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Kehl C, Suter M, Johannesdottir E, Dörig M, Bangerter C, Meier ML, Schmid S. Associations between pain-related fear and lumbar movement variability during activities of daily living in patients with chronic low back pain and healthy controls. Sci Rep 2024; 14:22889. [PMID: 39358482 PMCID: PMC11447241 DOI: 10.1038/s41598-024-73430-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 09/17/2024] [Indexed: 10/04/2024] Open
Abstract
Low back pain (LBP) is a global issue involving biological, psychological, and social factors. Pain-related fear has been shown to influence movement behavior, however, its association with some measures of movement behavior, such as spinal movement variability, remains inconclusive. To further investigate this, spinal kinematics during various activities of daily living (i.e., walking, running, lifting, and stair climbing) of 49 patients with chronic LBP and a group of 51 sex-, age-, and BMI-matched healthy controls were used to calculate lumbar spine movement variability which was quantified using different indices (i.e., coefficient of variation, coupling angle variability in vector coding, deviation phase of the continuous relative phase and an angle-angular velocity variability). General and task-specific pain-related fear was assessed using the Tampa Scale of Kinesiophobia and the Photograph Series of Daily Activities-Short Electronic Version, respectively. Linear regression analyses showed no significant association between movement variability and pain-related fear, however, the sample consisted of younger individuals with moderate disability and with low levels of pain and pain-related fear. In addition, the different variability indices were weakly correlated and varied greatly depending on the method used and the task performed. Therefore, comparisons between studies with different movement variability calculation methods or different activities should be treated with caution.
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Affiliation(s)
- Corinne Kehl
- Spinal Movement Biomechanics Group, Division of Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Magdalena Suter
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Embla Johannesdottir
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Monika Dörig
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Christian Bangerter
- Spinal Movement Biomechanics Group, Division of Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Michael L Meier
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Schmid
- Spinal Movement Biomechanics Group, Division of Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
- Faculty of Medicine, University of Basel, Basel, Switzerland.
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Ippersiel P, Preuss R, Wideman TH, Robbins SM. Pain-related threat and coordination in adults with chronic low back pain during a lifting task: A cross-sectional study. J Electromyogr Kinesiol 2024; 78:102923. [PMID: 39208555 DOI: 10.1016/j.jelekin.2024.102923] [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: 11/17/2023] [Revised: 08/06/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVES People with low back pain (LBP) exhibit altered coordination, possibly indicating guarded movement. The connection between these changes and pain-related threat remains unclear. We aimed to determine if pain-related threat was related to spinal coordination and variability, during a lifting task, in people with chronic LBP. METHODS Participants were adults with chronic LBP (n = 47). Upper lumbar, lower lumbar, and hipkinematics were measured during 10crate lifting/lowering repetitions. Coordination and variability of the Hip-Lower Lumbar, and Lower Lumbar-Upper Lumbar joint pairs were calculated. Pain-related threat was measured using the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and task-specific fear. Linear regression analyses tested the relationship between pain-related threat and coordination. RESULTS Adding catastrophizing to our base model (sex) explained variance in Hip-Lower lumbar coordination (r2 change = 0.125, p = 0.013). General and task specific measures of fear were unrelated to coordination and variability at both joint pairs (r2 change < 0.064, p > 0.05). Exploratory t-tests revealed subgroups aligned with phenotypes of "tight" and "loose" control, where "tight" control was characterized by greater catastrophizing and disability. CONCLUSION Pain catastrophizing, but not measures of fear, was related to more in-phase ("tight") Hip-Lower Lumbar coordination during lifting/lowering. Considering this relationship based on subgroups may add clarity.
