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Janssens L, Jacobs N, Goossens N, Brumagne S, Langer D, Hodges PW. The effect of acute respiratory demand on postural control: A systematic review. Gait Posture 2024; 113:310-318. [PMID: 38996504 DOI: 10.1016/j.gaitpost.2024.06.021] [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: 08/28/2023] [Revised: 05/16/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Postural control can be challenged by breathing. RESEARCH QUESTION What is the effect of an acute increase in respiratory demand on postural control compared to quiet breathing? METHODS A systematic review was conducted. Electronic databases were systematically searched until October 18, 2022 on studies reporting changes in center of pressure (CoP) motion related to an acute manipulation of respiratory demand compared to quiet breathing during upright standing in healthy participants and/or participants with a clinical condition. RESULTS Twenty-one studies in healthy participants showed that voluntary (not metabolic-induced) hyperventilation or inspiratory resistive loading significantly increased CoP motion, while breath-holding decreased CoP motion, compared to quiet breathing (p< 0.05). Manipulating respiratory rate or breathing patterns did not reveal consistent results. Four studies showed that people with low back pain showed similar CoP responses to increasing respiratory demand (p> 0.05), except for breathing at different rates, whereas they showed greater CoP motion during quiet breathing. SIGNIFICANCE The extent of postural disturbance depended on the breathing mode and how it was quantified (i.e., CoP coupled with breathing movement or overall CoP measures). Voluntary hyperventilation and inspiratory resistive loading increased postural sway. For voluntary hyperventilation, this could be explained by CoP motion being directly coupled to chest wall movements whereas metabolic-induced hyperventilation did not increase CoP motion or CoP coupling with breathing. Breath-holding decreased postural sway. Patients with low back pain show greater postural sways than pain-free individuals during quiet breathing, although they exhibit similar postural adaptations to respiratory-related challenges as controls.
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Affiliation(s)
- Lotte Janssens
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Wetenschapspark 7, 3590 Diepenbeek, Belgium.
| | - Nina Jacobs
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Wetenschapspark 7, 3590 Diepenbeek, Belgium.
| | - Nina Goossens
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Wetenschapspark 7, 3590 Diepenbeek, Belgium.
| | - Simon Brumagne
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3000 Leuven, Belgium.
| | - Daniel Langer
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3000 Leuven, Belgium.
| | - Paul W Hodges
- The University of Queensland, School of Health & Rehabilitation Sciences/Biomedical Sciences, Brisbane, Qld 4072, Australia.
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Pallavi, Mitra S, Palermo AE. Functional Sitting Balance and Anthropometric Measures Are Related to Inspiratory Muscle Performance in People with Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2024; 30:41-49. [PMID: 39139776 PMCID: PMC11317645 DOI: 10.46292/sci23-00052] [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] [Indexed: 08/15/2024]
Abstract
Background Respiratory complications are a leading cause of mortality post spinal cord injury (SCI). Along with breathing, respiratory muscles have a role in maintaining seated balance. Postinjury breathing influences respiratory muscle function. Preliminary evidence indicates a relation between respiratory muscle function and seated balance in people with chronic SCI dwelling in the community, but the relationship between balance and body habitus has not been explored. Objectives To explore the relationships among inspiratory muscle function, functional seated balance (FSB), and body habitus in people with SCI. Methods A convenience sample of inpatients with SCI (C5-T12) aged 18 to 60 years who were using a wheelchair was recruited from November 2022 to March 2023. Those with additional neurological disorders or respiratory support were excluded. Respiratory muscle function measures included maximal inspiratory pressure (MIP), sustained MIP (SMIP), and Fatigue Index Test (FIT). FSB was scored using the Function in Sitting Test (FIST). Body habitus was assessed using the axillary: umbilical (A:U) ratio. Spearman correlations explored the relationships. Results Thirty-eight of 42 screened participants were eligible and participated (male, 32). Levels of injury ranged from C5 to T12. The mean (SD) age and duration of injury of the sample was 25.61 (6.68) years and 31.03 (28.69) months, respectively. SMIP and FIT correlated significantly with FSB (r s= .441, p = .01, and r s= .434, p = .006, respectively). A significant correlation between SMIP and A:U ratio (r s= -.330, p = .043) was observed. Conclusion We observed a significant correlation between inspiratory pressure parameters and both functional seated balance and body habitus, adding to evidence on postural role of respiratory muscles.
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Affiliation(s)
- Pallavi
- Indian Spinal Injury Center, Institute of Rehabilitation Sciences
| | - Shambhovi Mitra
- Associate Professor, Indian Spinal Injury Center, Institute of Rehabilitation Sciences
| | - Anne E. Palermo
- Research Fellow, Neuroscience Research Australia, Associate Lecturer, University of New South Wales, Australia
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Ladriñán-Maestro A, Sánchez-Infante J, Martín-Vera D, Sánchez-Sierra A. Influence of an inspiratory muscle fatigue protocol on healthy youths on respiratory muscle strength, vertical jump performance and muscle oxygen saturation: a randomized controlled trial. J Transl Med 2024; 22:732. [PMID: 39103816 DOI: 10.1186/s12967-024-05555-3] [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: 05/29/2024] [Accepted: 07/29/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Inspiratory muscle fatigue has been shown to have effects on limbs blood flow and physical performance. This study aimed to evaluate the influence of an inspiratory muscle fatigue protocol on respiratory muscle strength, vertical jump performance and muscle oxygen saturation in healthy youths. METHODS A randomized and double-blinded controlled clinical trial, was conducted. Twenty-four participants aged 18-45 years, non-smokers and engaged in sports activity at least three times a week for a minimum of one year were enrolled in this investigation. Participants were randomly assigned to three groups: Inspiratory Muscle Fatigue (IMFG), Activation, and Control. Measurements of vertical jump, diaphragmatic ultrasound, muscle oxygen saturation, and maximum inspiratory pressure were taken at two stages: before the intervention (T1) and immediately after treatment (T2). RESULTS The IMFG showed lower scores in muscle oxygen saturation and cardiorespiratory variables after undergoing the diaphragmatic fatigue intervention compared to the activation and control groups (p < 0.05). For the vertical jump variables, intragroup differences were found (p < 0.01), but no differences were shown between the three groups (p > 0.05). CONCLUSIONS Inspiratory muscle fatigue appears to negatively impact vertical jump performance, muscle oxygen saturation and inspiratory muscle strength in healthy youths. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT06271876. Date of registration 02/21/2024. https://clinicaltrials.gov/study/NCT06271876 .
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Affiliation(s)
- Arturo Ladriñán-Maestro
- School for Doctoral Studies and Research, Universidad Europea de Madrid, Madrid, Spain
- Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Jorge Sánchez-Infante
- Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
- Department of Sport Sciences, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Spain
- Physiotherapy Research Group of Toledo (GIFTO), Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Daniel Martín-Vera
- Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, 28670, Spain
| | - Alberto Sánchez-Sierra
- Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain.
- Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain.
- Physiotherapy Research Group of Toledo (GIFTO), Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain.
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, 28670, Spain.
- Clínica Sierra Varona SL, Av Boladiez, 34, 45007, Toledo, Spain.
- Department of Physical Therapy, Camilo José Cela University, Madrid, Spain.
- Department of Physical Therapy , Universidad Alfonso X El Sabio, Villanueva de la Cañada, Spain.
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Jiang X, Sun W, Chen Q, Xu Q, Chen G, Bi H. Effects of breathing exercises on chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. J Back Musculoskelet Rehabil 2024; 37:13-23. [PMID: 37718775 DOI: 10.3233/bmr-230054] [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] [Indexed: 09/19/2023]
Abstract
BACKGROUND A range of studies concerning the effects of breathing exercises on chronic low back pain (CLBP) have been proven inconclusive. OBJECTIVE The study aimed to evaluate the effectiveness of breathing exercises for the treatment of CLBP. METHODS We considered randomized controlled trials in English or Chinese that used breathing exercises for the treatment of CLBP. An electronic search was performed in the MEDLINE, EMBASE, Web of Science, Cochrane Library, CNKI, Wan Fang, and CBM databases for articles published up to November 2022. Two reviewers independently screened the articles, assessed the risk of bias using the Cochrane risk of bias tool, and extracted the data. The outcomes included pain, lumbar function and pulmonary function post-intervention. RESULTS A total of thirteen studies (n= 677) satisfied the inclusion criteria. The meta-analysis results demonstrated a significant effect of breathing exercises on the Visual Analog Scale (VAS) score (SMD =-0.84, 95% CI: -1.24 to -0.45, P< 0.0001), the Oswestry Disability Index (ODI) score (SMD =-0.74, 95% CI: -0.95 to -0.54, P< 0.00001), Forced Vital Capacity (FVC) score (MD = 0.24, 95% CI: 0.10 to 0.37, P= 0.0006), Forced Expiratory Volume in 1 second /Forced Vital Capacity (FEV1/FVC) (MD = 1.90, 95% CI: 0.73 to 3.07, P= 0.001), although there was no significant difference between the breathing exercises and control interventions for Forced Expiratory Volume in the first second (FEV1) score (MD = 0.22, 95% CI = [0.00, 0.43], P= 0.05), and Maximal Voluntary Ventilation (MVV) score (MD = 8.22, 95% CI = [-4.02, 20.45], P= 0.19). CONCLUSION Breathing exercises can reduce pain, assist people with lumbar disabilities, and improve pulmonary function, and could be considered as a potential alternative treatment for CLBP.
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Affiliation(s)
- Xiaoyu Jiang
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Wenyu Sun
- Department of Rehabilitation Medicine, Affiliated Hospital of Shandong University of Chinese Medicine, Jinan, Shandong, China
| | - Qiang Chen
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Qiling Xu
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Guoming Chen
- Department of Rehabilitation Medicine, Affiliated Hospital of Shandong University of Chinese Medicine, Jinan, Shandong, China
| | - Hongyan Bi
- Department of Rehabilitation Medicine, Affiliated Hospital of Shandong University of Chinese Medicine, Jinan, Shandong, China
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Masroor S, Tanwar T, Aldabbas M, Iram I, Veqar Z. Effect of Adding Diaphragmatic Breathing Exercises to Core Stabilization Exercises on Pain, Muscle Activity, Disability, and Sleep Quality in Patients With Chronic Low Back Pain: A Randomized Control Trial. J Chiropr Med 2023; 22:275-283. [PMID: 38205226 PMCID: PMC10774616 DOI: 10.1016/j.jcm.2023.07.001] [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: 03/16/2021] [Revised: 04/12/2023] [Accepted: 07/22/2023] [Indexed: 01/12/2024] Open
Abstract
Objective The purpose of this study was to test the effect of adding diaphragmatic breathing exercises (DBEs) to core stabilization exercises (CSEs) for patients with chronic low back pain (CLPB). Methods Twenty-two patients with CLPB were randomly allocated to the experimental (DBE + CSE) or control group (CSE only). They were given 12 treatment sessions 3 times a week for 4 weeks. Patients were evaluated before and after the 12 sessions. Surface electromyography of transverse abdominis, Oswestry Disability Index, Fear Avoidance Belief Questionnaire, Pittsburgh Sleep Quality Index, Numeric Pain Rating Scale, and chest expansion were used as outcome measures for pain, muscle activity, disability, and sleep quality. Results The outcome measure scores showed statistical significance of (P = .01) in time effect on muscle activity, sleep quality, disability score, pain score, fear-avoidance belief of patients and chest expansion; and group effect on Fear Avoidance Belief Questionnaire and physical activity parameter (P = .05). An interaction effect (time x group) on muscle activity for right transverse abdominus during tuck in (P = .01) and chest expansion (P = .01) was also found; however, no significant difference was found related to other parameters. Conclusion The combination of DBE and CSE interventions compared to CSE alone showed improvement in the measured parameters for patients with CLBP. Incorporating DBE with CSE also improved muscle activation and chest expansion.
