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Sample records for chronic neck muscle

  1. Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain.

    Science.gov (United States)

    Ylinen, Jari; Takala, Esa-Pekka; Kautiainen, Hannu; Nykänen, Matti; Häkkinen, Arja; Pohjolainen, Timo; Karppi, Sirkka-Liisa; Airaksinen, Olavi

    2004-10-01

    Several studies have reported lower neck muscle strength in patients with chronic neck pain compared to healthy controls. The aim of the present study was to evaluate the association between the severity of neck pain and disability with neck strength and range of movement in women suffering from chronic neck pain. One hundred and seventy-nine female office workers with chronic neck pain were selected to the study. The outcome was assessed by the self-rating questionnaires on neck pain (visual analogue scale, Vernon's disability index, Neck pain and disability index) and by measures of the passive range of movement (ROM) and maximal isometric neck muscle strength. No statistically significant correlation was found between perceived neck pain and the disability indices and the maximal isometric neck strength and ROM measures. However, the pain values reported during the strength tests were inversely correlated with the results of strength tests (r=-0.24 to -0.46), showing that pain was associated with decreased force production. About two-thirds of the patients felt pain during test efforts. Pain may prevent full effort during strength tests and hence the production of maximal force. Thus in patients with chronic neck pain the results do not always describe true maximal strength, but rather the patients' ability to bear strain, which may be considerably influenced by their painful condition. The results of the present study suggest that rehabilitation in cases of chronic neck pain should aim at raising tolerance to mechanical strain.

  2. Short Term Effects of Mobilization Techniques on Neck Pain and Deep Neck Flexor Muscle Endurance in Patients with Mechanical Chronic Neck Pain

    OpenAIRE

    Kılınç, Hasan Erkan; Harput, Gülcan; Baltacı, Gül; İnce, Deniz İnal

    2014-01-01

    Objectives: The aim of the study was to investigate short term effects of cervical and scapular mobilization techniques on neck pain and deep cervical muscles endurance in chronical mechanical neck pain patients. Methods: 22 chronical mechanic neck pain patients four male 18 female (mean age: mean±sd 35.59± 15.85) were included. Before treatment, neck pain level (visual analog scale) and deep neck flexor muscles endurance (in supine position with digital chronometer) of all patients were eval...

  3. Increased neck muscle activity and impaired balance among females with whiplash-related chronic neck pain

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Clausen, Brian; Ris Hansen, Inge

    2013-01-01

    To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls.......To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls....

  4. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain

    OpenAIRE

    2016-01-01

    [Purpose] The purpose of this study was to investigate clinical effects of deep cervical flexor (DCF) muscles exercise on pain, Neck Disability Index (NDI), and neck and shoulder postures in patients with chronic neck pain. [Subjects and Methods] Twenty-eight patients with chronic neck pain were randomly assigned into either the general strengthening exercise (GSE) group or the DCF activation group as control and experimental groups, respectively. All exercises were performed three times per ...

  5. Torque-EMG-velocity relationship in female workers with chronic neck muscle pain

    DEFF Research Database (Denmark)

    Andersen, Lars L; Nielsen, Pernille K; Søgaard, Karen

    2008-01-01

    The present study investigated the effect of chronic neck muscle pain (defined as trapezius myalgia) on neck/shoulder muscle function during concentric, eccentric and static contraction. Forty-two female office workers with trapezius myalgia (MYA) and 20 healthy matched controls (CON) participated...

  6. Muscle activation during selected strength exercises in women with chronic neck muscle pain

    DEFF Research Database (Denmark)

    Andersen, Lars L; Kjaer, Michael; Andersen, Christoffer H

    2008-01-01

    .6 (range=3-8) on a scale of 0 to 9. METHOD: Electromyographic activity in the trapezius and deltoid muscles was measured during the exercises (lateral raises, upright rows, shrugs, one-arm rows, and reverse flys) and normalized to EMG activity recorded during a maximal voluntary static contraction (MVC......). RESULTS: For most exercises, the level of muscle activation was relatively high (>60% of MVC), highlighting the effectiveness and specificity of the respective exercises. For the trapezius muscle, the highest level of muscle activation was found during the shrug (102+/-11% of MVC), lateral raise (97......+/-6% of MVC), and upright row (85+/-5% of MVC) exercises, but the latter 2 exercises required smaller training loads (3-10 kg) compared with the shrug exercise (20-30 kg). DISCUSSION AND CONCLUSION: The lateral raise and upright row may be suitable alternatives to shrugs during rehabilitation of chronic neck...

  7. Short Term Effects of Mobilization Techniques on Neck Pain and Deep Neck Flexor Muscle Endurance in Patients with Mechanical Chronic Neck Pain

    Science.gov (United States)

    Kılınç, Hasan Erkan; Harput, Gülcan; Baltacı, Gül; İnce, Deniz İnal

    2014-01-01

    Objectives: The aim of the study was to investigate short term effects of cervical and scapular mobilization techniques on neck pain and deep cervical muscles endurance in chronical mechanical neck pain patients. Methods: 22 chronical mechanic neck pain patients four male 18 female (mean age: mean±sd 35.59± 15.85) were included. Before treatment, neck pain level (visual analog scale) and deep neck flexor muscles endurance (in supine position with digital chronometer) of all patients were evaluated. Cyriax cervical mobilization for 10 minutes and scapular mobilization for 10 repetition 10 sets were performed to patients as treatment protocol. After treatment, 24 hours after and a week after evaluations of neck pain and deep cervical muscles endurance were repeated. Results: Before treatment Neck pain Visual Analog Scale scores was 5.78±1.43 point, 2.80±1.99 point after treatment, 24 hours later 3.36±2.12 point, one week later 3.91±2.24 point. This alteration was found significant statistically (p<0.01). Before treatment deep cervical flexor muscle endurance score was 27.25±17.74 sec, after treatment 39.46±25.20 sec, 24 hours later 38.67±28.43 and one week later 40.11±27.82 sec. This alteration was also found significant statistically (p=0.01). Conclusion: Initially neck pain scores in our subjects decreased quickly, after 24 hours these scores increased but last scores were below first neck pain level in a week follow-up. Deep neck cervical flexor muscles test scores also increased quickly, after 24 hours later this scores were stable along a week. Mobilization techniques are effective methods on neck pain and endurance in chronical mechanic neck pain patients.

  8. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain.

    Science.gov (United States)

    Kim, Jin Young; Kwag, Kwang Il

    2016-01-01

    [Purpose] The purpose of this study was to investigate clinical effects of deep cervical flexor (DCF) muscles exercise on pain, Neck Disability Index (NDI), and neck and shoulder postures in patients with chronic neck pain. [Subjects and Methods] Twenty-eight patients with chronic neck pain were randomly assigned into either the general strengthening exercise (GSE) group or the DCF activation group as control and experimental groups, respectively. All exercises were performed three times per week over 4 weeks. NDI and numeric rating scale (NRS) score for pain were determined and radiological assessment of neck-shoulder postures (head tilt angle [HTA], neck flexion angle [NFA], and forward shoulder angle [FSA]) was performed before (baseline), 4 weeks after, and 8 weeks after exercise in order to directly compare the exercise effects between the groups. [Results] In the DCF group, the NDI, NRS score, and neck-shoulder postures (analyzed by uisng HTA, NFA, and FSA) were significantly improved. [Conclusion] DCF activation exercise was effective to alleviate pain, recover functions, and correct forward head posture in the patients with neck pain. Hence, it might be recommended in the rehabilitation of patients with chronic neck pain.

  9. Preliminary study of neck muscle size and strength measurements in females with chronic non-specific neck pain and healthy control subjects.

    Science.gov (United States)

    Rezasoltani, Asghar; Ali-Reza, Ahmadipor; Khosro, Khademi-Kalantari; Abbass, Rahimi

    2010-08-01

    Neck muscle weakness and atrophy are two common causes of pain and disability among office workers. The aim of this study was to compare the strength of the neck extensor and flexor muscles and the size of the semispinalis capitis muscle (SECM) in patients with chronic non-specific neck pain (CNNP) and healthy subjects. Twenty female office workers (10 patients with CNNP and 10 healthy subjects) participated in this study. The strength of the neck extensor and flexor muscles was measured by an isometric device and the SECM size was measured by ultrasonography. Neck muscle strength, size of the SECM and the ratios of neck strength to body weight, neck extensor strength to SECM size, SECM size to body weight and neck flexor to extensor strength were all significantly lower in patients compared to controls (P neck strength, the size of the SECM and the ratio of neck muscle strength to SECM size appear to be useful parameters in appraising patients with CNNP.

  10. Effect of brief daily resistance training on occupational neck/shoulder muscle activity in office workers with chronic pain

    DEFF Research Database (Denmark)

    Lidegaard, Mark; Jensen, Rene B; Andersen, Christoffer H

    2013-01-01

    PURPOSE: This study investigates the acute and longitudinal effects of resistance training on occupational muscle activity in office workers with chronic pain. METHODS: 30 female office workers with chronic neck and shoulder pain participated for 10 weeks in high-intensity elastic resistance trai...

  11. Effect of two contrasting types of physical exercise on chronic neck muscle pain

    DEFF Research Database (Denmark)

    Andersen, L.L.; Kjær, Michael; Søgaard, Kirsten;

    2008-01-01

    Objective. The prevalence of neck muscle pain has steadily increased and especially pain from the descending part of the trapezius muscle has been associated with monotonous work tasks such as computer work. Physical exercise is generally recommended as treatment, but it is unclear which type...... of training is most effective. Our objective was to determine the effectiveness of specific strength training of the painful muscle versus general fitness training without direct involvement of the painful muscle (leg bicycling) on work-related neck muscle pain. Methods. We conducted a randomized controlled...

  12. Effect of two contrasting types of physical exercise on chronic neck muscle pain

    DEFF Research Database (Denmark)

    Andersen, Lars L; Kjaer, Michael; Søgaard, Karen

    2008-01-01

    OBJECTIVE: The prevalence of neck muscle pain has steadily increased and especially pain from the descending part of the trapezius muscle has been associated with monotonous work tasks such as computer work. Physical exercise is generally recommended as treatment, but it is unclear which type of ...

  13. Muscle activation during selected strength exercises in women with chronic neck muscle pain

    DEFF Research Database (Denmark)

    Andersen, L.L.; Kjaer, M.; Andersen, C.H.

    2008-01-01

    contraction (MVC). Results. For most exercises, the level of muscle activation was relatively high (>60% of MVC), highlighting the effectiveness and specificity of the respective exercises. For the trapezius muscle, the highest level of muscle activation was found during the shrug (102 +/- 11% of MVC......), lateral raise (97+/-6% of MVC), and upright row (85 +/- 5% of MVC) exercises, but the latter 2 exercises required smaller training loads (3-10 kg) compared with the shrug exercise (20-30 kg). Discussion and Conclusion. The lateral raise and upright row may be suitable alternatives to shrugs during...

  14. The effectiveness of cervical adjustment therapy, dry needling of the levator scapulae muscle and the combination of the two in the treatment of chronic mechanical neck pain

    OpenAIRE

    2011-01-01

    M.Tech. The aim of this study was to compare the effectiveness of cervical adjustment therapy, dry needling of the levator scapulae muscle and a combination of the two in the treatment of chronic mechanical neck pain. Forty-five patients were recruited via posters and advertisements from in and around the University of Johannesburg. The participants had to present with bilateral neck pain, decreased range of motion and an active levator scapulae muscles trigger point, which was diagnosed u...

  15. Does Deep Cervical Flexor Muscle Training Affect Pain Pressure Thresholds of Myofascial Trigger Points in Patients with Chronic Neck Pain? A Prospective Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Pavlos Bobos

    2016-01-01

    Full Text Available Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs. Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67 completed the study. Neck disability and neck pain were improved over time between and within groups (p<0.05. However, no differences were found within and between the therapeutic groups (p<0.05 in the tested muscles’ PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

  16. 肌肉疲劳与慢性颈痛的研究现状%Research Status on Relation of Muscle Fatigue and Chronic Neck Pain (review)

    Institute of Scientific and Technical Information of China (English)

    潘泳鸿; 仲卫红; 张俊新; 王诗忠

    2015-01-01

    Chronic neck pain is a common chronic musculoskeletal disorder. Research on neck muscle fatigue contributed to the under-standing the pathogenesis of chronic neck pain. The influences caused by the neck muscle fatigue, such as the change of cervical propriocep-tion and balance, could easily lead to chronic injury. Changes in morphology and recruitment strategy of cervical muscle could decrease muscle endurance, which bring about further damage. Targeted therapy and training can relieve muscle fatigue, improve muscle function, and reduce the recurrence rate. Surface electromyography has unique advantages in the evaluation of cervical muscle fatigue. The assess-ment of muscle fatigue could provide for assistance to the treatment and curative effect of chronic neck pain.%慢性颈痛是一种常见的慢性肌肉骨骼疾病,有关颈部肌肉疲劳的研究有助于认识慢性颈痛的发病机制。颈肌疲劳会对颈椎本体感觉和身体平衡等产生影响,易造成慢性损伤。慢性颈痛患者肌肉组织形态学和募集策略等的改变,使颈部肌肉抗疲劳能力下降,又可能导致颈部肌肉进一步损伤。针对性地治疗和训练能够缓解肌肉疲劳,提高肌肉功能,减少慢性颈痛的复发率。表面肌电图在评价颈肌疲劳中有着独特的优势,颈肌疲劳的评估可为慢性颈痛的治疗和疗效评价提供帮助。

  17. Respiratory weakness in patients with chronic neck pain.

    Science.gov (United States)

    Dimitriadis, Zacharias; Kapreli, Eleni; Strimpakos, Nikolaos; Oldham, Jacqueline

    2013-06-01

    Respiratory muscle strength is one parameter that is currently proposed to be affected in patients with chronic neck pain. This study was aimed at examining whether patients with chronic neck pain have reduced respiratory strength and with which neck pain problems their respiratory strength is associated. In this controlled cross-sectional study, 45 patients with chronic neck pain and 45 healthy well-matched controls were recruited. Respiratory muscle strength was assessed through maximal mouth pressures. The subjects were additionally assessed for their pain intensity and disability, neck muscle strength, endurance of deep neck flexors, neck range of movement, forward head posture and psychological states. Paired t-tests showed that patients with chronic neck pain have reduced Maximal Inspiratory (MIP) (r = 0.35) and Maximal Expiratory Pressures (MEP) (r = 0.39) (P Neck muscle strength (r > 0.5), kinesiophobia (r neck pain and disability (r Neck muscle strength was the only predictor that remained as significant into the prediction models of MIP and MEP. It can be concluded that patients with chronic neck pain present weakness of their respiratory muscles. This weakness seems to be a result of the impaired global and local muscle system of neck pain patients, and psychological states also appear to have an additional contribution. Clinicians are advised to consider the respiratory system of patients with chronic neck pain during their usual assessment and appropriately address their treatment.