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Affiliation(s)
- P Ippersiel
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-Mackay Rehabilitation Centre, Quebec, Canada.
| | - R Preuss
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-Mackay Rehabilitation Centre, Quebec, Canada
| | - T H Wideman
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-Mackay Rehabilitation Centre, Quebec, Canada
| | - S M Robbins
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-Mackay Rehabilitation Centre, Quebec, Canada
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Takasaki H, Kanayasu S. KOJI AWARENESS, a self-rating whole-body movement assessment system, has intersession reliability and comparability to external examiner rating. PLoS One 2024; 19:e0308973. [PMID: 39146306 PMCID: PMC11326541 DOI: 10.1371/journal.pone.0308973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/03/2024] [Indexed: 08/17/2024] Open
Abstract
KOJI AWARENESS is a newly developed self-rating whole-body movement assessment system that includes 11 domains and 22 tests. The primary aim of this study was to investigate the intersession reliability of KOJI AWARENESS, and the secondary aim was to determine whether a fixed bias existed between self-rating and external examiner rating. Fifty university students rated their movement ability in two separate sessions; an external examiner also rated the students' movement ability. Participants were blinded to their scores at the first session as well as the external examiner's rating scores. The primary analysis included examining the intersession reliability of the total score with intraclass correlation coefficients (ICCs). ICC values were interpreted as follows: insufficient, < .7 and sufficient, ≥ .7. To achieve the secondary aim, Bland-Altman analysis was performed. ICC for the intersession reliability was .86 with a 95% confidence interval (CI) of .77 to .92 and a minimum detectable change (MDC) of 5.15. Bland-Altman analysis revealed fixed bias as the 95% CIs of the mean difference between the two different rating scores (-3.49 to -2.43 and -3.94 to -2.98 in the first and second sessions, respectively) did not include 0 in the data of each session. However, no proportional bias was identified because no statistically significant Pearson's correlation (P > .05) was noted between the means of the two methods and the mean difference between the two different methods in each session. This study identified that KOJI AWARENESS has sufficient intersession reliability among relatively young and healthy participants. External examiner rating tended to have lower total scores than self-rating; however, the bias was below the MDC and seemed not to be clinically significant.
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Affiliation(s)
- Hiroshi Takasaki
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Shunsuke Kanayasu
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Saitama, Japan
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Oliosi E, Júlio A, Probst P, Silva L, Vilas-Boas JP, Pinheiro AR, Gamboa H. Exploring the Real-Time Variability and Complexity of Sitting Patterns in Office Workers with Non-Specific Chronic Spinal Pain and Pain-Free Individuals. SENSORS (BASEL, SWITZERLAND) 2024; 24:4750. [PMID: 39066146 PMCID: PMC11281106 DOI: 10.3390/s24144750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/14/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024]
Abstract
Chronic spinal pain (CSP) is a prevalent condition, and prolonged sitting at work can contribute to it. Ergonomic factors like this can cause changes in motor variability. Variability analysis is a useful method to measure changes in motor performance over time. When performing the same task multiple times, different performance patterns can be observed. This variability is intrinsic to all biological systems and is noticeable in human movement. This study aims to examine whether changes in movement variability and complexity during real-time office work are influenced by CSP. The hypothesis is that individuals with and without pain will have different responses to office work tasks. Six office workers without pain and ten with CSP participated in this study. Participant's trunk movements were recorded during work for an entire week. Linear and nonlinear measures of trunk kinematic displacement were used to assess movement variability and complexity. A mixed ANOVA was utilized to compare changes in movement variability and complexity between the two groups. The effects indicate that pain-free participants showed more complex and less predictable trunk movements with a lower degree of structure and variability when compared to the participants suffering from CSP. The differences were particularly noticeable in fine movements.
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Affiliation(s)
- Eduarda Oliosi
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
- Research Centre in Physical Activity, Health and Leisure (CIAFEL-FADEUP), Faculty of Sport, University of Porto, 4000-000 Porto, Portugal
| | - Afonso Júlio
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
| | - Phillip Probst
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
| | - Luís Silva
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
| | - João Paulo Vilas-Boas
- Centre for Research, Training, Innovation and Intervention in Sport (CIFI2D), Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sport, University of Porto, 4000-000 Porto, Portugal;
| | - Ana Rita Pinheiro
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, 3800-000 Aveiro, Portugal;
| | - Hugo Gamboa
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Faculty of Sciences and Technology, NOVA University of Lisbon, 2820-001 Caparica, Portugal; (A.J.); (P.P.); (L.S.); (H.G.)
