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Güneş M, Apaydın AS, Keski N NK. Investigation of lumbar multifidus muscle, pain, and fear of falling in patients with lumbar spinal stenosis with poor balance. Clin Neurol Neurosurg 2024; 246:108578. [PMID: 39383585 DOI: 10.1016/j.clineuro.2024.108578] [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: 08/15/2024] [Revised: 09/17/2024] [Accepted: 09/29/2024] [Indexed: 10/11/2024]
Abstract
BACKGROUND This study aimed to compare the muscle thickness and cross-sectional area (CSA), pain, disability, and fear of falling in patients with lumbar spinal stenosis (LSS) with and without balance problems. METHODS Sixty-four patients diagnosed with LSS by magnetic resonance imaging (MRI) were included in this cross-sectional study. The patients were divided into poor (n=31) and normal balance (n=33) groups according to the single leg standing test. Low back pain (Numeric rating scale), dynamic balance (Time up and go test), disability (Oswestry disability index) and fear of falling (International fall efficacy scale) in patients with LSS levels were evaluated. Lumbar (L4/5) multifidus muscle thickness and CSA were obtained from MRI images. RESULTS The poor balance group had a lower L4/5 multifidus thickness (p<0.05) and CSA (p<0.05) than the normal balance group. It was determined that an increase in left L4/5 multifidus muscle CSA was associated with decreased impaired balance (p=0.036). Also, a significant correlation was detected between static balance and muscle thickness and CSA (p<0.01). In addition, low back pain, disability, and fear of falling were significantly higher in LSS patients in the poor balance group (p<0.05). CONCLUSION Muscle atrophy and decrease in CSA are more common in LSS patients with poor balance. Decreased L4/5 multifidus muscle CSA may increase the risk of balance impairment. Also, LSS patients with poor balance are more likely to experience pain, disability, and fear of falling. Strategies to improve lumbar muscle stability, mass, and pain may reduce impaired balance in LSS.
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Affiliation(s)
- Musa Güneş
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey.
| | - Aydın Sinan Apaydın
- Department of Neurosurgery, Faculty of Medicine, Karabuk University, Karabuk, Turkey.
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Osanlou S, Miri H, Nichols JF, Hosseinzadeh M. Investigating the relationship between sagittal spinal curvature and fall incidence and fall risk among elderly nursing home residents. Osteoporos Int 2024:10.1007/s00198-024-07232-z. [PMID: 39172253 DOI: 10.1007/s00198-024-07232-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 08/14/2024] [Indexed: 08/23/2024]
Abstract
Designing appropriate diagnostic and treatment methods to reduce fall risk and improve quality of life, as well as reduce the cost of care in elderlies. Our findings have potential for early diagnosis of those with a high probability of falling based on fairly simple clinical measures of hyperkyphosis, forward head, and lordosis. INTRODUCTION Poor balance is an underlying cause of falling in the elderly, for which a change in the natural curvature of the spine plays a major role. Little is known about the relationship between spinal curvatures and fall incidence in this population. We primarily aimed to investigate the relationship between sagittal plane spinal curvatures and fall incidence over 1 year among nursing facility residents. Secondarily, we aim to determine associations of sagittal plane spinal curvatures with participants' perception of fall risk and balance capability. METHODS Participants (100 residents mean age 70.17 ± 6.01 years) underwent standing measures of sagittal plane spinal curvatures (flexible ruler technique) and forward displacement of the head relative to the cervical spine. The Tinetti Performance Oriented Mobility Assessment (POMA) and Fall Efficacy Scale assessed participants' perception of balance and fear of falling. Incident falls were self-reported monthly and tracked across 1 year. Spearman's correlations and logistic regression evaluated associations between fall incidence and spinal curvature. Predictive performance of spinal curvature and fall risk was determined by the corresponding ROC for defining a cut-off for variables of spinal curvature and fall risk indicators. RESULTS Predictive performance of spinal curvature and fall risk factors indicated 84% and 77% of participants were correctly classified using models of kyphosis and head angle, respectively. CONCLUSIONS Our study adds new data on spinal curvatures and incident falls among nursing facility residents. Efforts are needed to intervene to counter progression of spinal curvatures and improve fall prevention practices.