  18. Effect of cycling on oxygenation of relaxed neck/shoulder muscles in women with and without chronic pain

    DEFF Research Database (Denmark)

    Andersen, Lars L; Blangsted, Anne Katrine; Nielsen, Pernille Kofoed;

    2010-01-01

    Work-related neck/shoulder muscle pain has been associated with increased anaerobic muscle metabolism. Thus, interventions to enhance oxygenation of painful muscles seem relevant. While cycling with relaxed shoulders has been shown to result in acute neck/shoulder muscle pain reduction, the effect......-maximal cycling in an upright position with relaxed shoulders. Near-infrared spectroscopy was used to measure trapezius muscle oxygenation during and 2 min after the cycling period. For both MYA and CON, oxygenation of the passive trapezius increased in a linear fashion over time, to values approximately 5 micro...... increases oxygenation of resting neck/shoulder muscles in women with and without trapezius myalgia, indicating acute positive effects of either neural or humoral factors on vascular beds of distant relaxed muscles. Although this beneficial response was observed in both groups, the post-exercise response...

  19. Altered spinal kinematics and muscle recruitment pattern of the cervical and thoracic spine in people with chronic neck pain during functional task.

    Science.gov (United States)

    Tsang, Sharon M H; Szeto, Grace P Y; Lee, Raymond Y W

    2014-02-01

    Knowledge on the spinal kinematics and muscle activation of the cervical and thoracic spine during functional task would add to our understanding of the performance and interplay of these spinal regions during dynamic condition. The purpose of this study was to examine the influence of chronic neck pain on the three-dimensional kinematics and muscle recruitment pattern of the cervical and thoracic spine during an overhead reaching task involving a light weight transfer by the upper limb. Synchronized measurements of the three-dimensional spinal kinematics and electromyographic activities of cervical and thoracic spine were acquired in thirty individuals with chronic neck pain and thirty age- and gender-matched asymptomatic controls. Neck pain group showed a significantly decreased cervical velocity and acceleration while performing the task. They also displayed with a predominantly prolonged coactivation of cervical and thoracic muscles throughout the task cycle. The current findings highlighted the importance to examine differential kinematic variables of the spine which are associated with changes in the muscle recruitment in people with chronic neck pain. The results also provide an insight to the appropriate clinical intervention to promote the recovery of the functional disability commonly reported in patients with neck pain disorders.

  20. The relationship between superficial muscle activity during the cranio-cervical flexion test and clinical features in patients with chronic neck pain.

    Science.gov (United States)

    O'Leary, Shaun; Falla, Deborah; Jull, Gwendolen

    2011-10-01

    Changes in motor behavior are a known feature of chronic mechanical neck pain disorders. This study examined the strength of the association between reported levels of pain and disability from 84 individuals (63 women, 21 men) with chronic mechanical neck pain and levels of electromyographic activity recorded from superficial cervical flexor (sternocleidomastoid; SCM and anterior scalene; AS) muscles during progressive stages of the cranio-cervical flexion muscle test. A significant positive association was observed between superficial muscle activity and pain intensity (P 0.5) or perceived disability (P > 0.21). The strongest relationship between pain intensity and superficial muscle activity occurred at the final increment of the cranio-cervical flexion test (inner-range test position) for both the SCM and AS muscles (R(2) = 0.16). Although a positive and significant relationship between pain intensity and superficial muscle activity was shown, the relationship was only modest (16% explained variance), indicating that multiple factors contribute to the altered motor function observed in individuals with chronic mechanical neck pain.

  1. Fatty infiltrate in the cervical extensor muscles is not a feature of chronic, insidious-onset neck pain

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, J. [Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane (Australia); Department of Physical Therapy, Rueckert-Hartman School for Health Professions, Regis University, Denver, Colorado (United States); Centre for Magnetic Resonance, University of Queensland, Brisbane (Australia)], E-mail: jelltt@regis.edu; Sterling, M. [Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane (Australia); Noteboom, J.T. [Department of Physical Therapy, Rueckert-Hartman School for Health Professions, Regis University, Denver, Colorado (United States); Darnell, R. [Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane (Australia); Galloway, G. [Centre for Magnetic Resonance, University of Queensland, Brisbane (Australia); Jull, G. [Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane (Australia)

    2008-06-15

    Aim: To investigate the presence of fatty infiltrate in the cervical extensor musculature in patients with insidious-onset neck pain to better understand the possible pathophysiology underlying such changes in chronic whiplash-associated disorders (WAD). Materials and methods: A sample of convenience of 23 women with persistent insidious-onset neck pain (mean age 29.2 {+-} 6.9 years) was recruited for the study. Magnetic resonance imaging (MRI) was used to quantify fatty infiltration in the cervical extensor musculature. Quantitative Sensory Testing (QST; pressure and thermal pain thresholds) was performed as sensory features are present in chronic whiplash. Self-reported pain and disability, as well as psychological distress, were measured using the Neck Disability Index (NDI) and the General Health Questionnaire-28 (GHQ-28), respectively. Results: Measures were compared with those of a previous dataset of chronic whiplash patients (n = 79, mean age 29.7 {+-} 7.8 years). Using a classification tree, insidious-onset neck pain was clearly identified from whiplash (p < 0.001), based on the presence of MRI fatty infiltrate in the cervical extensor musculature (0/102 individuals) and altered temperature thresholds (cold; 3/102 individuals). Conclusion: Fatty infiltrates in the cervical extensor musculature and widespread hyperalgesia were not features of the insidious-onset neck pain group in this study; whereas these features have been identified in patients with chronic WAD. This novel finding may enable a better understanding of the underlying pathophysiological processes in patients with chronic whiplash.

  2. Chronic calcific tendinitis of the neck

    Energy Technology Data Exchange (ETDEWEB)

    Newmark, H.; Zee, C.S.; Frankel, P.; Robinson, A.; Blau, L.; Gans, D.C.

    1981-12-01

    The authors present the first three cases of chronic calcific tendinits of the neck. This condition is diagnosed radiologically by the presence of calcification located just inferior to the anterior tubercle of C1. The calcification is at the insertion of the longus colli muscle. No soft tissue swelling is present and the patients are asymptomatic.

  3. Effectiveness of home-based cupping massage compared to progressive muscle relaxation in patients with chronic neck pain--a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Romy Lauche

    Full Text Available UNLABELLED: Chronic neck pain is a major public health problem with very few evidence-based complementary treatment options. This study aimed to test the efficacy of 12 weeks of a partner-delivered home-based cupping massage, compared to the same period of progressive muscle relaxation in patients with chronic non-specific neck pain. Patients were randomly assigned to self-directed cupping massage or progressive muscle relaxation. They were trained and asked to undertake the assigned treatment twice weekly for 12 weeks. Primary outcome measure was the current neck pain intensity (0-100 mm visual analog scale; VAS after 12 weeks. Secondary outcome measures included pain on motion, affective pain perception, functional disability, psychological distress, wellbeing, health-related quality of life, pressure pain thresholds and adverse events. Sixty one patients (54.1±12.7 years; 73.8%female were randomized to cupping massage (n = 30 or progressive muscle relaxation (n = 31. After treatment, both groups showed significantly less pain compared to baseline however without significant group differences. Significant effects in favor of cupping massage were only found for wellbeing and pressure pain thresholds. In conclusion, cupping massage is no more effective than progressive muscle relaxation in reducing chronic non-specific neck pain. Both therapies can be easily used at home and can reduce pain to a minimal clinically relevant extent. Cupping massage may however be better than PMR in improving well-being and decreasing pressure pain sensitivity but more studies with larger samples and longer follow-up periods are needed to confirm these results. TRIAL REGISTRATION: ClinicalTrials.gov NCT01500330.

  4. An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain

    Directory of Open Access Journals (Sweden)

    Persson Ann L

    2011-10-01

    Full Text Available Abstract Background Neck-shoulder pain conditions, e.g., chronic trapezius myalgia, have been associated with sensory disturbances such as increased sensitivity to experimentally induced pain. This study investigated pain sensitivity in terms of bilateral pressure pain thresholds over the trapezius and tibialis anterior muscles and pain responses after a unilateral hypertonic saline infusion into the right legs tibialis anterior muscle and related those parameters to intensity and area size of the clinical pain and to psychological factors (sleeping problems, depression, anxiety, catastrophizing and fear-avoidance. Methods Nineteen women with chronic non-traumatic neck-shoulder pain but without simultaneous anatomically widespread clinical pain (NSP and 30 age-matched pain-free female control subjects (CON participated in the study. Results NSP had lower pressure pain thresholds over the trapezius and over the tibialis anterior muscles and experienced hypertonic saline-evoked pain in the tibialis anterior muscle to be significantly more intense and locally more widespread than CON. More intense symptoms of anxiety and depression together with a higher disability level were associated with increased pain responses to experimental pain induction and a larger area size of the clinical neck-shoulder pain at its worst. Conclusion These results indicate that central mechanisms e.g., central sensitization and altered descending control, are involved in chronic neck-shoulder pain since sensory hypersensitivity was found in areas distant to the site of clinical pain. Psychological status was found to interact with the perception, intensity, duration and distribution of induced pain (hypertonic saline together with the spreading of clinical pain. The duration and intensity of pain correlated negatively with pressure pain thresholds.

  5. Effect of Brief Daily Resistance Training on Occupational Neck/Shoulder Muscle Activity in Office Workers with Chronic Pain: Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Mark Lidegaard

    2013-01-01

    Full Text Available Purpose. This study investigates the acute and longitudinal effects of resistance training on occupational muscle activity in office workers with chronic pain. Methods. 30 female office workers with chronic neck and shoulder pain participated for 10 weeks in high-intensity elastic resistance training for 2 minutes per day (n=15 or in control receiving weekly email-based information on general health (n=15. Electromyography (EMG from the splenius and upper trapezius was recorded during a normal workday. Results. Adherence to training and control interventions were 86% and 89%, respectively. Compared with control, training increased isometric muscle strength 6% (P<0.05 and decreased neck/shoulder pain intensity by 40% (P<0.01. The frequency of periods with complete motor unit relaxation (EMG gaps decreased acutely in the hours after training. By contrast, at 10-week follow-up, training increased average duration of EMG gaps by 71%, EMG gap frequency by 296% and percentage time below 0.5%, and 1.0% EMGmax by 578% and 242%, respectively, during the workday in m. splenius. Conclusion. While resistance training acutely generates a more tense muscle activity pattern, the longitudinal changes are beneficial in terms of longer and more frequent periods of complete muscular relaxation and reduced pain.