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Affiliation(s)
- Sana Masroor
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Tarushi Tanwar
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Mosab Aldabbas
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Iram Iram
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Zubia Veqar
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
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Kawai K, Kato Y, Ito T, Yamazaki K, Fukuhara J, Sakai Y, Morita Y. Biological Responses to Local Vibratory Stimulation for the Lower Legs and Lower Back and Criterion Values Based on Sweep Frequencies of Healthy Individuals: An Observational Study. Healthcare (Basel) 2023; 11:2243. [PMID: 37628441 PMCID: PMC10454103 DOI: 10.3390/healthcare11162243] [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: 05/02/2023] [Revised: 07/12/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Declining proprioceptive function is associated with problems such as lower back pain and falls. Therefore, we developed a vibration device using sweep frequency to evaluate several proprioceptors with different response frequency ranges. This study aimed to elucidate the biological responses of healthy individuals to vibratory stimulation at different sites and frequency ranges and to propose cutoff values to determine the decline in proprioceptive function. Mechanical vibration was separately applied to the lower legs and lower back, and proprioceptive function was evaluated by defining the ratio of the center of pressure (CoP) in the anteroposterior direction during mechanical vibration to that during no vibration in the three frequency ranges. The cut-off value was defined as the mean value, with the standard deviation subtracted for each indicator. The cut-off values were higher in the lower legs than in the lower back at all frequency ranges and in the 30-53 Hz and 56-100 Hz frequency ranges for both the lower legs and lower back. In healthy individuals, 9.9% and 8.6% were below the cut-off values in the 30-53 Hz and 56-100 Hz frequency ranges for the lower legs, respectively.
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Affiliation(s)
- Keitaro Kawai
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (K.K.); (J.F.)
| | - Yoshiji Kato
- Department of Physical Therapy, Nagoya Women’s University, Nagoya 467-8610, Japan;
| | - Tadashi Ito
- Three-Dimensional Motion Analysis Room, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki 444-0002, Japan;
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Japan
| | - Kazunori Yamazaki
- Institutional Research Center, Aichi Mizuho College, Nagoya 467-0867, Japan;
| | - Jo Fukuhara
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (K.K.); (J.F.)
| | - Yoshihito Sakai
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan;
| | - Yoshifumi Morita
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (K.K.); (J.F.)
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7
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Formiga MF, Dosbaba F, Hartman M, Batalik L, Senkyr V, Radkovcova I, Richter S, Brat K, Cahalin LP. Role of the Inspiratory Muscles on Functional Performance From Critical Care to Hospital Discharge and Beyond in Patients With COVID-19. Phys Ther 2023; 103:pzad051. [PMID: 37247250 DOI: 10.1093/ptj/pzad051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 01/04/2023] [Accepted: 02/19/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The role of inspiratory muscle performance in functional performance in patients with coronavirus disease 2019 (COVID-19) is poorly understood. The purpose of this study was to perform a longitudinal examination of inspiratory and functional performance from intensive care unit (ICU) discharge (ICUD) to hospital discharge (HD) and symptoms at HD and 1 month after HD in patients with COVID-19. METHODS Thirty patients (19 men, 11 women) with COVID-19 were included. Examination of inspiratory muscle performance at ICUD and HD was performed with an electronic manometer, which provided the maximal inspiratory pressure (MIP) and several other inspiratory measures. Examination of dyspnea and functional performance was performed at ICUD and HD with the Modified Borg Dyspnea Scale and the 1-minute sit-to-stand test (1MSST), respectively. RESULTS The mean age was 71 (SD = 11) years, the mean length of ICU stay was 9 (SD = 6) days, and the mean length of hospital stay was 26 (SD = 16) days. Most of the patients were diagnosed with severe COVID-19 (76.7%) and had a mean Charlson Comorbidity Index of 4.4 (SD = 1.9), reflecting high comorbidity. The mean MIP of the entire cohort increased minimally from ICUD to HD (from 36 [SD = 21] to 40 [SD = 20] cm H2O), reflecting predicted values for men and women at ICUD and HD of 46 (25%) to 51 (23%) and 37 (24%) to 37 (20%), respectively. The 1MSTS score increased significantly from ICUD to HD (9.9 [SD = 7.1] vs 17.7 [SD = 11.1]) for the entire cohort but remained far below population-based reference values (2.5th percentile) for the majority of patients at ICUD and HD. At ICUD, MIP was found to be a significant predictor of a favorable change in 1MSTS performance (β = 0.308; odds ratio = 1.36) at HD. CONCLUSION A significant reduction in inspiratory and functional performance exists in patients with COVID-19 at both ICUD and HD, with a greater MIP at ICUD being a significant predictor of a greater 1MSTS score at HD. IMPACT This study shows that inspiratory muscle training may be an important adjunct after COVID-19.
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Affiliation(s)
- Magno F Formiga
- Programa Pós-Graduação em Fisioterapia e Funcionalidade, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
| | - Martin Hartman
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University Brno, Brno, South Moravia, Czech Republic
| | - Vojtech Senkyr
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
| | - Ivana Radkovcova
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
| | - Svatopluk Richter
- Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno, South Moravia, Czech Republic
| | - Kristian Brat
- Department of Respiratory Diseases, University Hospital Brno, Brno South Moravia, Czech Republic
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA
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Gherscovici ED, Mayer JM. Impact of Indoor Air Quality and Breathing on Back and Neck Pain: A Systematic Review. Cureus 2023; 15:e43945. [PMID: 37638265 PMCID: PMC10447999 DOI: 10.7759/cureus.43945] [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] [Accepted: 08/22/2023] [Indexed: 08/29/2023] Open
Abstract
Back pain and neck pain are important public health concerns and are among the most common and disabling conditions globally. However, the relationships among indoor air quality (IAQ), breathing parameters (pulmonary function, respiratory disorders), and back pain and neck pain have not been adequately assessed. The purpose of this study was to systematically review the literature about the impact of IAQ and breathing parameters on back pain and neck pain (PROSPERO ID: CRD42022380515). CINAHL, EMBASE, PEDRo, and PubMed databases were searched through January 19, 2023. Inclusion criteria for study eligibility were observational studies (except case reports) or randomized controlled trials (RCTs), published in peer-reviewed journals in the English language, human research, original research, examined the relationships between IAQ, or breathing parameters with back pain or neck pain. Review procedures were conducted and reported according to PRISMA recommendations. Empirical evidence statements were developed for observational studies, and grades of evidence statements were developed for RCTs. Sixty-seven eligible studies were found (54 observational studies and 13 RCTs) that enrolled 345,832 participants. None of the studies assessed the combined impact of IAQ and breathing parameters on back pain or neck pain. No level 1 studies were found, which precludes making strong statements about causality and strong recommendations about the efficacy of IAQ and breathing exercise interventions for reducing pain and disability related to back pain and neck pain. Evidence indicates that poor IAQ and respiratory disorders are related to an increased risk of back pain and neck pain. Conflicting evidence exists about the association between pulmonary function with back pain and neck pain. Evidence for breathing exercise interventions was mixed with numerous limitations. This review provides preliminary evidence on the relationships of IAQ and breathing parameters with back pain and neck pain, which can be used to guide future research and clinical implementation efforts. Assuming positive findings in subsequent research, a wide range of stakeholders involved with this complex human-building-environment interface can be equipped to address IAQ and breathing parameters, along with other established risk factors to help those suffering from back pain and neck pain.
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Affiliation(s)
| | - John M Mayer
- Research & Development, Healthy Buildings LLC, Malibu, USA
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Krkoska P, Vlazna D, Sladeckova M, Minarikova J, Barusova T, Batalik L, Dosbaba F, Vohanka S, Adamova B. Adherence and Effect of Home-Based Rehabilitation with Telemonitoring Support in Patients with Chronic Non-Specific Low Back Pain: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1504. [PMID: 36674258 PMCID: PMC9860722 DOI: 10.3390/ijerph20021504] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Home-based exercises have been on the rise recently. This pilot study aimed to assess the adherence and effect of a home-based rehabilitation programme using telemonitoring in patients with chronic non-specific low back pain (CNLBP). Twenty-seven patients with CNLBP were enrolled in the study, each of whom underwent a neurological assessment, including patient-oriented measures and a functional assessment-a battery of tests that comprehensively evaluated trunk muscle function. The rehabilitation programme lasted 18 weeks and included daily home-based exercises. A mobile application or an exercise diary was used to monitor compliance. Adherence to the programme was excellent for both the diary and mobile application groups, with 82.3% in the diary group exercising at least once a day and 72.9% twice a day, and 94.8% in the mobile application group exercising at least once a day and 86.6% twice a day. Both patient-oriented and functional outcomes improved significantly; however, the relative changes of the parameters in these two groups did not correlate, which supports the idea that trunk muscle function does not directly relate to patient complaints and that CNLBP is a multifactorial issue. This model of rehabilitation programme should be used in clinical practice, as its adherence and effectiveness seem noticeable.
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Affiliation(s)
- Peter Krkoska
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Daniela Vlazna
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Michaela Sladeckova
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Jitka Minarikova
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Rehabilitation and Sports Medicine, Second Medical Faculty, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Tamara Barusova
- Institute of Biostatistics and Analysis Ltd., 602 00 Brno, Czech Republic
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Stanislav Vohanka
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Blanka Adamova
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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Usman A, Tanwar T, Veqar Z. Exploring the role of respiratory intervention as an effective adjunct tool in the management of chronic low back pain: A scoping systematic review. J Bodyw Mov Ther 2023; 33:60-68. [PMID: 36775527 DOI: 10.1016/j.jbmt.2022.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 05/01/2022] [Accepted: 09/17/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individuals with chronic low back pain (CLBP) are usually prescribed manual therapy and exercise programs. Respiratory exercise interventions are also recommended by some researchers for CLBP. However, the evidence for the relative effectiveness of these treatments is limited, and the question of which sort of intervention is most suited remains unanswered. OBJECTIVE This systematic review aims to evaluate the effectiveness of respiratory interventions in CLBP. METHODS A systematic search was performed using databases: PubMed, Web of Science, PEDro, Cochrane Library, and Science Direct. The review was registered in PROSPERO (CRD42021233739). RESULTS Seven studies met the inclusion criteria. Out of these, one was of poor, three were of fair, and three were of good qualities. A total of 293 subjects were included in seven studies, the mean age of subjects ranged from 21 to 53 years. The largest effect size was reported for pain (d = 1.5) and maximum inspiratory pressure (d = 1.38). No detrimental effects were reported for any of the intervention programs. CONCLUSIONS Since most of the research has been done on pain and MIP, and both of these parameters have revealed significant changes with large effect size, therefore it can be concluded that respiratory interventions improve pain and MIP in CLBP. Owing to the limited number of studies available, a definitive outcome could not be documented for other parameters. Thus, further research is needed to provide a more robust piece of evidence and understanding.
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Affiliation(s)
- Arshi Usman
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (Central University), New Delhi, 110025, India.
| | - Tarushi Tanwar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, 110025, India.
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (Central University), New Delhi, 110025, India.
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11
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Palermo AE, Nash MS, Kirk-Sanchez NJ, Cahalin LP. Adherence to and impact of home-based high-intensity IMT in people with spinal cord injury: a pilot study. Spinal Cord Ser Cases 2022; 8:85. [PMID: 36309488 PMCID: PMC9617741 DOI: 10.1038/s41394-022-00551-5] [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: 07/22/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022] Open
Abstract
Study design The pilot study was completed in 5 phases (Control and 4 phases of IMT) incorporating assessments at Baseline 1 (BL1), BL2, Follow-up 1 (F1), F2, F3, and F4. Objective To assess the adherence and impact of a daily high-intensity (80% of max) inspiratory muscle training (IMT) home program with once weekly supervision for people with spinal cord injury (SCI). Setting Assessments: research institution or zoom. IMT: participant’s home. Methods Participants completed daily IMT in IMT Phase 1 and 2, once weekly in IMT Phase 3, self-selected frequency in IMT Phase 4. All phases had one weekly supervised session except IMT Phase 4. Primary outcomes included adherence and a difficulty score [DS (0- not difficult to 10- the most difficult)]. Secondary outcomes included respiratory function and seated balance. Results Data from 10 people with chronic SCI (>1 year) (Cervical level of injury: 6, AIS: A-B, injury duration: 10.9 years 95% CI [3.9, 18.1]) were used in the analysis. Participants completed 69% of their training days in IMT Phase 1 and 65% overall reporting an average DS of 7.4 ± 1.4. Only one participant completed training during IMT Phase 4. One participant’s training load was reduced due to suspected overtraining. Maximal inspiratory pressure (MIP), sustained MIP (SMIP), and total power (TP), improved significantly (p < 0.05) from BL2 to F1. Conclusion Our data suggest that people with SCI can perform high-intensity IMT at home to improve inspiratory performance. It is strongly recommended that participants be intermittently monitored for adherence and safety. ClinicalTrials.gov Registration number: NCT04210063.