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Affiliation(s)
- Samaneh Osanlou
- Department of Physical Education and Sports Sciences, Raja University, Qazvin, Iran
| | - Hadi Miri
- Department of Physical Education and Sport Sciences, Amir Kabir University of Technology, Tehran, Iran
| | - Jeanne F Nichols
- Exercise and Physical Activity Resource Center (EPARC), Graduate School of Public Health & Human Longevity Science, University of California, San Diego, California, USA
| | - Mahdi Hosseinzadeh
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, No. 3, 5Th Alley, Miremad Street, Motahhari Street, Tehran, Iran.
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Xiong Y, Zhang C, Chen X, Wu L, Liang S, Zhang Y, Huang J, Guo W, Zeng X, Xu F. Prediction of Subsequent Vertebral Fracture After Acute Osteoporotic Fractures from Clinical and Paraspinal Muscle Features. Calcif Tissue Int 2024; 114:614-624. [PMID: 38714533 PMCID: PMC11090933 DOI: 10.1007/s00223-024-01209-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/25/2024] [Indexed: 05/10/2024]
Abstract
To construct a nomogram based on clinical factors and paraspinal muscle features to predict vertebral fractures occurring after acute osteoporotic vertebral compression fracture (OVCF). We retrospectively enrolled 307 patients with acute OVCF between January 2013 and August 2022, and performed magnetic resonance imaging of the L3/4 and L4/5 intervertebral discs (IVDs) to estimate the cross-sectional area (CSA) and degree of fatty infiltration (FI) of the paraspinal muscles. We also collected clinical and radiographic data. We used univariable and multivariable Cox proportional hazards models to identify factors that should be included in the predictive nomogram. Post-OVCF vertebral fracture occurred within 3, 12, and 24 months in 33, 69, and 98 out of the 307 patients (10.8%, 22.5%, and 31.9%, respectively). Multivariate analysis revealed that this event was associated with percutaneous vertebroplasty treatment, higher FI at the L3/4 IVD levels of the psoas muscle, and lower relative CSA of functional muscle at the L4/5 IVD levels of the multifidus muscle. Area under the curve values for subsequent vertebral fracture at 3, 12, and 24 months were 0.711, 0.724, and 0.737, respectively, indicating remarkable accuracy of the nomogram. We developed a model for predicting post-OVCF vertebral fracture from diagnostic information about prescribed treatment, FI at the L3/4 IVD levels of the psoas muscle, and relative CSA of functional muscle at the L4/5 IVD levels of the multifidus muscle. This model could facilitate personalized predictions and preventive strategies.
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Affiliation(s)
- Yuchao Xiong
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China
| | - Cici Zhang
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China
| | - Xiaopei Chen
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China
| | - Li Wu
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China
| | - Shaohua Liang
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China
| | - Ye Zhang
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China
| | - Junbing Huang
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China
| | - Wei Guo
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China
| | - Xuwen Zeng
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China.
| | - Fan Xu
- Department of Radiology, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China.