  6. Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Fernández-Mayoralas, Daniel M; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Palacios-Ceña, Domingo; Pareja, Juan A

    2011-02-01

    Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children's condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

  7. Chronic neck pain disability due to an acute whiplash injury.

    Science.gov (United States)

    Nederhand, Marc J; Hermens, Hermie J; IJzerman, Maarten J; Turk, Dennis C; Zilvold, Gerrit

    2003-03-01

    Several theories about musculoskeletal pain syndromes such as whiplash-associated disorder (WAD) suggest that pain and muscle activity interact and may contribute to the chronicity of symptoms. Studies using surface electromyography (sEMG) have demonstrated abnormal muscle activation patterns of the upper trapezius muscles in the chronic stage of WAD (grade II). There are, however, no studies that confirm that these muscle reactions are initiated in the acute stage of WAD, nor that these muscle reactions persist in the transition from acute neck pain to chronic neck pain disability. We analyzed the muscle activation patterns of the upper trapezius muscles in a cohort of 92 subjects with acute neck pain due to a motor vehicle accident (MVA). This cohort was followed up in order to evaluate differences in muscular activation patterns between subjects who have recovered and those subjects who have not recovered following an acute WAD and developed chronic neck pain. sEMG parameters were obtained at 1, 4, 8, 12, and 24 weeks after an MVA. The level of muscle reactivity (the difference in pre- and post-exercise EMG levels) and the level of muscle activity during an isometric and a dynamic task were used as EMG parameters. The results revealed no elevated muscle reactivity either in the acute stage, or during the follow-up period. The results of both the isometric and dynamic task, showed statistically significant different EMG levels between four neck pain disability subgroups (analysis of variance reaching P-levels of 0.000), with an inverse relationship between the level of neck pain disability and EMG level. Furthermore, follow-up assessments of the EMG level during these two tasks, did not show a time related change. In conclusion, in subjects with future disability, the acute stage is characterized by a reorganization of the muscular activation of neck and shoulder muscles, possibly aimed at minimizing the use of painful muscles. This change of motor control, is in

  8. Noninvasive analysis of human neck muscle function

    Science.gov (United States)

    Conley, M. S.; Meyer, R. A.; Bloomberg, J. J.; Feeback, D. L.; Dudley, G. A.

    1995-01-01

    STUDY DESIGN. Muscle use evoked by exercise was determined by quantifying shifts in signal relaxation times of T2-weighted magnetic resonance images. Images were collected at rest and after exercise at each of two intensities (moderate and intense) for each of four head movements: 1) extension, 2) flexion, 3) rotation, and 4) lateral flexion. OBJECTIVE. This study examined the intensity and pattern of neck muscle use evoked by various movements of the head. The results will help elucidate the pathophysiology, and thus methods for treating disorders of the cervical musculoskeletal system. SUMMARY OF BACKGROUND DATA. Exercise-induced contrast shifts in T2 has been shown to indicate muscle use during the activity. The noninvasive nature of magnetic resonance imaging appears to make it an ideal approach for studying the function of the complex neuromuscular system of the neck. METHODS. The extent of T2 increase was examined to gauge how intensely nine different neck muscles or muscle pairs were used in seven subjects. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation was assessed to infer the pattern of use among and within individual neck muscles or muscle pairs. RESULTS. Signal relaxation increased with exercise intensity for each head movement. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation also increased with exercise load. Neck muscles or muscle pairs extensively used to perform each head movement were: extension--semispinalis capitis and cervicis and splenius capitis; flexion--sternocleidomastoid and longus capitis and colli; rotation--splenius capitis, levator scapulae, scalenus, semispinalis capitis ipsilateral to the rotation, and sternocleidomastoid contralateral; and lateral flexion--sternocleidomastoid CONCLUSION. The results of this study, in part, agree with the purported functions of neck muscles derived from anatomic location. This also was true for the few

  9. Neck muscle function in violinists/violists with and without neck pain.

    Science.gov (United States)

    Steinmetz, Anke; Claus, Andrew; Hodges, Paul W; Jull, Gwendolen A

    2016-04-01

    Neck pain is associated with changes in neuromuscular control of cervical muscles. Violin and viola playing requires good function of the flexor muscles to stabilize the instrument. This study investigated the flexor muscle behaviour in violin/viola players with and without neck pain using the craniocervical flexion test (CCFT). In total, 12 violin/viola players with neck pain, 21 violin/viola players without neck pain in the preceding 12 weeks and 21 pain-free non-musicians were included. Activity of the sternocleidomastoid muscles (SCM) was measured with surface electromyography (EMG) during the CCFT. Violin/viola players with neck pain displayed greater normalised SCM EMG amplitudes during CCFT than the pain-free musicians and non-musicians (P neck pain in violinists/violists is associated with altered behaviour of the superficial neck flexor muscles consistent with neck pain, despite the specific use of the deep and superficial neck flexors during violin playing.

  10. Experimental neck muscle pain impairs standing balance in humans

    CERN Document Server

    Vuillerme, Nicolas; 10.1007/s00221-008-1639-7

    2009-01-01

    Impaired postural control has been reported in patients with chronic neck pain of both traumatic and non-traumatic etiologies, but whether painful stimulation of neck muscle per se can affect balance control during quiet standing in humans remains unclear. The purpose of the present experiment was thus to investigate the effect of experimental neck muscle pain on standing balance in young healthy adults. To achieve this goal, 16 male university students were asked to stand upright as still as possible on a force platform with their eyes closed in two conditions of No pain and Pain of the neck muscles elicited by experimental painful electrical stimulation. Postural control and postural performance were assessed by the displacements of the center of foot pressure (CoP) and of the center of mass (CoM), respectively. The results showed increased CoP and CoM displacements variance, range, mean velocity, and mean and median frequencies in the Pain relative to the No pain condition. The present findings emphasize t...

  11. Neck muscle fatigue alters upper limb proprioception.

    Science.gov (United States)

    Zabihhosseinian, Mahboobeh; Holmes, Michael W R; Murphy, Bernadette

    2015-05-01

    Limb proprioception is an awareness by the central nervous system (CNS) of the location of a limb in three-dimensional space and is essential for movement and postural control. The CNS uses the position of the head and neck when interpreting the position of the upper limb, and altered input from neck muscles may affect the sensory inputs to the CNS and consequently may impair the awareness of upper limb joint position. The purpose of this study was to determine whether fatigue of the cervical extensors muscles (CEM) using a submaximal fatigue protocol alters the ability to recreate a previously presented elbow angle with the head in a neutral position. Twelve healthy individuals participated. CEM activity was examined bilaterally using surface electromyography, and kinematics of the elbow joint was measured. The fatigue protocol included an isometric neck extension task at 70 % of maximum until failure. Joint position error increased following fatigue, demonstrating a significant main effect of time (F 2, 18 = 19.41, p ≤ 0.0001) for absolute error. No significant differences were found for variable error (F 2, 18 = 0.27, p = 0.76) or constant error (F 2, 18 = 1.16 of time, p ≤ 0.33). This study confirms that fatigue of the CEM can reduce the accuracy of elbow joint position matching. This suggests that altered afferent input from the neck subsequent to fatigue may impair upper limb proprioception.

  12. Effects of chronic neck-shoulder pain on normalized mutual information analysis of surface electromyography during functional tasks

    DEFF Research Database (Denmark)

    Madeleine, Pascal; Xie, Yanfei; Szeto, Grace P. Y.;

    2016-01-01

    OBJECTIVE: To investigate the effects neck-shoulder pain on the connectivity of surface electromyography (SEMG) signals during functional tasks. METHODS: Twenty adults suffering from chronic neck-shoulder pain and 20 healthy controls were recruited. The SEMG signals from the left and right proximal....... Moreover, NMI values in homonymous proximal muscles were higher during texting compared with computer typing with both hands. CONCLUSIONS: Our results show for the first time that chronic neck-shoulder pain affects the functional connectivity of muscle pairs. SIGNIFICANCE: The study furnishes novel...... information about the effects of chronic neck-shoulder pain on the interplay of muscle pairs during functional tasks....

  13. Acupuncture for patients with chronic neck pain.

    Science.gov (United States)

    Witt, Claudia M; Jena, Susanne; Brinkhaus, Benno; Liecker, Bodo; Wegscheider, Karl; Willich, Stefan N

    2006-11-01

    Acupuncture is widely used by patients with neck pain, but there is a lack of information about its effectiveness in routine medical care. The aim was to investigate the effectiveness of acupuncture in addition to routine care in patients with chronic neck pain compared to treatment with routine care alone. We performed a randomized controlled multicentre trial plus non-randomized cohort in general practices in Germany. 14,161 patients with chronic neck pain (duration >6 months). Patients were randomly allocated to an acupuncture group or a control group receiving no acupuncture. Patients in the acupuncture group received up to 15 acupuncture sessions over three months. Patients who did not consent to randomization received acupuncture treatment. All subjects were allowed to receive usual medical care in addition to study treatment. Neck pain and disability (NPAD Scale by Wheeler) after three months. Of 14,161 patients (mean age 50.9+/-13.1 years, 68% female) 1880 were randomized to acupuncture and 1886 to control, and 10,395 included into the non-randomized acupuncture group. At three months, neck pain and disability improved by 16.2 (SE: 0.4) to 38.3 (SE: 0.4); and by 3.9 (SE: 0.4) to 50.5 (SE: 0.4), difference 12.3 (pacupuncture and control group, respectively. Treatment success was essentially maintained through six months. Non-randomized patients had more severe symptoms at baseline and showed higher neck pain and disability improvement compared to randomized patients. Treatment with acupuncture added to routine care in patients with chronic neck pain was associated with improvements in neck pain and disability compared to treatment with routine care alone.

  14. Analysis of scapular muscle EMG activity in patients with idiopathic neck pain: a systematic review.

    Science.gov (United States)

    Castelein, Birgit; Cools, Ann; Bostyn, Emma; Delemarre, Jolien; Lemahieu, Trees; Cagnie, Barbara

    2015-04-01

    It is proposed that altered scapular muscle function can contribute to abnormal loading of the cervical spine. However, it is not clear if patients with idiopathic neck pain show altered activity of the scapular muscles. The aim of this paper was to systematically review the literature regarding the differences or similarities in scapular muscle activity, measured by electromyography ( = EMG), between patients with chronic idiopathic neck pain compared to pain-free controls. Case-control (neck pain/healthy) studies investigating scapular muscle EMG activity (amplitude, timing and fatigue parameters) were searched in Pubmed and Web of Science. 25 articles were included in the systematic review. During rest and activities below shoulder height, no clear differences in mean Upper Trapezius ( = UT) EMG activity exist between patients with idiopathic neck pain and a healthy control group. During overhead activities, no conclusion for scapular EMG amplitude can be drawn as a large variation of results were reported. Adaptation strategies during overhead tasks are not the same between studies. Only one study investigated timing of the scapular muscles and found a delayed onset and shorter duration of the SA during elevation in patients with idiopathic neck pain. For scapular muscle fatigue, no definite conclusions can be made as a wide variation and conflicting results are reported. Further high quality EMG research on scapular muscles (broader than the UT) is necessary to understand/draw conclusions on how scapular muscles react in the presence of idiopathic neck pain.

  15. Chronic neck pain and masticatory dysfunction.

    Science.gov (United States)

    Catanzariti, Jean-François; Debuse, Thierry; Duquesnoy, Bernard

    2005-12-01

    Chronic nonspecific neck pain is a common problem in rheumatology and may resist conventional treatment. Pathophysiological links exist between the cervical spine and masticatory system. Occlusal disorders may cause neck pain and may respond to dental treatment. The estimated prevalence of occlusal disorders is about 45%, with half the cases being due to functional factors. Minor repeated masticatory dysfunction (MD) with craniocervical asymmetry is the most common clinical picture. The pain is usually located in the suboccipital region and refractory to conventional treatment. The time pattern may be suggestive, with nocturnal arousals or triggering by temporomandibular movements. MD should be strongly suspected in patients with at least two of the following: history of treated or untreated MD, unilateral temporomandibular joint pain and clicking, lateral deviation during mouth opening, and limitation of mouth opening (less than three fingerbreadths). Rheumatologists should consider MD among causes of neck pain, most notably in patients with abnormal craniocervical posture, signs linking the neck pain to mastication, and clinical manifestations of MD. Evidence suggesting that MD may cause neck pain has been published. However, studies are needed to determine whether treatment of MD can relieve neck pain.

  16. Chronic Neck Pain and Cervicogenic Headaches.

    Science.gov (United States)

    Feng, Frank L.; Schofferman, Jerome

    2003-11-01

    Chronic axial neck pain and cervicogenic headache are common problems, and there have been significant advances in the understanding of the etiology and treatment of each. The severity and duration of pain drives the process. For patients who have had slight to moderate pain that has been present for less than 6 months and have no significant motor loss, strength training of anterior, posterior, and interscapular muscle groups coupled with body mechanics training is prescribed. After 8 weeks, if the patient is better, exercises are continued at home or in a gym. If the patient is not better, physical therapy is continued for up to 8 more weeks. In patients with motor loss or severe pain, radiographs and magnetic resonance imaging (MRI) should be ordered at the initial visit. In patients with slight to moderate pain who are not better by 4 to 6 months, plain radiographs of the neck and MRI should be ordered. Based on the results, a spinal injection is usually prescribed. If MRI reveals spinal stenosis of the central or lateral canal, or a disc herniation, an epidural corticosteroid injection should be ordered. If the epidural provides good relief, the patient can be referred for more aggressive physical therapy and repeat the epidural as needed up to a maximum of three times. If there is no pathology within the canal, medial branch blocks and intra-articular steroid injections can be ordered based on the joints that are most tender or where disc space narrowing is greatest, or MRI or radiographs are recommended. If there is excellent relief from the medial branch block and joint injections, repeat when the steroids wear off. If there is good relief again, but pain recurs, medial branch radiofrequency neurotomy is recommended. For patients with one or two level disc degeneration that has not responded, a psychologic evaluation and discography is recommended. If there are no significant psychologic abnormalities, and one or two (rarely three) painful discs, surgical

  17. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial.