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Affiliation(s)
- Anne E Palermo
- Neuroscience Research Australia, Sydney, NSW, Australia. .,University of New South Wales, Sydney, NSW, Australia.
| | - Mark S Nash
- University of Miami Miller School of Medicine, Department of Physical Therapy and The Miami Project to Cure Paralysis, Miami, FL, USA
| | - Neva J Kirk-Sanchez
- University of Miami Miller School of Medicine, Department of Physical Therapy, Miami, FL, USA
| | - Lawrence P Cahalin
- University of Miami Miller School of Medicine, Department of Physical Therapy, Miami, FL, USA
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12
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Stutz J, Casutt S, Spengler CM. Respiratory muscle endurance training improves exercise performance but does not affect resting blood pressure and sleep in healthy active elderly. Eur J Appl Physiol 2022; 122:2515-2531. [PMID: 36018510 PMCID: PMC9613745 DOI: 10.1007/s00421-022-05024-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/04/2022] [Indexed: 11/29/2022]
Abstract
Purpose Ageing is associated with increased blood pressure (BP), reduced sleep, decreased pulmonary function and exercise capacity. The main purpose of this study was to test whether respiratory muscle endurance training (RMET) improves these parameters. Methods Twenty-four active normotensive and prehypertensive participants (age: 65.8 years) were randomized and balanced to receive either RMET (N = 12) or placebo (PLA, N = 12). RMET consisted of 30 min of volitional normocapnic hyperpnea at 60% of maximal voluntary ventilation while PLA consisted of 1 inhalation day−1 of a lactose powder. Both interventions were performed on 4–5 days week−1 for 4–5 weeks. Before and after the intervention, resting BP, pulmonary function, time to exhaustion in an incremental respiratory muscle test (incRMET), an incremental treadmill test (IT) and in a constant-load treadmill test (CLT) at 80% of peak oxygen consumption, balance, sleep at home, and body composition were assessed. Data was analyzed with 2 × 2 mixed ANOVAs. Results Compared to PLA, there was no change in resting BP (independent of initial resting BP), pulmonary function, IT performance, sleep, body composition or balance (all p > 0.05). Performance significantly increased in the incRMET (+ 6.3 min) and the CLT (+ 3.2 min), resulting in significant interaction effects (p < 0.05). Conclusion In the elderly population, RMET might be used to improve respiratory and whole body endurance performance either as an adjunct to physical exercise training or as a replacement thereof for people not being able to intensively exercise even if no change in BP or sleep may be expected.
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Affiliation(s)
- Jan Stutz
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Selina Casutt
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland. .,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
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13
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Van Hove O, Pichon R, Pallanca P, Cebolla AM, Noel S, Feipel V, Deboeck G, Bonnechère B. Influence of Speech and Cognitive Load on Balance and Timed Up and Go. Brain Sci 2022; 12:brainsci12081018. [PMID: 36009081 PMCID: PMC9405849 DOI: 10.3390/brainsci12081018] [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: 06/15/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022] Open
Abstract
The interaction between oral and/or mental cognitive tasks and postural control and mobility remains unclear. The aim of this study was to analyse the influence of speech production and cognitive load levels on static balance and timed up and go (TUG) during dual-task activities. Thirty healthy young subjects (25 ± 4 years old, 17 women) participated in this study. A control situation and two different cognitive arithmetic tasks were tested: counting backward in increments of 3 and 7 under oral (O) and mental (M) conditions during static balance and the TUG. We evaluated the dual-task cost (DTC) and the effect of speech production (SP) and the level of cognitive load (CL) on these variables. There was a significant increase in the centre of pressure oscillation velocity in static balance when the dual task was performed orally compared to the control situation The DTC was more pronounced for the O than for the M. The SP, but not the CL, had a significant effect on oscillation velocity. There was an increase in TUG associated with the cognitive load, but the mental or oral aspect did not seem to have an influence. Mobility is more affected by SP when the cognitive task is complex. This may be particularly important for the choice of the test and understanding postural control disorders.
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Affiliation(s)
- Olivier Van Hove
- Department of Pneumology, Erasme Hospital, 1070 Brussels, Belgium
- Correspondence:
| | - Romain Pichon
- Institut de Formation en Pédicurie-Podologie, Ergothérapie Kinésithérapie (IFPEK), 35000 Rennes, France;
- M2S Laboratory—EA7470, University Rennes 2, 35000 Rennes, France
| | - Pauline Pallanca
- Department of Intensive Care, Erasme Hospital, 1070 Brussels, Belgium;
| | - Ana Maria Cebolla
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles, 1070 Brussels, Belgium; (A.M.C.); (S.N.)
| | - Sarah Noel
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles, 1070 Brussels, Belgium; (A.M.C.); (S.N.)
| | - Véronique Feipel
- Laboratory of Functional Anatomy, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Gaël Deboeck
- Research Unit in Rehabilitation, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, 3590 Diepenbeek, Belgium;
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, University of Hasselt, 3590 Diepenbeek, Belgium
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14
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Palermo AE, Kirk-Sanchez NJ, Garcia KL, Nash MS, Cahalin LP. Inspiratory Muscle Performance Is Related to Seated Balance Function in People With Spinal Cord Injury: An Observational Study. Arch Phys Med Rehabil 2022; 103:1303-1310. [PMID: 34922931 DOI: 10.1016/j.apmr.2021.11.006] [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: 08/27/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the relationship between inspiratory muscle performance (IMP) and functional sitting balance (FSB) in persons with chronic spinal cord injury (SCI). We hypothesized that a moderate correlation would be found between IMP and FSB and that individuals with better balance would have better IMP. DESIGN The SCI-specific modification of the Function in Sitting Test (FIST-SCI) measured FSB. The IMP measures included (1) maximal inspiratory pressure (MIP), (2) sustained MIP (SMIP), and (3) inspiratory duration. Upper extremity motor score (UEMS) and level of injury (LOI) were taken from International Standards for Neurological Classification of Spinal Cord Injury examinations. Spearman correlational analyses assessed relationships among these factors in the sample (N=37). Mann-Whitney U tests explored differences between 2 comparison group pairs (tetraplegia group [TG] vs paraplegia group [PG]; independent transfer group [ITG] vs assisted transfer group [ATG]). Regression analysis examined variables predictive of FSB in the TG. SETTING Research facility. PARTICIPANTS Volunteers with tetraplegia (n=21, American Spinal Injury Association Impairment Scale (AIS) A=8, B=7, C=6) and paraplegia (n=16, AIS A=9, B=4, C=3) (N=37). INTERVENTION Not applicable. MAIN OUTCOME MEASURES IMP, LOI, UEMS, FIST-SCI. RESULTS UEMS, MIP, SMIP, and LOI had moderate to high correlations with FIST-SCI scores (ρ=0.720 (P<.001), 0.480 (P=.003), 0.467 (P=.004), 0.527 (P=.001), respectively). UEMS, MIP, and FIST-SCI scores were higher in the PG and ITG than the TG and ATG, respectively (PG vs. TG P values=<.001, .008, .002, respectively, and ITG vs. ATG P values=<.001, .032, <.001, respectively). Further, SMIP and UEMS predicted FIST-SCI balance scores in the TG, accounting for 55% of total variance (P<.001) (FIST-SCI=11.88+0.03 [SMIP]+0.425 [UEMS]). CONCLUSIONS The relationship between IMP and balance appears preserved after SCI. FSB was predicted, in part, via UEMS and SMIP in the TG. Future research should focus on the effect of SCI-based breathing interventions on FSB.
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Affiliation(s)
- Anne E Palermo
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida; Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida.
| | - Neva J Kirk-Sanchez
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida
| | - Kelsey L Garcia
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida; Department of Rehabilitation, Jackson Health Systems, Miami, Florida
| | - Mark S Nash
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida; Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida
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15
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Martinez-Navarro I, Collado E, Hernando B, Hernando C. Pulmonary and Inspiratory Muscle Function Response to a Mountain Ultramarathon. J Sports Sci Med 2021; 20:706-713. [PMID: 35321133 PMCID: PMC8488829 DOI: 10.52082/jssm.2021.706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/18/2021] [Indexed: 06/14/2023]
Abstract
The study aimed to provide within-race data on the time course of pulmonary function during a mountain ultramarathon (MUM). Additionally, we wanted to assess possible sex differences regarding pre- to post-race change in pulmonary and inspiratory muscle function. Lastly, we were interested in evaluating whether changes in respiratory function were associated with relative running speed and due to general or specific fatigue. 47 athletes (29 males and 18 females; 41 ± 5 years) were submitted to a cardiopulmonary exercise test (CPET) before a 107-km MUM. Spirometric variables: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and peak expiratory flow (PEF); maximal inspiratory pressure (MIP); squat jump (SJ) and handgrip strength (HG) were assessed before and after the race. Additionally PEF was measured at three aid stations (33rd, 66th and 84th km) during the race. PEF declined from the 33rd to the 66th km (p = 0.004; d = 0.72) and from the 84th km to the finish line (p = 0.003; d = 0.90), while relative running speed dropped from the first (0-33 km) to the second (33-66 km) race section (p < 0.001; d = 1.81) and from the third (66-84 km) to the last race section (p < 0.001; d = 1.61). Post-race, a moderate reduction was noted in FVC (-13%; p < 0.001; d = 0.52), FEV1 (-19.5%; p < 0.001; d = 0.65), FEV1/FVC (-8.4%; p = 0.030; d = 0.59), PEF (-20.3%; p < 0.001; d = 0.58), MIP (-25.3%; p < 0.001; d = 0.79) and SJ (-31.6%; p < 0.001; d = 1.42). Conversely, HG did not change from pre- to post-race (-1.4%; p = 0.56; d = 0.05). PEF declined during the race in parallel with running speed drop. No sex differences were noted regarding post-race respiratory function, except that FEV1/FVC decay was significantly greater among women. The magnitude of pre- to post-race respiratory function decline was uncorrelated with relative running speed.
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Affiliation(s)
- Ignacio Martinez-Navarro
- Physical Education and Sports Department, University of Valencia, Valencia, Spain
- Sports Health Unit, Vithas 9 de Octubre Hospital, Valencia, Spain
| | - Eladio Collado
- Faculty of Health Sciences, Jaume I University, Castellon, Spain
| | | | - Carlos Hernando
- Sport Service, Jaume I University, Castellon, Spain
- Department of Education and Specific Didactics, Jaume I University, Castellon, Spain
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16
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Assessment of Lumbar Extensor Muscles in the Context of Trunk Function, a Pilot Study in Healthy Individuals. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11209518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A comprehensive assessment of trunk function, including the lumbar extensor muscles, appears to be important in various conditions affecting axial musculature. This pilot cross-sectional observational study aimed to define a battery of tests that comprehensively assess trunk muscle function (strength and muscular endurance). Sixty subjects without low back pain (LBP) underwent measurement of isometric lower back extensor strength using a hand-held dynamometer (HHD) in three positions; measurement of respiratory muscle strength; and Biering-Sørensen, prone-plank, and side-bridge tests. The repeatability, short-term and long-term reliability using the HHD device in different postural positions was confirmed. The greatest isometric lower back extensor strength was generated in the sitting position by male subjects. Time of effort in the Biering-Sørensen test was longer in women and older subgroups than in men and younger individuals, although this was not the case for the other two muscular endurance tests. This pilot monitoring of trunk muscle strength and endurance in healthy volunteers may lead to a better understanding of trunk muscle function. Based on this methodological background, the authors aim to use the defined battery of tests in their further studies in a group of patients with LBP and certain neuromuscular diseases to verify its usefulness in clinical practice.
