuromuscular electrical stimulation. Physiother Theory Pract 2018; 36:516-523. [DOI: 10.1080/09593985.2018.1488908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Won Sung
- GSPP Penn Therapy and Fitness, Philadelphia, PA
| | - Ardy Wong
- School of Biomedical Engineering Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Ahmad Pourshogi
- School of Biomedical Engineering Science and Health Systems, Drexel University, Philadelphia, PA, USA
- Rhyton Group, Tehran, Iran
| | - Kambiz Pourrezaei
- School of Biomedical Engineering Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Sheri Silfies
- College of Nursing and Health Professionals, Drexel University, Philadelphia, PA, USA
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Valdivieso P, Franchi MV, Gerber C, Flück M. Does a Better Perfusion of Deconditioned Muscle Tissue Release Chronic Low Back Pain? Front Med (Lausanne) 2018; 5:77. [PMID: 29616222 PMCID: PMC5869187 DOI: 10.3389/fmed.2018.00077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/07/2018] [Indexed: 12/19/2022] Open
Abstract
Non-specific chronic low back pain (nsCLBP) is a multifactorial condition of unknown etiology and pathogenesis. Physical and genetic factors may influence the predisposition of individuals to CLBP, which in many instances share a musculoskeletal origin. A reduced pain level in low back pain patients that participate in exercise therapy highlights that disuse-related muscle deconditioning may predispose individuals to nsCLBP. In this context, musculoskeletal pain may be the consequence of capillary rarefaction in inactive muscle as this would lower local tissue drainage and washing out of toxic waste. Muscle activity is translated into an angio-adaptative process, which implicates angiogenic-gene expression and individual response differences due to heritable modifications of such genes (gene polymorphisms). The pathophysiologic mechanism underlying nsCLBP is still largely unaddressed. We hypothesize that capillary rarefaction due to a deconditioning of dorsal muscle groups exacerbates nsCLBP by increasing noxious sensation, reducing muscle strength and fatigue resistance by initiating a downward spiral of local deconditioning of back muscles which diminishes their load-bearing capacity. We address the idea that specific factors such as angiotensin-converting enzyme and Tenascin-C might play an important role in altering susceptibility to nsCLBP via their effects on microvascular perfusion and vascular remodeling of skeletal muscle, inflammation, and pain sensation. The genetic profile may help to explain the individual predisposition to nsCLBP, thus identifying subgroups of patients, which could benefit from ad hoc treatment types. Future therapeutic approaches aimed at relieving the pain associated with nsCLBP should be based on the verification of mechanistic processes of activity-induced angio-adaptation and muscle-perfusion.
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Affiliation(s)
- Paola Valdivieso
- Laboratory for Muscle Plasticity, Department of Orthopedics, University of Zurich, Zürich, Switzerland.,Interdisciplinary Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, Zürich, Switzerland
| | - Martino V Franchi
- Laboratory for Muscle Plasticity, Department of Orthopedics, University of Zurich, Zürich, Switzerland
| | - Christian Gerber
- Orthopedics Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Martin Flück
- Laboratory for Muscle Plasticity, Department of Orthopedics, University of Zurich, Zürich, Switzerland
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Sakai Y, Ito S, Hida T, Ito K, Koshimizu H, Harada A. Low Back Pain in Patients with Lumbar Spinal Stenosis-Hemodynamic and electrophysiological study of the lumbar multifidus muscles. Spine Surg Relat Res 2017; 1:82-89. [PMID: 31440617 PMCID: PMC6698562 DOI: 10.22603/ssrr.1.2016-0016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 12/20/2016] [Indexed: 11/10/2022] Open
Abstract
Introduction Several studies have demonstrated improvement in low back pain (LBP) after decompression surgery for lower extremity symptoms in lumbar spinal stenosis (LSS); however, the influence of neuropathic disorders on LBP is uncertain. Aim of this study is to identify the features of motion-induced and walking-induced LBP in patients with LSS and to assess whether neuropathic LBP develops. Methods In total, 234 patients with LSS including L4/5 lesion were asked to identify their LBP. Subjects were classified into three groups: walking-induced LBP that aggravated during walking (W group), motion-induced LBP that aggravated during sitting up (M group), and no LBP (N group). Cross-sectional areas of the dural sac, lumbar multifidus, and the erector spinae were measured. Intramuscular oxygenation was evaluated with near-infrared spectrophotometer. Surface electromyography (EMG) and mechanomyography (MMG) were performed on the lumbar multifidus. Morphological, hemodynamic, and electrophysiological differences in the onset of LBP were evaluated. Results The prevalence of W, M, and control groups was 31.2%, 32.1%, 36.8%, respectively. Concordance between the laterality of LBP and leg symptoms including pain and numbness was 86.3% in the W group and 47.0% in the M group. Dural sac area was lower in the W group than in the M and control groups. In the hemodynamic evaluation, the oxygenated hemoglobin level was significantly lower in the W group than in the M and N groups. In electrophysiological evaluation of lumbar multifidus, the mean power frequency in EMG was significantly higher in the W group than in the N group. Amplitude in MMG was significantly lower in the W group than in the N group. Conclusions Neurologic disturbance in patients with LSS may be attributed to “neuropathic LBP.” Neuropathic multifidus disorder plays a role in walking-induced LBP.