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Morikawa T, Mura N, Sato T, Katoh H. Validity of the estimated angular information obtained using an inertial motion capture system during standing trunk forward and backward bending. BMC Sports Sci Med Rehabil 2024; 16:154. [PMID: 39020423 PMCID: PMC11253345 DOI: 10.1186/s13102-024-00942-1] [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: 03/07/2024] [Accepted: 07/03/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Bending the trunk forward and backward while standing are common daily activities and can have various patterns. However, any dysfunction in these movements can considerably affect daily living activities. Consequently, a comprehensive evaluation of spinal motion during these activities and precise identification of any movement abnormalities are important to facilitate an effective rehabilitation. In recent years, with the development of measurement technology, the evaluation of movement patterns using an inertial motion capture system (motion sensor) has become easy. However, the accuracy of estimated angular information obtained via motion sensor measurements can be affected by angular velocity. This study aimed to compare the validity of estimated angular information obtained by assessing standing trunk forward and backward bending at different movement speeds using a motion sensor with a three-dimensional motion analysis system. METHODS The current study included 12 healthy older men. A three-dimensional motion analysis system and a motion sensor were used for measurement. The participants performed standing trunk forward and backward bending at comfortable and maximum speeds, and five sensors were attached to their spine. Statistical analysis was performed using the paired t-test, intraclass correlation coefficient, mean absolute error, and multiple correlation coefficient. RESULTS Results showed that the estimated angular information obtained using each motion sensor was not affected by angular velocity and had a high validity. CONCLUSIONS Therefore, the angular velocity in this study can be applied clinically for an objective evaluation in rehabilitation.
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Affiliation(s)
- Taiki Morikawa
- Department of Rehabilitation, Eniwa Hospital, Eniwa, Hokkaido, 061-1449, Japan.
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata, Yamagata, 990-2212, Japan.
| | - Nariyuki Mura
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata, Yamagata, 990-2212, Japan
| | - Toshiaki Sato
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata, Yamagata, 990-2212, Japan
| | - Hiroshi Katoh
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata, Yamagata, 990-2212, Japan
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Ippersiel P, Larson DJ, Robbins SM. Using continuous relative phase and modified vector coding analyses to quantify spinal coordination and coordinative variability for healthy and chronic low back pain patients: An exploratory comparative analysis. J Biomech 2024; 172:112207. [PMID: 38968648 DOI: 10.1016/j.jbiomech.2024.112207] [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: 03/01/2024] [Revised: 06/04/2024] [Accepted: 06/24/2024] [Indexed: 07/07/2024]
Abstract
Differences in coordination and coordinative variability are common in people with low back pain. While differences may relate to the different analyses used to quantify these metrics, the preferred approach remains unclear. We aimed to compare coordination and coordinative variability, in people with and without low back pain performing a lifting/lowering task, using continuous relative phase and vector coding procedures, and to identify which technique better detects group differences. Upper lumbar (T12-L3), lower lumbar (L3-S1), and hip angular kinematics were measured using electromagnetic motion capture during 10 crate lifting/lowering repetitions from adults with (n = 47) and without (n = 17) low back pain. Coordination and coordinative variability for the Hip-Lower Lumbar and Lower Lumbar-Upper Lumbar joint pairs were quantified using mean absolute relative phase and deviation phase (continuous relative phase), and coupling angle and coupling angle variability (vector coding), respectively. T-tests examined group differences in coordination and variability. Cohen's d bootstrapping analyses identified the more sensitive technique for detecting group differences. Less in-phase and more variable behavior was observed in the low back pain group, mostly independent of joint pair and analytical technique (P < 0.05, Cohen's d range = 0.61 to 1.33). Qualitatively, the low back group limited motion at the lower lumbar spine during lifting/lowering. Continuous relative phase was more sensitive in detecting group differences in coordinative variability, while vector coding was more sensitive towards differences in coordination. These procedures convey distinct information and have their respective merits. Researchers should consider the choice of analytical techniques based on their study objectives.