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17
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Kozinc Ž, Trajković N, Smajla D, Šarabon N. The Effect of Fatigue on Single-Leg Postural Sway and Its Transient Characteristics in Healthy Young Adults. Front Physiol 2021; 12:720905. [PMID: 34489739 PMCID: PMC8418113 DOI: 10.3389/fphys.2021.720905] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Neuromuscular fatigue is known to impair balance ability, which is reflected in increased postural sway during quiet standing tasks. Recently, quantifying transient characteristics of postural sway has been suggested as an approach to obtain additional information regarding postural control. However, this approach is currently vastly unexplored. The purpose of this study was to investigate the effects of fatigue (induced by a repeated change of direction task) on postural sway and its transient characteristics during single-leg standing, including whole-trial estimates and indexes of transient behavior in young healthy active adults. The study involved 28 physically active students (14 females). Single-leg postural sway was recorded for 30s before and after a fatiguing protocol, which consisted of a repeated change of direction tasks. We calculated the traditional whole-trial estimates of postural sway [center-of-pressure (CoP) velocity and amplitude in anterior-posterior (AP) and medial-lateral (ML) directions] and corresponding transient behavior indexes, based on three 10-s intervals. Statistically significant sex×fatigue interaction with medium effect sizes was found for whole-trial CoP velocity in AP (p=0.028; η2=0.17) and ML directions (p=0.019; η2=0.19). Post-hoc test showed that both variables substantially decreased in female participants (p=0.041–0.045; d=0.54–0.56), but remained similar in males (p=0.194–0.294). There were small to medium statistically significant main effects of fatigue on transient index for CoP amplitude in both directions (p=0.042–0.049; η2=0.02–0.14). Notably, CoP AP amplitude increased in the first 10-s interval for males (before fatigue: 5.6±1.3mm; after fatigue: 6.3±1.6mm), while the CoP AP amplitude in the third interval remained similar after fatigue (before fatigue: 5.5±1.4mm; after fatigue: 5.1±1.2mm). In conclusion, the responses to fatigue in terms of postural sway were time interval specific, and there were certain sex-differences in responses to fatigue, which could be related to better ability to adapt balance strategies in females. Moreover, our results demonstrate that the indexes of transient behavior could perhaps detect smaller fatigue-induced changes in postural sway that are seen in whole-trial estimates.
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Affiliation(s)
- Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Nebojša Trajković
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Darjan Smajla
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Human Health Department, InnoRenew CoE, Izola, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Human Health Department, InnoRenew CoE, Izola, Slovenia.,Laboratory for Motor Control and Motor Behavior, S2P, Science to Practice, Ltd., Ljubljana, Slovenia
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18
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Body Balance and Physiotherapy in the Aquatic Environment and at a Gym. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9925802. [PMID: 34239934 PMCID: PMC8241514 DOI: 10.1155/2021/9925802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/14/2021] [Indexed: 11/17/2022]
Abstract
The increase in the average age of our society represents a growing medical and social problem, which requires concentration on the issue concerning balance disorders. The aquatic environment has a number of complex properties that have miscellaneous effects on the human body. In the light of the above, water is becoming an ideal environment to learn correct neuromuscular communication, and a properly prepared training session in water helps to practice balance and movement coordination. The objective of the study was to assess the impact of rehabilitation in the aquatic environment on patients' balance and compare the results obtained with patients who received rehabilitation at a gym. The study was carried out among patients hospitalised in the “Krzeszowice” Rehabilitation Centre. It encompassed 137 patients, randomly assigned to either the study group (the aquatic environment) or the control group (the gym). The preliminary examination included general medical history and a test on the stabilometric platform. The patients attended training sessions for 4 weeks, 5 times a week for 30 minutes. It was a single-blinded study wherein the authors did not know which group a given patient had been assigned to. Upon completion of a monthly therapy, the stabilometric test was carried out again. The study revealed that the patients from both groups experienced a significant improvement in balance. However, the improvement was slightly greater in those exercising in the pool. Physiotherapy in the aquatic environment makes a greater contribution to the improvement of body balance compared to physical exercises performed at a gym.
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Ziaeifar M, Sarrafzadeh J, Noorizadeh Dehkordi S, Arab AM, Haghighatkhah H, Zendehdel Jadehkenari A. Diaphragm thickness, thickness change, and excursion in subjects with and without nonspecific low back pain using B-mode and M-mode ultrasonography. Physiother Theory Pract 2021; 38:2441-2451. [PMID: 34061721 DOI: 10.1080/09593985.2021.1926022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Previous studies have demonstrated that respiratory dysfunction has a potential association with low back pain (LBP). Despite the role of the diaphragm for respiration and spinal stability, knowledge of the function of both sides of the diaphragm in subjects with LBP is still limited.Objective: This study aimed to compare the structural integrity and function of the right and left hemidiaphragm by ultrasonography (USG) in subjects with and without nonspecific chronic low back pain (NS-CLBP).Methods: A total of 37 subjects with NS-CLBP and 34 healthy subjects participated in this case-control study. The thickness, thickness change, and excursion of the right and left hemidiaphragm were compared within and between the groups during quiet breathing (QB) and deep breathing (DB) through B-mode and M-mode ultrasound imaging.Results: The LBP group had a significantly smaller degree of right hemidiaphragm thickness change (P = .001) compared with the healthy control group, with a strong effect size. Nevertheless, there was no significant change for diaphragm thickness and excursion between the two groups. The result showed that, in the healthy group, the right hemidiaphragm had a significantly smaller thickness at expiration and larger thickness change compared with the left hemidiaphragm, with a moderate effect size. Based on the multivariate prediction analysis, the right hemidiaphragm thickness change might significantly predict LBP.Conclusion: We found that participants with LBP had a smaller degree of right hemidiaphragm thickness change. Also, the right hemidiaphragm thickness change might significantly predict LBP.
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Affiliation(s)
- Maryam Ziaeifar
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mirdamad Blvd, Tehran, Iran
| | - Javad Sarrafzadeh
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mirdamad Blvd, Tehran, Iran
| | - Shohreh Noorizadeh Dehkordi
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mirdamad Blvd, Tehran, Iran
| | - Amir Massoud Arab
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamidreza Haghighatkhah
- Radiology Department of Diagnosis Imaging Shohadae Tajrish Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Alieh Zendehdel Jadehkenari
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mirdamad Blvd, Tehran, Iran
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Effects of Manual Therapy on the Diaphragm in the Musculoskeletal System: A Systematic Review. Arch Phys Med Rehabil 2021; 102:2402-2415. [PMID: 33932362 DOI: 10.1016/j.apmr.2021.03.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/14/2021] [Accepted: 03/23/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To analyze the effects at the musculoskeletal level of manual treatment of the diaphragm muscle in adults. DATA SOURCES Systematic review using 4 databases: PubMed, Science Direct, Web of Science, and Scopus. STUDY SELECTION AND DATA EXTRACTION Two independent reviewers applied the selection criteria and assessed the quality of the studies using the Physiotherapy Evidence Database scale for experimental studies. A third reviewer intervened in cases where a consensus had not been reached. A total of 9 studies were included in the review. DATA SYNTHESIS Manual therapy directed to the diaphragm has been shown to be effective in terms of the immediate increase in diaphragmatic mobility and thoracoabdominal expansion. The immediate improvement in the posterior muscle chain flexibility test is another of the most frequently found findings in the evaluated studies. Limited studies show improvements at the lumbar and cervical level in the range of motion and in pain. CONCLUSION Manual diaphragm therapy has shown an immediate significant effect on parameters related to costal, spinal, and posterior muscle chain mobility. Further studies are needed, not only to demonstrate the effectiveness of manual diaphragm therapy in the long-term and in symptomatic populations, but also to investigate the specific neurophysiological mechanisms involved in this type of therapy.
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21
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Van Hove O, Cebolla AM, Andrianopoulos V, Leduc D, Guidat PA, Feipel V, Deboeck G, Bonnechère B. The influence of cognitive load on static balance in chronic obstructive pulmonary disease patients. CLINICAL RESPIRATORY JOURNAL 2020; 15:351-357. [PMID: 33217122 DOI: 10.1111/crj.13307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/13/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Patients with chronic obstructive pulmonary disease (COPD) may demonstrate cognitive function and balance deterioration. These two phenomena are often realized simultaneously during daily living activities, where the risk of falling may be increased due to possible postural disturbance when focusing on a cognitive task during motion. Despite the high rate of falls in COPD, there is currently a lack of affordable clinical instruments to quantify the interaction between cognitive tasks and static balance in these patients. Therefore, this study aims to assess the balance perturbation induced by cognitive tasks using a new cost-effective protocol which can easily be implemented in clinical settings. METHOD A total of 21 COPD patients (Age: 64 ± 8 yrs, Forced Expiratory Volume in one second = 41 ± 17%, Women: 7) and 21 matched healthy controls participated in the study. They performed two cognitive tasks (counting backward by 3s and naming animals) with eyes open and with eyes closed. Each trial lasted 60 s, with balance-related parameters recorded and quantified using a Wii Balance Board. A three-way ANOVA (cognitive task, eyes action, and health status) for balance-related parameters derived from the center of pressure displacement was performed. RESULTS COPD, vision, and cognitive tasks altered the balance; no interaction between conditions was observed. There was no correlation between cognitive ability, respiratory function, and the balance-related parameters. CONCLUSION Compared to healthy controls, the COPD patients had impaired balance. Cognitive tasks altered postural control in both COPD and controls, where this alteration was more pronounced with eyes closed.
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Affiliation(s)
| | - Ana Maria Cebolla
- Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles, Brussels, Belgium
| | - Vasileios Andrianopoulos
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Dimitri Leduc
- Department of Pneumology, Erasme Hospital, Brussels, Belgium.,Laboratory of Cardiorespiratory Physiology, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Véronique Feipel
- Laboratory of Functional Anatomy, Université Libre de Bruxelles, Brussels, Belgium
| | - Gaël Deboeck
- Research Unit in Rehabilitation, Université Libre de Bruxelles, Brussels, Belgium
| | - Bruno Bonnechère
- Department of Psychiatry and Behavioural and Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Martinez-Navarro I, Montoya-Vieco A, Collado E, Hernando B, Hernando C. Inspiratory and Lower-Limb Strength Importance in Mountain Ultramarathon Running. Sex Differences and Relationship with Performance. Sports (Basel) 2020; 8:sports8100134. [PMID: 33066606 PMCID: PMC7602444 DOI: 10.3390/sports8100134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 12/20/2022] Open
Abstract
The study was aimed at comparing lower-limb strength and respiratory parameters between male and female athletes and their interaction with performance in a 107 km mountain ultramarathon. Forty seven runners (29 males and 18 females; mean ± SD age: 41 ± 5 years) were enrolled. Lower-limb strength assessment comprised a squat jump test, an ankle rebound test, and an isometric strength test. Respiratory assessment included pulmonary function testing and the measurement of maximal inspiratory pressure. Male athletes performed largely better in the squat jump (26 ± 4 vs. 21 ± 3 cm; p < 0.001; d = 1.48), while no sex differences were found in the other two lower-limb tests. Concerning the respiratory parameters, male athletes showed largely greater values in pulmonary expiratory variables: forced vital capacity (5.19 ± 0.68 vs. 3.65 ± 0.52 L; p < 0.001; d = 2.53), forced expiratory volume in 1 s (4.24 ± 0.54 vs. 2.97 ± 0.39 L; p < 0.001; d = 2.69), peak expiratory flow (9.9 ± 1.56 vs. 5.89 ± 1.39 L/min; p < 0.001; d = 2.77) and maximum voluntary ventilation in 12 s (171 ± 39 vs. 108 ± 23 L/min; p < 0.001; d = 1.93); while no sex differences were identified in maximal inspiratory pressure. Race time was associated with ankle rebound test performance (r = −0.390; p = 0.027), isometric strength test performance (r = −0.349; p = 0.049) and maximal inspiratory pressure (r = −0.544; p < 0.001). Consequently, it seems that athletes competing in mountain ultramarathons may benefit from improving lower-limb isometric strength, ankle reactive strength and inspiratory muscle strength. Nevertheless, further interventional studies are required to confirm these exploratory results. In addition, the fact that the magnitude of the sex difference for isometric strength was minor, as compared with the other strength tests, could represent one of the factors explaining why the performance gap between males and females is reduced in ultramarathons.