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Affiliation(s)
- Yoshihito Sakai
- Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Japan
| | - Sadayuki Ito
- Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Japan
| | - Tetsuro Hida
- Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan
| | - Kenyu Ito
- Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan
| | - Hiroyuki Koshimizu
- Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Japan
| | - Atsushi Harada
- Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Japan
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9
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Role of obesity on cerebral hemodynamics and cardiorespiratory responses in healthy men during repetitive incremental lifting. Eur J Appl Physiol 2015; 115:1905-17. [DOI: 10.1007/s00421-015-3171-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 04/07/2015] [Indexed: 01/08/2023]
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10
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Quirk DA, Hubley-Kozey CL. Age-related changes in trunk neuromuscular activation patterns during a controlled functional transfer task include amplitude and temporal synergies. Hum Mov Sci 2014; 38:262-80. [PMID: 25457424 DOI: 10.1016/j.humov.2014.08.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 07/22/2014] [Accepted: 08/08/2014] [Indexed: 12/01/2022]
Abstract
While healthy aging is associated with physiological changes that can impair control of trunk motion, few studies examine how spinal muscle responses change with increasing age. This study examined whether older (over 65 years) compared to younger (20-45 years) adults had higher overall amplitude and altered temporal recruitment patterns of trunk musculature when performing a functional transfer task. Surface electromyograms from twelve bilateral trunk muscle (24) sites were analyzed using principal component analysis, extracting amplitude and temporal features (PCs) from electromyographic waveforms. Two PCs explained 96% of the waveform variance. Three factor ANOVA models tested main effects (group, muscle and reach) and interactions for PC scores. Significant (p<.0125) group interactions were found for all PC scores. Post hoc analysis revealed that relative to younger adults, older adults recruited higher agonist and antagonistic activity, demonstrated continuous activation levels in specific muscle sites despite changing external moments, and had altered temporal synergies within abdominal and back musculature. In summary both older and younger adults recruit highly organized activation patterns in response to changing external moments. Differences in temporal trunk musculature recruitment patterns suggest that older adults experience different dynamic spinal stiffness and loading compared to younger adults during a functional lifting task.
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Affiliation(s)
- D Adam Quirk
- School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada; School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Cheryl L Hubley-Kozey
- School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada; School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada; School of Physiotherapy, Dalhousie University, Halifax, NS, Canada.
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11
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Olivier N, Thevenon A, Berthoin S, Prieur F. An exercise therapy program can increase oxygenation and blood volume of the erector spinae muscle during exercise in chronic low back pain patients. Arch Phys Med Rehabil 2012; 94:536-42. [PMID: 23131528 DOI: 10.1016/j.apmr.2012.10.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 10/10/2012] [Accepted: 10/18/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether erector spinae muscle oxygenation (OXY) and blood volume during a progressive isoinertial lifting evaluation (PILE) are modified by an exercise therapy program. DESIGN Pre- (t1) and post- (t2) exercise therapy experimental design. SETTING Hospital. PARTICIPANTS Subjects with chronic low back pain (LBP group) (n=24) and healthy subjects (control group) (n=24) were evaluated. INTERVENTION Exercise program. MAIN OUTCOME MEASURES The control group was evaluated once, and the LBP group was evaluated before (t1) the exercise therapy program and 28 days thereafter (t2). The maximal load lifted, total work, and total power were determined using the PILE test. Continuous-wave near-infrared spectroscopy was used to measure OXY and blood volume during the PILE test. RESULTS The maximal load lifted, total power, and total work were significantly lower in the LBP group (-42%±5%, -46%±6%, and -67%±6% at t1, respectively; P<.05) than the control group. In the LBP subjects, these parameters improved significantly after the exercise therapy program (+20%±3%, +56%±4%, and +61%±5%; P<.05). At each submaximal power (ie, 25, 50, 75, and 100% of maximal load lifted at t1), OXY and blood volume were significantly higher at t2 than t1. One-half recovery time for OXY was significantly higher in the LBP group (at t1 and t2) than in control subjects. CONCLUSIONS The findings in this study suggest that LBP subjects present an impairment in their capacity to deliver oxygen at the level of the erector spinae muscle, which can be partly restored by an exercise therapy program.