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Affiliation(s)
- Patrick Ippersiel
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Quebec, Canada; School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Canada.
| | - Dennis J Larson
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
| | - Shawn M Robbins
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Quebec, Canada.
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Kendell M, Smith A, O'Sullivan P, Beales D, Chan J, Li KM, McMullan M, Smith K, Rabey M. How do people with chronic low back pain pick a pencil off the floor? Physiother Theory Pract 2024; 40:576-593. [PMID: 36066194 DOI: 10.1080/09593985.2022.2120374] [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: 05/10/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Picking objects off the floor is provocative for people with chronic low back pain (CLBP). There are no clinically applicable methods evaluating movement strategies for this task. The relationship between strategy and multidimensional profiles is unknown. OBJECTIVE Develop a movement evaluation tool (MET) to examine movement strategies in people with CLBP (n = 289) picking a pencil off the floor. Describe those movement strategies, and determine reliability of the MET. Explore differences across multidimensional profiles and movement strategies. METHODS An MET was developed using literature and iterative processes, and its inter-rater agreement determined. Latent class analysis (LCA) derived classes demonstrating different strategies using six movement parameters as indicator variables. Differences between classes across multidimensional profiles were investigated using analysis of variance, Kruskal-Wallis, or chi-squared tests. RESULTS Six movement parameters were evaluated. There was substantial inter-rater agreement (Cohen's Kappa = 0.39-0.79) across parameters. LCA derived three classes with different strategies: Class 1 (71.8%) intermediate trunk inclination/knee flexion; Class 2 (24.5%) greater forward trunk inclination, lower knee flexion; Class 3 (3.7%) lower forward trunk inclination, greater knee flexion. Pain duration differed across all classes (p ≤ .001). Time taken to complete forward bends differed between Class 3 and other classes (p = .024). CONCLUSIONS Movement strategies can be reliably assessed using the MET. Three strategies for picking lightweight objects off the floor were derived, which differed across pain duration and speed of movement.
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Affiliation(s)
- Michelle Kendell
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Anne Smith
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Peter O'Sullivan
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Darren Beales
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Jonathan Chan
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Kun Man Li
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Matthew McMullan
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Kelby Smith
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Martin Rabey
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Beange KHE, Chan ADC, Graham RB. Investigating concurrent validity of inertial sensors to evaluate multiplanar spine movement. J Biomech 2024; 164:111939. [PMID: 38310004 DOI: 10.1016/j.jbiomech.2024.111939] [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: 08/29/2023] [Revised: 12/13/2023] [Accepted: 01/04/2024] [Indexed: 02/05/2024]
Abstract
Inertial measurement units (IMUs) offer a portable and inexpensive alternative to traditional optical motion capture systems, and have potential to support clinical diagnosis and treatment of low back pain; however, due to a lack of confidence regarding the validity of IMU-derived metrics, their uptake and acceptance remain a challenge. The objective of this work was to assess the concurrent validity of the Xsens DOT IMUs for tracking multiplanar spine movement, and to evaluate concurrent validity and reliability for estimating clinically relevant metrics relative to gold-standard optical motion capture equipment. Ten healthy controls performed spine range of motion (ROM) tasks, while data were simultaneously tracked from IMUs and optical marker clusters placed over the C7, T12, and S1 vertebrae. Root mean square error (RMSE), mean absolute error (MAE), and intraclass correlation coefficients (ICC2,1) were calculated to assess validity and reliability of absolute (abs; C7, T12, and S1 sensors) and relative joint (rel; intersegmental thoracic, lumbar, and total) motion. Overall RMSEabs = 1.33°, MAEabs = 0.74° ± 0.69, and ICC2,1,abs = 0.953 across all movements, sensors, and planes. Results were slightly better for uniplanar movements when evaluating the primary rotation axis (prim) absolute ROM (MAEabs,prim = 0.56° ± 0.49; ICC2,1,abs,prim = 0.999). Similarly, when evaluating relative intersegmental motion, overall RMSErel = 2.39°, MAErel = 1.10° ± 0.96, and ICC2,1,rel = 0.950, and relative primary rotation axis achieved MAErel,prim = 0.87° ± 0.77, and ICC2,1,rel,prim = 0.994. Findings from this study suggest that these IMUs can be considered valid for tracking multiplanar spine movement, and may be used to objectively assess spine movement and neuromuscular control in clinics.