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Affiliation(s)
- Ignacio Martinez-Navarro
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain;
- Sports Health Unit, Vithas 9 de Octubre Hospital, 46015 Valencia, Spain
- Correspondence:
| | - Antonio Montoya-Vieco
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain;
- Sports Health Unit, Vithas 9 de Octubre Hospital, 46015 Valencia, Spain
| | - Eladio Collado
- Faculty of Health Sciences, Jaume I University, 12071 Castellon, Spain;
| | - Bárbara Hernando
- Department of Medicine, Jaume I University, 12071 Castellon, Spain;
| | - Carlos Hernando
- Sport Service, Jaume I University, 12071 Castellon, Spain;
- Department of Education and Specific Didactics, Jaume I University, 12071 Castellon, Spain
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Yamazaki K, Ito T, Sakai Y, Nishio R, Ito Y, Morita Y. Postural Sway during Local Vibratory Stimulation for Proprioception in Elderly Individuals with Pre-Sarcopenia. Phys Ther Res 2020; 23:149-152. [PMID: 33489652 DOI: 10.1298/ptr.e10001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 04/04/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Many studies have demonstrated that the loss of muscle mass (LMM) poses a risk of postural instability in the elderly; however, few studies have shown how LMM decreases proprioception. In this study, we investigated the changes in postural sway among older individuals with LMM induced by application of a local vibratory stimulus. METHOD We enrolled 64 older adults (mean age). Postural sway was measured while applying vibration stimuli of 30, 60, and 240 Hz to both the gastrocnemius and lumbar multifidus muscles. We also measured the relative proprioceptive weighting ratio (RPW) of postural sway. The patients were divided into LMM and non-LMM (NLMM) groups. The study subjects were compared in terms of their age, height, weight, body mass index (BMI), lower leg skeletal muscle mass index (LSMI), L4/5 lumbar multifidus cross-sectional area ratio, and RPW at 30, 60, and 240 Hz. RESULTS Subjects in the LMM group showed a significantly lower RPW at 60 Hz, LSMI, and BMI than did those in the NLMM group. CONCLUSIONS Decrease in RPW with 60-Hz stimulation concerning the lower leg proprioception is a risk factor for LMM-associated postural instability in the elderly. Consequently, with respect to the gastrocnemius muscles proprioception in LMM, it is necessary to perform assessments using muscle spindle stimuli.
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Affiliation(s)
- Kazunori Yamazaki
- Faculty of Clinical Engineering, School of Medical Sciences, Fujita Health University
| | - Tadashi Ito
- Three-Dimensional Motion Analysis Room, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities
| | - Yoshihito Sakai
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology
| | - Reiya Nishio
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology
| | - Yohei Ito
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology
| | - Yoshifumi Morita
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology
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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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Ito T, Sakai Y, Ito Y, Yamazaki K, Morita Y. Association Between Back Muscle Strength and Proprioception or Mechanoreceptor Control Strategy in Postural Balance in Elderly Adults with Lumbar Spondylosis. Healthcare (Basel) 2020; 8:healthcare8010058. [PMID: 32164248 PMCID: PMC7151025 DOI: 10.3390/healthcare8010058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/25/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the relationship between back muscle strength and proprioception or mechanoreceptor control strategies used for postural balance in elderly adults with lumbar spondylosis. The displacement of the center of pressure (COP) excursion was determined in 24 elderly adults with lumbar spondylosis and 24 healthy young adults while the participants were standing upright on a balance board with their eyes closed. Vibratory stimulations of 30, 60, and 240 Hz were applied to the gastrocnemius (GS) and lumbar multifidus (LM) muscles to evaluate the effect of different proprioceptive signals on postural control. Back muscle strength was evaluated. Spearman’s rank correlation analysis was performed to determine the relationship between back muscle strength and significant COP excursion. Compared with young adults, elderly adults with lumbar spondylosis showed an increase in COP excursion displacement when a vibratory stimulation of 240 Hz was applied to the GS (P = 0.002) and LM muscles (P < 0.001). LM stimulation at 240 Hz was significantly associated with back muscle strength (P = 0.038). Postural control assessment with 240-Hz mechanoreceptor stimulation of the trunk could be a good indicator of postural instability due to over-dependence on mechanoreceptors and back muscle weakness in elderly adults with lumbar spondylosis.
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Affiliation(s)
- Tadashi Ito
- Three-Dimensional Motion Analysis Room, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki 444-0002, Japan
- Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Japan
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu 474-8501, Japan;
- Correspondence: ; Tel.: +81-564-64-7980
| | - Yoshihito Sakai
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu 474-8501, Japan;
| | - Yohei Ito
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (Y.I.); (Y.M.)
| | - Kazunori Yamazaki
- Faculty of Clinical Engineering, School of Health Sciences, Fujita Health University, Toyoake 470-1192, Japan;
| | - Yoshifumi Morita
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (Y.I.); (Y.M.)
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Bedo BLS, Pereira DR, Moraes R, Kalva-Filho CA, Will-de-Lemos T, Santiago PRP. The rapid recovery of vertical force propulsion production and postural sway after a specific fatigue protocol in female handball athletes. Gait Posture 2020; 77:52-58. [PMID: 31986376 DOI: 10.1016/j.gaitpost.2020.01.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/11/2019] [Accepted: 01/20/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Muscle fatigue is characterized by a decrease in muscle performance, accompanied by an increase in perceived exertion to produce a desired amount of force. The duration of the fatigue effects is not completely clear regarding postural sway and force production in athletes. RESEARCH QUESTION What is the effect of a specific fatigue protocol in postural sway and force production in female handball athletes and the recovery time necessary for these variables? METHODS Twenty female handball athletes participated in this study. Specific handball actions composed the fatigue protocol in the format of a circuit with the gradual increment of laps. They stood upright in one-leg posture on a force plate. For the maximum propulsion force (FMAX), they performed a countermovement jump on the force plate. The center of pressure (COP) and the FMAX were obtained at baseline, immediately after the exhaustion due to the fatigue protocol and every minute during the first 10 min of the recovery phase. RESULTS The FMAX decreased ∼9.5% after the fatigue protocol, whereas de COP area increased 224%. During the recovery phase, the FMAX and the COP area returned to baseline values after five minutes. SIGNIFICANCE The first five minutes immediately after the fatigue protocol represent the time interval where the fatigue effects are still present. Future studies willing to investigate the effects of fatigue in athletes should perform the analysis within this short time-window.
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Affiliation(s)
- Bruno Luiz Souza Bedo
- Biomechanics and Motor Control Laboratory, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Rehabilitation and Functional Performance Graduate Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Dayanne Rodrigues Pereira
- Biomechanics and Motor Control Laboratory, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Renato Moraes
- Biomechanics and Motor Control Laboratory, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Rehabilitation and Functional Performance Graduate Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Carlos Augusto Kalva-Filho
- Rehabilitation and Functional Performance Graduate Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Tenysson Will-de-Lemos
- Biomechanics and Motor Control Laboratory, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Paulo Roberto Pereira Santiago
- Biomechanics and Motor Control Laboratory, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Rehabilitation and Functional Performance Graduate Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Rasouli O, Shanbehzadeh S, Arab AM, ShahAli S, Sarafraz H. The Effect of Respiratory Phase on Abdominal Muscle Activity During Stable and Unstable Sitting Positions in Individuals With and Without Chronic Low Back Pain. J Manipulative Physiol Ther 2020; 43:225-233. [DOI: 10.1016/j.jmpt.2019.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 01/07/2019] [Accepted: 02/25/2019] [Indexed: 11/27/2022]
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Faghy MA, Brown PI. Functional training of the inspiratory muscles improves load carriage performance. ERGONOMICS 2019; 62:1439-1449. [PMID: 31389759 DOI: 10.1080/00140139.2019.1652352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 07/29/2019] [Indexed: 06/10/2023]
Abstract
Inspiratory Muscle Training (IMT) whilst adopting body positions that mimic exercise (functional IMT; IMTF) improves running performance above traditional IMT methods in unloaded exercise. We investigated the effect of IMTF during load carriage tasks. Seventeen males completed 60 min walking at 6.5 km·h-1 followed by a 2.4 km load carriage time-trial (LCTT) whilst wearing a 25 kg backpack. Trials were completed at baseline; post 4 weeks IMT (consisting of 30 breaths twice daily at 50% of maximum inspiratory pressure) and again following either 4 weeks IMTF (comprising four inspiratory loaded core exercises) or maintenance IMT (IMTCON). Baseline LCTT was 15.93 ± 2.30 min and was reduced to 14.73 ± 2.40 min (mean reduction 1.19 ± 0.83 min, p < 0.01) after IMT. Following phase two, LCTT increased in IMTF only (13.59 ± 2.33 min, p < 0.05) and was unchanged in post-IMTCON. Performance was increased following IMTF, providing an additional ergogenic effect beyond IMT alone. Practitioner Summary: We confirmed the ergogenic benefit of Inspiratory Muscle Training (IMT) upon load carriage performance. Furthermore, we demonstrate that functional IMT methods provide a greater performance benefit during exercise with thoracic loads. Abbreviations: [Lac-]B: blood lactate; FEV1: forced expiratory volume in one second; FEV1/FVC: forced expiratory volume in one second/forced vital capacity ratio; FVC: forced vital capacity; HR: heart rate; IMT: inspiratory muscle training; IMTCON: inspiratory muscle training maintenance; IMTF: functional inspiratory muscle training; LC: load carriage; LCTT: load carriage time trial; Pdi: transdiaphragmatic pressure; PEF: peak expiratory flow; PEmax: maximum expiratory mouth pressure; PImax: maximum inspiratory mouth pressure; RPE: rating of perceived exertion; RPEbreating: rating of perceived exertion for the breathing; RPEleg: rating of perceived exertion for the legs; SEPT: sport-specific endurance plank test; V̇ O2: oxygen consumption; V̇ O2peak: peak oxygen consumption.
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Affiliation(s)
- Mark A Faghy
- Human Science Research Centre, University of Derby , Derby , UK
| | - Peter I Brown
- English Institute of Sport, High Performance Centre, Loughborough University , Manchester , United Kingdom of Great Britain and Northern Ireland
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Baltrusch SJ, van Dieën JH, Bruijn SM, Koopman AS, van Bennekom CAM, Houdijk H. The effect of a passive trunk exoskeleton on metabolic costs during lifting and walking. ERGONOMICS 2019; 62:903-916. [PMID: 30929608 DOI: 10.1080/00140139.2019.1602288] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
The objective of this study was to assess how wearing a passive trunk exoskeleton affects metabolic costs, movement strategy and muscle activation during repetitive lifting and walking. We measured energy expenditure, kinematics and muscle activity in 11 healthy men during 5 min of repetitive lifting and 5 min of walking with and without exoskeleton. Wearing the exoskeleton during lifting, metabolic costs decreased as much as 17%. In conjunction, participants tended to move through a smaller range of motion, reducing mechanical work generation. Walking with the exoskeleton, metabolic costs increased up to 17%. Participants walked somewhat slower with shortened steps while abdominal muscle activity slightly increased when wearing the exoskeleton. Wearing an exoskeleton during lifting decreased metabolic costs and hence may reduce the development of fatigue and low back pain risk. During walking metabolic costs increased, stressing the need for a device that allows disengagement of support depending on activities performed. Practitioner summary: Physiological strain is an important risk factor for low back pain. We observed that an exoskeleton reduced metabolic costs during lifting, but had an opposite effect while walking. Therefore, exoskeletons may be of benefit for lifting by decreasing physiological strain but should allow disengagement of support when switching between tasks. Abbreviations: COM: centre of mass; EMG: electromyography; LBP: low back pain; MVC: maximum voluntary isometric contraction; NIOSH: National Institute for Occupational Safety and Health; PLAD: personal lift augmentation device; PWS: preferred walking speed without exoskeleton; PWSX: preferred walking speed with exoskeleton; ROM: range of motion; RER: respiratory exchange ratio; V ̇O2max: maximum rate of oxygen consumption.