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Alenazi AM, Alanazi MF, Elnaggar RK, Alshehri MM, Alqahtani BA, Alhowimel AS, Alhwoaimel NA, Alanazi AD, Alotaibi MA, Almutairi SM, Alghamdi MS, Bindawas SM. Prevalence and risk factors for falls among community-dwelling adults in Riyadh area. PeerJ 2023; 11:e16478. [PMID: 38077414 PMCID: PMC10710170 DOI: 10.7717/peerj.16478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/26/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives This study aimed to assess fall prevalence, identify related risk factors, and establish cut-off scores for fall risk measures among community-dwelling adults in Riyadh region of Saudi Arabia. Methods A cross-sectional study was conducted in community, Riyadh city, Saudi Arabia. A sample of 276 Saudi citizens aged ≥40 years who were able to read and write in Arabic. Fall history and number of falls in the past 12 months were determined via self-reports. Variables assessed included demographic information, self-reported chronic diseases, depressive symptoms, and back pain severity. Results Participants were classified as either fallers (n = 28, 10.14%) or non-fallers. Fallers were more likely to have arthritis (odds ratio [OR]: 7.60, p = 0.001), back pain (OR: 5.22, p = 0.002), and higher depressive symptom scores (OR: 1.09, p = 0.013) than non-fallers. The number of reported falls was significantly associated with an elevated body mass index (incidence rate ratio [IRR]: 1.09, p = 0.045), arthritis (IRR: 8.74, p < 0.001), back pain (IRR: 4.08, p = 0.005), neurological diseases (IRR: 13.75, p < 0.007), and depressive symptoms (IRR: 1.08, p = 0.005). Cut-off scores predictive of falls associated with back pain and depressive symptoms were 1.5 (sensitivity: 0.61; specificity: 0.79; area under the curve [AUC]: 0.70) and 11.5 score (sensitivity: 0.57; specificity: 0.76; AUC: 0.66), respectively. Conclusions The prevalence of falls was relatively low among the individuals considered in this study. Chronic conditions, back pain severity, and depressive symptoms were determined to be associated with falls among community-dwelling individuals in Saudi Arabia.
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Affiliation(s)
- Aqeel M. Alenazi
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Maram F. Alanazi
- Occupational Therapy, Sydney University, Sydney, New South Wales, Australia
| | - Ragab K. Elnaggar
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Cairo University, Cairo, Giza, Egypt
| | | | - Bader A. Alqahtani
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Ahmed S. Alhowimel
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Norah A. Alhwoaimel
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Ahmad D. Alanazi
- Department of Rehabilitation Science, Majmaah University, Majmaah, Riyadh, Saudi Arabia
| | - Mazyad A. Alotaibi
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Sattam M. Almutairi
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Mohammed S. Alghamdi
- Department of Medical Rehabilitation Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Saad M. Bindawas
- Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia
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Kobayashi H, Sekiguchi M, Otani K, Ono R, Nikaido T, Watanabe K, Kato K, Kobayashi Y, Yabuki S, Konno SI, Matsumoto Y. Assessment of Lumbar Spinal Stenosis as a Risk Factor for Development of Sleep Disorder: The Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS). Int J Gen Med 2023; 16:5417-5424. [PMID: 38021067 PMCID: PMC10679514 DOI: 10.2147/ijgm.s435739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Insomnia has been reported to coexist with various musculoskeletal disorders. Although lumbar spinal stenosis (LSS) is the most frequently operated on spinal disease, the causal relationship between LSS and development of sleep disorders remains unclear due to lack of longitudinal studies. This study aimed to determine whether LSS was a risk factor for developing new sleep disorders, primarily insomnia, using a prospective cohort of community residents. Patients and Methods This study was a prospective cohort study. Participants aged ≥65 years from the "Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS)" conducted in 2008 formed our study population. LSS was diagnosed using the self-administered, self-reported history questionnaire, a validated diagnostic support tool for LSS. Sleep disorder was investigated using a questionnaire during the 2-year follow-up. The impact of LSS on sleep disorder onset was analyzed after adjusting for potential confounders, such as age, sex, obesity, hypertension, diabetes, depression, and smoking habits, using propensity score matching. Results Of the 489 participants who were followed up for two years, 38 (7.8%) had newly developed a sleep disorder in 2010. After adjusting for confounding factors, a comparison of 133 participants each in the control and LSS groups showed significantly higher frequency of new-onset sleep disorders (19 [14.3%] in the LSS group versus 6 [4.5%] in the control group). Conclusion LSS was found to be an independent risk factor for sleep disorders.