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Affiliation(s)
- Kristen H E Beange
- Department of Systems and Computer Engineering, Faculty of Engineering and Design, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada; Ottawa-Carleton Institute for Biomedical Engineering, Ottawa, Ontario, Canada
| | - Adrian D C Chan
- Department of Systems and Computer Engineering, Faculty of Engineering and Design, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, Ontario K1N 6N5, Canada; Ottawa-Carleton Institute for Biomedical Engineering, Ottawa, Ontario, Canada
| | - Ryan B Graham
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, Ontario K1N 6N5, Canada; Ottawa-Carleton Institute for Biomedical Engineering, Ottawa, Ontario, Canada.
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Saito H, Yokoyama H, Sasaki A, Nakazawa K. Direction-Specific Changes in Trunk Muscle Synergies in Individuals With Extension-Related Low Back Pain. Cureus 2024; 16:e54649. [PMID: 38523944 PMCID: PMC10959767 DOI: 10.7759/cureus.54649] [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: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Background Identifying altered trunk control is critical for treating extension-related low back pain (ERLBP), a common subgroup classified by clinical manifestations. The changed coordination of trunk muscles within this group during particular trunk tasks is still not clearly understood. Objectives The objective of this study is to investigate trunk muscle coordination during 11 trunk movement and stability tasks in individuals with ERLBP compared to non-low back pain (LBP) participants. Methods Thirteen individuals with ERLBP and non-LBP performed 11 trunk movement and stability tasks. We recorded the electromyographic activities of six back and abdominal muscles bilaterally. Trunk muscle coordination was assessed using the non-negative matrix factorization (NMF) method to identify trunk muscle synergies. Results The number of synergies in the ERLBP group during the cross-extension and backward bend tasks was significantly higher than in the non-LBP group (p<0.05). The cluster analysis identified the two trunk synergies for each task with strikingly similar muscle activation patterns between groups. In contrast, the ERLBP group exhibited additional trunk muscle synergies that were not identified in the non-LBP group. The number of synergies in the other tasks did not differ between groups (p>0.05). Conclusion Individuals with ERLBP presented directionally specific alterations in trunk muscle synergies that were considered as increased coactivations of multiple trunk muscles. These altered patterns may contribute to the excessive stabilization of and the high frequency of hyperextension in the spine associated with the development and persistence of ERLBP.
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Affiliation(s)
- Hiroki Saito
- Department of Physical Therapy, Tokyo University of Technology, Tokyo, JPN
| | - Hikaru Yokoyama
- Division of Advanced Health Science, Institute of Engineering, Tokyo University of Agriculture and Technology, Tokyo, JPN
| | - Atsushi Sasaki
- Department of Physical Medicine and Rehabilitation, The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, USA
| | - Kimitaka Nakazawa
- Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, Tokyo, JPN
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Alsubaie AM, Mazaheri M, Martinez-Valdes E, Falla D. Is movement variability altered in people with chronic non-specific low back pain? A systematic review. PLoS One 2023; 18:e0287029. [PMID: 37315096 DOI: 10.1371/journal.pone.0287029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/28/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Variability in spine kinematics is a common motor adaptation to pain, which has been measured in various ways. However, it remains unclear whether low back pain (LBP) is typically characterised by increased, decreased or unchanged kinematic variability. Therefore, the aim of this review was to synthesise the evidence on whether the amount and structure of spine kinematic variability is altered in people with chronic non-specific LBP (CNSLBP). METHODS Electronic databases, grey literature, and key journals were searched from inception up to August 2022, following a published and registered protocol. Eligible studies must investigated kinematic variability in CNSLBP people (adults ≥18 years) while preforming repetitive functional tasks. Two reviewers conducted screening, data extraction, and quality assessment independently. Data synthesis was conducted per task type and individual results were presented quantitatively to provide a narrative synthesis. The overall strength of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation guidelines. FINDINGS Fourteen observational studies were included in this review. To facilitate the interpretation of the results, the included studies were grouped into four categories according to the task preformed (i.e., repeated flexion and extension, lifting, gait, and sit to stand to sit task). The overall quality of evidence was rated as a very low, primarily due to the inclusion criteria that limited the review to observational studies. In addition, the use of heterogeneous metrics for analysis and varying effect sizes contributed to the downgrade of evidence to a very low level. INTERPRETATION Individuals with chronic non-specific LBP exhibited altered motor adaptability, as evidenced by differences in kinematic movement variability during the performance of various repetitive functional tasks. However, the direction of the changes in movement variability was not consistent across studies.