    Science.gov (United States)

    Cerezo-Téllez, Ester; Torres-Lacomba, María; Fuentes-Gallardo, Isabel; Perez-Muñoz, Milagros; Mayoral-Del-Moral, Orlando; Lluch-Girbés, Enrique; Prieto-Valiente, Luis; Falla, Deborah

    2016-09-01

    Chronic neck pain attributed to a myofascial pain syndrome is characterized by the presence of muscle contractures referred to as myofascial trigger points. In this randomized, parallel-group, blinded, controlled clinical trial, we examined the effectiveness of deep dry needling (DDN) of myofascial trigger points in people with chronic nonspecific neck pain. The study was conducted at a public Primary Health Care Centre in Madrid, Spain, from January 2010 to December 2014. A total of 130 participants with nonspecific neck pain presenting with active myofascial trigger points in their cervical muscles were included. These participants were randomly allocated to receive: DDN plus stretching (n = 65) or stretching only (control group [n = 65]). Four sessions of treatment were applied over 2 weeks with a 6-month follow-up after treatment. Pain intensity, mechanical hyperalgesia, neck active range of motion, neck muscle strength, and perceived neck disability were measured at baseline, after 2 sessions of intervention, after the intervention period, and 15, 30, 90, and 180 days after the intervention. Significant and clinically relevant differences were found in favour of dry needling in all the outcomes (all P neck pain. The results support the use of DDN in the management of myofascial pain syndrome in people with chronic nonspecific neck pain.

  18. Novel insights into the interplay between ventral neck muscles in individuals with whiplash-associated disorders.

    Science.gov (United States)

    Peterson, Gunnel; Nilsson, David; Trygg, Johan; Falla, Deborah; Dedering, Åsa; Wallman, Thorne; Peolsson, Anneli

    2015-10-16

    Chronic whiplash-associated disorder (WAD) is common after whiplash injury, with considerable personal, social, and economic burden. Despite decades of research, factors responsible for continuing pain and disability are largely unknown, and diagnostic tools are lacking. Here, we report a novel model of mechanical ventral neck muscle function recorded from non-invasive, real-time, ultrasound measurements. We calculated the deformation area and deformation rate in 23 individuals with persistent WAD and compared them to 23 sex- and age-matched controls. Multivariate statistics were used to analyse interactions between ventral neck muscles, revealing different interplay between muscles in individuals with WAD and healthy controls. Although the cause and effect relation cannot be established from this data, for the first time, we reveal a novel method capable of detecting different neck muscle interplay in people with WAD. This non-invasive method stands to make a major breakthrough in the assessment and diagnosis of people following a whiplash trauma.

  19. Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

    Directory of Open Access Journals (Sweden)

    Mortensen Ole S

    2011-07-01

    Full Text Available Abstract Background Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. Methods Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'. Results In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%. In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%. In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations. Conclusions A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius. Trial Registration ISRCTN60264809

  20. Effect of contrasting physical exercise interventions on rapid force capacity of chronically painful muscles

    DEFF Research Database (Denmark)

    Andersen, Lars L; Andersen, Jesper L; Suetta, Charlotte

    2009-01-01

    as neural and muscular adaptations in women with chronic neck muscle pain. A group of employed women (n = 42) with a clinical diagnosis of trapezius myalgia participated in a 10-wk randomized controlled trial; specific strength training of the neck/shoulder muscles, general fitness training performed as leg...

  1. Prevalence of cervical facet joint pain in chronic neck pain.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Rivera, Jose; Pampati, Vidyasagar

    2002-07-01

    Neck pain is considered to be one of the most common chronic pain conditions in modern society. Various structures identified as capable of transmitting pain in the cervical spine include facet joints, intervertebral discs, nerve root dura, ligaments, fascia, and muscles. The prevalence of cervical facet joint pain in patients with chronic pain after whiplash has been determined as 54% to 60%. However, the prevalence of chronic cervical facet joint pain has not yet been determined in a heterogenous population or in patients with cervical spine pain of idiopathic origin in a controlled environment. This study evaluated 160 patients seen in one interventional pain management practice in a non-university setting. Cervical facet joints were investigated with diagnostic blocks using lidocaine 1% preservative free initially, followed by bupivacaine 0.25%, usually 2 to 4 weeks apart. The study population consisted of 76 women and 30 men aged 43 +/- 13 years of age (mean +/- SD). Mode of onset of neck pain was determined as following a traumatic incident in 48% of the patients, whereas it was with gradual onset without an identifiable specific incident in the remaining 55 patients (52%). Eighty-one or 70% of the patients (70%) reported a definite response to lidocaine blocks. Confirmatory blocks with bupivacaine were performed in 81 patients with 64 patients with 60% of the total sample, or 79%, of the lidocaine-positive group reporting definite response with improvement in their pain. Thus, a prevalence rate of facet joint pain in chronic neck pain was determined to be 60% (95% CI, 50%-70%), with a false positive rate of controlled diagnostic blocks of 40% (95% CI, 34%-46%).

  2. Chronic neck pain: making the connection between capsular ligament laxity and cervical instability.

    Science.gov (United States)

    Steilen, Danielle; Hauser, Ross; Woldin, Barbara; Sawyer, Sarah

    2014-01-01

    The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narrative review are to provide an overview of chronic neck pain as it relates to cervical instability, to describe the anatomical features of the cervical spine and the impact of capsular ligament laxity, to discuss the disorders causing chronic neck pain and their current treatments, and lastly, to present prolotherapy as a viable treatment option that heals injured ligaments, restores stability to the spine, and resolves chronic neck pain. The capsular ligaments are the main stabilizing structures of the facet joints in the cervical spine and have been implicated as a major source of chronic neck pain. Chronic neck pain often reflects a state of instability in the cervical spine and is a symptom common to a number of conditions described herein, including disc herniation, cervical spondylosis, whiplash injury and whiplash associated disorder, postconcussion syndrome, vertebrobasilar insufficiency, and Barré-Liéou syndrome. When the capsular ligaments are injured, they become elongated and exhibit laxity, which causes excessive movement of the cervical vertebrae. In the upper cervical spine (C0-C2), this can cause a number of other symptoms including, but not limited to, nerve irritation and vertebrobasilar insufficiency with associated vertigo, tinnitus, dizziness, facial pain, arm pain, and migraine headaches. In the lower cervical spine (C3-C7), this can cause muscle spasms, crepitation, and/or paresthesia in addition to chronic neck pain. In either case, the presence of

  3. Altered Pain Sensitivity in Elderly Women with Chronic Neck Pain

    OpenAIRE

    2015-01-01

    Background Age-related changes occur in both the peripheral and central nervous system, yet little is known about the influence of chronic pain on pain sensitivity in older persons. The aim of this study was to investigate pain sensitivity in elders with chronic neck pain compared to healthy elders. Methods Thirty elderly women with chronic neck pain and 30 controls were recruited. Measures of pain sensitivity included pressure pain thresholds, heat/cold pain thresholds and suprathreshold hea...

  4. [Neck pain due to tendonitis of the longus colli muscle].

    Science.gov (United States)

    Coebergh, Jan Adriaan; Koppen, Hille; van Gils, Ad P; de Bruijn, Bas F

    2010-01-01

    Two patients presented to Accidents and Emergency with severe neck pain: a 70-year-old woman with acute, severe neck pain, which had developed a few days after outpatient resection of her left lingual tonsil. The patient was suspected to have spondylodiscitis. The other patient, a 54-year-old woman, was referred with severe neck pain and suspected meningitis. In both women, the pain was diagnosed as acute calcifying tendonitis of the longus colli muscle. This benign condition can present to many different specialities. Both patients responded well to treatment with NSAIDs. Acute calcifying tendonitis of the longus colli muscle can be diagnosed using various imaging techniques, such as X-ray, CT or MRI imaging. Calcification on cervical CT or a high signal on T2-weighted MRI images of the longus colli muscle are pathognomonic of tendonitis. A correct diagnosis can prevent further invasive diagnostics and/or unnecessary treatment.

  5. Effect of neck strength training on health-related quality of life in females with chronic neck pain: a randomized controlled 1-year follow-up study

    Directory of Open Access Journals (Sweden)

    Kautiainen Hannu

    2010-05-01

    Full Text Available Abstract Background Chronic neck pain is a common condition associated not only with a decrease in neck muscle strength, but also with decrease in health-related quality of life (HRQoL. While neck strength training has been shown to be effective in improving neck muscle strength and reducing neck pain, HRQoL among patients with neck pain has been reported as an outcome in only two short-term exercise intervention studies. Thus, reports on the influence of a long-term neck strength training intervention on HRQoL among patients with chronic neck pain have been lacking. This study reports the effect of one-year neck strength training on HRQoL in females with chronic neck pain. Methods One hundred eighty female office workers, 25 to 53 years of age, with chronic neck pain were randomized to a strength training group (STG, n = 60, endurance training group (ETG, n = 60 or control group (CG, n = 60. The STG performed high-intensity isometric neck strengthening exercises with an elastic band while the ETG performed lighter dynamic neck muscle training. The CG received a single session of guidance on stretching exercises. HRQoL was assessed using the generic 15D questionnaire at baseline and after 12 months. Statistical comparisons among the groups were performed using bootstrap-type analysis of covariance (ANCOVA with baseline values as covariates. Effect sizes were calculated using the Cohen method for paired samples. Results Training led to statistically significant improvement in the 15D total scores for both training groups, whereas no changes occurred for the control group (P = 0.012, between groups. The STG improved significantly in five of 15 dimensions, while the ETG improved significantly in two dimensions. Effect size (and 95% confidence intervals for the 15D total score was 0.39 (0.13 to 0.72 for the STG, 0.37 (0.08 to 0.67 for the ETG, and -0.06 (-0.25 to 0.15 for the CG. Conclusions One year of either strength or endurance training seemed

  6. The effect of fear of movement on muscle activation in posttraumatic neck pain disability

    NARCIS (Netherlands)

    Nederhand, Marc J.; Hermens, Hermie J.; IJzerman, Maarten J.; Groothuis, Karin G.M.; Turk, Dennis C.

    2006-01-01

    Studies using surface electromyography have demonstrated a reorganization of muscle activation patterns of the neck and shoulder muscles in patients with posttraumatic neck pain disability. The neurophysiologically oriented "pain adaptation" model explains this reorganization as a useful adaptation

  7. Bilateral experimental neck pain reorganize axioscapular muscle coordination and pain sensitivity

    DEFF Research Database (Denmark)

    Christensen, Steffan Wittrup; Hirata, Rogerio Pessoto; Graven-Nielsen, Thomas

    2017-01-01

    BACKGROUND: Neck pain is a large clinical problem where reorganized trunk and axioscapular muscle activities have been hypothesised contributing to pain persistence and pain hypersensitivity. This study investigated the effects of bilateral experimental neck pain on trunk and axioscapular muscle ...

  8. Effect of non-surgical spinal decompression system traction on neck mus-cle surface electromyography of patients with chronic neck pain%非手术脊柱减压系统牵引对慢性颈痛患者颈部肌肉表面肌电信号的影响

    Institute of Scientific and Technical Information of China (English)

    凌雁; 张娜; 朱志华

    2015-01-01

    Objective To explore effect of non-surgical spinal decompression system (SDS) traction on neck muscle surface electromyography (EMG) of patients with chronic neck pain. Methods 100 patients with chronic neck pain in Rehabilitation Department of Motion Rehabilitation Research Center of Shandong Province and Rehabilitation Depart-ment of Qilu Hospital from February 2013 to February 2015 were selected and randomly divided into SDS group and ordinary group, with 50 cases in each group. The patients of SDS group and ordinary group were treated with SDS and general traction system for cervical traction respectively. Surface EMG telemeter was used to measure affected side cer-vical paraspinal muscle and cervical erector spinae muscle surface EMG, and VAS and NDI score after a course of treatment were observed. Results There were statistical differences between two groups of EMG amplitude and frequen-cy slope of affected side cervical paraspinal muscle before, during and after traction for the first time (P<0.05). After a course of treatment, affected side cervical paraspinal muscle EMG amplitude and frequency slope of SDS group were significantly higher than those of ordinary group (P<0.05). There were statistical difference between two groups of EMG amplitude and frequency slope of cervical erector spinae muscle before, during and after traction for the first time (P<0.05). After a course of treatment, cervical erector spinae muscle EMG amplitude and frequency slope of SDS group were significantly higher than those of ordinary group (P<0.05). VAS and NDI score of two groups after a course of treat-ment were significantly lower than those before treatment (P<0.05), and VAS and NDI score of SDS group were signif-icantly lower than those of ordinary group (P<0.05). Conclusion SDS traction is superior to ordinary traction as to the func-tion of relaxing neck muscles and relieving muscle fatigue, much superior as to the treatment effect of chronic neck pain.%目的:探讨

  9. Muscle activation patterns in posttraumatic neck pain

    NARCIS (Netherlands)

    Nederhand, Marcus Johannes

    2003-01-01

    As an important consequence of our research, we question the relevance of the criteria of the WAD injury severity classification system. We showed that the musculoskeletal signs in WAD grade II are not characterized by muscle spasm, (i.e. increase of muscle activity), but rather by a decrease in mus

  10. Muscle parameters for musculoskeletal modelling of the human neck

    NARCIS (Netherlands)

    Borst, J.; Forbes, P.A.; Happee, R.; Veeger, H.E.J.