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Affiliation(s)
- S J Baltrusch
- a Department of Research and Development , Rehabilitation Center Heliomare , Wijk aan Zee , The Netherlands
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - J H van Dieën
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - S M Bruijn
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - A S Koopman
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - C A M van Bennekom
- a Department of Research and Development , Rehabilitation Center Heliomare , Wijk aan Zee , The Netherlands
| | - H Houdijk
- a Department of Research and Development , Rehabilitation Center Heliomare , Wijk aan Zee , The Netherlands
- b Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences , Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
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Rojhani-Shirazi Z, Amiri Z, Ebrahimi S. Effects of Plantar Flexor Muscles Fatigue on Postural Control during Quiet Stance and External Perturbation in Healthy Subjects. J Biomed Phys Eng 2019; 9:233-242. [PMID: 31214529 PMCID: PMC6538917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/17/2017] [Indexed: 06/09/2023]
Abstract
BACKGROUND The maintenance of postural control is a key component in dynamic physical activity, especially during muscle fatigue and against external forces. Despite many studies in this field, there is no consensus regarding the effects of plantar flexor muscles fatigue on postural control during different postural tasks. OBJECTIVE To evaluate the effects of plantar flexor muscles fatigue on postural control during quiet stance and external perturbation in healthy subjects. MATERIAL AND METHODS Twenty four healthy individuals (20-35 years) participated this interventional study. The foot center of pressure data was measured using a single force platform, and then the postural control parameters, including the center of pressure displacement and velocity in the anterior-posterior and medial-lateral direction and also path length calculated under two conditions; quiet and perturbed stance, before and after plantar flexor muscles fatigue. RESULTS The statistical analysis demonstrated that mean displacement and velocity of the center of pressure in the anterior-posterior direction and also path length increased after the fatigue protocol in the perturbed condition. However, fatigue had no significant effects on postural control parameters in the quiet standing condition. CONCLUSION These results indicated that the effects of muscle fatigue on postural control depend on the difficulty of the task and the relevance of proprioceptive information. The postural control system appears to use distinct control strategies in different situations such as quiet and perturbed stance conditions, and these strategies may be differentially altered by fatigue. In conclusion, due to the potential risk of loss of balance, it is important to take the role of plantar flexor muscle fatigue into account during more difficult postural tasks.
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Affiliation(s)
- Z Rojhani-Shirazi
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Z Amiri
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Ebrahimi
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Van Hove O, Van Muylem A, Leduc D, Jansen B, Feipel V, Van Sint Jan S, Bonnechère B. Validation of the Wii Balance Board to assess balance modifications induced by increased respiratory loads in healthy subjects. Gait Posture 2019; 68:449-452. [PMID: 30597447 DOI: 10.1016/j.gaitpost.2018.12.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/18/2018] [Accepted: 12/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is a link between breathing and balance and posture. When the inspiratory loads are increased by pathologies, there is a decrease of postural control. The increase of the inspiratory load on respiratory muscles is a common feature in various chronic pulmonary pathologies. Consequently, the balance of those patients is likely affected. RESEARCH QUESTION The aim of this study is to validate the use of the Nintendo Wii Balance Board (WBB) to assess balance modifications induced by increased respiratory loads in healthy subjects. METHODS Thirty-seven healthy young participants (25 ± 4 years old, 17 women) participated in this study. Five different conditions were tested: without anything (control), throughout a mouthpiece, and throughout three inspiratory threshold loads (ITL) at 10% (low), 40% (mid) and 60% (high) of the maximal inspiratory pressure. Each trial lasted for 60 s. Nine parameters were extracted based on center of pressure displacement based on a previously-validated method. ANOVA tests were used to compare the different conditions followed by Bonferroni's corrections. RESULTS Highly statistically significant differences (all p < 0.01) and large effect sizes (all ω2 > 0.24) were obtained for all parameters between the different loads and the mouthpiece condition. There is a linear relationship between the load and balance perturbation. SIGNIFICANCE In this study, we demonstrated the validity of the WBB to detect the effect of the inspiratory load on balance in young healthy subjects. Further studies are needed to determine if such a kind of evaluation can be used in clinics with patients suffering from chronic respiratory disease.
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Affiliation(s)
- O Van Hove
- Chest and Thoracic Surgery Department, Erasme Hospital, Brussels, Belgium
| | - A Van Muylem
- Chest and Thoracic Surgery Department, Erasme Hospital, Brussels, Belgium
| | - D Leduc
- Chest and Thoracic Surgery Department, Erasme Hospital, Brussels, Belgium
| | - B Jansen
- Department of Electronics and Informatics - ETRO, Vrije Universiteit Brussel, Brussels, Belgium; imec, Leuven, Belgium
| | - V Feipel
- Laboratory of Functional Anatomy, Université Libre de Bruxelles, Brussels, Belgium
| | - S Van Sint Jan
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, Brussels, Belgium
| | - B Bonnechère
- Department of Electronics and Informatics - ETRO, Vrije Universiteit Brussel, Brussels, Belgium; imec, Leuven, Belgium; Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, Brussels, Belgium.
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Hernandez L, Manning J, Zhang S. Voluntary control of breathing affects center of pressure complexity during static standing in healthy older adults. Gait Posture 2019; 68:488-493. [PMID: 30616178 DOI: 10.1016/j.gaitpost.2018.12.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 12/17/2018] [Accepted: 12/25/2018] [Indexed: 02/02/2023]
Abstract
Background Physiological/biomechanical systems display high degrees of complexity in their corresponding physiological and/or biomechanical outputs, indicative of normal healthy physiological functioning, though little attention has been paid to potential mechanisms which may affect complexity. Center of pressure (CoP) dynamics also display high degrees of complexity and may be affected via altered respiratory-motor interactions such as during voluntary control of breathing. Purpose The purpose of this study was to investigate the differences in the complexity of CoP dynamics during autonomous vs. voluntary control of breathing and between different voluntarily controlled breathing conditions. Methods Center of pressure recordings were taken from 18 older adults during static standing under three different breathing conditions: 1) neutral breathing, 2) abdominal breathing, and 3) thoracic breathing, the first constituting the autonomous breathing condition and the latter two constituting voluntarily controlled breathing conditions. CoP dynamics were quantified using sample entropy, standard deviation, 95% sway area, and average radial velocity. Repeated measure MANOVAs were used to assess the effect of breathing on CoP dynamics, with top-down application of ANOVAs and pairwise comparison as needed. Results Voluntary control of breathing during both conditions resulted in significantly higher CoP variability and lower sample entropy than during autonomous control of breathing in the mediolateral direction, indicating less complex dynamics and loss of system control. No significant differences between voluntary breathing conditions were observed. Conclusion Voluntary control of breathing significantly affected on CoP dynamics during static standing. The complexity of the postural control system may be affected via alterations in respiratory-motor interactions.
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Affiliation(s)
| | | | - Shuqi Zhang
- Northern Illinois University, United States.
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January Special Issues! Cardiopulm Phys Ther J 2019. [DOI: 10.1097/cpt.0000000000000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Proprioceptive Weighting Ratio for Balance Control in Static Standing Is Reduced in Elderly Patients With Non-Specific Low Back Pain. Spine (Phila Pa 1976) 2018; 43:1704-1709. [PMID: 30059489 DOI: 10.1097/brs.0000000000002817] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
UNLABELLED MINI: Elderly patients older than 65 years were divided into non-specific low back pain (NSLBP) and non-LBP (NLBP) groups. The postural control study of the relative contributions of different proprioceptive signals (relative proprioceptive weighting ratio [RPW]) revealed lower leg proprioceptive decreases (RPW 240 Hz) in NSLBP compared to NLBP. STUDY DESIGN A cross-sectional, observational study. OBJECTIVE The aim of this study was to determine a specific proprioceptive control strategy during postural balance in elderly patients with non-specific low back pain (NSLBP) and non-LBP (NLBP). SUMMARY OF BACKGROUND DATA Proprioceptive decline is an important risk factor for decreased balance control in elderly patients with NSLBP. The resulting reduction in proprioception in the trunk or lower legs may contribute to a reduction in postural sway. This study aims to determine the specific proprioceptive control strategy used during postural balance in elderly patients with NSLBP and NLBP and to assess whether this strategy is related to proprioceptive decline in NSLBP. METHODS Pressure displacement centers were determined in 28 elderly patients with NSLBP and 46 elderly patients with NLBP during upright stances on a balance board without the benefit of vision. Gastrocnemius and lumbar multifidus muscle vibratory stimulations at 30, 60, and 240 Hz, respectively, were applied to evaluate the relative contributions of the different proprioceptive signals (relative proprioceptive weighting ratio, RPW) used in postural control. RESULTS Compared to elderly patients with NLBP, those with NSLBP had a lower RPW at 240 Hz and significantly higher RPW at 30 Hz. A logistic regression analysis showed that RPW at 240 Hz was independently associated with NSLBP after controlling for confounding factors. CONCLUSION Elderly patients with NSLBP decreased their reliance on ankle strategy (RPW at 240 Hz) and hip strategy (RPW at 30 Hz) proprioceptive signals during balance control. The inability to control hip and ankle strategies indicates a deficit of postural control and is hypothesized to result from proprioceptive impairment. Moreover, elderly patients with NSLBP are at higher risk for lower leg proprioceptive decrease (240 Hz) through the NSLBP exacerbation. LEVEL OF EVIDENCE 4.
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Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial. Arch Phys Med Rehabil 2018; 99:1720-1729. [PMID: 29787734 DOI: 10.1016/j.apmr.2018.04.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/18/2018] [Accepted: 04/21/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of an osteopathic manipulative treatment (OMT), which includes a diaphragm intervention compared to the same OMT with a sham diaphragm intervention in chronic nonspecific low back pain (NS-CLBP). DESIGN Parallel group randomized controlled trial. SETTING Private and institutional health centers. PARTICIPANTS Participants (N=66) (18-60y) with a diagnosis of NS-CLBP lasting at least 3 months. INTERVENTIONS Participants were randomized to receive either an OMT protocol including specific diaphragm techniques (n=33) or the same OMT protocol with a sham diaphragm intervention (n=33), conducted in 5 sessions provided during 4 weeks. MAIN OUTCOME MEASURES The primary outcomes were pain (evaluated with the Short-Form McGill Pain Questionnaire [SF-MPQ] and the visual analog scale [VAS]) and disability (assessed with the Roland-Morris Questionnaire [RMQ] and the Oswestry Disability Index [ODI]). Secondary outcomes were fear-avoidance beliefs, level of anxiety and depression, and pain catastrophization. All outcome measures were evaluated at baseline, at week 4, and at week 12. RESULTS A statistically significant reduction was observed in the experimental group compared to the sham group in all variables assessed at week 4 and at week 12 (SF-MPQ [mean difference -6.2; 95% confidence interval, -8.6 to -3.8]; VAS [mean difference -2.7; 95% confidence interval, -3.6 to -1.8]; RMQ [mean difference -3.8; 95% confidence interval, -5.4 to -2.2]; ODI [mean difference -10.6; 95% confidence interval, -14.9 to 6.3]). Moreover, improvements in pain and disability were clinically relevant. CONCLUSIONS An OMT protocol that includes diaphragm techniques produces significant and clinically relevant improvements in pain and disability in patients with NS-CLBP compared to the same OMT protocol using sham diaphragm techniques.
