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Huang YC, Liu PC, Lin HH, Wang ST, Su YP, Chou PH, Yao YC. Risk prediction model of pedicle screw loosening within 2 years after decompression and instrumented fusion surgery for degenerative lumbar disease. Spine J 2025:S1529-9430(25)00061-0. [PMID: 39894275 DOI: 10.1016/j.spinee.2025.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 12/17/2024] [Accepted: 01/20/2025] [Indexed: 02/04/2025]
Abstract
BACKGROUND CONTEXT Pedicle screw loosening (PSL) after spinal fusion surgery is one of the most frequently reported complications and leads to poor clinical outcomes. PURPOSE This study aimed to develop and validate a risk prediction model for PSL within two years in patients undergoing lumbar instrumented fusion surgery based on their risk profiles. STUDY DESIGN/SETTING Retrospective, observational study. PATIENT SAMPLE Patients who underwent lumbar instrumented fusion surgery at a single academic institution between May 2015 and February 2019. OUTCOME MEASURES Risk assessment of PSL and development of a rating score based on patient characteristics. METHODS The demographic profiles and radiographic parameters using computed tomography were obtained. These factors were analyzed to determine possible risk factors related to postoperative PSL after 2 years. A scoring system was developed using these independent risk factors and validated using prospectively collected data from another center between May 2019 and December 2021. RESULTS The occurrence of PSL within 2 years postoperation was 12.7% (40/315). PSL was significantly predicted by smoking, low Hounsfield units (HU) of the pedicle tract at the index level (P), and a low psoas-lumbar vertebral index (PLVI). The risk of PSL according to the categories of the risk score was 1.1% for those with a score of 0-1, 15.1% for a score of 2-3, and 61.5% for a score of 4-6. In validation, this model demonstrated both good discrimination and calibration results. The area under the curve was 0.887 (95% CI 0.830-0.938) for the derivation cohort and 0.835 (95% CI 0.738-0.918) for the external validation cohort. CONCLUSIONS This PSL risk score, including smoking, Index P HU, and PLVI, is a novel approach to predict PSL 2 years post-surgery. This approach highlights the role of factors associated with osteoporosis and sarcopenia in the development of PSL and could aid in preoperative decision-making and surgical planning.
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Affiliation(s)
- Yen-Chun Huang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Chun Liu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsi-Hsien Lin
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Tien Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Ping Su
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Hsin Chou
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Cheng Yao
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.
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Mallio CA, Russo F, Vadalà G, Papalia R, Pileri M, Mancuso V, Bernetti C, Volpecina M, Di Gennaro G, Beomonte Zobel B, Denaro V. The importance of psoas muscle on low back pain: a single-center study on lumbar spine MRI. NORTH AMERICAN SPINE SOCIETY JOURNAL 2024; 18:100326. [PMID: 38947493 PMCID: PMC11214412 DOI: 10.1016/j.xnsj.2024.100326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 07/02/2024]
Abstract
Background Low back pain (LBP) is the most frequent indication to magnetic resonance imaging (MRI) examinations of the lumbosacral spine. The individual role of soft tissues, including muscles, on LBP is not fully understood and the contribution of each MRI-derived parameter of soft tissues status on the intensity of LBP has not been investigated in detail. Methods The study design was observational retrospective, single center carried out at a University Hospital. Images were acquired using a using a 1.5 Tesla scanner. Patients completed a symptom questionnaire and rated their pain intensity using the Visual Analogue Scale (VAS). The VAS scores were categorized as mild, moderate, and severe using cutoff values of 3.8 and 5.7, based on the literature. Biometric data, including weight and height, were also recorded to calculate the body mass index (BMI). The ratios between intramuscular fat infiltration and net muscle area were also calculated. Patient sample included 94 patients with LBP underwent MRI of the lumbosacral spine. Results The stepwise analysis revealed that increasing psoas net area was associated with lower VAS levels (odds ratio [OR]: 0.94: 95% confidence interval [CI]: 0.90-0.98; p=.005), and an increase of one square centimeter of total psoas area resulted in a greater probability of reporting a mild (+1.21%; 95% CI: 0.37, 2.05%) or a moderate VAS (+0.40%; 95% CI: -0.02, 0.82%), Furthermore, a more severe VAS was associated with a higher BMI (OR: 1.13; 95% CI: 1.00-1.27). Conclusion Our study demonstrates a relationship between LBP and MRI parameters of paravertebral and psoas muscles status. The psoas muscle is extremely important for spine stabilization and is linked to clinical symptoms of patients affected by LBP. These findings could contribute to future studies and improve treatment options in patients with LBP, possibly reducing the impact on disability, quality of life and socioeconomical burden.
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Affiliation(s)
- Carlo A. Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Fabrizio Russo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Gianluca Vadalà
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Rocco Papalia
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Matteo Pileri
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Valeria Mancuso
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Caterina Bernetti
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Manuel Volpecina
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Gianfranco Di Gennaro
- Department of Health Sciences, Chair of Medical Statistics, University of Catanzaro Magna Græcia, Viale Europa, 88100 Catanzaro, Italy
| | - Bruno Beomonte Zobel
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Vincenzo Denaro
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
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Mangum LC, Skibski A, Devorski L, Slater L. Balance Error Scoring System Performance Differences in Figure Skaters Based on Discipline. Int J Sports Phys Ther 2023; 18:898-904. [PMID: 37547844 PMCID: PMC10399104 DOI: 10.26603/001c.81598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/07/2023] [Indexed: 08/08/2023] Open
Abstract
Background Balance and postural stability are required of figure skaters throughout on-ice performance. Spinning, jumping, and landing each rely on this skill set to maintain control while skaters manage changing demands for each skating discipline. Hypothesis/Purpose The aim of this study was to compare balance error scoring system (BESS) performance in figure skaters between disciplines and determine if age was related to BESS performance. Study Design Cross-sectional study. Methods Three hundred and fifty-eight figure skaters (age: 15.4±3.3 years, 213 females, 145 males) of multiple disciplines completed the BESS during the United States Figure Skating's Standardized Testing of Athleticism to Recognize Skaters (S.T.A.R.S.) combine. Errors during each condition of the BESS were recorded by trained evaluators. A 3x6 ANOVA was used to determine BESS differences based on skating discipline. Spearman's rho (ρ) correlation coefficients were calculated for relationships between BESS errors and age. Results Ice dancers had more errors than singles and pairs for bipedal foam (p<0.001) but had fewer errors than single skaters for single leg foam (p=0.002). Tandem on a firm surface also showed an increase in errors for ice dancers and pairs skaters compared to singles (p<0.001). There were significant weak negative relationships noted between age and bipedal foam and single leg firm conditions (ρ=-0.14, -0.23, p<0.05). Conclusion Figure skaters of different disciplines have varying levels of static postural stability. Assessing postural stability in figure skaters can provide insight to improve performance and may identify skaters at risk of injury. Level of Evidence 3©The Author(s).
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Affiliation(s)
- L Colby Mangum
- Kinesiology and Rehabilitation Sciences University of Central Florida
| | - Andrew Skibski
- Kinesiology and Rehabilitation Sciences University of Central Florida
| | - Luk Devorski
- Kinesiology and Rehabilitation Sciences University of Central Florida
| | - Lindsay Slater
- Physical Therapy University of Illinois at Chicago
- Athlete High Performance United States Figure Skating
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Paramanidis N, Kabasakalis A, Koutlianos N, Tsalis G, Kouidi E. Shoulder Pain and Trunk Muscles Endurance in Young Male and Female Swimmers. Healthcare (Basel) 2023; 11:2145. [PMID: 37570385 PMCID: PMC10419166 DOI: 10.3390/healthcare11152145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Shoulder pain is a common syndrome in swimming and affects a large number of competitive swimmers. The purpose of the study was to investigate the relationship between pain in the shoulder girdle and the endurance of the trunk muscles in young swimmers. A total of 24 boys and 22 girls, aged 13 to 18 years, participated in the study. The measurements included the completion of a questionnaire (Shoulder Pain and Disability Index, SPADI) and a field test (McGill's Torso Muscular Endurance Test). The total SPADI score correlated weakly and negatively with the endurance time of back muscles in both sexes (r2 = 0.10, p = 0.035), and moderately and negatively in girls (r2 = 0.23, p = 0.023). A weak negative correlation was found between the disability index and the back muscles' endurance time in both sexes (r2 = 0.15, p = 0.007), which was moderate in girls only (r2 = 0.25, p = 0.019). The disability index displayed moderate negative correlations with the right oblique's (r2 = 0.18, p = 0.049) and left oblique's endurance time (r2 = 0.23, p = 0.024) in girls. Weight, body mass index, the total out-of-water training time per week and age significantly affected the endurance times of the trunk muscles in boys and girls (p < 0.05). In conclusion, strengthening the dorsal and the oblique muscles could reduce shoulder pain and disability in young swimmers and especially girls.
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Affiliation(s)
- Nikolaos Paramanidis
- Laboratory of Sports Medicine, School of Physical Education and Sports Science at Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (N.P.); (N.K.); (E.K.)
| | - Athanasios Kabasakalis
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Nikolaos Koutlianos
- Laboratory of Sports Medicine, School of Physical Education and Sports Science at Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (N.P.); (N.K.); (E.K.)
| | - George Tsalis
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Evangelia Kouidi
- Laboratory of Sports Medicine, School of Physical Education and Sports Science at Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (N.P.); (N.K.); (E.K.)
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Swanson DC, Sponbeck JK, Swanson DA, Stevens CD, Allen SP, Mitchell UH, George JD, Johnson AW. Validity of ultrasound imaging for intrinsic foot muscle cross-sectional area measurements demonstrated by strong agreement with MRI. BMC Musculoskelet Disord 2022; 23:146. [PMID: 35164718 PMCID: PMC8842549 DOI: 10.1186/s12891-022-05090-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Intrinsic foot muscles maintain foot structural integrity and contribute to functional movement, posture and balance. Thus, assessing intrinsic foot muscle size and strength are important. Magnetic resonance imaging (MRI) has been shown to accurately image the individual muscles but is costly and time consuming. Ultrasound (US) imaging may provide an alternative that is less costly and more readily available. The purpose of this study was to investigate the validity and intratester reliability of US imaging in measuring intrinsic foot muscle size in comparison to MRI. METHODS US and MRI were employed to measure the intrinsic foot muscle size involving 35 participants (females = 13; males = 22). The scanned intrinsic foot muscles included the flexor hallucis brevis (FHB), abductor hallucis (ABDH), flexor digitorum brevis (FDB), quadratus plantae (QP) and abductor digiti minimi (ADM). Pearson product correlation (r), intraclass correlation coefficients (ICC), standard error of the measurement (SEm) and minimal detectable difference (MDD) were calculated. RESULTS High correlations were detected between the US and MRI cross-sectional area (CSA) measurements (r = .971 to 0.995). Test reliability was excellent for both MRI and US (ICC = 0.994 to 0.999). Limits of agreement between MRI and US measurements from ranged from 5.7 to 12.2% of muscle size. SEm values for US ranged from 0.026 to 0.044 cm2, while the SEm for MRI ranged from 0.018 to 0.023 cm2. MDD values for US ranged from 0.073 to 0.122 cm2, while MRI ranged from 0.045 to 0.064 cm2. CONCLUSIONS US appears to be a valid and reliable alternative to MRI when measuring intrinsic foot muscle CSA. While US is less costly and more readily available, the MRI results were shown to be slightly more precise.