    2011-01-01

    Background: To study normal or pathological neuromuscular control, a musculoskeletal model of the neck has great potential but a complete and consistent anatomical dataset which comprises the muscle geometry parameters to construct such a model is not yet available. Methods: A dissection experiment

  11. Muscle histochemistry in chronic alcoholism

    Directory of Open Access Journals (Sweden)

    M. L. Ferraz

    1989-06-01

    Full Text Available Twenty-two chronic acoholic patients were assessed by neurologic examination and muscle biopsy. The patients manifested proximal muscular weakness to a variable extent. One case presented as an acute bout of myopathy, according to the Manual Muscle Test, MMT. The most prominent histologic feature observed was muscle atrophy (95.3% better evidenced through the ATPase stain with the predominance of type II A fibers (71.4%. Lack of the mosaic pattern (type grouping seen in 76% of the cases and an important mitochondrial proliferation with intrasarcoplasmatic lipid accumulation in 63% of the patients. In case of acute presentation of muscle weakness the. pathological substrate is quite different, i.e. presence of myositis mainly interstitial characterized by lymphoplasmocytic infiltrate and several spots of necrosis like Zencker degeneration. Based on histologic criteria, our data suggest that: the main determinant of muscle weakness seen in chronic alcoholic patients is neurogenic in origin (alcoholic polineuropathy; the direct toxic action of ethanol under the skeletal muscle is closely related to the mitochondrial metabolism; the so-called acute alcoholic myopathy has probably viral etiology.

  12. Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jinu; Shin, Eun Seow; Kim, Jeong Eon; Yoon, Sang Pil [Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Young Suk [Dept. of Radiation Oncology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2015-12-15

    Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered.

  13. Chronic neck pain patients with traumatic or non-traumatic onset

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Juul-Kristensen, Birgit; Boyle, Eleanor

    2017-01-01

    tests of cervical range of motion, gaze stability, eye movement, cranio-cervical flexion, cervical extensors, and pressure pain threshold. The participants completed the following questionnaires: physical and mental component summary of the Short Form Health Survey, EuroQol-5D, Neck Disability Index....... The purpose of this study was to investigate the clinical presentation of chronic neck pain patients with and without traumatic onset by examining cervical mobility, sensorimotor function, cervical muscle performance and pressure pain threshold in addition to the following self-reported characteristics...... in the traumatic group showed worse results on all measures compared with those in the non-traumatic group, significantly on neck muscle function (cervical extension mobility p = 0.005, cranio-cervical flexion test p = 0.007, cervical extensor test p = 0.006) and cervical pressure pain threshold bilateral (p = 0...

  14. Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

    DEFF Research Database (Denmark)

    Andersen, Lars L; Hansen, Klaus; Mortensen, Ole S;

    2011-01-01

    Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults...... with nonspecific neck/shoulder pain....

  15. Muscle strength in patients with chronic pain

    NARCIS (Netherlands)

    van Wilgen, C.P.; Akkerman, L.; Wieringa, J.; Dijkstra, P.U.

    2003-01-01

    Objective: To analyse the influence of chronic pain on muscle strength. Design: Muscle strength of patients with unilateral nonspecific chronic pain, in an upper or lower limb, were measured according to a standardized protocol using a hand-held dynamometer. Before and after muscle strength measurem

  16. Flexion-relaxation ratio in computer workers with and without chronic neck pain.

    Science.gov (United States)

    Pinheiro, Carina Ferreira; dos Santos, Marina Foresti; Chaves, Thais Cristina

    2016-02-01

    This study evaluated the flexion-relaxation phenomenon (FRP) and flexion-relaxation ratios (FR-ratios) using surface electromyography (sEMG) of the cervical extensor muscles of computer workers with and without chronic neck pain, as well as of healthy subjects who were not computer users. This study comprised 60 subjects 20-45years of age, of which 20 were computer workers with chronic neck pain (CPG), 20 were computer workers without neck pain (NPG), and 20 were control individuals who do not use computers for work and use them less than 4h/day for other purposes (CG). FRP and FR-ratios were analyzed using sEMG of the cervical extensors. Analysis of FR-ratios showed smaller values in the semispinalis capitis muscles of the two groups of workers compared to the control group. The reference FR-ratio (flexion relaxation ratio [FRR], defined as the maximum activity in 1s of the re-extension/full flexion sEMG activity) was significantly higher in the computer workers with neck pain compared to the CG (CPG: 3.10, 95% confidence interval [CI95%] 2.50-3.70; NPG: 2.33, CI95% 1.93-2.74; CG: 1.99, CI95% 1.81-2.17; p<0.001). The FR-ratios and FRR of sEMG in this study suggested that computer use could increase recruitment of the semispinalis capitis during neck extension (concentric and eccentric phases), which could explain our results. These results also suggest that the FR-ratios of the semispinalis may be a potential functional predictive neuromuscular marker of asymptomatic neck musculoskeletal disorders since even asymptomatic computer workers showed altered values. On the other hand, the FRR values of the semispinalis capitis demonstrated a good discriminative ability to detect neck pain, and such results suggested that each FR-ratio could have a different application.

  17. Changes in the activity of the muscles surrounding the neck according to the angles of movement of the neck in adults in their 20s

    OpenAIRE

    Lee , Tae-Ho; Lee, Joon-Hyuk; Lee, Yun-seob; Kim, Myoung-Kwon; Kim, Seong-Gil

    2015-01-01

    [Purpose] The aim of this study was to examine changes in the muscle activity around the neck according to the neck movement angle during neck flexion and extension. [Subjects and Methods] Activities of the sternocleidomastoid muscle (SCM), splenius capitis and splenius cervicis muscles, upper trapezius muscle, and middle trapezius muscle during flexion and extension were assessed in 24 college students. [Results] SCM muscle activation significantly increased at every angle during flexion and...

  18. Does posture of the cervical spine influence dorsal neck muscle activity when lifting?

    Science.gov (United States)

    Peolsson, Anneli; Marstein, Eivind; McNamara, Timothy; Nolan, Damien; Sjaaberg, Espen; Peolsson, Michael; Jull, Gwendolen; O'Leary, Shaun

    2014-02-01

    Previous studies have shown that postural orientations of the neck, such as flexed or forward head postures, are associated with heightened activity of the dorsal neck muscles. While these studies describe the impact of variations in neck posture alone, there is scant literature regarding the effect of neck posture on muscle activity when combined with upper limb activities such as lifting. The purpose of this study was to evaluate the effect of three different neck postures on the activity of the different layers of the dorsal neck muscles during a lifting task. Ultrasound measurements of dorsal neck muscle deformation were compared over two time points (rest, during lift) during a lifting task performed in three different neck postural conditions (neutral, flexed and forward head posture) in 21 healthy subjects. Data were analysed by post-process speckle tracking analysis. Results demonstrated significantly greater muscle deformation induced by flexed and forward head postures, compared to the neutral posture, for all dorsal neck muscles at rest (pposture of the cervical spine influenced the level of muscle deformation not only at rest, but also when lifting. The findings of the study suggest that neck posture should be considered during the evaluation or design of lifting activities as it may contribute to excessive demands on dorsal neck muscles with potential detrimental consequences.

  19. A novel method for neck coordination exercise – a pilot study on persons with chronic non-specific neck pain

    Directory of Open Access Journals (Sweden)

    Björklund Martin

    2008-12-01

    Full Text Available Abstract Background Chronic neck pain is a common problem and is often associated with changes in sensorimotor functions, such as reduced proprioceptive acuity of the neck, altered coordination of the cervical muscles, and increased postural sway. In line with these findings there are studies supporting the efficacy of exercises targeting different aspects of sensorimotor function, for example training aimed at improving proprioception and muscle coordination. To further develop this type of exercises we have designed a novel device and method for neck coordination training. The aim of the study was to investigate the clinical applicability of the method and to obtain indications of preliminary effects on sensorimotor functions, symptoms and self-rated characteristics in non-specific chronic neck pain Methods The study was designed as an uncontrolled clinical trial including fourteen subjects with chronic non-specific neck pain. A new device was designed to allow for an open skills task with adjustable difficulty. With visual feedback, subjects had to control the movement of a metal ball on a flat surface with a rim strapped on the subjects' head. Eight training sessions were performed over a four week period. Skill acquisition was measured throughout the intervention period. After intervention subjects were interviewed about their experience of the exercise and pain and sensorimotor functions, including the fast and slow components of postural sway and jerkiness-, range-, position sense-, movement time- and velocity of cervical rotation, were measured. At six-month follow up, self-rated pain, health and functioning was collected. Results The subjects improved their skill to perform the exercise and were overall positive to the method. No residual negative side-effects due to the exercise were reported. After intervention the fast component of postural sway (p = 0.019 and jerkiness of cervical rotation (p = 0.032 were reduced. The follow up

  20. Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

    OpenAIRE

    2011-01-01

    Abstract Background Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. Methods Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with ...

  1. Experimental Muscle Pain Impairs the Synergistic Modular Control of Neck Muscles.

    Directory of Open Access Journals (Sweden)

    Leonardo Gizzi

    Full Text Available A motor task can be performed via different patterns of muscle activation that show regularities that can be factorized in combinations of a reduced number of muscle groupings (also referred to as motor modules, or muscle synergies. In this study we evaluate whether an acute noxious stimulus induces a change in the way motor modules are combined to generate movement by neck muscles. The neck region was selected as it is a region with potentially high muscular redundancy. We used the motor modules framework to assess the redistribution of muscular activity of 12 muscles (6 per side in the neck region of 8 healthy individuals engaged in a head and neck aiming task, in non-painful conditions (baseline, isotonic saline injection, post pain and after the injection of hypertonic saline into the right splenius capitis muscle. The kinematics of the task was similar in the painful and control conditions. A general decrease of activity was noted for the injected muscle during the painful condition together with an increase or decrease of the activity of the other muscles. Subjects did not adopt shared control strategies (motor modules inter subject similarity at baseline 0.73±0.14; the motor modules recorded during the painful condition could not be used to reconstruct the activation patterns of the control conditions, and the painful stimulus triggered a subject-specific redistribution of muscular activation (i.e., in some subjects the activity of a given muscle increased, whereas in other subjects it decreased with pain. Alterations of afferent input (i.e., painful stimulus influenced motor control at a multi muscular level, but not kinematic output. These findings provide new insights into the motor adaptation to pain.

  2. Experimental Muscle Pain Impairs the Synergistic Modular Control of Neck Muscles.

    Science.gov (United States)

    Gizzi, Leonardo; Muceli, Silvia; Petzke, Frank; Falla, Deborah

    2015-01-01

    A motor task can be performed via different patterns of muscle activation that show regularities that can be factorized in combinations of a reduced number of muscle groupings (also referred to as motor modules, or muscle synergies). In this study we evaluate whether an acute noxious stimulus induces a change in the way motor modules are combined to generate movement by neck muscles. The neck region was selected as it is a region with potentially high muscular redundancy. We used the motor modules framework to assess the redistribution of muscular activity of 12 muscles (6 per side) in the neck region of 8 healthy individuals engaged in a head and neck aiming task, in non-painful conditions (baseline, isotonic saline injection, post pain) and after the injection of hypertonic saline into the right splenius capitis muscle. The kinematics of the task was similar in the painful and control conditions. A general decrease of activity was noted for the injected muscle during the painful condition together with an increase or decrease of the activity of the other muscles. Subjects did not adopt shared control strategies (motor modules inter subject similarity at baseline 0.73±0.14); the motor modules recorded during the painful condition could not be used to reconstruct the activation patterns of the control conditions, and the painful stimulus triggered a subject-specific redistribution of muscular activation (i.e., in some subjects the activity of a given muscle increased, whereas in other subjects it decreased with pain). Alterations of afferent input (i.e., painful stimulus) influenced motor control at a multi muscular level, but not kinematic output. These findings provide new insights into the motor adaptation to pain.

  3. The effectiveness of isometric exercises as compared to general exercises in the management of chronic non-specific neck pain.

    Science.gov (United States)

    Khan, Muhammad; Soomro, Rabail Rani; Ali, Syed Shahzad

    2014-09-01

    To evaluate the effectiveness of isometric exercises as compared to general exercises in chronic non-specific neck pain. For this randomised controlled trial total 68 patients (34 each group) with chronic non-specific neck pain were recruited from Alain Poly Clinic and Institute of Physical Medicine & Rehabilitation Dow University of Health Sciences, Karachi between May, 2012 and August, 2012. Simple randomisation method was used to assign participants into isometric exercise group and general exercise groups. The isometric exercise group performed exercises for neck muscle groups with a rubber band and general exercises group performed active range of movement exercises for all neck movements. Patients in both groups received 3 supervised treatment sessions per week for 12 weeks. Visual Analogue Scale (VAS), North wick Park Neck Pain Questionnaire and goniometer were used to assess pain, disability and neck range of movements at baseline and after 12 weeks. Both interventions showed statistically significant improvements in pain, function and range of movement p = 0.001f or isometric exercise group, p = 0.04 for general exercises group and p = 0.001 for range of movement. However, mean improvements in post intervention VAS score and North wick Park Neck Pain Questionnaire score was better in isometric exercises group as compared to general exercise group. In conclusion, both interventions are effective in the treatment of chronic non-specific neck pain however; isometric exercises are clinically more effective than general exercises.