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Affiliation(s)
- Hiroshi Kobayashi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Miho Sekiguchi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Koji Otani
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Rei Ono
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Settsu, Japan
| | - Takuya Nikaido
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kazuyuki Watanabe
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kinshi Kato
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshihiro Kobayashi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shoji Yabuki
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shin-ichi Konno
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
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Arai H, Nozoe M, Kamiya K, Matsumoto S, Morimoto T. Association Between Skeletal Muscle Mass Index and Falls in Patients With Functional Impairment. Am J Phys Med Rehabil 2023; 102:913-918. [PMID: 37405906 DOI: 10.1097/phm.0000000000002249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
OBJECTIVE This study aimed to assess the association between skeletal muscle mass index and falls in patients with functional impairment. DESIGN This retrospective cohort study was implemented at a convalescent rehabilitation ward. Patients with no measurement of skeletal muscle mass index and bed-ridden patients were excluded from this study. Patients were dichotomized into the low skeletal muscle mass index group and the high skeletal muscle mass index group. The occurrence of fall was assessed according to skeletal muscle mass index groups. RESULTS Of the 327 included patients, 231 (71%) were assigned to the low skeletal muscle mass index group. In total, 66 patients (20%) experienced at least one fall, and a total of 102 falls occurred. The incidence of falls for the low skeletal muscle mass index group was not significantly greater than that for the high skeletal muscle mass index group (4.9 per 1000 patient-days vs. 4.5 per 1000 patient-days, P = 0.9). Low skeletal muscle mass index was not significantly associated with one or more incidents of falls (odds ratio [95% confidence intervals] = 0.6 [0.3-1.17]). CONCLUSIONS This study found that skeletal muscle mass index was not significantly associated with falls in patients undergoing convalescent rehabilitation.
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Affiliation(s)
- Hideki Arai
- From the Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan (HA, TM); Toyonaka Heisei Hospital, Toyonaka, Osaka, Japan (HA, SM); Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Hyogo, Japan (MN); and Department of Hygiene and Public Health, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (KK)
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Yamane M, Aoki M, Sasaki Y, Hayashi T, Okino K. Activity of deep trunk muscles for postural control to predictable and unpredictable sagittal plane perturbations: Electromyographic analysis. J Back Musculoskelet Rehabil 2023; 36:1411-1420. [PMID: 37482983 DOI: 10.3233/bmr-220416] [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: 07/25/2023]
Abstract
BACKGROUND The activity of deep trunk muscles (psoas major; PM, quadratus lumborum; QL, transverse abdominis; TrA, and lumbar multifidus; MF) in response to external perturbation is not clearly known. OBJECTIVE This study aimed to record the onset and amount of activity of the deep trunk muscles during sagittal plane perturbations. METHODS Fourteen healthy males participated in this study. The activity of the right deep trunk muscles was recorded using wire electrodes. In standing, the participants performed three tasks: a pendulum impacted from anterior with predictable and unpredictable and posterior with unpredictable. RESULTS In predictable anterior perturbation, the TrA and PM demonstrated feedforward activation, while all deep trunk muscles demonstrated feedback activation in unpredictable anterior and posterior perturbations. In the anticipatory postural adjustment phase, the activity of the TrA was large in predictable anterior perturbation, while that of all deep trunk muscles was slight in other perturbations. In the compensatory postural adjustment phase, the activity of the PM, QL, and TrA in unpredictable anterior perturbation and those of the PM, QL, and MF in unpredictable posterior perturbation were large. CONCLUSIONS These results showed that the onset and magnitude of deep trunk muscle activity changed depending on both predictable or unpredictable perturbation and the direction of perturbation.