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Affiliation(s)
- Dallin C Swanson
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Joshua K Sponbeck
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Derek A Swanson
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Conner D Stevens
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Steven P Allen
- Electrical and Computer Engineering, Ira A. Fulton College of Engineering, Brigham Young University, Provo, UT, USA
| | - Ulrike H Mitchell
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - James D George
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Aaron Wayne Johnson
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA.
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Kanamoto H, Orita S, Inage K, Shiga Y, Abe K, Eguchi Y, Ohtori S. Effect of Ultrasound-Guided Hydrorelease of the Multifidus Muscle on Acute Low Back Pain. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:981-987. [PMID: 32840876 PMCID: PMC8247302 DOI: 10.1002/jum.15473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/20/2020] [Accepted: 07/30/2020] [Indexed: 05/13/2023]
Abstract
OBJECTIVES To examine improvement in acute low back pain (LBP) using ultrasound-guided hydrorelease of the multifidus muscle. METHODS This prognostic cohort study was conducted in a private clinic on samples of 75 patients with acute LBP diagnosed based on physical and imaging findings. Hydrorelease of the multifidus muscle was performed at the L4/5 level. The LBP visual analog scale (VAS) scores (cm) before and 5 minutes after hydrorelease were statistically evaluated. We defined improvement rate (%) as {LBP VAS scores (cm) immediately before hydrorelease - LBP VAS scores (cm) 5 minutes after hydrorelease} × 100 / LBP VAS scores (cm) immediately before hydrorelease and examined the correlation of the Heckmatt score and average age with the improvement rate. RESULTS LBP VAS scores (cm) before and 5 minutes after hydrorelease were 7.19 ± 1.01 (mean ± SD) and 2.85 ± 1.25, respectively (p < 0.05). No significant correlations were noted between the LBP improvement rate and the Heckmatt score or age. There were no gender variations in the improvement rate. CONCLUSIONS Ultrasound-guided hydrorelease of the multifidus muscle led to considerable LBP VAS score improvement at the outpatient level. The improvement rate showed no correlations with the Heckmatt score or age, and there were no significant gender variations in the improvement rate. Therefore, fatty degeneration of muscles and change in muscle echogenicity due to age and gender may not be associated with muscular LBP. These findings suggest that multifidus muscle hydrorelease could be useful in the diagnosis and treatment of acute LBP.
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Affiliation(s)
- Hirohito Kanamoto
- Department of Orthopaedic SurgeryKanamoto Orthopaedic Clinic760‐7 Matsunaga, Numazu, Shizuoka410‐0874Japan
- Department of Orthopaedic SurgeryGraduate School of Medicine, Chiba University1‐8‐1 Inohana, Chuo‐ku, Chiba260‐8670Japan
| | - Sumihisa Orita
- Department of Orthopaedic SurgeryGraduate School of Medicine, Chiba University1‐8‐1 Inohana, Chuo‐ku, Chiba260‐8670Japan
| | - Kazuhide Inage
- Department of Orthopaedic SurgeryGraduate School of Medicine, Chiba University1‐8‐1 Inohana, Chuo‐ku, Chiba260‐8670Japan
| | - Yasuhiro Shiga
- Department of Orthopaedic SurgeryGraduate School of Medicine, Chiba University1‐8‐1 Inohana, Chuo‐ku, Chiba260‐8670Japan
| | - Koki Abe
- Department of Orthopaedic SurgeryGraduate School of Medicine, Chiba University1‐8‐1 Inohana, Chuo‐ku, Chiba260‐8670Japan
| | - Yawara Eguchi
- Department of Orthopaedic SurgeryGraduate School of Medicine, Chiba University1‐8‐1 Inohana, Chuo‐ku, Chiba260‐8670Japan
| | - Seiji Ohtori
- Department of Orthopaedic SurgeryGraduate School of Medicine, Chiba University1‐8‐1 Inohana, Chuo‐ku, Chiba260‐8670Japan
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Trunk Muscle Characteristics: Differences Between Sedentary Adults With and Without Unilateral Lower Limb Amputation. Arch Phys Med Rehabil 2021; 102:1331-1339. [PMID: 33684366 DOI: 10.1016/j.apmr.2021.02.008] [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: 09/02/2020] [Revised: 01/06/2021] [Accepted: 02/03/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The primary purpose of this study was to compare trunk muscle characteristics between adults with and without unilateral lower limb amputation (LLA) to determine the presence of modifiable trunk muscle deficits (ie, impaired activity, reduced volume, increased intramuscular fat) evaluated by ultrasonography (US) and magnetic resonance imaging (MRI). We hypothesized that compared with adults without LLA (controls), individuals with transfemoral or transtibial LLA would demonstrate reduced multifidi activity, worse multifidi and erector spinae morphology, and greater side-to-side trunk muscle asymmetries. DESIGN Cross-sectional imaging study. SETTING Research laboratory and imaging center. PARTICIPANTS Sedentary adults (n=38 total) with LLA (n=9 transfemoral level; n=14 transtibial level) and controls without LLA (n=15). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES We examined bilateral multifidi activity using US at levels L3/L4-L5/S1. MRI was performed using 3-dimensional quantitative fat-water imaging; bilateral L1-L5 multifidi and erector spinae were manually traced, and muscle volume (normalized to body weight) and percentage intramuscular fat were determined. Between-group and side-to-side differences were evaluated. RESULTS Compared with adults without LLA, participants with LLA demonstrated reduced sound-side multifidi activity; those with transfemoral LLA had larger amputated-side multifidi volume, whereas those with transtibial LLA had greater sound- and amputated-side erector spinae intramuscular fat (P<.050). With transfemoral LLA, side-to-side differences in erector spinae volume, as well as multifidi and erector spinae intramuscular fat, were found (P<.050). CONCLUSIONS Impaired trunk muscle activity and increased intramuscular fat may be modifiable targets for intervention after LLA.
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Dallaway A, Hattersley J, Diokno M, Tallis J, Renshaw D, Wilson A, Wayte S, Weedall A, Duncan M. Age-related degeneration of lumbar muscle morphology in healthy younger versus older men. Aging Male 2020; 23:1583-1597. [PMID: 33691587 DOI: 10.1080/13685538.2021.1878130] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
AIM The aim of this study was to evaluate age-related changes in lumbar paravertebral muscle (LPM) morphology in healthy younger and older adult men. METHODS T2-weighted axial MRI of the lumbar spine were obtained for 12 healthy older (67.3 ± 6.0 years) and younger (24.7 ± 3.1 years) men. Normalised muscle volume (NMV) and muscle fat infiltrate (MFI) were determined bilaterally for the psoas (PS), quadratus lumborum (QL), erector spinae (ES) and multifidus (MF). MANOVA was used to compare NMV and MFI between age groups. Follow-up ANOVA compared NMV and MFI for each muscle between age groups, with physical activity (PA) as a covariate. Stepwise regression was used to explore the association between muscle morphology. RESULTS NMV of the ES and QL were significantly lower in the older group (OG) (p = 0.040 and p < 0.001, respectively). MFI across all muscles was significantly greater in the OG (p < 0.001). PA did not moderate the relationship between aging and muscle degeneration. Non-dominant handgrip strength was associated with NMV (p = 0.003). CONCLUSIONS Age-related atrophy is muscle specific in the lumbar spine; changes in lumbar musculature is independent of PA, handgrip strength may reflect morphological changes in the postural muscles with age. This study supports establishing effective targeted exercise interventions in the lumbar musculature.
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Affiliation(s)
- Alexander Dallaway
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- Coventry NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - John Hattersley
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- Coventry NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - Michael Diokno
- Department of Radiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Jason Tallis
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Derek Renshaw
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Adrian Wilson
- Coventry NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Coventry, UK
- Radiology Physics, Department of Clinical Physics and Bioengineering, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Sarah Wayte
- Radiology Physics, Department of Clinical Physics and Bioengineering, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Andrew Weedall
- Radiology Physics, Department of Clinical Physics and Bioengineering, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Michael Duncan
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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Erdağı K, Poyraz N. The determination of the cross-sectional area of the lumbar erector spinae muscles of Olympic style weightlifting athletes by using MRI. J Back Musculoskelet Rehabil 2020; 33:405-412. [PMID: 31868659 DOI: 10.3233/bmr-191725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The study aims to measure the cross-sectional area of the lumbar erector spinae muscles from L3-L4 intervertebral disc levels by using magnetic resonance images of Olympic style weightlifting athletes (male n= 15, female n= 15) and sedentary individuals (male n= 15, female n= 15). METHODS A 1.5 Tesla device was used for the magnetic resonance imaging process of all participants. The images were then executed in ImageJ software and the cross-sectional area was measured after the required synchronization steps were conducted. RESULTS On the images taken from L3-L4 intervertebral disc levels, we observed that right-left cross-sectional area measurements of erector spinae muscles of sedentary males and females in the control groups were smaller than those of male and female athletes in Olympic style weightlifting. We also found a symmetry between right-left cross-sectional area measurements of groups of athletes. CONCLUSIONS From the study findings, we might conclude that trainings of Olympic style weightlifting possess a hypertrophic effect on the cross-sectional area of erector spinae muscles of Olympic style weightlifting athletes.
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Affiliation(s)
- Kenan Erdağı
- Physical Education and Sports Department, Faculty of Education, Necmettin Erbakan University, Konya, Turkey
| | - Necdet Poyraz
- Radiology Department, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Stability Training and Effectiveness of Playing Basketball. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2020. [DOI: 10.18276/cej.2020.2-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Long-term Impacts of Brace Treatment for Adolescent Idiopathic Scoliosis on Body Composition, Paraspinal Muscle Morphology, and Bone Mineral Density. Spine (Phila Pa 1976) 2019; 44:E1075-E1082. [PMID: 31261269 DOI: 10.1097/brs.0000000000003069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective, long-term follow-up study. OBJECTIVE We aimed to investigate the long-term impacts of brace treatment for adolescent idiopathic scoliosis (AIS) on the musculoskeletal system. SUMMARY OF BACKGROUND DATA Although full-time brace treatment is the mainstay of conservative treatment for AIS, the restrictive nature of brace treatment for lumbosacral motion might negatively affect the musculoskeletal system. METHODS Of 319 patients treated nonoperatively for AIS, 80 patients completed clinical and imaging examinations. Body composition, including body fat mass, lean mass, fat percent, and muscle mass, was estimated via bioelectrical impedance analysis. Bone mineral density (BMD) was measured at the lumbar spine and left hip. In 73 patients, the measurement of cross-sectional area and fatty degeneration of paraspinal muscles at the superior endplate of L4 were performed using axial T2-weighted magnetic resonance imaging. Patients were divided into the full-time brace (FB; >13 hours per day) and nonfull-time brace (NFB; observation, part-time bracing, or drop out from FB within a year) groups. RESULTS There were 44 patients in the FB group and 36 in the NFB group. Patients in the FB group were significantly younger at the initial visit (12.7 ± 1.3 years) and older at the final follow-up (41.5 ± 5.6 years) than those in the NFB group (14.2 ± 3.2 and 37.4 ± 7.1 years, respectively; P < 0.01). The rate of patients engaging in mild or moderate sports activity in adulthood tended to be higher in the FB group (47.7%) than in the NFB group (25%) (P = 0.11). However, there were no significant differences in body composition, paraspinal muscle morphology, and BMD between the two groups both before and after adjusting for age. CONCLUSION Full-time brace wearing during adolescence did not have any negative impacts on the musculoskeletal system in adulthood. This information will be helpful for improving the compliance of full-time bracing. LEVEL OF EVIDENCE 4.