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Lee AL, Goldstein RS, Chan C, Rhim M, Zabjek K, Brooks D. Postural deviations in individuals with chronic obstructive pulmonary disease (COPD). CANADIAN JOURNAL OF RESPIRATORY, CRITICAL CARE, AND SLEEP MEDICINE 2018. [DOI: 10.1080/24745332.2017.1409091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Annemarie L. Lee
- Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada
- Department of Physical Therapy, Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Australia
| | - Roger S. Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada
- Department of Physical Therapy, Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christen Chan
- Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada
| | - Matthew Rhim
- Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada
| | - Karl Zabjek
- Department of Physical Therapy, Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada
- Department of Physical Therapy, Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada
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Mohan V, Paungmali A, Sitilerpisan P, Hashim UF, Mazlan MB, Nasuha TN. Respiratory characteristics of individuals with non-specific low back pain: A cross-sectional study. Nurs Health Sci 2018; 20:224-230. [PMID: 29421851 DOI: 10.1111/nhs.12406] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/17/2017] [Accepted: 11/29/2017] [Indexed: 11/27/2022]
Abstract
Non-specific low back pain (NS-LBP) is known to cause respiratory dysfunction. In this study, we investigated alterations in breathing, respiratory strength and endurance, core stability, diaphragm mobility, and chest expansion among patients with NS-LBP and healthy individuals. The specific aim of the study was to correlate between respiratory function and other variables among NS-LBP patients. Thirty four patients with NS-LBP were matched with 34 healthy participants before undergoing total faulty breathing scale, spirometer, respiratory pressure meter, chest expansion, ultrasound, and pressure biofeedback measurements. There were signs of faulty breathing in the NS-LBP patients when compared to the healthy participants. Diaphragmatic mobility and respiratory muscle endurance were lower in the NS-LBP group. Chest expansion exhibited a significant decrease at the level of the fourth intercostal space in the NS-LBP group, but respiratory muscle strength and core stability were not significant between the two groups. Positive correlations were found to be fairly significant regarding respiratory muscle strength. The findings of this study indicated altered respiratory characteristics in the NS-LBP patients, and suggested that they would improve through respiratory exercises.
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Affiliation(s)
- Vikram Mohan
- Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand.,Centre of Physiotherapy, Universiti Teknologi MARA Selangor, Bandar Puncak Alam, Puncak Alam, Malaysia
| | - Aatit Paungmali
- Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand
| | | | - Ummi F Hashim
- Centre of Medical Imaging, Universiti Teknologi MARA Selangor, Bandar Puncak Alam, Puncak Alam, Malaysia
| | - Munifa B Mazlan
- Centre of Physiotherapy, Universiti Teknologi MARA Selangor, Bandar Puncak Alam, Puncak Alam, Malaysia
| | - Tuan N Nasuha
- Centre of Physiotherapy, Universiti Teknologi MARA Selangor, Bandar Puncak Alam, Puncak Alam, Malaysia
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Ito T, Sakai Y, Yamazaki K, Igarashi K, Sato N, Yokoyama K, Morita Y. Proprioceptive change impairs balance control in older patients with low back pain. J Phys Ther Sci 2017; 29:1788-1792. [PMID: 29184289 PMCID: PMC5684010 DOI: 10.1589/jpts.29.1788] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 07/07/2017] [Indexed: 02/04/2023] Open
Abstract
[Purpose] This study aims to determine the specific proprioceptive control strategy used
during postural balance in older patients with low back pain (LBP) and non-LBP (NLBP) and
to assess whether this strategy is related to proprioceptive decline and LBP. [Subjects
and Methods] Pressure displacement center was determined in 47 older persons with LBP and
64 older persons with NLBP during upright stance on a balance board without vision.
Gastrocnemius (GS) and lumbar multifidus muscle (LM) vibratory stimulations of 60 and
240-Hz, respectively, were applied to evaluate the relative contributions of different
proprioceptive signals (relative proprioceptive weighting ratio, RPW) used in postural
control. Age, height, weight, back muscle strength, L1/2 and L4/5 lumbar multifidus cross
section area ratio, skeletal muscle mass index, sagittal vertical axis, and Roland-Morris
disability questionnaire (RDQ) were evaluated. [Results] Compared with older patients with
NLBP, those with LBP showed a lower RPW 240-Hz, lower L4/5 lumbar multifidus
cross-sectional area ratio, and a significantly higher age and RDQ. Logistic regression
analysis showed that RPW 240-Hz and age were independently associated with LBP, after
controlling for confounding factors. [Conclusion] Older patients with LBP decreased their
reliance on GS (RPW 240-Hz) proprioceptive signals during balance control.
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Affiliation(s)
- Tadashi Ito
- Three-dimensional Motion Analysis Room, Aichi Prefecture Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities: 9-3 Koyaba, Kouryuji-cho, Okazaki-shi, Aichi 444-0002, Japan.,National Center for Geriatrics and Gerontology, Japan.,Nagoya City University School of Design & Architecture, Japan
| | | | - Kazunori Yamazaki
- Faculty of Clinical Engineering, School of Health Sciences, Fujita Health University, Japan
| | | | | | - Kiyoko Yokoyama
- Nagoya City University School of Design & Architecture, Japan
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Wong ML, Anderson RG, Garcia K, Housmann EM, McHale E, Goldberger GS, Cahalin LP. The effect of inspiratory muscle training on respiratory variables in a patient with ankylosing spondylitis: A case report. Physiother Theory Pract 2017; 33:805-814. [PMID: 28715240 DOI: 10.1080/09593985.2017.1346023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Ankylosing Spondylitis (AS) presents with both musculoskeletal and cardiorespiratory pathophysiological manifestations. Inspiratory muscle training (IMT) may be a useful intervention to address deficits in respiratory and functional status. CASE DESCRIPTION A 25-year-old male with AS initially sought treatment for low back and right hip pain, but 7 weeks of IMT was also provided due to abnormal respiratory performance. OUTCOMES At baseline, the patient presented with a resting respiratory rate (RR) of 14.5 breaths/minute, tidal volume (TV) of 0.76 L, minute ventilation (VE) of 10.87 L/min, and end tidal CO2 (PetCO2) of 30.56 mmHg. Baseline exercise test results revealed a VO2max of 44 ml/kg/min and VE to CO2 output (VE/VCO2) slope of 30. Baseline MIP, SMIP, and MEP were 54 cm H2O, 507 PTU, and 87 cm H2O, respectively, and increased to 176 cm H2O, 807 PTU, and 151 cm H2O, respectively, after IMT. The VO2max increased to 51 ml/kg/min with decreases in the VE/VCO2 slope (29), resting RR (12 breaths/minute), resting TV (0.52 L), and resting VE (6.83 L/min) after IMT. Improvements during postural challenges were also observed. DISCUSSION This case demonstrates the clinical utility of respiratory gas analysis and respiratory performance measures to identify functional deficits and manage a patient with AS. The improvements in respiratory performance at rest, during postural challenges, and during maximal exercise after a relatively short period of IMT highlights the role IMT may have to improve functional status in patients with AS. Further investigation of IMT in patients with AS is warranted.
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Affiliation(s)
- Marlon L Wong
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Rachael G Anderson
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Kelsey Garcia
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Elissa M Housmann
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Erin McHale
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Gregory S Goldberger
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Lawrence P Cahalin
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
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Lee AL, Goldstein RS, Brooks D. Chronic Pain in People With Chronic Obstructive Pulmonary Disease: Prevalence, Clinical and Psychological Implications. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2017; 4:194-203. [PMID: 28848931 PMCID: PMC5556911 DOI: 10.15326/jcopdf.4.3.2016.0172] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2016] [Indexed: 01/22/2023]
Abstract
Background: Although pain is a common symptom in chronic obstructive pulmonary disease (COPD), pain characteristics such as frequency, duration and type are unclear. The primary study aim was to identify these pain characteristics in individuals with COPD versus healthy control participants. The secondary aim was to explore the clinical and psychological associations with pain in those with COPD. Methods: Participants with COPD and age and gender-matched, healthy controls completed questionnaires to elicit pain characteristics. Those with COPD also had assessments of dyspnea, health-related quality of life, psychological associations (anxiety and depression) and physical activity. Results: Sixty-four participants with COPD (mean [standard deviation (SD)] age 71[10] , forced expiratory volume in 1 second [FEV1] 38% predicted) and 64 control participants (mean [SD] age 67 [13] , FEV1 91% predicted) were included. Chronic pain was more prevalent in individuals with COPD compared to control participants (41% versus 29%, p=0.03). The pain was more prevalent in the chest and upper back (p=0.04). COPD participants with chest or upper back pain had a higher total lung capacity (mean difference 2.0L, 95% confidence interval [CI] 0.6 to 3.0L) compared to COPD participants without pain. Greater dyspnea (p<0.001), more depression (p=0.02) and lower physical activity levels (p=0.03) were also present in people with COPD experiencing pain. Conclusions: Chronic pain is common in COPD. It is associated with higher dyspnea and depression and lower physical activity.
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Affiliation(s)
- Annemarie L. Lee
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Ontario, Canada
| | - Roger S. Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Ontario, Canada
| | - Dina Brooks
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Ontario, Canada
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Tong TK, McConnell AK, Lin H, Nie J, Zhang H, Wang J. "Functional" Inspiratory and Core Muscle Training Enhances Running Performance and Economy. J Strength Cond Res 2016; 30:2942-51. [PMID: 25162653 DOI: 10.1519/jsc.0000000000000656] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Tong, TK, McConnell, AK, Lin, H, Nie, J, Zhang, H, and Wang, J. "Functional" inspiratory and core muscle training enhances running performance and economy. J Strength Cond Res 30(10): 2942-2951, 2016-We compared the effects of two 6-week high-intensity interval training interventions. Under the control condition (CON), only interval training was undertaken, whereas under the intervention condition (ICT), interval training sessions were followed immediately by core training, which was combined with simultaneous inspiratory muscle training (IMT)-"functional" IMT. Sixteen recreational runners were allocated to either ICT or CON groups. Before the intervention phase, both groups undertook a 4-week program of "foundation" IMT to control for the known ergogenic effect of IMT (30 inspiratory efforts at 50% maximal static inspiratory pressure [P0] per set, 2 sets per day, 6 days per week). The subsequent 6-week interval running training phase consisted of 3-4 sessions per week. In addition, the ICT group undertook 4 inspiratory-loaded core exercises (10 repetitions per set, 2 sets per day, inspiratory load set at 50% post-IMT P0) immediately after each interval training session. The CON group received neither core training nor functional IMT. After the intervention phase, global inspiratory and core muscle functions increased in both groups (p ≤ 0.05), as evidenced by P0 and a sport-specific endurance plank test (SEPT) performance, respectively. Compared with CON, the ICT group showed larger improvements in SEPT, running economy at the speed of the onset of blood lactate accumulation, and 1-hour running performance (3.04% vs. 1.57%, p ≤ 0.05). The changes in these variables were interindividually correlated (r ≥ 0.57, n = 16, p ≤ 0.05). Such findings suggest that the addition of inspiratory-loaded core conditioning into a high-intensity interval training program augments the influence of the interval program on endurance running performance and that this may be underpinned by an improvement in running economy.
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Affiliation(s)
- Tomas K Tong
- 1Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Department of Physical Education, Hong Kong Baptist University, Hong Kong, China; 2Centre for Sports Medicine & Human Performance, Brunel University, Uxbridge, United Kingdom; 3Department of Physical Education, Liaoning Normal University, Dalian, China; 4School of Physical Education and Sports, Macao Polytechnic Institute, Macao, China; and 5Physical Education College, Hebei Normal University, Shijiazhuang, China
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The presence of respiratory disorders in individuals with low back pain: A systematic review. ACTA ACUST UNITED AC 2016; 26:77-86. [PMID: 27501326 DOI: 10.1016/j.math.2016.07.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/14/2016] [Accepted: 07/16/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Inspiratory muscles, such as the diaphragm, play a key role in both respiration and spinal control. Therefore, diaphragm dysfunctions are often related to low back pain (LBP). However, few is known on the association between the presence of LBP and the presence of respiratory disorders (RD). OBJECTIVES To perform a systematic review on the relation between RD and LBP. STUDY DESIGN Systematic review. METHODS Two reviewers searched on PubMed/MEDLINE for studies concerning LBP and RD, from 1950 up to January 2016. The search string consisted of the following key words: low back pain, dyspnea, respiratory problems, lung diseases, comorbidity, pulmonary disease, chronic obstructive, smoking, asthma, allergy, sinusitis, respiratory tract infection and hyperventilation. The aim was to evaluate a potential correlation, co-occurrence or causality between RD and LBP. RESULTS A total of 16 articles were included. A significant correlation between the presence of LBP and the presence of RD such as dyspnea, asthma, different forms of allergy, and respiratory infections was found. No correlation was found between Chronic Obstructive Pulmonary Disease (COPD) and LBP, and no articles were found on the correlation between hyperventilation and LBP. CONCLUSIONS This is the first study providing an overview of the literature on the relation between LBP and RD. Immunological, biomechanical, psychosocial and socio-economic factors might explain this correlation. Smoking is likely to contribute. Future studies must reveal the causative relationship. LEVEL OF EVIDENCE Therapy, level 2a.