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Affiliation(s)
- Amal M Alsubaie
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Masood Mazaheri
- Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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Devecchi V, Falla D, Cabral HV, Gallina A. Neuromuscular adaptations to experimentally induced pain in the lumbar region: systematic review and meta-analysis. Pain 2023; 164:1159-1180. [PMID: 36730706 DOI: 10.1097/j.pain.0000000000002819] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/20/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Experimental pain models are frequently used to understand the influence of pain on the control of human movement. In this systematic review, we assessed the effects of experimentally induced pain in the lumbar region of healthy individuals on trunk muscle activity and spine kinematics. Databases were searched from inception up to January 31, 2022. In total, 26 studies using either hypertonic saline injection (n = 19), heat thermal stimulation (n = 3), nociceptive electrical stimulation (n = 3), or capsaicin (n = 1) were included. The identified adaptations were task dependent, and their heterogeneity was partially explained by the experimental pain model adopted. Meta-analyses revealed an increase of erector spinae activity (standardized mean difference = 0.71, 95% confidence interval [CI] = 0.22-1.19) during full trunk flexion and delayed onset of transversus abdominis to postural perturbation tasks (mean difference = 25.2 ms, 95% CI = 4.09-46.30) in the presence of pain. Low quality of evidence supported an increase in the activity of the superficial lumbar muscles during locomotion and during voluntary trunk movements during painful conditions. By contrast, activity of erector spinae, deep multifidus, and transversus abdominis was reduced during postural perturbation tasks. Reduced range of motion of the lumbar spine in the presence of pain was supported by low quality of evidence. Given the agreement between our findings and the adaptations observed in clinical populations, the use of experimental pain models may help to better understand the mechanisms underlying motor adaptations to low back pain.
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Affiliation(s)
- Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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Saito H, Yokoyama H, Sasaki A, Nakazawa K. Muscle synergy patterns as altered coordination strategies in individuals with chronic low back pain: a cross-sectional study. J Neuroeng Rehabil 2023; 20:69. [PMID: 37259142 DOI: 10.1186/s12984-023-01190-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 05/10/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Chronic low back pain (CLBP) is a highly prevalent disease with poorly understood underlying mechanisms. In particular, altered trunk muscle coordination in response to specific trunk tasks remains largely unknown. METHODS We investigated the muscle synergies during 11 trunk movement and stability tasks in 15 healthy individuals (8 females and 7 males, aged 21. 3 (20.1-22.8) ± 0.6 years) and in 15 CLBP participants (8 females and 7 males, aged 20. 9 (20.2-22.6) ± 0.7 years) by recording the surface electromyographic activities of 12 back and abdominal muscles (six muscles unilaterally). Non-negative matrix factorization was performed to extract the muscle synergies. RESULTS We found six trunk muscle synergies and temporal patterns in both groups. The high similarity of the trunk synergies and temporal patterns in the groups suggests that both groups share the common feature of the trunk coordination strategy. We also found that trunk synergies related to the lumbar erector spinae showed lower variability in the CLBP group. This may reflect the impaired back muscles that reshape the trunk synergies in the fixed structure of CLBP. Furthermore, the higher variability of trunk synergies in the other muscle regions such as in the latissimus dorsi and oblique externus, which were activated in trunk stability tasks in the CLBP group, represented more individual motor strategies when the trunk tasks were highly demanding. CONCLUSION Our work provides the first demonstration that individual modular organization is fine-tuned while preserving the overall structures of trunk synergies and temporal patterns in the presence of persistent CLBP.