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Schmid S, Burkhart KA, Allaire BT, Grindle D, Anderson DE. Musculoskeletal full-body models including a detailed thoracolumbar spine for children and adolescents aged 6-18 years. J Biomech 2019; 102:109305. [PMID: 31471110 DOI: 10.1016/j.jbiomech.2019.07.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/11/2019] [Accepted: 07/12/2019] [Indexed: 11/30/2022]
Abstract
Currently available musculoskeletal inverse-dynamics thoracolumbar spine models are entirely based on data from adults and might therefore not be applicable for simulations in children and adolescents. In addition, these models lack lower extremities, which are required for comprehensive evaluations of functional activities or therapeutic exercises. We therefore created OpenSim-based musculoskeletal full-body models including a detailed thoracolumbar spine for children and adolescents aged 6-18 years and validated by comparing model predictions to in vivo data. After combining our recently developed adult thoracolumbar spine model with a lower extremity model, children and adolescent models were created for each year of age by adjusting segmental length and mass distribution, center of mass positions and moments of inertia of the major body segments as well as sagittal pelvis and spine alignment based on literature data. Similarly, muscle strength properties were adjusted based on CT-derived cross-sectional area measurements. Simulations were conducted from in vivo studies reported in the literature involving children and adolescents evaluating maximum trunk muscle strength (MTMS), lumbar disc compressibility (LDC), intradiscal pressure (IDP) and trunk muscle activity (MA). Model predictions correlated highly with in vivo data (MTMS: r ≥ 0.82, p ≤ 0.03; LDC: r = 0.77, p < 0.001; IDP: r ≥ 0.78, p < 0.001; MA: r ≥ 0.90, p < 0.001), indicating suitability for the reasonably accurate prediction of maximal trunk muscle strength, segmental loading and trunk muscle activity in children and adolescents. When aiming at investigating children or adolescents with pathologies such as idiopathic scoliosis, our models can serve as a basis for the creation of deformed spine models and for comparative purposes.
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Affiliation(s)
- Stefan Schmid
- Beth Israel Deaconess Medical Center, Center for Advanced Orthopaedic Studies, Boston, MA, United States; Harvard Medical School, Department of Orthopaedic Surgery, Boston, MA, United States; Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland.
| | - Katelyn A Burkhart
- Beth Israel Deaconess Medical Center, Center for Advanced Orthopaedic Studies, Boston, MA, United States; Massachusetts Institute of Technology, Harvard-MIT Health Sciences and Technology Program, Cambridge, MA, United States
| | - Brett T Allaire
- Beth Israel Deaconess Medical Center, Center for Advanced Orthopaedic Studies, Boston, MA, United States
| | - Daniel Grindle
- Beth Israel Deaconess Medical Center, Center for Advanced Orthopaedic Studies, Boston, MA, United States
| | - Dennis E Anderson
- Beth Israel Deaconess Medical Center, Center for Advanced Orthopaedic Studies, Boston, MA, United States; Harvard Medical School, Department of Orthopaedic Surgery, Boston, MA, United States
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Honkanen T, Mäntysaari M, Leino T, Avela J, Kerttula L, Haapamäki V, Kyröläinen H. Cross-sectional area of the paraspinal muscles and its association with muscle strength among fighter pilots: a 5-year follow-up. BMC Musculoskelet Disord 2019; 20:170. [PMID: 30991977 PMCID: PMC6469149 DOI: 10.1186/s12891-019-2551-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/02/2019] [Indexed: 11/30/2022] Open
Abstract
Background A small cross sectional area (CSA) of the paraspinal muscles may be related to low back pain among military aviators but previous studies have mainly concentrated on spinal disc degeneration. Therefore, the primary aim of the study was to investigate the changes in muscle CSA and composition of the psoas and paraspinal muscles during a 5-year follow up among Finnish Air Force (FINAF) fighter pilots. Methods Study population consisted of 26 volunteered FINAF male fighter pilots (age: 20.6 (±0.6) at the baseline). The magnetic resonance imaging (MRI) examinations were collected at baseline and after 5 years of follow-up. CSA and composition of the paraspinal and psoas muscles were obtained at the levels of 3–4 and 4–5 lumbar spine. Maximal isometric strength tests were only performed on one occasion at baseline. Results The follow-up comparisons indicated that the mean CSA of the paraspinal muscles increased (p < 0.01) by 8% at L3–4 level and 7% at L4–5 level during the 5-year period. There was no change in muscle composition during the follow-up period. The paraspinal and psoas muscles’ CSA was positively related to overall maximal isometric strength at the baseline. However, there was no association between LBP and muscle composition or CSA. Conclusions The paraspinal muscles’ CSA increased among FINAF fighter pilots during the first 5 years of service. This might be explained by physically demanding work and regular physical activity. However, no associations between muscle composition or CSA and low back pain (LBP) experienced were observed after the five-year follow-up.
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Affiliation(s)
- Tuomas Honkanen
- Centre for Military Medicine, P.O.Box 50, FI-00301, Helsinki, Finland.
| | - Matti Mäntysaari
- Centre for Military Medicine, P.O.Box 50, FI-00301, Helsinki, Finland
| | - Tuomo Leino
- Air Force Command Finland, Tikkakoski, Finland.,Department of Leadership and Military Pedagogy, National Defense University, Helsinki, Finland
| | - Janne Avela
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | | | - Heikki Kyröläinen
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Leadership and Military Pedagogy, National Defense University, Helsinki, Finland
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Seo YG, Park WH, Lee CS, Kang KC. Lumbar Extensor Muscle Size and Isometric Muscle Strength in Women with Symptomatic Lumbar Degenerative Diseases. Asian Spine J 2018; 12:943-950. [PMID: 30213179 PMCID: PMC6147876 DOI: 10.31616/asj.2018.12.5.943] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/05/2018] [Indexed: 11/25/2022] Open
Abstract
Study Design A cross-sectional design. Purpose To determine the characteristics of lumbar extensor muscle (LEM) size and isometric muscle strength and examine their correlations in women with lumbar degenerative diseases (LDDs). Overview of Literature Many studies have evaluated the relationship between muscle size and strength, but the results have been controversial. Methods Seventy-four female patients (mean age, 66 years) who consecutively underwent posterior lumbar interbody fusion (L1–S1) were recruited. The cross-sectional area (CSA) of the back extensor muscles was measured between L1–2 to L5–S1, and the total sum of the CSAs at each disc level was calculated. Back extensor muscle strength was evaluated using a MedX lumbar extension machine. The Oswestry Disability Index (ODI, 0–100) and Visual Analog Scale (VAS, 0–10) of lower back pain were determined. Results The mean CSAs of the LEM at each level (L1/2–L5/S1) and the total sum were 34.3, 36.3, 35.1, 31.4, 21.9, and 156.2 cm2, respectively. The mean isometric strength at each angle (range, 0°–72°) was 32.5, 50.1, 72.0, 88.7, 100.7, 112.2, and 126.2 ft-lb, respectively. The mean ODI and VAS scores were 54.6 and 6.6, and the mean body weight and body mass index (BMI) were 59.9 kg and 24.9 kg/m2, respectively. The CSAs of the upper lumbar level (L1–4) and the total sum of the CSAs were associated with isometric strength, which was negatively correlated with patients’ age and ODI and positively associated with body weight and BMI, mainly at higher lumbar flexion angles (48°–72°). Conclusions In women with LDD, LEM sizes of the upper lumbar levels (L1–4) were larger than those of the lower levels (L4–S1) and were positively associated with muscle strength. The upper lumbar levels in patients with LDDs appear to play a compensatory role when degenerative lesions are present in the lower lumbar levels.
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Affiliation(s)
- Yong Gon Seo
- Division of Sports Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Hah Park
- Division of Sports Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Suh Lee
- Division of Sports Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Chung Kang
- Department of Orthopedic Surgery, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
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Janwantanakul P, Sihawong R, Sitthipornvorakul E, Paksaichol A. A Path Analysis of the Effects of Biopsychosocial Factors on the Onset of Nonspecific Low Back Pain in Office Workers. J Manipulative Physiol Ther 2018; 41:405-412. [DOI: 10.1016/j.jmpt.2017.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 10/26/2017] [Indexed: 11/24/2022]
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Wachi M, Suga T, Higuchi T, Misaki J, Tsuchikane R, Tanaka D, Miyake Y, Kanazawa N, Isaka T. Applicability of ultrasonography for evaluating trunk muscles size in athletes: a study focused on baseball batters. J Phys Ther Sci 2017; 29:1534-1538. [PMID: 28931982 PMCID: PMC5599815 DOI: 10.1589/jpts.29.1534] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/05/2017] [Indexed: 11/27/2022] Open
Abstract
[Purpose] Recently, we demonstrated that the thicknesses of trunk muscles measured using
ultrasonography were correlated strongly with the cross-sectional areas measured using
magnetic resonance imaging in untrained subjects. To further explore the applicability of
ultrasonography in the clinical setting, the present study examined the correlation
between ultrasonography-measured thicknesses and magnetic resonance imaging-measured
cross-sectional areas of trunk muscles in athletes with trained trunk muscles. [Subjects
and Methods] The thicknesses and cross-sectional areas at total 10 sites of the bilateral
sides of the upper, central, and lower parts of the rectus abdominis, abdominal wall, and
multifidus lumborum in 30 male baseball batters were measured. [Results] Overall
thicknesses and cross-sectional areas of the trunk muscles in baseball batters were higher
than those in untrained subjects who participated in our previous study. The
ultrasonography-measured thicknesses at all 10 sites of the trunk muscles correlated
highly with the magnetic resonance imaging-measured cross-sectional areas in baseball
batters. [Conclusion] These results suggest that the thicknesses of the trunk muscles
measured using ultrasonography can be used as a surrogate marker for the cross-sectional
area measured using magnetic resonance imaging, in athletes who have larger trunk muscles
than that of untrained subjects.
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Affiliation(s)
- Michio Wachi
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan.,Kanazawa Orthopaedic & Sports Medicine Clinic, Japan
| | - Tadashi Suga
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Takatoshi Higuchi
- Faculty of Socio-Environmental Studies, Fukuoka Institute of Technology, Japan
| | - Jun Misaki
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Ryo Tsuchikane
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Daichi Tanaka
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Yuto Miyake
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Nobuhiko Kanazawa
- Kanazawa Orthopaedic & Sports Medicine Clinic, Japan.,Faculty of Nursing and Rehabilitation, Aino University, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
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Indices of Paraspinal Muscles Degeneration: Reliability and Association With Facet Joint Osteoarthritis: Feasibility Study. Clin Spine Surg 2016; 29:465-470. [PMID: 27137159 DOI: 10.1097/bsd.0b013e31828be943] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
STUDY DESIGN A reliability and cross-sectional observational study. OBJECTIVE To introduce a scoring system for visible fat infiltration in paraspinal muscles; to evaluate intertester and intratester reliability of this system and its relationship with indices of muscle density; to evaluate the association between indices of paraspinal muscle degeneration and facet joint osteoarthritis. SUMMARY OF BACKGROUND DATA Current evidence suggests that the paraspinal muscles degeneration is associated with low back pain, facet joint osteoarthritis, spondylolisthesis, and degenerative disc disease. However, the evaluation of paraspinal muscles on computed tomography is not radiological routine, probably because of absence of simple and reliable indices of paraspinal degeneration. METHODS One hundred fifty consecutive computed tomography scans of the lower back (N=75) or abdomen (N=75) were evaluated. Mean radiographic density (in Hounsfield units) and SD of the density of multifidus and erector spinae were evaluated at the L4-L5 spinal level. A new index of muscle degeneration, radiographic density ratio=muscle density/SD of density, was calculated. To evaluate the visible fat infiltration in paraspinal muscles, we proposed a 3-graded scoring system. The prevalence of facet joint osteoarthritis was also evaluated. Intraclass correlation and κ statistics were used to evaluate inter-rater and intra-rater reliability. Logistic regression examined the association between paraspinal muscle indices and facet joint osteoarthritis. RESULTS Intra-rater reliability for fat infiltration score (κ) ranged between 0.87 and 0.92; inter-rater reliability between 0.70 and 0.81. Intra-rater reliability (intraclass correlation) for mean density of paraspinal muscles ranged between 0.96 and 0.99, inter-rater reliability between 0.95 and 0.99; SD intra-rater reliability ranged between 0.82 and 0.91, inter-rater reliability between 0.80 and 0.89. Significant associations (P<0.01) were found between facet joint osteoarthritis, fat infiltration score, and radiographic density ratio. CONCLUSIONS Two suggested indices of paraspinal muscle degeneration showed excellent reliability and were significantly associated with facet joint osteoarthritis. Additional studies are needed to evaluate the associations with other spinal degeneration features and low back pain.