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Affiliation(s)
- Masahiro Yamane
- Department of Rehabilitation, Health Sciences University of Hokkaido Hospital, Sapporo, Japan
| | - Mitsuhiro Aoki
- Department of PhysicalTherapy, Faculty of Rehabilitation Science, Health Sciences University of Hokkaido, Ishikari, Japan
| | - Yuji Sasaki
- Department of PhysicalTherapy, Faculty of Rehabilitation Science, Health Sciences University of Hokkaido, Ishikari, Japan
| | - Tomoya Hayashi
- Department of Rehabilitation, Do-nan Royal Hospital, Kuon, Japan
| | - Kumiko Okino
- Department of Clinical Laboratory, Health Sciences University of Hokkaido Hospital, Sapporo, Japan
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Shahtahmassebi B, Hatton J, Hebert JJ, Hecimovich M, Correia H, Fairchild TJ. The effect of the inclusion of trunk-strengthening exercises to a multimodal exercise program on physical activity levels and psychological functioning in older adults: secondary data analysis of a randomized controlled trial. BMC Geriatr 2022; 22:738. [PMID: 36088283 PMCID: PMC9463852 DOI: 10.1186/s12877-022-03435-3] [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: 02/11/2022] [Accepted: 09/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background Engaging in multimodal exercise program helps mitigate age-related decrements by improving muscle size, muscle strength, balance, and physical function. The addition of trunk-strengthening within the exercise program has been shown to significantly improve physical functioning outcomes. Whether these improvements result in improved psychological outcomes associated with increased physical activity levels requires further investigation. We sought to explore whether the inclusion of trunk-strengthening exercises to a multimodal exercise program improves objectively measured physical activity levels and self-reported psychological functioning in older adults. Method We conducted a secondary analysis within a single-blinded parallel-group randomized controlled trial. Sixty-four healthy older (≥ 60 years) adults were randomly allocated to a 12-week walking and balance exercise program with (n = 32) or without (n = 32) inclusion of trunk strengthening exercises. Each program involved 12 weeks of exercise training, followed by a 6-week walking-only program (identified as detraining). Primary outcome measures for this secondary analysis were physical activity (accelerometry), perceived fear-of-falling, and symptoms of anxiety and depression. Results Following the 12-week exercise program, no significant between-group differences were observed for physical activity, sedentary behaviour, fear-of-falling, or symptoms of anxiety or depression. Significant within-group improvements (adjusted mean difference [95%CI]; percentage) were observed in moderate-intensity physical activity (6.29 [1.58, 11.00] min/day; + 26.3%) and total number of steps per min/day (0.81 [0.29 to 1.33] numbers or + 16.3%) in trunk-strengthening exercise group by week 12. With respect to within-group changes, participants in the walking-balance exercise group increased their moderate-to-vigorous physical activity (MVPA) (4.81 [0.06 to 9.56] min/day; + 23.5%) and reported reduction in symptoms of depression (-0.26 [-0.49 to -0.04] points or -49%) after 12 weeks of the exercise program. The exercise-induced increases in physical activity levels in the trunk-strengthening exercise group were abolished 6-weeks post-program completion. While improvements in physical activity levels were sustained in the walking-balance exercise group after detraining phase (walking only). Conclusions The inclusion of trunk strengthening to a walking-balance exercise program did not lead to statistically significant between-group improvements in physical activity levels or psychological outcomes in this cohort following completion of the 12-week exercise program. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12613001176752), registered on 28/10/2013. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03435-3.
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Murata Y, Nakamura E, Tsukamoto M, Nakagawa T, Takeda M, Kozuma M, Kadomura T, Narusawa K, Shimizu K, Uchida S, Hayashi T, Sakai A. Longitudinal study of risk factors for decreased cross-sectional area of psoas major and paraspinal muscle in 1849 individuals. Sci Rep 2021; 11:16986. [PMID: 34417520 PMCID: PMC8379148 DOI: 10.1038/s41598-021-96448-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/06/2021] [Indexed: 12/13/2022] Open
Abstract
This 10-year retrospective observational study investigated longitudinal losses in psoas major and paraspinal muscle area in 1849 healthy individuals (1690 male, 159 female) screened using computed tomography. Logistic regression analysis revealed significant decreases in psoas major and paraspinal muscle area at 10 years relative to the baseline area regardless of age or sex, starting at 30 years of age. Only aging [≥ 50 s (odds ratio [OR]: 1.72; 95% confidence interval [CI] 1.05–2.84; p = 0.03) and ≥ 60 s (OR: 2.67; 95% CI 1.55–4.60; p < 0.001)] was a risk factor for decreases in psoas major area. Age ≥ 60 years (OR: 2.05; 95% CI 1.24–3.39; p = 0.005), body mass index ≥ 25 kg/m2 (OR: 1.32; 95% CI 1.01–1.73; p = 0.04), and visceral fat ≥ 100 cm2 (OR: 1.61; 95% CI 1.20–2.15; p = 0.001) were risk factors for decreases in paraspinal muscle area. Physical activity ≥ 900 kcal/week (OR: 0.68; 95% CI 0.50–0.94; p = 0.02) attenuated paraspinal muscle area loss in male. Our study demonstrated that walking > 45 min daily (Calories = METs (walking: 3.0) × duration of time (h) × weight (60 kg) × 1.05) can reduce paraspinal muscle loss, which may in turn decrease the risk of falls, low-back pain, and sarcopenia.