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Affiliation(s)
- Hiroki Saito
- Graduate School of Arts and Sciences, Department of Life Sciences, The University of Tokyo, Tokyo, Japan
- Department of Physical Therapy, Tokyo University of Technology, Tokyo, Japan
| | - Hikaru Yokoyama
- Institute of Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan.
| | - Atsushi Sasaki
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Osaka, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kimitaka Nakazawa
- Graduate School of Arts and Sciences, Department of Life Sciences, The University of Tokyo, Tokyo, Japan
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Lin CW, Fang YT, Yang JF, Hsue BJ, Lin CF. Dancers with non-specific low back pain have less lumbar movement smoothness than healthy dancers. Biomed Eng Online 2023; 22:39. [PMID: 37101155 PMCID: PMC10131470 DOI: 10.1186/s12938-023-01101-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Ballet is a highly technical and physically demanding dance form involving extensive end-range lumbar movements and emphasizing movement smoothness and gracefulness. A high prevalence of non-specific low back pain (LBP) is found in ballet dancers, which may lead to poor controlled movement and possible pain occurrence and reoccurrence. The power spectral entropy of time-series acceleration is a useful indicator of random uncertainty information, and a lower value indicates a greater smoothness or regularity. The current study thus applied a power spectral entropy method to analyze the movement smoothness in lumbar flexion and extension in healthy dancers and dancers with LBP, respectively. METHOD A total of 40 female ballet dancers (23 in the LBP group and 17 in the control group) were recruited in the study. Repetitive end-range lumbar flexion and extension tasks were performed and the kinematic data were collected using a motion capture system. The power spectral entropy of the time-series acceleration of the lumbar movements was calculated in the anterior-posterior (AP), medial-lateral (ML), vertical (VT), and three-directional (3D) vectors. The entropy data were then used to conduct receiver operating characteristic curve analyses to evaluate the overall distinguishing performance and thus cutoff value, sensitivity, specificity, and area under the curve (AUC) were calculated. RESULTS The power spectral entropy was significantly higher in the LBP group than the control group in the 3D vector in both lumbar flexion and lumber extension (flexion: p = 0.005; extension: p < 0.001). In lumbar extension, the AUC in the 3D vector was 0.807. In other words, the entropy provides an 80.7% probability of distinguishing between the two groups (i.e., LBP and control) correctly. The optimal cutoff entropy value was 0.5806 and yielded a sensitivity of 75% and specificity of 73.3%. In lumbar flexion, the AUC in the 3D vector was 0.777, and hence the entropy provided a probability of 77.7% of distinguishing between the two groups correctly. The optimal cutoff value was 0.5649 and yielded a sensitivity of 90% and a specificity of 73.3%. CONCLUSIONS The LBP group showed significantly lower lumbar movement smoothness than the control group. The lumbar movement smoothness in the 3D vector had a high AUC and thus provided a high differentiating capacity between the two groups. It may therefore be potentially applied in clinical contexts to screen dancers with a high risk of LBP.
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Affiliation(s)
- Chai-Wei Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 70101, Taiwan
| | - Yi-Ting Fang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 70101, Taiwan
| | - Jeng-Feng Yang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 70101, Taiwan
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan, 70101, Taiwan
| | - Bih-Jen Hsue
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 70101, Taiwan
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan, 70101, Taiwan
| | - Cheng-Feng Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 70101, Taiwan.
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 70101, Taiwan.
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan, 70101, Taiwan.