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Iwai K, Koyama K, Okada T, Nakazato K, Takahashi R, Matsumoto S, Yamamoto Y, Hiranuma K. Asymmetrical and smaller size of trunk muscles in combat sports athletes with lumbar intervertebral disc degeneration. SPRINGERPLUS 2016; 5:1474. [PMID: 27652049 PMCID: PMC5009060 DOI: 10.1186/s40064-016-3155-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 08/24/2016] [Indexed: 12/21/2022]
Abstract
Background Lumbar intervertebral disc degeneration (LDD) frequently occurs in athletes. Associations between LDD and trunk muscles still remain unclear. Purpose This study examined whether there is an association between the prevalence of LDD and the symmetry and size of the cross-sectional areas (CSAs) of the trunk muscles in combat sports athletes. Methods Participants in this study were 151 collegiate male combat sports athletes. A total of 755 lumbar intervertebral discs from L1–2 to L5–S1 in 151 athletes were assessed using magnetic resonance imaging (MRI) and a comprehensive grading system of LDD (grades I–V). All 151 athletes were divided into 2 groups: LDD and non-LDD. CSAs of trunk muscles at the L3–4 disc level were measured using MRI. Results Sixty-nine athletes had LDD at 1 or more disc levels (45.7 %). The LDD grade for the lower 2 disc levels was significantly higher than that for the other disc levels (p < 0.001). The CSAs of the left and right sides in trunk muscles were significantly asymmetrical, independent of the LDD which was prevalent in the disc levels (obliques: p = 0.040; quadratus lumborum: p < 0.001). The relative CSAs of trunk muscles to their body weight in the LDD group were significantly smaller than those in the non-LDD group (rectus abdominis: p = 0.011; obliques: p = 0.024; quadratus lumborum: p = 0.006; lumbar erector spinae plus multifidus: p = 0.001). Conclusion This study suggests that the prevalence of LDD is associated with asymmetrical and relatively smaller CSAs of trunk muscles in combat sports athletes.
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Affiliation(s)
- Kazunori Iwai
- School of Kinesiology, Western University, 1151 Richmond Street, London, ON N6A 3K7 Canada ; Hiroshima Maritime College, National Institute of Technology, 4272-1 Higashino Osakikamijima-cho, Toyota-gun, Hiroshima, 725-0231 Japan
| | - Koji Koyama
- Department of Judotherapy, Tokyo Ariake University of Medical and Health Science, 2-9-1 Ariake, Koto-ku, Tokyo, 135-0063 Japan
| | - Takashi Okada
- Faculty of Sport Science, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo, 158-8508 Japan
| | - Koichi Nakazato
- Graduate School of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo, 158-8508 Japan
| | - Ray Takahashi
- School of Kinesiology, Western University, 1151 Richmond Street, London, ON N6A 3K7 Canada
| | - Shingo Matsumoto
- Sports Methodology (Wrestling), Nippon Sport Science University, 1221-1, Kamoshida-cho, Aoba-ku, Yokohama, Kanagawa 227-0033 Japan
| | - Yosuke Yamamoto
- Sports Methodology (Judo), Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo, 158-8508 Japan
| | - Kenji Hiranuma
- Graduate School of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo, 158-8508 Japan
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Moal B, Bronsard N, Raya JG, Vital JM, Schwab F, Skalli W, Lafage V. Volume and fat infiltration of spino-pelvic musculature in adults with spinal deformity. World J Orthop 2015; 6:727-737. [PMID: 26495250 PMCID: PMC4610915 DOI: 10.5312/wjo.v6.i9.727] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/20/2015] [Accepted: 08/14/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate fat infiltration and volume of spino-pelvic muscles in adults spinal deformity (ASD) with magnetic resonance imaging (MRI) and 3D reconstructions.
METHODS: Nineteen female ASD patients (mean age 60 ± 13) were included prospectively and consecutively and had T1-weighted Turbo Spin Echo sequence MRIs with Dixon method from the proximal tibia up to T12 vertebra. The Dixon method permitted to evaluate the proportion of fat inside each muscle (fat-water ratio). In order to investigate the accuracy of the Dixon method for estimating fat vs water, the same MRI acquisition was performed on phantoms of four vials composed of different proportion of fat vs water. With Muscl’X software, 3D reconstructions of 17 muscles or group of muscles were obtained identifying the muscle’s contour on a limited number of axial images [Deformation of parametric specific objects (DPSO) Method]. Musclar volume (Vmuscle), infiltrated fat volume (Vfat) and percentage of fat infiltration [Pfat, calculated as follow: Pfat = 100 × (Vfat/Vmuscle)] were characterized by extensor or flexor function respectively for the spine, hip and knee and theirs relationship with demographic data were investigated.
RESULTS: Phantom acquisition demonstrated a non linear relation between Dixon fat-water ratio and the real fat-water ratio. In order to correct the Dixon fat-water ratio, the non linear relation was approximated with a polynomial function of degree three using the phantom acquisition. On average, Pfat was 13.3% ± 5.3%. Muscles from the spinal extensor group had a Pfat significantly greater than the other muscles groups, and the largest variability (Pfat = 31.9% ± 13.8%, P < 0.001). Muscles from the hip extensor group ranked 2nd in terms of Pfat (14% ± 8%), and were significantly greater than those of the knee extensor (P = 0.030). Muscles from the knee extensor group demonstrated the least Pfat (12% ± 8%). They were also the only group with a significant correlation between Vmuscle and Pfat (r = -0.741, P < 0.001), however this correlation was lacking in the other groups. No correlation was found between the Vmuscle total and age or body mass index. Except for the spine flexors, Pfat was correlated with age. Vmuscle and Vfat distributions demonstrated that muscular degeneration impacted the spinal extensors most.
CONCLUSION: Mechanisms of fat infiltration are not similar among the muscle groups. Degeneration impacted the spinal and hip extensors most, key muscles of the sagittal alignment.
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Dejanovic A, Balkovec C, McGill S. Head Posture Influences Low Back Muscle Endurance Tests in 11-Year-Old Children. J Mot Behav 2014; 47:226-31. [DOI: 10.1080/00222895.2014.974493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fortin M, Videman T, Gibbons LE, Battié MC. Paraspinal muscle morphology and composition: a 15-yr longitudinal magnetic resonance imaging study. Med Sci Sports Exerc 2014; 46:893-901. [PMID: 24091994 DOI: 10.1249/mss.0000000000000179] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE The purposes of this study were to define the natural progression of age-related changes of the lumbar paraspinal muscles during adulthood and to investigate the influence of lifestyle and individual factors (e.g., physical activity levels at work and leisure, body mass index, and low back pain [LBP]). METHODS This population-based longitudinal study included a sample of 99 adult male twins. Data were collected through a structured interview, physical examination, and magnetic resonance imaging. Measurements of the lumbar multifidus and erector spinae muscles were obtained from T2-weighted axial images at L3-L4 and L5-S1 at baseline and 15-yr follow-up. Muscle cross-sectional area (CSA), functional CSA (FCSA) (fat-free mass), and FCSA/CSA (composition) as well as CSA and FCSA asymmetry and FCSA/CSA side-to-side differences were measured. RESULTS Subjects' mean ± SD age was 47.3 ± 7.4 yr at baseline and 62.3 ± 8.0 yr at follow-up. During the 15-yr period, both muscles exhibited a decrease in CSA and FCSA and an increase in fatty infiltration and side-to-side differences in size and composition at both spinal levels. Both muscles displayed greater changes at L5-S1 than L3-L4. Age and BMI were found to be significantly associated with the degree of paraspinal muscle changes over time. However, there was no association between the change in paraspinal muscle size, composition, or asymmetry with the level of physical demands at work or leisure or LBP history. CONCLUSIONS The present longitudinal study suggests that over adulthood, the multifidus and erector spinae undergo similar morphological changes. Moreover, our findings suggest that the long-term progression of lumbar paraspinal muscle changes evaluated through magnetic resonance imaging are not associated with the range of physical demand levels as were typical of Finnish men or LBP history.
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Affiliation(s)
- Maryse Fortin
- 1University of Alberta, Faculty of Rehabilitation Medicine, Edmonton, AB, CANADA; and 2University of Washington, Seattle, WA
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Jung HW, Kim JW, Kim JY, Kim SW, Yang HK, Lee JW, Lee KW, Kim DW, Kang SB, Kim KI, Kim CH, Kim JH. Effect of muscle mass on toxicity and survival in patients with colon cancer undergoing adjuvant chemotherapy. Support Care Cancer 2014; 23:687-94. [PMID: 25163434 DOI: 10.1007/s00520-014-2418-6] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 08/18/2014] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this study was to elucidate the effect of decreased muscle mass on the toxicity and survival of patients with colon cancer treated with adjuvant chemotherapy after surgery. METHODS We reviewed the data of 229 consecutive patients with stage III colon cancer who received adjuvant oxaliplatin, 5-fluorouracil, and leucovorin chemotherapy at a single center between 2003 and 2010. Baseline muscle mass was assessed by measuring the cross-sectional area of the psoas muscle at the level of the fourth lumbar vertebra on computed tomography images. Effects of muscle mass on toxicity of chemotherapy and survival were assessed. RESULTS The median age of the 229 patients was 61 years (range, 28-80) and 134 (58.5 %) were men. The mean psoas muscle mass index (PI, psoas muscle area divided by height(2) [mm(2)/m(2)]) was 548.3. A 1 SD decrement in the PI was associated with an increase in all grade 3-4 toxicities in univariate (OR = 1.69, 95 % CI = 1.18-2.27) and multivariate (OR = 1.56, 95 % CI = 1.05-2.38) analyses. In univariate analysis, the PI was not associated with overall survival. However, multivariate analysis showed that a 1 SD decrement in the PI increased the hazard of overall mortality by 85 % (HR = 1.85, 95 % CI = 1.10-3.13). This effect of the PI on mortality was maintained in subgroup analyses, especially in older and obese patients. CONCLUSIONS Decreased muscle mass was associated with increased risk of grade 3-4 toxicity and poor prognosis in patients with stage III colon cancer.