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Goossens N, Janssens L, Pijnenburg M, Caeyenberghs K, Van Rompuy C, Meugens P, Sunaert S, Brumagne S. Test–Retest Reliability and Concurrent Validity of an fMRI-Compatible Pneumatic Vibrator to Stimulate Muscle Proprioceptors. Multisens Res 2016; 29:465-92. [DOI: 10.1163/22134808-00002526] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Processing proprioceptive information in the brain is essential for optimal postural control and can be studied with proprioceptive stimulation, provided by muscle vibration, during functional magnetic resonance imaging (fMRI). Classic electromagnetic muscle vibrators, however, cannot be used in the high-strength magnetic field of the fMRI scanner. Pneumatic vibrators offer an fMRI-compatible alternative. However, whether these devices produce reliable and valid proprioceptive stimuli has not been investigated, although this is essential for these devices to be used in longitudinal research. Test–retest reliability and concurrent validity of the postural response to muscle vibration, provided by custom-made fMRI-compatible pneumatic vibrators, were assessed in a repeated-measures design. Mean center of pressure (CoP) displacements during, respectively, ankle muscle and back muscle vibration (45–60 Hz, 0.5 mm) provided by an electromagnetic and a pneumatic vibrator were measured in ten young healthy subjects. The test was repeated on the same day and again within one week. Intraclass correlation coefficients (ICC) were calculated to assess (a) intra- and interday reliability of the postural responses to, respectively, pneumatic and electromagnetic vibration, and (b) concurrent validity of the response to pneumatic compared to electromagnetic vibration. Test–retest reliability of mean CoP displacements during pneumatic vibration was good to excellent (ICCs = 0.64–0.90) and resembled that of responses to electromagnetic vibration (ICCs = 0.64–0.94). Concurrent validity of the postural effect of pneumatic vibration was good to excellent (ICCs = 0.63–0.95). In conclusion, the proposed fMRI-compatible pneumatic vibrator can be used with confidence to stimulate muscle spindles during fMRI to study central processing of proprioception.
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Affiliation(s)
- Nina Goossens
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
| | - Lotte Janssens
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
- Biomedical Research Institute, Hasselt University, Agoralaan A, 3590 Diepenbeek, Belgium
| | - Madelon Pijnenburg
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
| | - Karen Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne Campus (St Patrick), Locked Bag 4115, Fitzroy MDC, VIC 3065, Australia
| | - Charlotte Van Rompuy
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
| | - Paul Meugens
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging & Pathology, KU Leuven — University of Leuven, UZ Herestraat 49, Box 7003, 3000 Leuven, Belgium
| | - Simon Brumagne
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven — University of Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium
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Franklin SH, Allen KJ. Assessment of dynamic upper respiratory tract function in the equine athlete. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12432] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. H. Franklin
- School of Animal and Veterinary Sciences; University of Adelaide; Roseworthy Australia
| | - K. J. Allen
- Equine Sports Medicine Centre; University of Bristol; UK
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Ito T, Sakai Y, Nakamura E, Yamazaki K, Yamada A, Sato N, Morita Y. Relationship between paraspinal muscle cross-sectional area and relative proprioceptive weighting ratio of older persons with lumbar spondylosis. J Phys Ther Sci 2015; 27:2247-51. [PMID: 26311962 PMCID: PMC4540857 DOI: 10.1589/jpts.27.2247] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 04/13/2015] [Indexed: 01/27/2023] Open
Abstract
[Purpose] The purpose of this study was to examine the relationship between the
paraspinal muscle cross-sectional area and the relative proprioceptive weighting ratio
during local vibratory stimulation of older persons with lumbar spondylosis in an upright
position. [Subjects] In all, 74 older persons hospitalized for lumbar spondylosis were
included. [Methods] We measured the relative proprioceptive weighting ratio of postural
sway using a Wii board while vibratory stimulations of 30, 60, or 240 Hz were applied to
the subjects’ paraspinal or gastrocnemius muscles. Back strength, abdominal muscle
strength, and erector spinae muscle (L1/L2, L4/L5) and lumbar multifidus (L1/L2, L4/L5)
cross-sectional areas were evaluated. [Results] The erector spinae muscle (L1/L2)
cross-sectional area was associated with the relative proprioceptive weighting ratio
during 60Hz stimulation. [Conclusion] These findings show that the relative proprioceptive
weighting ratio compared to the erector spinae muscle (L1/L2) cross-sectional area under
60Hz proprioceptive stimulation might be a good indicator of trunk proprioceptive
sensitivity.
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Affiliation(s)
- Tadashi Ito
- Division of Physical Therapy, Department of Health Science, Graduate School of International University of Health and Welfare, Japan ; National Center for Geriatrics and Gerontology, Japan
| | | | | | - Kazunori Yamazaki
- Faculty of Clinical Engineering, School of Health Sciences, Fujita Health University, Japan
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Pijnenburg M, Caeyenberghs K, Janssens L, Goossens N, Swinnen SP, Sunaert S, Brumagne S. Microstructural integrity of the superior cerebellar peduncle is associated with an impaired proprioceptive weighting capacity in individuals with non-specific low back pain. PLoS One 2014; 9:e100666. [PMID: 24949796 PMCID: PMC4065054 DOI: 10.1371/journal.pone.0100666] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/27/2014] [Indexed: 12/13/2022] Open
Abstract
Introduction Postural control is a complex sensorimotor task that requires an intact network of white matter connections. The ability to weight proprioceptive signals is crucial for postural control. However, research into central processing of proprioceptive signals for postural control is lacking. This is specifically of interest in individuals with non-specific low back pain (NSLBP), because impairments in postural control have been observed as possible underlying mechanisms of NSLBP. Therefore, the objective was to investigate potential differences in sensorimotor white matter microstructure between individuals with NSLBP and healthy controls, and to determine whether the alterations in individuals with NSLBP are associated with the capacity to weight proprioceptive signals for postural control. Methods The contribution of proprioceptive signals from the ankle and back muscles to postural control was evaluated by local muscle vibration in 18 individuals with NSLBP and 18 healthy controls. Center of pressure displacement in response to muscle vibration was determined during upright standing on a stable and unstable support surface. Diffusion magnetic resonance imaging was applied to examine whether this proprioceptive contribution was associated with sensorimotor white matter microstructure. Results Individuals with NSLBP showed a trend towards a reduced fractional anisotropy along the left superior cerebellar peduncle compared to healthy controls (p = 0.039). The impaired microstructural integrity of the superior cerebellar peduncle in individuals with NSLBP was significantly correlated with the response to ankle muscle vibration (p<0.003). Conclusions In individuals with NSLBP, a decreased integrity of the superior cerebellar peduncle was associated with an increased reliance on ankle muscle proprioception, even on unstable support surface, which implies an impaired proprioceptive weighting capacity. Our findings emphasize the importance of the superior cerebellar peduncle in proprioceptive weighting for postural control in individuals with NSLBP.
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Affiliation(s)
- Madelon Pijnenburg
- KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
- * E-mail:
| | - Karen Caeyenberghs
- Department of Physical Therapy and Motor Rehabilitation, University of Ghent, Ghent, Belgium
- Department of Movement and Sports Sciences, University of Ghent, Ghent, Belgium
| | - Lotte Janssens
- KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
| | - Nina Goossens
- KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
| | - Stephan P. Swinnen
- KU Leuven Department of Kinesiology, University of Leuven, Leuven, Belgium
| | - Stefan Sunaert
- KU Leuven Department of Imaging and Pathology, University of Leuven, Leuven, Belgium
| | - Simon Brumagne
- KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
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Coenen P, Kingma I, Boot CRL, Bongers PM, van Dieën JH. Cumulative mechanical low-back load at work is a determinant of low-back pain. Occup Environ Med 2014; 71:332-7. [PMID: 24676271 DOI: 10.1136/oemed-2013-101862] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Reported associations of physical exposures during work (eg, lifting, trunk flexion or rotation) and low-back pain (LBP) are rather inconsistent. Mechanical back loads (eg, moments on the low back) as a result of exposure to abovementioned risk factors have been suggested to be important as such loads provide a more direct relationship with tissue failure and thus LBP. Since information on the effect of such load metrics with LBP is lacking yet, we aimed to assess this effect in a prospective study. METHODS Of 1131 workers, categorised into 19 groups, LBP was prospectively assessed over 3 years. Video and hand force recordings of 4-5 workers per group (93 in total) were used to estimate mechanical low-back loads (peak load and three cumulative load metrics, ie, linear weighted load, squared weighted load and load weighted to the tenth power) during manual materials handling (MMH) tasks using a video analysis method. These data were combined with static mechanical load estimates based on structured observation of non-MMH tasks. Associations of mechanical loads and LBP were tested using generalised estimating equations. RESULTS Significant effects on LBP were found for cumulative low-back moments (linear and squared weighted; both p<0.01 and ORs of 3.01 and 3.50, respectively) but not for peak and cumulative moments weighted to the tenth power. CONCLUSIONS Results of this first prospective study on the effect of mechanical low-back load on LBP support a LBP aetiology model of cumulative loads, potentially due to accumulation of microdamage or fatigue. Therefore, prevention of LBP should focus on reducing cumulative low-back loads, especially in highly exposed occupational groups, for example, by reducing handling of heavy loads and working in awkward body postures.
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Affiliation(s)
- Pieter Coenen
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
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Faghy MA, Brown PI. Thoracic load carriage-induced respiratory muscle fatigue. Eur J Appl Physiol 2014; 114:1085-93. [DOI: 10.1007/s00421-014-2839-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 01/27/2014] [Indexed: 10/25/2022]
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50
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Janssens L, Pijnenburg M, Claeys K, McConnell AK, Troosters T, Brumagne S. Postural strategy and back muscle oxygenation during inspiratory muscle loading. Med Sci Sports Exerc 2014; 45:1355-62. [PMID: 23470314 DOI: 10.1249/mss.0b013e3182853d27] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Most healthy individuals show a multisegmental control strategy during challenging standing conditions, whereas others show a rigid ankle-steered strategy, which is assumed as suboptimal. Respiratory-demanding tasks exert a perturbing effect on balance, although the underlying mechanisms remain poorly understood. The purpose of this study was to investigate whether inspiratory resistive loading (IRL) affects postural strategy, back muscle oxygenation, and blood volume during postural control. METHODS We assessed the acute effects of increased respiratory effort by measuring the center of pressure displacement in 12 healthy individuals during upright standing on an unstable support surface while breathing against an IRL. Simultaneous ankle and back muscle vibration was used to evaluate the proprioceptive strategy (multisegmental vs ankle-steered) during postural control. Back muscles oxygenation and blood volume were assessed using near-infrared spectroscopy (tissue oxygenation index, deoxyhemoglobin, oxyhemoglobin, and combined hemoglobin). RESULTS An increased proprioceptive gain at the ankles and an decreased gain at the back were observed after approximately 7 min of IRL. Retrospectively, the group was subdivided on the basis of the participants' dominant proprioceptive use during a baseline postural control. During IRL, the ankle-steered group showed an increased reliance on ankle proprioception compared with a multisegmental group (-5.9 ± 3.1 and 1.0 ± 1.9 cm, respectively, P < 0.05). Tissue oxygenation index, deoxyhemoglobin, oxyhemoglobin, and combined hemoglobin declined progressively in the ankle-steered group during the IRL (from baseline (100%) to -1%, -1%, -45%, and -18%, respectively, P < 0.05), whereas no decline was found in the multisegmental group (from baseline (100%) to 134%, 82%, 129%, and 153%, respectively, P > 0.05). CONCLUSION Individuals who adopted an ankle-steered strategy during IRL showed a progressive decline in back muscle oxygenation and blood volume. In contrast, IRL did not affect back muscle oxygenation and blood volume in individuals who showed a multisegmental strategy in upright standing.
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Affiliation(s)
- Lotte Janssens
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.
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