  4. Alterations in 18F-FDG accumulation into neck-related muscles after neck dissection for patients with oral cancers

    Science.gov (United States)

    Kito, Shinji; Koga, Hirofumi; Kodama, Masaaki; Habu, Manabu; Kokuryo, Shinya; Oda, Masafumi; Matsuo, Kou; Nishino, Takanobu; Matsumoto-Takeda, Shinobu; Uehara, Masataka; Yoshiga, Daigo; Tanaka, Tatsurou; Nishimura, Shun; Miyamoto, Ikuya; Sasaguri, Masaaki; Tominaga, Kazuhiro; Yoshioka, Izumi; Morimoto, Yasuhiro

    2016-01-01

    Background 18F-fluoro-2-deoxy-D-glucose (18F-FDG) accumulations are commonly seen in the neck-related muscles of the surgical and non-surgical sides after surgery with neck dissection (ND) for oral cancers, which leads to radiologists having difficulty in diagnosing the lesions. To examine the alterations in 18F-FDG accumulation in neck-related muscles of patients after ND for oral cancer. Material and Methods 18F-FDG accumulations on positron emission tomography (PET)-computed tomography (CT) in neck-related muscles were retrospectively analyzed after surgical dissection of cervical lymph nodes in oral cancers. Results According to the extent of ND of cervical lymph nodes, the rate of patients with 18F-FDG-PET-positive areas increased in the trapezius, sternocleidomastoid, and posterior neck muscles of the surgical and/or non-surgical sides. In addition, SUVmax of 18F-FDG-PET-positive areas in the trapezius and sternocleidomastoid muscles were increased according to the extent of the ND. Conclusions In evaluating 18F-FDG accumulations after ND for oral cancers, we should pay attention to the 18F-FDG distributions in neck-related muscles including the non-surgical side as false-positive findings. Key words:18F-FDG, PET-CT, oral cancers, muscles. PMID:27031062

  5. EFFICACY OF POST ISOMETRIC RELAXATION VERSUS STATIC STRECHING IN SUBJECTS WITH CHRONIC NON SPECIFIC NECK PAIN

    Directory of Open Access Journals (Sweden)

    P.Haritha

    2015-12-01

    Full Text Available Background: Neck pain is a common problem within our society. Upper trapezius sternocleidomastoid and the levator scapulae are the most common postural muscles that tends to get shorten leading to restricted neck mobility. There is lack of evidence to allow conclusions to be drawn about the effectiveness of post isometric relaxation when compared with static stretching exercises. The aim is to find out the effectiveness of Post isometric relaxation Versus Static stretching in the subjects with chronic nonspecific neck pain. To evaluate the effectiveness of post isometric relaxation technique on pain by using Visual analoge scale, range of motion by using Universal Goniometry, and functional disability by using Neck Disability Index in chronic nonspecific neck pain. Methods: A convenient sample of thirty seven subjects was diagnosed with nonspecific neck pain was randomly allocated to one of the two treatment groups on the basis of the inclusion criteria. The experimental group (n=15 received three sessions of post isometric relaxation technique for trapezius, sternocleidomastoid and the levator scapulae and control group (n=15 received the three sessions of static stretching for trapezius, sternocliedomastiod and levator scapulae for four weeks. Results: Non parametric tests demonstrated a statistically significant difference with experimental group showing greater improvement in ROM, VAS, and NDI than the control group and significant difference within the group also. Conclusion: This study concluded and the results reflected that post isometric relaxation technique group had better improvement in reduction of pain, improvement in the range of motion, and increased neck functional activities than the static stretching group.

  6. Future perspectives: pathogenesis of chronic muscle pain.

    Science.gov (United States)

    Staud, Roland

    2007-06-01

    Chronic painful muscle conditions include non-inflammatory and inflammatory illnesses. This review is focused on chronic non-inflammatory pain conditions such as myofascial pain syndrome (MPS) and fibromyalgia syndrome (FM), and will not discuss metabolic, genetic or inflammatory muscle diseases such as McArdle's disease, muscular dystrophy, polymyositis, dermatomyositis, or inclusion body myositis.

  7. Chronic neck pain disability due to an acute whiplash injury

    NARCIS (Netherlands)

    Nederhand, Marc J.; Hermens, Hermie J.; IJzerman, Maarten J.; Turk, Dennis C.; Zilvold, Gerrit

    2003-01-01

    Several theories about musculoskeletal pain syndromes such as whiplash-associated disorder (WAD) suggest that pain and muscle activity interact and may contribute to the chronicity of symptoms. Studies using surface electromyography (sEMG) have demonstrated abnormal muscle activation patterns of the

  8. Frequency response of vestibular reflexes in neck, back, and lower limb muscles.

    Science.gov (United States)

    Forbes, Patrick A; Dakin, Christopher J; Vardy, Alistair N; Happee, Riender; Siegmund, Gunter P; Schouten, Alfred C; Blouin, Jean-Sébastien

    2013-10-01

    Vestibular pathways form short-latency disynaptic connections with neck motoneurons, whereas they form longer-latency disynaptic and polysynaptic connections with lower limb motoneurons. We quantified frequency responses of vestibular reflexes in neck, back, and lower limb muscles to explain between-muscle differences. Two hypotheses were evaluated: 1) that muscle-specific motor-unit properties influence the bandwidth of vestibular reflexes; and 2) that frequency responses of vestibular reflexes differ between neck, back, and lower limb muscles because of neural filtering. Subjects were exposed to electrical vestibular stimuli over bandwidths of 0-25 and 0-75 Hz while recording activity in sternocleidomastoid, splenius capitis, erector spinae, soleus, and medial gastrocnemius muscles. Coherence between stimulus and muscle activity revealed markedly larger vestibular reflex bandwidths in neck muscles (0-70 Hz) than back (0-15 Hz) or lower limb muscles (0-20 Hz). In addition, vestibular reflexes in back and lower limb muscles undergo low-pass filtering compared with neck-muscle responses, which span a broader dynamic range. These results suggest that the wider bandwidth of head-neck biomechanics requires a vestibular influence on neck-muscle activation across a larger dynamic range than lower limb muscles. A computational model of vestibular afferents and a motoneuron pool indicates that motor-unit properties are not primary contributors to the bandwidth filtering of vestibular reflexes in different muscles. Instead, our experimental findings suggest that pathway-dependent neural filtering, not captured in our model, contributes to these muscle-specific responses. Furthermore, gain-phase discontinuities in the neck-muscle vestibular reflexes provide evidence of destructive interaction between different reflex components, likely via indirect vestibular-motor pathways.

  9. Clinimetric evaluation of methods to measure muscle functioning in patients with non-specific neck pain: a systematic review.

    NARCIS (Netherlands)

    Koning, C.H. de; Heuvel, SP van den; Staal, J.B.; Smits-Engelsman, B.C.M.; Hendriks, E.J.M.

    2008-01-01

    BACKGROUND: Neck pain is a significant health problem in modern society. There is evidence to suggest that neck muscle strength is reduced in patients with neck pain. This article provides a critical analysis of the research literature on the clinimetric properties of tests to measure neck muscle st

  10. Altered motor control patterns in whiplash and chronic neck pain

    Directory of Open Access Journals (Sweden)

    Vasseljen Ottar

    2008-06-01

    Full Text Available Abstract Background Persistent whiplash associated disorders (WAD have been associated with alterations in kinesthetic sense and motor control. The evidence is however inconclusive, particularly for differences between WAD patients and patients with chronic non-traumatic neck pain. The aim of this study was to investigate motor control deficits in WAD compared to chronic non-traumatic neck pain and healthy controls in relation to cervical range of motion (ROM, conjunct motion, joint position error and ROM-variability. Methods Participants (n = 173 were recruited to three groups: 59 patients with persistent WAD, 57 patients with chronic non-traumatic neck pain and 57 asymptomatic volunteers. A 3D motion tracking system (Fastrak was used to record maximal range of motion in the three cardinal planes of the cervical spine (sagittal, frontal and horizontal, and concurrent motion in the two associated cardinal planes relative to each primary plane were used to express conjunct motion. Joint position error was registered as the difference in head positions before and after cervical rotations. Results Reduced conjunct motion was found for WAD and chronic neck pain patients compared to asymptomatic subjects. This was most evident during cervical rotation. Reduced conjunct motion was not explained by current pain or by range of motion in the primary plane. Total conjunct motion during primary rotation was 13.9° (95% CI; 12.2–15.6 for the WAD group, 17.9° (95% CI; 16.1–19.6 for the chronic neck pain group and 25.9° (95% CI; 23.7–28.1 for the asymptomatic group. As expected, maximal cervical range of motion was significantly reduced among the WAD patients compared to both control groups. No group differences were found in maximal ROM-variability or joint position error. Conclusion Altered movement patterns in the cervical spine were found for both pain groups, indicating changes in motor control strategies. The changes were not related to a

  11. The influence of different sitting postures on head/neck posture and muscle activity.

    Science.gov (United States)

    Caneiro, Joao Paulo; O'Sullivan, Peter; Burnett, Angus; Barach, Avi; O'Neil, David; Tveit, Orjan; Olafsdottir, Karolina

    2010-02-01

    To date the influence that specific sitting posture has on the head/neck posture and cervico-thoracic muscle activity has been insufficiently investigated. Therefore the aim of this study was to investigate whether three different thoraco-lumbar sitting postures affect head/neck posture and cervico-thoracic muscle activity. Twenty (10 men, 10 women) asymptomatic subjects were placed in 3 standardized thoraco-lumbar sitting postures (lumbo-pelvic, thoracic upright and slump) to investigate their influence on cervico-thoracic muscle activity and head/neck posture. There were significant differences in lumbar and thoracic curvatures in the 3 different sitting postures (Ppostures (P=0.015). Upper trapezius (UT) demonstrated no significant difference in muscle activation in the 3 sitting postures (Ppostures affect head/neck posture and cervico-thoracic muscle activity. It highlights the potential importance of thoraco-lumbar spine postural adjustment when training head/neck posture.

  12. Craniosacral Therapy for the Treatment of Chronic Neck Pain

    OpenAIRE

    2016-01-01

    Objectives: With growing evidence for the effectiveness of craniosacral therapy (CST) for pain management, the efficacy of CST remains unclear. This study therefore aimed at investigating CST in comparison with sham treatment in chronic nonspecific neck pain patients. Materials and Methods: A total of 54 blinded patients were randomized into either 8 weekly units of CST or light-touch sham treatment. Outcomes were assessed before and after treatment (week 8) and again 3 months later (week 20)...

  13. Neck and shoulder muscle activity of orthodontists in natural environments.

    Science.gov (United States)

    McNee, C; Kieser, J K; Antoun, J S; Bennani, H; Gallo, L M; Farella, M

    2013-06-01

    Work related musculoskeletal disorders (WMSDs) are common among dentists and possibly caused by prolonged static load. The aim of this study was to assess the contraction pattern of neck and shoulder muscles of orthodontists in natural environments. Electromyographic (EMG) activity of right sternocleidomastoid and trapezius muscles were recorded by means of portable recorders in eight orthodontists during working conditions, and both active and resting non-working conditions. Recordings were analysed in terms of contraction episode (CE) count, amplitude, and duration. The sternocleidomastoid and trapezius muscles contracted about 40-70times per hour in the natural environment. Their EMG activity pattern mainly consisted of short-lasting, low-amplitude CEs. The counts and amplitude of sternocleidomastoid CEs did not differ across vocational and non-vocational conditions. The number and amplitude of trapezius CEs were slightly but significantly higher during the vocational condition. There were highly significant (pmuscle contractions found in the vocational setting. During orthodontic work, operators commonly hold muscular contractions for significantly longer periods than are encountered in non-vocational settings. This behaviour may be associated causally with the increases seen in WMSDs through proposed pathophysiological mechanisms occurring at the motor unit level. Our findings may also be valid for other occupations characterised by seated static postures with precision hand and wrist movements.

  14. Chronic Neck Pain and Whiplash: A Case-Control Study of the Relationship between Acute Whiplash Injuries and Chronic Neck Pain

    Directory of Open Access Journals (Sweden)

    Michael D Freeman

    2006-01-01

    Full Text Available The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain.

  15. Electromyographic Study of Neck Muscle Activity According to Head Position in Rugby Tackles

    Science.gov (United States)

    Morimoto, Koji; Sakamoto, Masaaki; Fukuhara, Takashi; Kato, Kazuo

    2013-01-01

    [Purpose] This study examined differences in neck muscle activity in two different head positions during tackles with the aim of contributing to the prevention of sports injuries. [Subjects] The subjects were 28 male high-school rugby players. [Methods] Two tackle positions were considered: a head-up position and a head-down position. Muscle activities of the sternocleidomastoid muscles and the upper, middle, and lower parts of the trapezius muscles were measured. [Results] Muscle activities of the sternocleidomastoid muscles and the right upper trapezius muscle were significantly increased in the head-up position, and the activity of the lower trapezius was significantly increased in the head-down position. [Conclusion] Tackling with the head-up position increases neck muscle activity and stability of the head and the neck. PMID:24259802

  16. TRAPEZOID SHAPED OMOHYOIDEUS MUSCLE: An Anatomic Variation seen in Functional Neck Dissection

    OpenAIRE

    Lokman Uzun; Numan Kokten; Gul Ozbilen Acar

    2015-01-01

    Omohyoid muscle (Om) is an important anatomical landmark in cervical lymph node partition, neck dissection for head and neck cancers and cervical spine surgery. It consists of two bellies united at an angle by an intermediate tendon. Variations in the origin and insertion of the muscle, absence or duplication of the superior or inferior bellies, aberrant position in relation to IJV and sternocleideomastoid muscle have been reported. We report a rare anatomical variation of the Om in this repo...