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Affiliation(s)
- Hee-Won Jung
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam, 463-707, South Korea
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Fortin M, Gibbons LE, Videman T, Battié MC. Do variations in paraspinal muscle morphology and composition predict low back pain in men? Scand J Med Sci Sports 2014; 25:880-7. [PMID: 25134643 DOI: 10.1111/sms.12301] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2014] [Indexed: 11/27/2022]
Abstract
This longitudinal study aimed to clarify the longstanding controversy over whether variations in paraspinal muscle morphology (e.g., size, composition and asymmetry) are predictors of low back pain (LBP). A sample of 99 Finnish men were included in this population-based longitudinal study. Data were collected through a structured interview, physical examination and magnetic resonance imaging (MRI). Baseline measurements of the lumbar multifidus and erector spinae muscles were obtained from T2-weighted axial images at L3-L4 and L5-S1, and interview data were obtained at baseline, 1- and 15-year follow-ups. Few of the paraspinal muscle parameters investigated were predictors of change in LBP frequency, intensity or sciatica at 1- and 15-year follow-ups in the population-based sample, and findings were not consistent across muscles and spinal levels. However, greater multifidus and erector spinae fatty infiltration at L5-S1 was associated with a higher risk of having continued, frequent, persistent LBP at 1-year follow-up. None of the relationships observed was confounded by body mass index or the amount of physical activity at work or leisure. This longitudinal study provided evidence that variations in paraspinal muscle morphology on MRI have a limited, if not uncertain, role in the short- and long-term predictions of LBP in men.
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Affiliation(s)
- M Fortin
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - L E Gibbons
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - T Videman
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - M C Battié
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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Kong BJ, Lim JS, Kim K. A study on dispersion and rate of fat infiltration in the lumbar spine of patients with herniated nucleus polpusus. J Phys Ther Sci 2014; 26:37-40. [PMID: 24567672 PMCID: PMC3927038 DOI: 10.1589/jpts.26.37] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 07/29/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated the relationship between herniated nucleus pulposus
(HNP) and fat infiltration of muscles around the spine by measuring body mass index (BMI)
and fat infiltration of the muscles around the spine. [Subjects and Methods] Subjects were
82 people, both men and women they were divided into two groups, a normal group and a
patient group who were suffering from serious HNP between L4 and L5. Of the anthropometric
measurement, and fat infiltration muscles by measuring the cross-sectional area from the
center of the disc to the muscle around the spine and the cross-sectional area of fat
infiltration. [Results] Fat infiltration rate of each lumbar layer in the normal group was
different L34–L45 and L45–L5S1, but not between L23–L34. Fat infiltration in the muscle
between the normal group and patients with HNP was different in the layers and the
difference was greatest in the L5–S1 layer. [Conclusion] We performed correlation analysis
of BMI and the total fat infiltration rate in each group to find the relationship between
obesity and fat infiltration in the lumbar spine. Fat infiltration increased, and normal
people or patients with chronic back pain are considered to be exposed to other diseases
as fat infiltration in the lumbar spine increases.
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Affiliation(s)
- Bong-Jun Kong
- Department of Physical Therapy, Daegu University Graduate School of Physical Therapy, Daegu University, Republic of Korea
| | - Jong-Soo Lim
- Department of Physical Therapy, Daegu University Graduate School of Physical Therapy, Daegu University, Republic of Korea
| | - Kyung Kim
- Department of Physical Therapy, Daegu University Graduate School of Physical Therapy, Daegu University, Republic of Korea
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Sihawong R, Janwantanakul P, Jiamjarasrangsi W. A prospective, cluster-randomized controlled trial of exercise program to prevent low back pain in office workers. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 23:786-93. [PMID: 24492949 DOI: 10.1007/s00586-014-3212-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 01/21/2014] [Accepted: 01/21/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE The objective of this study was to evaluate the effects of an exercise program focusing on muscle stretching and endurance training on the 12-month incidence of low back pain (LBP) in office workers. METHODS A 12-month prospective cluster-randomized controlled trial was conducted in healthy office workers with lower-than-normal trunk extension flexibility or trunk muscle endurance. Healthy office workers (n = 563) were randomly assigned at the cluster level into either intervention (n = 282) or control (n = 281) groups. Participants in the intervention group received an exercise program that included daily stretching exercise and twice-a-week muscle endurance training. Those in the control group received no intervention. The 12-month incidence of LBP was the primary outcome. Secondary outcome were pain intensity, disability level, and quality of life and health status. Analyses were performed using the Cox proportional hazard models. RESULTS Over the 12-month follow-up, 8.8% of participants in the intervention group and 19.7% in the control group developed incidence of LBP. Hazard rate ratios showed a protective effect of the exercise program for LBP (HR = 0.37, 95% CI 0.22-0.64) after adjusting for biopsychosocial factors. There was no significant difference in pain intensity, disability, and quality of life and health status between those who reported incidence of LBP in the intervention and control groups. CONCLUSION An exercise program consisting of muscle stretching and endurance training is an effective intervention to reduce incident LBP for office workers with lower-than-normal trunk extension flexibility or trunk muscle endurance.
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Affiliation(s)
- Rattaporn Sihawong
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Factors associated with paraspinal muscle asymmetry in size and composition in a general population sample of men. Phys Ther 2013; 93:1540-50. [PMID: 23813083 PMCID: PMC3827715 DOI: 10.2522/ptj.20130051] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Paraspinal muscle asymmetry in cross-sectional area (CSA) and composition have been associated with low back pain and pathology. However, substantial multifidus muscle asymmetry also has been reported in men who were asymptomatic, and little is known about other factors influencing asymmetry. OBJECTIVE The goal of this study was to identify behavioral, environmental, and constitutional factors associated with paraspinal muscle asymmetry. DESIGN A cross-sectional study of 202 adult male twins was conducted. METHODS Data were collected through a structured interview, physical examination, and magnetic resonance imaging. Measurements of multifidus and erector spinae muscle CSA and the ratio of fat-free CSA to total CSA were obtained from T2-weighted axial images at L3-L4 and L5-S1. RESULTS In multivariable analyses, greater asymmetry in multifidus CSA at L3-L4 was associated with lower occupational physical demands and less disk height narrowing. Handedness was the only factor associated with multifidus muscle CSA asymmetry at L5-S1. For the erector spinae muscle, greater age, handedness, and disk height narrowing were associated with CSA asymmetry at L3-L4, and sports activity, handedness, disk height narrowing, and familial aggregation were associated with CSA asymmetry at L5-S1. In multivariable analyses of asymmetry in muscle composition, familial aggregation explained 7% to 20% of the variance in multifidus and erector spinae muscle side-to-side differences at both levels measured. In addition, handedness and pain severity entered the model for erector spinae muscle asymmetry at L5-S1, and disability, handedness, and disk height narrowing entered the model for multifidus muscle asymmetry at L5-S1. LIMITATIONS Reliance on participants' recall for low back pain history, occupation, and physical activity levels was a limitation of this study. CONCLUSIONS Few of the factors investigated were associated with paraspinal muscle asymmetry, and associations were inconsistent and modest, explaining little of the variance in paraspinal muscle asymmetry.
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Abstract
STUDY DESIGN Cross-sectional, observational study. OBJECTIVES To investigate the cross-sectional area (CSA) of trunk muscles in professional ballet dancers with and without low back pain (LBP). BACKGROUND LBP is the most prevalent chronic injury in classical ballet dancers. Research on nondancers has found changes in trunk muscle size and symmetry to be associated with LBP. There are no studies that examine these changes in ballet dancers. METHODS Magnetic resonance imaging was performed in 14 male and 17 female dancers. The CSAs of 4 muscles (multifidus, lumbar erector spinae, psoas, and quadratus lumborum) were measured and compared among 3 groups of dancers: those without LBP or hip pain (n = 8), those with LBP only (n = 13), and those with both hip-region pain and LBP (n = 10). RESULTS Dancers with no pain had larger multifidus muscles compared to those with LBP at L3-5 (P<.024) and those with both hip-region pain and LBP at L3 and L4 on the right side (P<.027). Multifidus CSA was larger on the left side at L4 and L5 in dancers with hip-region pain and LBP compared to those with LBP only (P<.033). Changes in CSA were not related to the side of pain (all, P>.05). The CSAs of the other muscles did not differ between groups. The psoas (P<.0001) and quadratus lumborum (P<.01) muscles were larger in male dancers compared to female dancers. There was a positive correlation between the size of the psoas muscles and the number of years of professional dancing (P = .03). CONCLUSION In classical ballet dancers, LBP and hip-region pain and LBP are associated with a smaller CSA of the multifidus but not the erector spinae, psoas, or quadratus lumborum muscles.
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Hoshikawa Y, Iida T, Ii N, Muramatsu M, Nakajima Y, Chumank K, Kanehisa H. Cross-sectional area of psoas major muscle and hip flexion strength in youth soccer players. Eur J Appl Physiol 2013; 112:3487-94. [PMID: 22297611 DOI: 10.1007/s00421-012-2335-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 01/22/2012] [Indexed: 10/14/2022]
Abstract
This study aimed to clarify the differences in the cross-sectional area (CSA) of the psoas major (PM) muscle and hip flexion force (HFF) of the right (dominant) side between adolescent male soccer players and age-matched non-athletes. PM CSA at L4–L5 and HFF at 1.05 rad/s were determined in 22 early (12.8–13.6 years) and 27 late (16.1–17.9 years) adolescent soccer players and 11 early (12.6–13.5 years) and 20 late (16.0–17.7 years) adolescent non-athletes. Fat-free mass (FFM) was greater in late adolescent soccer players than in late adolescent non-athletes, but was similar between the two early adolescent groups. Without the effect of age, PM CSA and HFF were greater in soccer players than in non-athletes. PM CSA and HFF were significantly correlated to FFM (soccer players, r = 0.860, P < 0.0001; non-athletes, r = 0.709, P < 0.0001) and PM CSA (soccer players, r = 0.760, P < 0.0001; non-athletes, r = 0.777, P < 0.0001), respectively. The difference between soccer players and non-athletes in PM CSA was still significant even when PM CSA was covaried for FFM. On the other hand, HFF covaried for PM CSA was similar between the two groups. The current results indicate that, as compared to age-matched non-athletes: (1) not only late, but also early adolescent soccer players have a greater PM CSA even when the difference in FFM was adjusted, and (2) their superiority in hip flexion force can be attributed to the difference in PM CSA.
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Affiliation(s)
- Yoshihiro Hoshikawa
- Sports Photonics Laboratory, Hamamatsu Photonics K.K., 2150-1 Iwai, Iwata, Shizuoka 438-0016, Japan
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Hides J, Stanton W. Muscle imbalance among elite Australian rules football players: a longitudinal study of changes in trunk muscle size. J Athl Train 2013; 47:314-9. [PMID: 22892413 DOI: 10.4085/1062-6050-47.3.03] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
CONTEXT Trunk muscles, such as the transversus abdominis (TrA) and multifidus, play a key role in lumbopelvic stability, which is important in athletic performance. Asymmetry or imbalance in these and other trunk muscles could result from the specific requirements of the game of Australian rules football. OBJECTIVE To determine whether seasonal variations in the sizes of key trunk muscles associated with lumbopelvic stability occur in Australian Football League players. DESIGN Cross-sectional study. SETTING Hospital. PATIENTS OR OTHER PARTICIPANTS The number of players eligible to participate at each of the 4 time points was 36 at the start of preseason 1 (T1), 31 at end of season 1 (T2), 43 at the end of preseason 2 (T3), and 41 at the start of preseason 3 (T4). The group with data at all 4 time points (n = 20) was used in the analyses and was shown to be representative of the total sample. INTERVENTION(S) Magnetic resonance imaging was used to determine the cross-sectional areas (CSAs) of the multifidus (vertebral levels L2 to L5) and lumbar erector spinae (LES) muscles (L3), as well as the thickness of the TrA and internal oblique (IO) muscles at L3. MAIN OUTCOME MEASURE(S) Cross-sectional areas of the multifidus and LES muscles and thickness of the TrA and IO muscles. RESULTS By the end of the playing season, results showed 11.1% atrophy for multifidus CSA at L3 and 21% atrophy for TrA thickness at rest. In comparison, the CSA of the LES muscles increased by 3.6%, and the thickness of the IO muscle increased by 11.8% compared with the start of the preseason. CONCLUSIONS The results indicated an imbalance of the key muscles associated with lumbopelvic stability.