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Affiliation(s)
- Yoichi Murata
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan
| | - Eiichiro Nakamura
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan.
| | - Manabu Tsukamoto
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan
| | - Toru Nakagawa
- Occupational Health Section, Hitachi Health Care Center, Hitachi Ltd., 4-3-16 Osecho, Hitachi, Ibaraki, 3170076, Japan
| | - Masaru Takeda
- Occupational Health Section, Hitachi Health Care Center, Hitachi Ltd., 4-3-16 Osecho, Hitachi, Ibaraki, 3170076, Japan
| | - Mio Kozuma
- University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan
| | - Takayuki Kadomura
- Health Care Business Unit, Hitachi Ltd., 2 Shintoyofuta, Kashiwa, Chiba, 2770804, Japan
| | - Kenichiro Narusawa
- Department of Orthopaedic Surgery, Nakashibetsu Town Hospital, 9-1-1, 10-jo Minami, Nakashibetsu-cho Nishi, Hokkaido, 0861110, Japan
| | - Kenji Shimizu
- Department of Orthopaedic Surgery, Tobata Kyoritsu Hospital, 2-5-1 Sawami, Tobata, Kitakyushu, Fukuoka, 8040093, Japan
| | - Soshi Uchida
- Department of Orthopaedic Surgery and Sports Medicine, Wakamatsu Hospital of University of Occupational and Environmental Health, 1-17-1 Hamamachi, Wakamatsu, Kitakyushu, Fukuoka, 8080024, Japan
| | - Takeshi Hayashi
- Occupational Health Section, Hitachi Health Care Center, Hitachi Ltd., 4-3-16 Osecho, Hitachi, Ibaraki, 3170076, Japan
| | - Akinori Sakai
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan
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Bondi D, Jandova T, Verratti V, D’Amico M, Kinel E, D’Attilio M, Di Filippo ES, Fulle S, Pietrangelo T. Static balance adaptations after neuromuscular electrical stimulation on quadriceps and lumbar paraspinal muscles in healthy elderly. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00777-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Abstract
Background
Strength training as neuromuscular electrical stimulation (NMES) is effective in counteracting age-related postural impairments in elderly. However, it remains unknown whether training different muscle groups would entail in different adaptations.
Aim
To evaluate the effect of NMES training on balance function in healthy inactive elderly, targeting paravertebral muscles, in addition to thigh muscles.
Methods
Eleven healthy elderly were trained with NMES for 8 week allocated to combined training (CT: quadriceps and lumbar paraspinal muscles) or to quadriceps training (QT), after completing lifestyle questionnaire and spine morphology measurements. Functional balance, static stabilometry, and isometric strength tests were assessed before and after the training period.
Results and conclusion
The CT group showed a greater improve in static balance control, i.e., reducing the CEA of the CoP displacement from 99 ± 38 to 76 ± 42 mm2 (Cohen’s d = 0.947). Benefits for improving static balance through CT might be due to NMES training, which increases spinal stabilization.
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Ito T, Sakai Y, Sugiura H, Kawai K, Morita Y, Yamazaki K. Association between Trunk Muscle Strength and Fall Risk in Older Men and Women with Lumbar Spondylosis. Healthcare (Basel) 2021; 9:healthcare9050521. [PMID: 33946785 PMCID: PMC8146285 DOI: 10.3390/healthcare9050521] [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: 03/12/2021] [Revised: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 11/16/2022] Open
Abstract
Various factors significantly affect the risk of falls among older adults with lumbar spondylosis. However, the relationship between falls and trunk muscle strength in older men is poorly explored. Thus, we aimed to investigate the relationship between back muscle strength and fall risk in older men and women with lumbar spondylosis. Based on self-reported fall scores, 39 outpatients were classified into two groups. Back and abdominal muscle strength, among other data, were compared between the two groups. Spearman's rank correlation analysis was used to assess the relationship between fall scores and selected variables. Back (r = -0.491, p = 0.002) and abdominal muscle strength (r = -0.415, p = 0.009) were related to the fall score. Furthermore, back and abdominal muscle strength were related to the fall score in women with a high risk of falls, whereas back muscle strength, erector spinae, and lumbar multifidus cross-sectional areas, and visual analog scale were related to the fall score in men with a high risk of falling. Back muscle strength and fall scores may be useful to assess the risk of falls in older patients with lumbar spondylosis. However, evaluating this relationship may require separate sex-specific analyses.