  17. Cervical Muscle Dysfunction in Chronic Whiplash-Associated Disorder Grade 2: The Relevance of the Trauma

    NARCIS (Netherlands)

    Nederhand, Marc J.; Hermens, Hermie J.; IJzerman, Maarten J.; Turk, Dennis C.; Zilvold, Gerrit

    2002-01-01

    Study Design. Surface electromyography measurements of the upper trapezius muscles were performed in patients with a chronic whiplash-associated disorder Grade 2 and those with nonspecific neck pain. Objective. To determine the etiologic relation between acceleration–deceleration trauma and the pre

  18. Neck and shoulder muscle strength in patients with tension-type headache

    DEFF Research Database (Denmark)

    Madsen, Bjarne K; Søgaard, Karen; Andersen, Lars L.

    2016-01-01

    in TTH patients and healthy controls by examining maximal voluntary isometric contraction (MVC) during shoulder abduction, neck flexion and extension as well as the extension/flexion strength ratio of the neck. METHODS: Sixty TTH patients and 30 sex- and age-matched healthy controls were included....... Patients were included if they had TTH ≥8 days per month. The MVC neck extensor and flexor muscles were tested with the participant seated upright. MVC shoulder abduction was tested with the individual lying supine. RESULTS: Compared to controls TTH patients had significantly weaker muscle strength in neck...

  19. Neck Muscle Fatigue Resulting from Prolonged Wear of Weighted Helmets

    Science.gov (United States)

    2008-06-01

    documented neck injury rates of 50% or higher ranging from minor neck strain to cervical vertebral fracture3,11-14,17. Lighter helmets were developed...greater neck fatigue and susceptibility to neck injury. There may be an increase in cervical loads during aircraft ejections (catapult, windblast...and compromised effectiveness for long missions. The neck load limits ( flexion , extension, and rotation) under operational conditions are

  20. Responses of Myosin Heavy Chain Phenotypes and Gene Expressions in Neck Muscle to Micro- an Hyper-Gravity in Mice

    Science.gov (United States)

    Ohira, Tomotaka; Ohira, Takashi; Kawano, F.; Shibaguchi, T.; Okabe, H.; Ohno, Y.; Nakai, N.; Ochiai, T.; Goto, K.; Ohira, Y.

    2013-02-01

    Neck muscles are known to play important roles in the maintenance of head posture against gravity. However, it is not known how the properties of neck muscle are influenced by gravity. Therefore, the current study was performed to investigate the responses of neck muscle (rhomboideus capitis) in mice to inhibition of gravity and/or increase to 2-G for 3 months to test the hypothesis that the properties of neck muscles are regulated in response to the level of mechanical load applied by the gravitational load. Three male wild type C57BL/10J mice (8 weeks old) were launched by space shuttle Discovery (STS-128) and housed in Japanese Experimental Module “KIBO” on the International Space Station in mouse drawer system (MDS) project, which was organized by Italian Space Agency. Only 1 mouse returned to the Earth alive after 3 months by space shuttle Atlantis (STS-129). Neck muscles were sampled from both sides within 3 hours after landing. Cage and laboratory control experiments were also performed on the ground. Further, 3-month ground-based control experiments were performed with 6 groups, i.e. pre-experiment, 3-month hindlimb suspension, 2-G exposure by using animal centrifuge, and vivarium control (n=5 each group). Five mice were allowed to recover from hindlimb suspension (including 5 cage control) for 3 months in the cage. Neck muscles were sampled bilaterally before and after 3-month suspension and 2-G exposure, and at the end of 3-month ambulation recovery. Spaceflight-associated shift of myosin heavy chain phenotype from type I to II and atrophy of type I fibers were observed. In response to spaceflight, 17 genes were up-regulated and 13 genes were down-regulated vs. those in the laboratory control. Expression of 6 genes were up-regulated and that of 88 genes were down-regulated by 3-month exposure to 2-G vs. the age-matched cage control. In response to chronic hindlimb suspension, 4 and 20 genes were up- or down-regulated. Further, 98 genes responded

  1. Clinimetric evaluation of methods to measure muscle functioning in patients with non-specific neck pain: a systematic review

    OpenAIRE

    2008-01-01

    Abstract Background Neck pain is a significant health problem in modern society. There is evidence to suggest that neck muscle strength is reduced in patients with neck pain. This article provides a critical analysis of the research literature on the clinimetric properties of tests to measure neck muscle strength or endurance in patients with non-specific neck pain, which can be used in daily practice. Methods A computerised literature search was performed in the Medline, CINAHL and Embase da...

  2. Chronic neck pain : An epidemiological, psychological and SPECT study with emphasis on whiplash-associated disorders

    OpenAIRE

    2006-01-01

    Chronic neck pain, a common cause of disability, seems to be the result of several interacting mechanisms. In addition to degenerative and inflammatory changes and trauma, psychological and psychosocial factors are also involved. One common type of trauma associated with chronic neck pain is whiplash injury; this sometimes results in whiplash-associated disorder (WAD), a controversial condition with largely unknown pathogenetic mechanisms. We studied the prevalence of chronic neck pain of tra...

  3. Multivariate analysis of ultrasound-recorded dorsal strain sequences: Investigation of dynamic neck extensions in women with chronic whiplash associated disorders

    Science.gov (United States)

    Peolsson, Anneli; Peterson, Gunnel; Trygg, Johan; Nilsson, David

    2016-08-01

    Whiplash Associated Disorders (WAD) refers to the multifaceted and chronic burden that is common after a whiplash injury. Tools to assist in the diagnosis of WAD and an increased understanding of neck muscle behaviour are needed. We examined the multilayer dorsal neck muscle behaviour in nine women with chronic WAD versus healthy controls during the entire sequence of a dynamic low-loaded neck extension exercise, which was recorded using real-time ultrasound movies with high frame rates. Principal component analysis and orthogonal partial least squares were used to analyse mechanical muscle strain (deformation in elongation and shortening). The WAD group showed more shortening during the neck extension phase in the trapezius muscle and during both the neck extension and the return to neutral phase in the multifidus muscle. For the first time, a novel non-invasive method is presented that is capable of detecting altered dorsal muscle strain in women with WAD during an entire exercise sequence. This method may be a breakthrough for the future diagnosis and treatment of WAD.

  4. Changes in the activity of the muscles surrounding the neck according to the angles of movement of the neck in adults in their 20s.

    Science.gov (United States)

    Lee, Tae-Ho; Lee, Joon-Hyuk; Lee, Yun-Seob; Kim, Myoung-Kwon; Kim, Seong-Gil

    2015-03-01

    [Purpose] The aim of this study was to examine changes in the muscle activity around the neck according to the neck movement angle during neck flexion and extension. [Subjects and Methods] Activities of the sternocleidomastoid muscle (SCM), splenius capitis and splenius cervicis muscles, upper trapezius muscle, and middle trapezius muscle during flexion and extension were assessed in 24 college students. [Results] SCM muscle activation significantly increased at every angle during flexion and extension. The activities of the splenius capitis and splenius cervicis muscles increased significantly during flexion. The activity of the upper trapezius muscle also increased significantly. [Conclusion] The results highlight the need for individuals not to adopt a neck flexion posture for extended periods.

  5. Electromyographic control of a hands-free electrolarynx using neck strap muscles

    OpenAIRE

    Kubert, Heather L.; Stepp, Cara E.; Zeitels, Steven M.; Gooey, John E.; Walsh, Michael J.; Prakash, S. R.; Hillman, Robert E.; Heaton, James T.

    2009-01-01

    Three individuals with total laryngectomy were studied for their ability to control a hands-free electrolarynx (EL) using neck surface electromyography (EMG) for on/off and pitch modulation. The laryngectomy surgery of participants was modified to preserve neck strap musculature for EMG-based EL control (EMG-EL), with muscles on one side maintaining natural innervation and those on the other side receiving a transferred recurrent laryngeal nerve (RLN). EMG from each side of the neck controlle...

  6. Physical workload on neck and shoulder muscles during military helicopter flight - a need for exercise training?

    OpenAIRE

    Murray, Mike; Lange, Britt; Chreiteh, Shadi Samir; Olsen, Henrik Baare; Søgaard, Karen; Sjøgaard, Gisela

    2013-01-01

    Introduction Work-related neck/shoulder pain is a common complaint among military helicopter pilots and crew members. The flight helmet and additional Night Vision Goggles (NVG) place a considerable load on the cervical spine. The aim of this study was to quantify the physical workload on neck/shoulder muscles to assess possible overload that may call for exercise training to improve capacity and prevent neck pain. Methods Nine pilots and nine crew members from the Royal Danish Air Force part...

  7. Frequency response of vestibular reflexes in neck, back, and lower limb muscles

    NARCIS (Netherlands)

    Forbes, P.A.; Dakin, C.J.; Vardy, A.N.; Happee, R.; Siegmund, G.P.; Schouten, A.C.; Blouin, J.S.

    2013-01-01

    Vestibular pathways form short-latency disynaptic connections with neck motoneurons, whereas they form longer-latency disynaptic and polysynaptic connections with lower limb motoneurons. We quantified frequency responses of vestibular reflexes in neck, back, and lower limb muscles to explain between

  8. Electromyographic Control of a Hands-Free Electrolarynx Using Neck Strap Muscles

    Science.gov (United States)

    Kubert, Heather L.; Stepp, Cara E.; Zeitels, Steven M.; Gooey, John E.; Walsh, Michael J.; Prakash, S. R.; Hillman, Robert E.; Heaton, James T.

    2009-01-01

    Three individuals with total laryngectomy were studied for their ability to control a hands-free electrolarynx (EL) using neck surface electromyography (EMG) for on/off and pitch modulation. The laryngectomy surgery of participants was modified to preserve neck strap musculature for EMG-based EL control (EMG-EL), with muscles on one side…

  9. Function and structure of the deep cervical extensor muscles in patients with neck pain.

    Science.gov (United States)

    Schomacher, Jochen; Falla, Deborah

    2013-10-01

    The deep cervical extensors are anatomically able to control segmental movements of the cervical spine in concert with the deep cervical flexors. Several investigations have confirmed changes in cervical flexor muscle control in patients with neck pain and as a result, effective evidence-based therapeutic exercises have been developed to address such dysfunctions. However, knowledge on how the deep extensor muscles behave in patients with neck pain disorders is scare. Structural changes such as higher concentration of fat within the muscle, variable cross-sectional area and higher proportions of type II fibres have been observed in the deep cervical extensors of patients with neck pain compared to healthy controls. These findings suggest that the behaviour of the deep extensors may be altered in patients with neck pain. Consistent with this hypothesis, a recent series of studies confirm that patients display reduced activation of the deep cervical extensors as well as less defined activation patterns. This article provides an overview of the various different structural and functional changes in the deep neck extensor muscles documented in patients with neck pain. Relevant recommendations for the management of muscle dysfunction in patients with neck pain are presented.

  10. Gradation of Neck Muscle Responses and Head/Neck Kinematics to Acceleration and Speed Change in Rear-end Collisions.

    Science.gov (United States)

    Siegmund, Gunter P; Sanderson, David J; Inglis, J Timothy

    2004-11-01

    Recent epidemiological evidence shows that the potential for whiplash injury varies with both the average acceleration and speed change of a rear-end collision. The goal of this study was to examine the gradation of neck muscle responses and the head and neck kinematics to rear-end collision pulses in which the acceleration and speed change were independently varied. Thirty subjects (15F, 15M) underwent 36 consecutive rear-end collisions consisting of three different average accelerations (ā = 0.5, 0.9 and 1.3 g) and three different speed changes (Deltav = 0.25, 0.50 and 0.75 m/s). Onset and amplitude of the sternocleidomastoid (SCM) and cervical paraspinal (PARA) muscle responses were measured using surface electromyography. Kinematic measures included linear and angular accelerations and displacements of the head and torso. The results showed that the amplitude of the muscle and kinematics responses was graded to both collision acceleration and speed change. The magnitude of early peaks in the head/neck kinematics correlated more strongly with collision acceleration (r(2) = 0.63 to 0.69), whereas the magnitude of later kinematic peaks correlated more strongly with collision speed change (r(2) = 0.59 to 0.95). Onset of the SCM muscle response correlated only weakly with collision acceleration and speed change (r(2) acceleration and speed change (āDeltav) yielded the strongest and most consistent correlations with neck muscle (r(2) = 0.48 to 0.58) and head/neck kinematic responses (r(2) = 0.78 to 0.94). This measure of collision severity is also consistent with the recent epidemiological evidence that whiplash symptom intensity and duration increases with both average acceleration and speed change.