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Affiliation(s)
- Julie Hides
- School of Physiotherapy, Australian Catholic University, Banyo, Queensland 4014, Australia.
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Ackerman KE, Putman M, Guereca G, Taylor AP, Pierce L, Herzog DB, Klibanski A, Bouxsein M, Misra M. Cortical microstructure and estimated bone strength in young amenorrheic athletes, eumenorrheic athletes and non-athletes. Bone 2012; 51:680-7. [PMID: 22878154 PMCID: PMC3482939 DOI: 10.1016/j.bone.2012.07.019] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 06/28/2012] [Accepted: 07/18/2012] [Indexed: 02/05/2023]
Abstract
CONTEXT Lower bone density in young amenorrheic athletes (AA) compared to eumenorrheic athletes (EA) and non-athletes may increase fracture risk during a critical time of bone accrual. Finite element analysis (FEA) is a unique tool to estimate bone strength in vivo, and the contribution of cortical microstructure to bone strength in young athletes is not well understood. OBJECTIVE We hypothesized that FEA-estimated stiffness and failure load are impaired in AA at the distal radius and tibia compared to EA and non-athletes despite weight-bearing exercise. DESIGN AND SETTING Cross-sectional study; Clinical Research Center SUBJECTS 34 female endurance athletes involved in weight-bearing sports (17 AA, 17 EA) and 16 non-athletes (14-21 years) of comparable age, maturity and BMI OUTCOME MEASURES: We used HR-pQCT images to assess cortical microarchitecture and FEA to estimate bone stiffness and failure load. RESULTS Cortical perimeter, porosity and trabecular area at the weight-bearing tibia were greater in both groups of athletes than non-athletes, whereas the ratio (%) of cortical to total area was lowest in AA. Despite greater cortical porosity in EA, estimated tibial stiffness and failure load was higher than in non-athletes. However, this advantage was lost in AA. At the non-weight-bearing radius, failure load and stiffness were lower in AA than non-athletes. After controlling for lean mass and menarchal age, athletic status accounted for 5-9% of the variability in stiffness and failure load, menarchal age for 8-23%, and lean mass for 12-37%. CONCLUSION AA have lower FEA-estimated bone strength at the distal radius than non-athletes, and lose the advantage of weight-bearing exercise seen in EA at the distal tibia.
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Affiliation(s)
- Kathryn E Ackerman
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
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Hides JA, Stanton WR, Mendis MD, Gildea J, Sexton MJ. Effect of motor control training on muscle size and football games missed from injury. Med Sci Sports Exerc 2012; 44:1141-9. [PMID: 22157811 DOI: 10.1249/mss.0b013e318244a321] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This panel-randomized intervention trial was designed to examine the effect of a motor control training program for elite Australian Football League players with and without low back pain (LBP). METHODS The outcome measures included cross-sectional area (CSA) and symmetry of multifidus, quadratus lumborum, and psoas muscles and the change in CSA of the trunk in response to an abdominal drawing-in task. These measures of muscle size and function were performed using magnetic resonance imaging. Availability of players for competition games was used to assess the effect of the intervention on the occurrence of injuries. The motor control program involved performance of voluntary contractions of the multifidus and transversus abdominis muscles while receiving feedback from ultrasound imaging. Because all players were to receive the intervention, the trial was delivered as a stepped-wedge design with three treatment arms (a 15-wk intervention, a 8-wk intervention, and a waitlist control who received a 7-wk intervention toward the end of the playing season). Players participated in a Pilates program when they were not receiving the intervention. RESULTS The intervention program was associated with an increase in multifidus muscle size relative to results in the control group. The program was also associated with an improved ability to draw-in the abdominal wall. Intervention was commensurate with an increase in availability for games and a high level of perceived benefit. CONCLUSIONS The motor control program delivered to elite footballers was effective, with demonstrated changes in the size and control of the targeted muscles. In this study, footballers who received the intervention early in the season missed fewer games because of injury than those who received it late in the playing season.
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Affiliation(s)
- Julie A Hides
- School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Brisbane Campus (McAuley at Banyo), Queensland, Australia.
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Copaver K, Hertogh C, Hue O. The effects of psoas major and lumbar lordosis on hip flexion and sprint performance. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2012; 83:160-167. [PMID: 22808701 DOI: 10.1080/02701367.2012.10599846] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In this study, we analyzed the correlations between hip flexion power; sprint performance, lumbar lordosis (LL) and the cross-sectional area (CSA) of the psoas muscle (PM). Ten young adults performed two sprint tests and isokinetic tests to determine hip flexion power. Magnetic resonance imaging was used to determine LL and PM CSA. There were correlations between hip flexion power, sprint performance, and PM CSA, but LL showed no correlation with any parameter The impact of hip flexion power and LL on sprint stride pattern efficiency was considered. Hip flexion might not have a simple role in the passive knee replacement of the stride pattern; instead, it may be an active parameter. Other investigations are needed to determine the influence of pelvic architecture on sprint performance.
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Affiliation(s)
- Karine Copaver
- Department of Physiology of Exercise (ACTES Laboratory), The French West Indies University.
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De Mars G, Thomis MAI, Windelinckx A, Van Leemputte M, Maes HH, Blimkie CJ, Claessens AL, Vlietinck R, Beunen G. Covariance of Isometric and Dynamic Arm Contractions: Multivariate Genetic Analysis. Twin Res Hum Genet 2012; 10:180-90. [PMID: 17539378 DOI: 10.1375/twin.10.1.180] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThe purpose of the present study was to examine genetic and environmental contributions to individual differences in maximal isometric, concentric and eccentric muscle strength and muscle cross-sectional area (MCSA) of the elbow flexors. A generality versus specificity hypothesis was explored to test whether the 4 strength variables share a genetic component or common factors in the environment or whether the genetic/environmental factors are specific for each strength variable. The 4 variables under study were measured in 25 monozygotic and 16 dizygotic male Caucasian twin pairs (22.4 ± 3.7 years). The multivariate genetic analyses showed that all 4 variables shared a genetic and environmental component, which accounted for 43% and 6% in MCSA (h2= 81%), 47% and 20% in eccentric (h2= 65%), 58% and 4% in isometric (h2= 70%) and 32% and 1% in concentric strength (h2= 32%) respectively. The remaining variation was accounted for by contraction type specific and muscle cross-sectional area specific genetic and environmental effects, which accounted for 38% and 14% in MCSA, 18% and 15% in eccentric, 12% and 26% in isometric and 0% and 67% in concentric strength respectively. This exploratory multivariate study suggests shared pleiotropic gene action for MCSA, eccentric, isometric and concentric strength, with a moderate to high genetic contribution to the variability of these characteristics.
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Affiliation(s)
- Gunther De Mars
- Department of Biomedical Kinesiology, Research Center for Exercise and Health, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
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Assessment of association between low back pain and paraspinal muscle atrophy using opposed-phase magnetic resonance imaging: a population-based study among young adults. Spine (Phila Pa 1976) 2011; 36:1961-8. [PMID: 21289551 DOI: 10.1097/brs.0b013e3181fef890] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A cross-sectional imaging study of young adults. OBJECTIVE To evaluate whether severity of low back symptoms predicts atrophy in the paraspinal muscles of young adults. SUMMARY OF BACKGROUND DATA Although an increased fat content of the lumbar muscles has been observed among adults with chronic LBP, there is limited knowledge of this association in younger populations. METHODS The population-based study sample consisted of 554 subjects (321 females and 233 males) from the 1986 Northern Finland Birth Cohort. Latent Class Analysis (LCA) was used to cluster the subjects according to the low back symptoms and functional limitations at 18, 19, and 21 years. The mean age of the subjects at the time of the MRI (magnetic resonance imaging) was 21 years (range, 20-23). Muscle atrophy was evaluated by assessing the fat content of the paraspinal muscles using Opposed-Phase MRI. The cross-sectional areas (CSAs) of the erector spinae and multifidus muscles were also measured. RESULTS LCA analysis produced five clusters differing in symptoms, ranging from a cluster (n = 65) in which subjects had high likelihood of symptoms and functional limitations at all time points, to a cluster (n = 165) with no pain ever. The fat content of the multifidus muscles was significantly higher among women than men (14.0% vs. 5.3%, P < 0.001), but it was not significantly associated with symptom severity. The CSA of both erector spinae and multifidus muscles were significantly larger among men than women (P < 0.001 in all of the muscles), but were not associated with pain severity. CONCLUSION Low back symptoms and functional limitations over a 3-year period were not associated with increased fat content or a reduction in the cross-sectional area of lumbar paraspinal muscles among young adults.
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Lescher S, Bender B, Eifler R, Haas F, Gruber K, Felber S. Isometric non-machine-based prevention training program: effects on the cross-sectional area of the paravertebral muscles on magnetic resonance imaging. Clin Neuroradiol 2011; 21:217-22. [PMID: 21904940 DOI: 10.1007/s00062-011-0104-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2011] [Accepted: 08/15/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE The purpose of this study was to determine potential effects of isometric non-machine-based training on the cross-sectional area (CSA) of the paravertebral muscles in volunteers who were participants in a prevention program. An increase in the CSA of back muscles after various machine-based exercises have been reported but non-machine-based training programs have not been adressed before. MATERIALS AND METHODS In the study 14 volunteers, who were participants of a company internal prevention program, underwent a magnetic resonance (MR) examination before and after a 3 months training program to improve back muscle strength. The MRI protocol consisted of T1-weighted and T2-weighted images aligned to the intervertebral disc spaces. The CSAs of the erector spinae and quadratus lumborum muscles were assessed twice by 2 operators at the levels L3/4, L4/5 and L5/S1. RESULTS Out of 14 subjects 11 completed the training. The recorded CSA values exhibited an intrarater and intrarater correlation coefficient ranging from 0.949 to 0.989. There was an increase in CSA in all subjects after the training period (mean increase 8%). CONCLUSIONS A 3-month isometric training program is sufficient to effect measurable increases in back muscles volume. The study demonstrated the usefulness of MRI to quantify such changes as a measure of training efficacy and compliance into the training program. These results represent a rationale for further studies to determine the effect of different training methods on the CSA of back muscles and to correlate structural changes with clinical symptoms in chronic low back pain syndrome.
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Affiliation(s)
- S Lescher
- Institut für diagnostische und interventionelle Radiologie, Stiftungsklinikum Mittelrhein Koblenz, Johannes-Müller-Str. 7, 56068, Koblenz, Deutschland.