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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;
- Correspondence: ; Tel.: +81-564-64-7980
| | - Yoshihito Sakai
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu 474-8501, Japan;
| | - Hideshi Sugiura
- Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Japan;
| | - Keitaro Kawai
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (K.K.); (Y.M.)
| | - Yoshifumi Morita
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (K.K.); (Y.M.)
| | - Kazunori Yamazaki
- School of Health Sciences, Faculty of Clinical Engineering, Fujita Health University, Toyoake 470-1192, Japan;
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Zhang Y, Zhu H, Zhou Z, Wu J, Sun Y, Shen X, Li C. Comparison Between Percutaneous Transforaminal Endoscopic Discectomy and Fenestration in the Treatment of Degenerative Lumbar Spinal Stenosis. Med Sci Monit 2020; 26:e926631. [PMID: 33035202 PMCID: PMC7552888 DOI: 10.12659/msm.926631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background This study aimed to investigate the therapeutic and prognostic effects of percutaneous transforaminal endoscopic decompression (PTED) for degenerative lumbar spinal stenosis (DLSS). Material/Methods One hundred eighty-eight patients with DLSS were randomly divided into the fenestration and the PTED group for decompression treatment. Operative time, incision length, amount of blood loss, length of hospitalization, and rates of complications in the 2 groups were compared. All patients underwent computed tomography (CT) scanning and magnetic resonance imaging (MRI) on the first postoperative day. All patients were assessed preoperatively and the treatment effects at 3, 6, and 12 months postoperatively were evaluated using visual analog scale (VAS), Japanese Orthopedic Association Score (JOA) and Oswestry Disability Index (ODI). The modified MacNab criteria were used to assess patient satisfaction 1 year after surgery at the last follow-up. Results Patients who underwent PTED had shorter incisions, less blood loss, and shorter hospital stays than those in the fenestration group, but operative times and complication rates were similar in the 2 groups. Moreover, CT scanning and MRI revealed similar treatment effects in the 2 groups. Compared with preoperative status, improvements in VAS, ODI, and JOA scores occurred at different times after surgery in the 2 groups. In particular, all 3 scores in the PTED group were higher than those in the fenestration group at 3 and 6 months postoperatively. There were no significant differences in MacNab scores between the 2 groups. Conclusions PTED is safer and more effective than traditional fenestration for management of DLSS.
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Affiliation(s)
- Yang Zhang
- Department of Bone Surgery, Yangzhou Hongquan Hospital, Yangzhou, Jiangsu, China (mainland)
| | - Hengjie Zhu
- Department of Bone Surgery, Yangzhou Hongquan Hospital, Yangzhou, Jiangsu, China (mainland)
| | - Zheng Zhou
- Department of Bone Surgery, Yangzhou Hongquan Hospital, Yangzhou, Jiangsu, China (mainland)
| | - Jixiang Wu
- Department of Bone Surgery, Yangzhou Hongquan Hospital, Yangzhou, Jiangsu, China (mainland)
| | - Yinming Sun
- Department of Bone Surgery, Yangzhou Hongquan Hospital, Yangzhou, Jiangsu, China (mainland)
| | - Xiang Shen
- Department of Bone Surgery, Yangzhou Hongquan Hospital, Yangzhou, Jiangsu, China (mainland)
| | - Chengcun Li
- Department of Bone Surgery, Yangzhou Hongquan Hospital, Yangzhou, Jiangsu, China (mainland)
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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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