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Affiliation(s)
- Nicolas Olivier
- University Lille Nord de France, Lille, France; UDSL, EA4488, Ronchin, France
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Shoulder and forearm oxygenation and myoelectric activity in patients with work-related muscle pain and healthy subjects. Eur J Appl Physiol 2012; 113:1103-15. [PMID: 23108582 DOI: 10.1007/s00421-012-2530-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 10/12/2012] [Indexed: 10/27/2022]
Abstract
We tested hypotheses of (a) reduced oxygen usage, oxygen recovery, blood flow and oxygen consumption; and (b) increased muscle activity for patients diagnosed with work-related muscle pain (WRMP) in comparison to healthy controls. Oxygenation was measured with near infrared spectroscopy (NIRS), and muscle activity with EMG for the extensor carpi radialis (ECR) and trapezius descendens (TD) muscles. Eighteen patients with diffuse neck-shoulder-arm pain and 17 controls (matched in age and sex) were equipped with NIRS and EMG probes. After determining an individual's maximum voluntary contraction (MVC) force, short-term (20 s) isometric contractions for the ECR and TD of 10, 30, 50 and 70 % MVC generated ∆StO₂ and StO₂% recovery (Rslope) from NIRS, and RMS%max from EMG signals. In addition, upper arm venous (VO) and arterial (AO) occlusions generated slopes of total hemoglobin (HbTslope) and deoxyhemoglobin (HHbslope) for the resting ECR as surrogates of blood flow and oxygen consumption, respectively. Mixed model analyses, t tests, and Mann-Whitney test were used to assess differences between groups. There was no significant difference in MVC between groups for either muscle. Also, ∆StO₂%, Rslope for either muscle, and ECR-HbTslope were not different between groups, thus our hypotheses of reduced oxygen use, recovery, and blood flow for patients were not confirmed. However, patients had a significantly lower ECR-HHbslope confirming our hypothesis of reduced consumption. Further, there was no difference in RMS%max during contractions meaning that the hypothesis of increased activity for patients was not confirmed. When taking into account the number of NIRS variables studied, differences we found between our patient group and healthy controls (i.e., in forearm oxygen consumption and shoulder oxygen saturation level) may be considered modest. Overall our findings may have been impacted by the fact that our patients and controls were similar in muscle strength, which is in contrast to previous studies.
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Effect of opioid administration on cardiorespiratory and muscle oxygenation during lifting in chronic back pain patients. Eur J Appl Physiol 2010; 109:241-50. [DOI: 10.1007/s00421-009-1332-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2009] [Indexed: 10/20/2022]
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Gross DP, Bhambhani Y, Haykowsky MJ, Rashiq S. Acute Opioid Administration Improves Work-Related Exercise Performance in Patients With Chronic Back Pain. THE JOURNAL OF PAIN 2008; 9:856-62. [DOI: 10.1016/j.jpain.2008.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Revised: 04/21/2008] [Accepted: 04/28/2008] [Indexed: 11/25/2022]
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The effect of muscle relaxant on the paraspinal muscle blood flow: a randomized controlled trial in patients with chronic low back pain. Spine (Phila Pa 1976) 2008; 33:581-7. [PMID: 18344850 DOI: 10.1097/brs.0b013e318166e051] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A randomized controlled trial. OBJECTIVE To investigate the effect of muscle relaxant for muscle blood flow at the trunk muscle in patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA Paraspinal muscle function is widely believed to play a role and considered to be of etiologic significance in LBP, and intramuscular pressure increases and blood flow decreases in the flexion position. Decrease in oxygenated hemoglobin at the trunk muscle is seen in patients with LBP. METHODS A total of 74 male patients with LBP lasting more than 6 months were randomized to 3 treatment groups: (1) physical therapy only (control) (n = 25), (2) administration of eperisone hydrochloride (EMPP) for 4 weeks (n = 24), and (3) McKenzie therapy (n = 25). The primary outcome variables, observed at 2 and 4 weeks, are the Japanese Orthopedic Association LBP score, visual analogue scale (VAS), Faces Pain Scale-Revised, and SF-36. Intramuscular oxygenation was evaluated using near-infrared spectroscopy during lumbar extension and flexion, and oxygenated hemoglobin and deoxygenated hemoglobin were compared. RESULTS VAS was significantly lower at 4 weeks in the McKenzie group than in the control group. There were no significant changes at 2 weeks in all parameters, however, the relative change of oxygenated hemoglobin during lumbar extension at 4 weeks was significantly higher in the EMPP group when compared with the other 2 groups. The relative change of deoxygenated hemoglobin during lumbar flexion showed a significant difference at 4 weeks in the EMPP group when compared with the control group. CONCLUSION Administration of EMPP for 4 weeks improved the LBP in VAS, though not as effective as McKenzie therapy. Our data demonstrated the effects of eperisone hydrochloride on paraspinal muscle hemodynamics improving intramuscular oxygenation during lumbar extension and flexion in patients with chronic LBP.
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