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Contreras B, Schoenfeld B. To Crunch or Not to Crunch: An Evidence-Based Examination of Spinal Flexion Exercises, Their Potential Risks, and Their Applicability to Program Design. Strength Cond J 2011. [DOI: 10.1519/ssc.0b013e3182259d05] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Reliability of magnetic resonance imaging measurements of the cross-sectional area of the muscle contractile and non-contractile components. Surg Radiol Anat 2011; 33:735-41. [PMID: 21618015 DOI: 10.1007/s00276-011-0825-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Accepted: 05/09/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND/PURPOSE Magnetic resonance imaging (MRI) is increasingly used to study skeletal muscles patients with muscular disorders. We report an MRI technique for evaluating the trunk muscles. This technique takes both the component surface area (CSA) and the density of the muscles on MRI axial slices into account . Using a computer-based image analysis system, we combined MRI data measuring the muscle CSA, which was separated into the contractile component (CCSA) and the non-contractile component (NCCSA). The purpose of this study was to analyze the reliability of this method of measuring the CSA, CCSA and NCCSA in trunk muscles on MRI axial slices through L4 and T12. METHODS Thirty volunteer subjects were enrolled in this study. Two acquisitions were performed. For the reliability analyses, each of the two slices (T12 and L4) from 30 subjects was measured by three raters trained in this technique, on two occasions 2 weeks apart. Each muscle was surrounded and its CSA, NCCSA and CCSA were recorded. For each muscle, the agreement between the two sets of 30 measurements performed by three observers was evaluated by calculating an intra-class correlation coefficient (ICC). RESULTS Regarding the slice through L4 and T12, the reliabilities of the measurement of CSA, CCSA were very good for all the muscles except the parietal muscles. CONCLUSION MRI measurements of the trunk muscle cross-sectional areas and of the CCSA and NCCSA are reliable.
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Ploumis A, Michailidis N, Christodoulou P, Kalaitzoglou I, Gouvas G, Beris A. Ipsilateral atrophy of paraspinal and psoas muscle in unilateral back pain patients with monosegmental degenerative disc disease. Br J Radiol 2010; 84:709-13. [PMID: 21081573 DOI: 10.1259/bjr/58136533] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the cross-sectional area (CSA) of both paraspinal and psoas muscles in patients with unilateral back pain using MRI and to correlate it with outcome measures. METHODS 40 patients, all with informed consent, with a minimum of 3 months of unilateral back pain with or without sciatica and one-level disc disease on MRI of the lumbosacral spine were included. Patients were evaluated with self-report measures regarding pain (visual analogue score) and disability (Oswestry disability index). The CSA of multifidus, erector spinae, quadratus lumborum and psoas was measured at the disc level of pathology and the two adjacent disc levels, bilaterally. Comparison of CSAs of muscles between the affected vs symptomless side was carried out with Student's t-test and correlations were conducted with Spearman's test. RESULTS The maximum relative muscle atrophy (% decrease in CSA on symptomatic side) independent of the level was 13.1% for multifidus, 21.8% for erector spinae, 24.8% for quadratus lumborum and 17.1% for psoas. There was significant difference (p<0.05) between sides (symptomatic and asymptomatic) in CSA of multifidus, erector spinae, quadratus lumborum and psoas. However, no statistically significant correlation was found between the duration of symptoms (average 15.5 months), patient's pain (average VAS 5.3) or disability (average ODI 25.2) and the relative muscle atrophy. CONCLUSION In patients with long-standing unilateral back pain due to monosegmental degenerative disc disease, selective multifidus, erector spinae, quadratus lumborum and psoas atrophy develops on the symptomatic side. Radiologists and clinicians should evaluate spinal muscle atrophy of patients with persistent unilateral back pain.
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Affiliation(s)
- A Ploumis
- Department of Surgery, Division of Orhthopedics and Rehabilitation, University of Ioannina, Greece.
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Kim K, Lee SK, Kim YH. The Biomechanical Effects of Variation in the Maximum Forces Exerted by Trunk Muscles on the Joint Forces and Moments in the Lumbar Spine: A Finite Element Analysis. Proc Inst Mech Eng H 2010; 224:1165-74. [DOI: 10.1243/09544119jeim765] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The weakening of trunk muscles is known to be related to a reduction of the stabilization function provided by the muscles to the lumbar spine; therefore, strengthening deep muscles might reduce the possibility of injury and pain in the lumbar spine. In this study, the effect of variation in maximum forces of trunk muscles on the joint forces and moments in the lumbar spine was investigated. Accordingly, a three-dimensional finite element model of the lumbar spine that included the trunk muscles was used in this study. The variation in maximum forces of specific muscle groups was then modelled, and joint compressive and shear forces, as well as resultant joint moments, which were presumed to be related to spinal stabilization from a mechanical viewpoint, were analysed. The increase in resultant joint moments occurred owing to decrease in maximum forces of the multifidus, interspinales, intertransversarii, rotatores, iliocostalis, longissimus, psoas, and quadratus lumborum. In addition, joint shear forces and resultant joint moments were reduced as the maximum forces of deep muscles were increased. These results from finite element analysis indicate that the variation in maximum forces exerted by trunk muscles could affect the joint forces and joint moments in the lumbar spine.
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Affiliation(s)
- K Kim
- Department of Mathematics, Kyonggi University, Suwon, Republic of Korea
| | - S-K Lee
- Department of Computer Science, Yonsei University, Seoul, Republic of Korea
| | - Y H Kim
- Department of Mechanical Engineering and e-Spine Centre in ILRI, Kyung Hee University, Yongin, Republic of Korea
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Paalanne NP, Korpelainen RI, Taimela SP, Auvinen JP, Tammelin TH, Hietikko TM, Kaikkonen HS, Kaikkonen KM, Karppinen JI. Muscular fitness in relation to physical activity and television viewing among young adults. Med Sci Sports Exerc 2010; 41:1997-2002. [PMID: 19812519 DOI: 10.1249/mss.0b013e3181a7f3a6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To study how time spent in physical activity and that in television (TV) viewing are associated with muscular fitness among young adults. METHODS The study population consisted of a cross-sectional sample of 381 males and 493 females aged 19.1 yr (SD 0.3) from the Northern Finland Birth Cohort 1986. Muscular fitness was measured by trunk muscle strength tests (trunk extension, flexion, and rotation) and jumping height test. Time spent on moderate- to vigorous-intensity physical activity and on TV viewing was self-reported by a questionnaire. RESULTS The most physically active young adults performed significantly better in most trunk muscle strength tests and the jumping test than the least active subjects. The mean difference between the most and least active groups was at minimum 1.6 kg (95% confidence interval (CI) = -0.5 to 3.7) and at maximum 10.6 kg (95% CI = 4.7-16.5) for different trunk muscle strength tests and at minimum 4.4 cm (95% CI = 2.7-6.1) for the jumping height test. Males and females who watched TV for >or=2 h x d(-1) performed significantly worse in trunk extension and flexion tests and females also performed worse in the jumping test compared with those who watched TV <2 h x d(-1), independent of their physical activity level. The mean difference between low and high TV users was at minimum -3.8 kg (95% CI = -6.7 to -0.9) for trunk extension and flexion strength and -1.2 cm (95% CI = -2.0 to -0.4) for jumping height in females. CONCLUSIONS Among young adults, daily TV viewing for >or=2 h, irrespective of physical activity level, was associated with poorer muscular fitness.
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Affiliation(s)
- Niko P Paalanne
- Department of Physical and Rehabilitation Medicine, Institute of Clinical Sciences, University of Oulu, Oulu, Finland
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Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2009; 19:1136-44. [PMID: 20033739 DOI: 10.1007/s00586-009-1257-5] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 10/17/2009] [Accepted: 12/10/2009] [Indexed: 01/01/2023]
Abstract
The objectives of the study were to evaluate the association between lumbar paraspinal muscle density, evaluated on computed tomography (CT) and age, sex and BMI; and to evaluate the association of those changes with low back pain (LBP) and spinal degeneration features in a community-based sample. This study was an ancillary project to the Framingham Study. A sample of 3,529 participants aged 40-80 years had a CT scan performed to assess aortic calcification. 187 individuals were randomly enrolled in this study. LBP in the last 12 months was evaluated using self-report questionnaire. Density (in Hounsfield units) of multifidus and erector spinae was evaluated on CT. The prevalence of intervertebral disc narrowing, facet joint osteoarthritis (FJOA), spondylolysis, spondylolisthesis and spinal stenosis were also evaluated. We used linear regression models to examine the association of paraspinal muscles density with age, sex, BMI, LBP, and spinal degeneration features. The results show that in our study, men have higher density of paraspinal muscles than women, younger individuals have higher density than older ones and individuals with lower weight have higher muscle density than overweight. No differences between individuals with and without LBP were found. Significant association was found between L4 multifidus/erector spinae density and FJOA at L4-L5; between multifidus at L4 and spondylolisthesis at L4-5; and between erector spinae at L4 and L5 with disc narrowing at L4-5 and L5-S1, respectively. We conclude that the paraspinal muscle density decreases with age, and increases BMI. It is associated with at some levels FJOA, spondylolisthesis and disc narrowing at the same level, but not associated with occurrence of LBP.
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Dahab KS, McCambridge TM. Strength training in children and adolescents: raising the bar for young athletes? Sports Health 2009; 1:223-6. [PMID: 23015875 PMCID: PMC3445252 DOI: 10.1177/1941738109334215] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CONTEXT Strength training in children, in combination with plyometric and/or agility training, has become an increasingly popular tactic for athletes to gain a competitive edge during the off-season. The present review clarifies some common myths associated with strength training in children, and it outlines the most current recommendations. EVIDENCE ACQUISITION Relevant studies on strength training in children and adolescents were reviewed (search results included studies indexed in PubMed and MEDLINE from 1980 through 2008). Also reviewed were recommendations from consensus guidelines and position statements applicable to strength training in youth. RESULTS Children can improve strength by 30% to 50% after just 8 to 12 weeks of a well-designed strength training program. Youth need to continue to train at least 2 times per week to maintain strength. The case reports of injuries related to strength training, including epiphyseal plate fractures and lower back injuries, are primarily attributed to the misuse of equipment, inappropriate weight, improper technique, or lack of qualified adult supervision. CONCLUSION Youth-athletes and nonathletes alike-can successfully and safely improve their strength and overall health by participating in a well-supervised program. Trained fitness professionals play an essential role in ensuring proper technique, form, progression of exercises, and safety in this age group.
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Affiliation(s)
- Katherine Stabenow Dahab
- Address correspondence to Katherine Stabenow Dahab, 434 East Clement Street, Baltimore, MD 21230 (e-mail: )
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Ropponen A, Videman T, Battié MC. The reliability of paraspinal muscles composition measurements using routine spine MRI and their association with back function. ACTA ACUST UNITED AC 2008; 13:349-56. [PMID: 17556006 DOI: 10.1016/j.math.2007.03.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Revised: 01/24/2007] [Accepted: 03/09/2007] [Indexed: 11/26/2022]
Abstract
This study examines the reliability of quantitative and qualitative muscle composition measurements of paraspinal muscle cross-sectional areas (CSAs) from routine lumbar spine magnetic resonance images and their association with maximal isokinetic lifting performance. The extent of paraspinal muscle composition reflects back function is currently not known. Measurements were repeated 4-8 weeks apart and different measurements of related constructs were compared. Participants were a population-based sample of 169 males, 35-67 years old, without considering the presence or absence of a history of low back pain or related problems in the selection of subjects. The quantitative and qualitative muscle composition measurements for axial magnetic resonance (MR) images of paraspinal muscles at the L3-L4 lumbar spine level, isokinetic lifting force and work, and body fat percentage were the main outcome measures. Results showed that the reproducibility of different paraspinal muscle composition measurements at the L3-L4 level was excellent for CSAs (ICC=0.95-0.99) and quantitative muscle composition measurements using cerebrospinal fluid adjusted signal intensity (ICC=0.96-0.99), and moderate for qualitative muscle composition ratings (Kappa=0.54-0.76). The correlations of the quantitative and qualitative muscle composition measurements with isokinetic lifting force and work were generally low (r=0.02-0.41), and favoured the qualitative assessments. In conclusion, quantitative and qualitative muscle composition measurements of paraspinal muscles are highly reproducible tissue measures, have low associations with body fat and isokinetic lifting performance, and show that paraspinal muscle morphology using routine spine magnetic resonance imaging (MRI) is poorly related to back function.