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Saito H, Yokoyama H, Sasaki A, Matsushita K, Nakazawa K. Variability of trunk muscle synergies underlying the multidirectional movements and stability trunk motor tasks in healthy individuals. Sci Rep 2023; 13:1193. [PMID: 36681745 PMCID: PMC9867711 DOI: 10.1038/s41598-023-28467-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Muscle synergy analysis is useful for investigating trunk coordination patterns based on the assumption that the central nervous system reduces the dimensionality of muscle activation to simplify movement. This study aimed to quantify the variability in trunk muscle synergy during various trunk motor tasks in healthy participants to provide reference data for evaluating trunk control strategies in patients and athletes. Sixteen healthy individuals performed 11 trunk movement and stability tasks with electromyography (EMG) recording of their spinal and abdominal muscles (6 bilaterally). Non-negative matrix factorization applied to the concatenated EMG of all tasks identified the five trunk muscle synergies (W) with their corresponding temporal patterns (C). The medians of within-cluster similarity defined by scalar products in W and rmax coefficient using the cross-correlation function in C were 0.73-0.86 and 0.64-0.75, respectively, while the inter-session similarities were 0.81-0.96 and 0.74-0.84, respectively. However, the lowest and highest values of both similarity indices were broad, reflecting the musculoskeletal system's redundancy within and between participants. Furthermore, the significant differences in the degree of variability between the trunk synergies may represent the different neural features of synergy organization and strategies to overcome the various mechanical demands of a motor task.
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Affiliation(s)
- Hiroki Saito
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
- Department of Physical Therapy, Tokyo University of Technology, Tokyo, Japan
| | - Hikaru Yokoyama
- Institute of Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan.
| | - Atsushi Sasaki
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | | | - Kimitaka Nakazawa
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
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Alcaraz-Clariana S, García-Luque L, Garrido-Castro JL, Aranda-Valera IC, Ladehesa-Pineda L, Puche-Larrubia MÁ, Carmona-Pérez C, Rodrigues-de-Souza DP, Alburquerque-Sendín F. Paravertebral Muscle Mechanical Properties in Patients with Axial Spondyloarthritis or Low Back Pain: A Case-Control Study. Diagnostics (Basel) 2021; 11:1898. [PMID: 34679595 PMCID: PMC8535094 DOI: 10.3390/diagnostics11101898] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 12/29/2022] Open
Abstract
Different musculoskeletal disorders are a source of pain in the spinal region; most of them can be divided into mechanical, such as low back pain (LBP), or inflammatory origins, as is the case of axial spondyloarthritis (axSpA). Nevertheless, insufficient information is available about the muscle negative consequences of these conditions. Thus, the objective of this study was to identify whether mechanical muscle properties (MMPs) of cervical and lumbar muscles are different between patients with axSpA, subacute LBP (sLBP), and healthy controls. Furthermore, we aimed identify whether MMPs were related to sociodemographic and clinical variables in various study groups. The MMPs, sociodemographic, and clinical variables were obtained in 43 patients with axSpA, 43 subjects with sLBP, and 43 healthy controls. One-way ANOVAs and ROC curves were applied to identify whether the MMPs could differentiate between the study groups. Intra-group Pearson r coefficients to test the associations between MMPs and the rest of the variables were calculated. The results showed that axSpA subjects have a higher tone and stiffness and a lower relaxation and creep than sLBP and healthy ones (p < 0.05). All lumbar and cervical MMPs, except for decrement, could correctly classify axSpA and healthy subjects and axSpA and sLBP patients (in both cases, Area Under the Curve > 0.8). However, no MMP could differentiate between sLBP and healthy subjects. Each group had a different pattern of bivariate correlations between MMPs and sociodemographic and clinical data, with a worse state and progression of the axSpA group associated with a higher tone and stiffness in both spinal regions. This study supports that MMPs are different and show different patterns of correlations depending on the type of spinal pain.
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Affiliation(s)
- Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Juan Luis Garrido-Castro
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Cordoba, 14071 Cordoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
| | - I. Concepción Aranda-Valera
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
- Department of Rheumatology, University Hospital Reina Sofía, 14004 Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain
| | - Lourdes Ladehesa-Pineda
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
- Department of Rheumatology, University Hospital Reina Sofía, 14004 Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain
| | - María Ángeles Puche-Larrubia
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
- Department of Rheumatology, University Hospital Reina Sofía, 14004 Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain
| | - Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
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