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Affiliation(s)
- Annina Ropponen
- Institute of Biomedicine, Physiology/Ergonomics, University of Kuopio, P.O. Box 1627, 70211 Kuopio, Finland.
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Abstract
Physical therapists must be able to determine the activity and passive properties of the musculoskeletal system in order to accurately plan and evaluate therapeutic measures. Discussed in this article are imaging methods that not only allow for the measurement of muscle activity but also allow for the measurement of cellular processes and passive mechanical properties noninvasively and in vivo. The techniques reviewed are T1- and T2-weighted magnetic resonance (MR) imaging, MR spectroscopy, cine-phase-contrast MR imaging, MR elastography, and ultrasonography. At present, many of these approaches are expensive and not readily available in physical therapy clinics but can be found at medical centers. However, there are ways of using these techniques to provide important knowledge about muscle function. This article proposes creative ways in which to use these techniques as evaluative tools.
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Affiliation(s)
- Richard L Segal
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, NC 27599-7135, USA.
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Gille O, Jolivet E, Dousset V, Degrise C, Obeid I, Vital JM, Skalli W. Erector spinae muscle changes on magnetic resonance imaging following lumbar surgery through a posterior approach. Spine (Phila Pa 1976) 2007; 32:1236-41. [PMID: 17495782 DOI: 10.1097/brs.0b013e31805471fe] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective randomized study of patients undergoing lumbar arthrodesis. OBJECTIVES To quantify MRI changes of the erector spinae following lumbar surgery through a posterior approach and the possible protection of these muscles during surgery by the use of cholinergic blockade. SUMMARY OF BACKGROUND DATA It has been shown that lumbar spine surgery through a posterior approach can induce iatrogenic lesions in the erector spinae. We have shown in a previous study that histologic changes on muscular biopsy performed in the multifidus at the end of the surgical procedure were not modified by the use of cholinergic blockade during surgery. METHODS Twenty patients scheduled to undergo pedicle-screw enhanced L4-L5 arthrodesis were enrolled in this study. Ten patients received curare during anesthesia and 10 patients did not. MRI was obtained the day before the operation and at 6 months of follow-up on the same MR scanner. T1-weighted images were obtained in the axial plane. The 2 slices immediately proximal and distal to the pedicle screw construct on the postoperative MRI were selected. The corresponding slices were selected on the preoperative MRI. Each erector spinae on the 4 slices was surrounded using a mouse-guided tool. The contractile component of the cross-sectional area (CCSA) was calculated from the number of pixels surrounded and the signal intensity of each pixel. RESULTS There was only slight changes in the erector spinae CCSA proximal to a posterior lumbar arthrodesis. Erector spinae CCSA decreased by 27% distal to the arthrodesis. Curare showed no efficacy in preventing muscle damage. CONCLUSIONS Erector spinae muscle alterations mainly occur distal to posterior lumbar surgical procedures.
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Affiliation(s)
- Olivier Gille
- University Hospital of Bordeaux, Spinal Unit, Department of Orthopaedic Surgery, Bordeaux, France
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Hoshikawa Y, Muramatsu M, Iida T, Uchiyama A, Nakajima Y, Kanehisa H, Fukunaga T. Influence of the psoas major and thigh muscularity on 100-m times in junior sprinters. Med Sci Sports Exerc 2007; 38:2138-43. [PMID: 17146321 DOI: 10.1249/01.mss.0000233804.48691.45] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate how the cross-sectional areas (CSA) of the quadriceps femoris (QF)3, hamstrings (Ham), and psoas major (PM) in junior sprinters are related to mean running velocity (MV100m) calculated from official records of 100-m races. METHODS In 44 sprinters (22 boys and 22 girls) aged 14-17 yr, cross-sectional images were taken at the upper thigh and midthigh and midway between the fourth and fifth lumbar vertebrae using magnetic resonance imaging. CSA of the three muscles located in both sides were analyzed. For each muscle, the mean values of the CSA of the right and left sides were calculated and used for regression analyses of the relationships between CSA variables and MV100m. RESULTS Stepwise multiple-regression analyses produced prediction equations of MV100m with independent variables of QF CSA at the midthigh and PM-to-QF CSA ratio at the upper thigh for boys (R = 0.38) and PM-to-QF CSA ratio at the midthigh for girls (R = 0.33). In the regression model for boys, QF CSA at the midthigh had a negative regression coefficient. CONCLUSION For junior sprinters of both genders, the higher development of PM relative to QF, rather than absolute muscle size, is a factor in achieving a better performance in 100-m race performance.
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Kjaer P, Bendix T, Sorensen JS, Korsholm L, Leboeuf-Yde C. Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain? BMC Med 2007; 5:2. [PMID: 17254322 PMCID: PMC1796893 DOI: 10.1186/1741-7015-5-2] [Citation(s) in RCA: 309] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Accepted: 01/25/2007] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Because training of the lumbar muscles is a commonly recommended intervention in low back pain (LBP), it is important to clarify whether lumbar muscle atrophy is related to LBP. Fat infiltration seems to be a late stage of muscular degeneration, and can be measured in a non-invasive manner using magnetic resonance imaging. The purpose of this study was to investigate if fat infiltration in the lumbar multifidus muscles (LMM) is associated with LBP in adults and adolescents. METHODS In total, 412 adults (40-year-olds) and 442 adolescents (13-year-olds) from the general Danish population participated in this cross-sectional cohort study. People with LBP were identified through questionnaires. Using MRI, fat infiltration of the LMM was visually graded as none, slight or severe. Odds ratios were calculated for both age groups, taking into account sex, body composition and leisure time physical activity for both groups, and physical workload (in adults only) or daily bicycling (in adolescents only). RESULTS Fat infiltration was noted in 81% of the adults but only 14% of the adolescents. In the adults, severe fat infiltration was strongly associated with ever having had LBP (OR 9.2; 95% CI 2.0-43.2), and with having LBP in the past year (OR 4.1; 1.5-11.2), but there was no such association in adolescents. None of the investigated moderating factors had an obvious effect on the OR in the adults. CONCLUSION Fat infiltration in the LMM is strongly associated with LBP in adults only. However, it will be necessary to quantify these measurements objectively and to investigate the direction of this link longitudinally in order to determine if the abnormal muscle is the cause of LBP or vice versa.
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Affiliation(s)
- Per Kjaer
- The Back Research Center, Backcenter Funen, Part of Clinical Locomotion Science, University of Southern Denmark, Denmark
| | - Tom Bendix
- The Back Research Center, Backcenter Funen, Part of Clinical Locomotion Science, University of Southern Denmark, Denmark
| | - Joan Solgaard Sorensen
- The Back Research Center, Backcenter Funen, Part of Clinical Locomotion Science, University of Southern Denmark, Denmark
| | - Lars Korsholm
- Department of biostatistics, University of Southern Denmark, Denmark
| | - Charlotte Leboeuf-Yde
- The Back Research Center, Backcenter Funen, Part of Clinical Locomotion Science, University of Southern Denmark, Denmark
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Malliou P, Gioftsidou A, Beneka A, Godolias G. Measurements and evaluations in low back pain patients. Scand J Med Sci Sports 2006; 16:219-30. [PMID: 16895526 DOI: 10.1111/j.1600-0838.2005.00504.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
With the present review of literature, the authors intended to compare the definition terms, selection criteria, and measurement tools or methods used in different studies related to chronic low back pain (CLBP) patients. The relevance of including all the above information is that any health-care professional can use them to evaluate their treatment methods with CLBP patients or use them in study designs according to their objectives. These measurements concern pain measurements, measures that were used to describe the CLBP pain, questionnaires used to measure the CLBP patients' responses to pain, the pain effects on their living activities, and also measurements of the physical abilities and functional performance. A computerized literature search in English MEDLINE was conducted using "low back pain," and "flexibility, "strength,""evaluation,""functional level," and "measurements" as search words. Identified abstracts were scanned, and useful articles were acquired for further review. Interms of CLBP definitions, the authors concluded that is best defined as a lumbar, sacral, or lumbosacral spinal pain that is continuous or essentially continuous but low level punctuated by exacerbations of pain, each of which is characterized as "acute." In order to establish the criteria for selecting participants in a study design related to CLBP, pain characteristics and clinical diagnoses have to be taken into consideration for obtaining homogeneity of groups. Finally, the selection of measurement tools and evaluation methods is related to the study's goals, the specialization of the researchers, and their validity.
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Affiliation(s)
- P Malliou
- Department of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece.
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Storheim K, Holm I, Gunderson R, Brox JI, Bø K. The effect of comprehensive group training on cross-sectional area, density, and strength of paraspinal muscles in patients sick-listed for subacute low back pain. JOURNAL OF SPINAL DISORDERS & TECHNIQUES 2003; 16:271-9. [PMID: 12792342 DOI: 10.1097/00024720-200306000-00008] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The effect of exercise on back muscle cross-sectional area (CSA), density, and strength was evaluated in patients sick-listed for subacute low back pain. Twenty-four patients were randomized into an exercise (n = 11) or a control (n = 13) group. Patients in the exercise group followed a biweekly exercise protocol for 15 weeks. Control patients received usual care. Muscle CSA and density were measured by computed tomography before and after intervention. Isokinetic test of back extensors was conducted simultaneously. Results showed a tendency to increased muscle CSA and density in patients in the exercise group, a significant decrease in muscle CSA at L4-L5 in control group patients, and a significant difference in change between groups in muscle CSA at L4-L5. Back extension strength increased in patients in the exercise group, but the improvement was not significant compared with control group patients. In conclusion, there was a tendency for reversal of muscle atrophy after exercise.
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Affiliation(s)
- Kjersti Storheim
- Norwegian University of Sport and Physical Education, and dagger National Hospital, Oslo, Norway.
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Danneels LA, Vanderstraeten GG, Cambier DC, Witvrouw EE, Bourgois J, Dankaerts W, De Cuyper HJ. Effects of three different training modalities on the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain. Br J Sports Med 2001; 35:186-91. [PMID: 11375879 PMCID: PMC1724339 DOI: 10.1136/bjsm.35.3.186] [Citation(s) in RCA: 161] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine the effect of different training schedules on the cross sectional area (CSA) of the lumbar multifidus muscle in patients with chronic low back pain. METHODS Each of 59 nine patients was randomly assigned to one of three programmes: 10 weeks of stabilisation training (group 1; n = 19); 10 weeks of stabilisation training combined with dynamic resistance training (group 2; n = 20); 10 weeks of stabilisation training combined with dynamic-static resistance training (group 3; n = 20). Before and after 10 weeks of training, multifidus CSAs were measured from standard computed tomography images at three different levels (upper end plate of L3 and L4, and lower end plate of L4). RESULTS The CSA of the multifidus muscle was significantly increased at all levels after training in group 3. In contrast, no significant differences were found in groups 1 and 2. CONCLUSIONS General stabilisation exercises and dynamic intensive lumbar resistance training have no significant effect on the CSA of the lumbar multifidus muscle in patients with chronic low back pain. The static holding component between the concentric and eccentric phase was found to be critical in inducing muscle hypertrophy during the first 10 weeks. Treatment consisting of stabilisation training combined with an intensive lumbar dynamic-static strengthening programme seems to be the most appropriate method of restoring the size of the multifidus muscle.
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Affiliation(s)
- L A Danneels
- Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine, Ghent University, Belgium.
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