  11. Effect of brief daily resistance training on rapid force development in painful neck and shoulder muscles

    DEFF Research Database (Denmark)

    Jay, Kenneth; Schraefel, Mc; Andersen, Christoffer H

    2013-01-01

    OBJECTIVE: To determine the effect of small daily amounts of progressive resistance training on rapid force development of painful neck/shoulder muscles. METHODS: 198 generally healthy adults with frequent neck/shoulder muscle pain (mean: age 43.1 years, computer use 93% of work time, 88% women...... relationship existed between changes in rapid force development and pain (r = 0.27, Pneck/shoulder pain increases rapid force development and...

  12. Effect of Neck Muscle Strength and Anticipatory Cervical Muscle Activation on the Kinematic Response of the Head to Impulsive Loads

    Science.gov (United States)

    Eckner, James T.; Oh, Youkeun K.; Joshi, Monica S.; Richardson, James K.; Ashton-Miller, James A.

    2015-01-01

    Background Greater neck strength and activating the neck muscles to brace for impact are both thought to reduce an athlete's risk of concussion during a collision by attenuating the head's kinematic response after impact. However, the literature reporting the neck's role in controlling postimpact head kinematics is mixed. Furthermore, these relationships have not been examined in the coronal or transverse planes or in pediatric athletes. Hypotheses In each anatomic plane, peak linear velocity (DV) and peak angular velocity (Dv) of the head are inversely related to maximal isometric cervical muscle strength in the opposing direction (H1). Under impulsive loading, DV and Dv will be decreased during anticipatory cervical muscle activation compared with the baseline state (H2). Study Design Descriptive laboratory study. Methods Maximum isometric neck strength was measured in each anatomic plane in 46 male and female contact sport athletes aged 8 to 30 years. A loading apparatus applied impulsive test forces to athletes' heads in flexion, extension, lateral flexion, and axial rotation during baseline and anticipatory cervical muscle activation conditions. Multivariate linear mixed models were used to determine the effects of neck strength and cervical muscle activation on head DV and Dv. Results Greater isometric neck strength and anticipatory activation were independently associated with decreased head DV and Dv after impulsive loading across all planes of motion (all P\\.001). Inverse relationships between neck strength and head DV and Dv presented moderately strong effect sizes (r = 0.417 to r = 0.657), varying by direction of motion and cervical muscle activation. Conclusion In male and female athletes across the age spectrum, greater neck strength and anticipatory cervical muscle activation (“bracing for impact”) can reduce the magnitude of the head's kinematic response. Future studies should determine whether neck strength contributes to the observed sex and

  13. Reliability and group differences in quantitative cervicothoracic measures among individuals with and without chronic neck pain

    Directory of Open Access Journals (Sweden)

    Shahidi Bahar

    2012-10-01

    Full Text Available Abstract Background Clinicians frequently rely on subjective categorization of impairments in mobility, strength, and endurance for clinical decision-making; however, these assessments are often unreliable and lack sensitivity to change. The objective of this study was to determine the inter-rater reliability, minimum detectable change (MDC, and group differences in quantitative cervicothoracic measures for individuals with and without chronic neck pain (NP. Methods Nineteen individuals with NP and 20 healthy controls participated in this case control study. Two physical therapists performed a 30-minute examination on separate days. A handheld dynamometer, gravity inclinometer, ruler, and stopwatch were used to quantify cervical range of motion (ROM, cervical muscle strength and endurance, and scapulothoracic muscle length and strength, respectively. Results Intraclass correlation coefficients for inter-rater reliability were significantly greater than zero for most impairment measures, with point estimates ranging from 0.45 to 0.93. The NP group exhibited reduced cervical ROM (P ≤ 0.012 and muscle strength (P ≤ 0.038 in most movement directions, reduced cervical extensor endurance (P = 0.029, and reduced rhomboid and middle trapezius muscle strength (P ≤ 0.049. Conclusions Results demonstrate the feasibility of obtaining objective cervicothoracic impairment measures with acceptable inter-rater agreement across time. The clinical utility of these measures is supported by evidence of impaired mobility, strength, and endurance among patients with NP, with corresponding MDC values that can help establish benchmarks for clinically significant change.

  14. Chronic neck pain. An epidemiological, psychological and SPECT study with emphasis on whiplash-associated disorders.

    Science.gov (United States)

    Guez, Michel

    2006-02-01

    Chronic neck pain, a common cause of disability, seems to be the result of several interacting mechanisms. In addition to degenerative and inflammatory changes and trauma, psychological and psychosocial factors are also involved. One common type of trauma associated with chronic neck pain is whiplash injury; this sometimes results in whiplash-associated disorder (WAD), a controversial condition with largely unknown pathogenetic mechanisms. We studied the prevalence of chronic neck pain of traumatic and non-traumatic origin and compared the prevalence of, sociodemographic data, self-perceived health, workload and chronic low-back pain in these groups. In a ready-made questionnaire (MONICA study), we added questions about cervical spine and low-back complaints. 6,000 (72%) completed a self-administered questionnaire. 43% reported neck pain: 48% of women and 38% of men. Women of working age had more neck pain than retired women, a phenomenon not seen in men. 19% of the studied population suffered from chronic neck pain and it was more frequent in women. A history of neck trauma was common in those with chronic neck pain. Those with a history of neck trauma perceived their health worse and were more often on sick-leave. About 50% of those with traumatic and non-traumatic chronic neck pain also had chronic low-back pain. We assessed the subjective and objective neuropsychological functioning in 42 patients with chronic neck pain, 21 with a whiplash trauma, and 21 without previous neck trauma. Despite cognitive complaints, the WAD patients had normal neuropsychological functioning, but the WAD group especially had deviant MMPI results-indicating impaired coping ability and somatization. WAD patients had no alterations in cerebral blood-flow pattern, as measured by rCBF-SPECT and SPM analysis, compared to healthy controls. This contrasts with the non-traumatic group with chronic neck pain, which showed marked blood-flow changes. The blood-flow changes in the non

  15. Reduced Neck Muscle Strength and Altered Muscle Mechanical Properties in Cervical Dystonia Following Botulinum Neurotoxin Injections: A Prospective Study

    Science.gov (United States)

    Mustalampi, Sirpa; Ylinen, Jari; Korniloff, Katariina; Weir, Adam; Häkkinen, Arja

    2016-01-01

    Objective To evaluate changes in the strength and mechanical properties of neck muscles and disability in patients with cervical dystonia (CD) during a 12-week period following botulinum neurotoxin (BoNT) injections. Methods Eight patients with CD volunteered for this prospective clinical cohort study. Patients had received BoNT injections regularly in neck muscles at three-month intervals for several years. Maximal isometric neck strength was measured by a dynamometer, and the mechanical properties of the splenius capitis were evaluated using two myotonometers. Clinical assessment was performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) before and at 2, 4, 8, and 12 weeks after the BoNT injections. Results Mean maximal isometric neck strength at two weeks after the BoNT injections decreased by 28% in extension, 25% in rotation of the affected side and 17% in flexion. At four weeks, muscle stiffness of the affected side decreased by 17% and tension decreased by 6%. At eight weeks, the muscle elasticity on the affected side increased by 12%. At two weeks after the BoNT injections, the TWSTRS-severity and TWSTRS-total scores decreased by 4.3 and 6.4, respectively. The strength, muscle mechanical properties and TWSTRS scores returned to baseline values at 12 weeks. Conclusions Although maximal neck strength and muscle tone decreased after BoNT injections, the disability improved. The changes observed after BoNT injections were temporary and returned to pre-injection levels within twelve weeks. Despite having a possible negative effect on function and decreasing neck strength, the BoNT injections improved the patients reported disability. PMID:26828215

  16. Reduced Neck Muscle Strength and Altered Muscle Mechanical Properties in Cervical Dystonia Following Botulinum Neurotoxin Injections: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Sirpa Mustalampi

    2016-01-01

    Full Text Available Objective To evaluate changes in the strength and mechanical properties of neck muscles and disability in patients with cervical dystonia (CD during a 12-week period following botulinum neurotoxin (BoNT injections. Methods Eight patients with CD volunteered for this prospective clinical cohort study. Patients had received BoNT injections regularly in neck muscles at three-month intervals for several years. Maximal isometric neck strength was measured by a dynamometer, and the mechanical properties of the splenius capitis were evaluated using two myotonometers. Clinical assessment was performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS before and at 2, 4, 8, and 12 weeks after the BoNT injections. Results Mean maximal isometric neck strength at two weeks after the BoNT injections decreased by 28% in extension, 25% in rotation of the affected side and 17% in flexion. At four weeks, muscle stiffness of the affected side decreased by 17% and tension decreased by 6%. At eight weeks, the muscle elasticity on the affected side increased by 12%. At two weeks after the BoNT injections, the TWSTRS-severity and TWSTRS-total scores decreased by 4.3 and 6.4, respectively. The strength, muscle mechanical properties and TWSTRS scores returned to baseline values at 12 weeks. Conclusions Although maximal neck strength and muscle tone decreased after BoNT injections, the disability improved. The changes observed after BoNT injections were temporary and returned to pre-injection levels within twelve weeks. Despite having a possible negative effect on function and decreasing neck strength, the BoNT injections improved the patients reported disability.

  17. Increased proportion of megafibers in chronically painful muscles

    DEFF Research Database (Denmark)

    Andersen, Lars L; Suetta, Charlotte; Andersen, Jesper Løvind

    2008-01-01

    Trapezius myalgia - chronic pain from the upper trapezius muscle - is frequent in female employees in monotonous stressful jobs, potentially due to chronic overload of type I muscle fibers. In this study, we investigated the intra-individual distribution of trapezius muscle fiber size, and hypoth......Trapezius myalgia - chronic pain from the upper trapezius muscle - is frequent in female employees in monotonous stressful jobs, potentially due to chronic overload of type I muscle fibers. In this study, we investigated the intra-individual distribution of trapezius muscle fiber size...

  18. How Do Patients with Chronic Neck Pain Experience the Effects of Qigong and Exercise Therapy? A Qualitative Interview Study

    Directory of Open Access Journals (Sweden)

    Christine Holmberg

    2016-01-01

    Full Text Available Background. The high prevalence of chronic neck pain in high income countries impacts quality of life and the social and work-related activities of those afflicted. We aimed to understand how mind-body therapies and exercise therapy may influence the experience of pain among patients with chronic neck pain. Methods. This qualitative interview study investigated how patients with chronic neck pain experienced the effects of exercise or qigong therapy at two time points: during an intervention at three months and after the intervention at six months. Interviews were analysed thematically across interviews and within person-cases. Based on other qualitative studies, a sample size of 20 participants was deemed appropriate. Results. The sample (n=20 consisted of 16 women and four men (age range: 29 to 59. Patients’ experiences differed according to the therapies’ philosophies. Exercise therapy group interviewees described a focus on correct posture and muscle tension release. Qigong group interviewees discussed calming and relaxing effects. Maintaining regular exercise was easier to achieve with exercise therapy. Conclusions. The findings of this study may help health care providers when counselling chronic pain patients on self-help interventions by informing them of different bodily and emotional experiences of mind-body interventions compared to exercise therapy.

  19. How Do Patients with Chronic Neck Pain Experience the Effects of Qigong and Exercise Therapy? A Qualitative Interview Study

    Science.gov (United States)

    Holmberg, Christine; Farahani, Zubin; Witt, Claudia M.

    2016-01-01

    Background. The high prevalence of chronic neck pain in high income countries impacts quality of life and the social and work-related activities of those afflicted. We aimed to understand how mind-body therapies and exercise therapy may influence the experience of pain among patients with chronic neck pain. Methods. This qualitative interview study investigated how patients with chronic neck pain experienced the effects of exercise or qigong therapy at two time points: during an intervention at three months and after the intervention at six months. Interviews were analysed thematically across interviews and within person-cases. Based on other qualitative studies, a sample size of 20 participants was deemed appropriate. Results. The sample (n = 20) consisted of 16 women and four men (age range: 29 to 59). Patients' experiences differed according to the therapies' philosophies. Exercise therapy group interviewees described a focus on correct posture and muscle tension release. Qigong group interviewees discussed calming and relaxing effects. Maintaining regular exercise was easier to achieve with exercise therapy. Conclusions. The findings of this study may help health care providers when counselling chronic pain patients on self-help interventions by informing them of different bodily and emotional experiences of mind-body interventions compared to exercise therapy. PMID:27418938

  20. Investigation of Cervical Fleksor and Extensor Muscle Activation During Isometric Neck Extension Applied by Therraband

    Science.gov (United States)

    Önal, Sercan; Can, Filiz; Yakut, Yavuz; Baltacı, Gül

    2014-01-01

    Objectives: Therrabands are commonly used for resistive exercises, streching and stabilization exercises and also isometric exercises. However, principles of practice of therrabands are mostly focused on exercise variety. Likewise it is only given point to exercise variety during therrabands’ usage at cervical region. Nevertheless, for effective usage of therrabands and for proper assessment of effectiveness response, it is necessary to know the amount of resistance being given or muscle activation response against the resistance given. The aim of this study was to compare activations of cervical flexor and extensor muscles during isometric extension exercise against the resistance of therraband in healthy individuals. Methods: 14 healthy subjects (8 female,6 male)aged between 19-32 have been included in the study. Subjects with neck problems, systemic diseases, history of trauma or operation were excluded. Neck isometric exercises with therraband was 2 sets with 2 minutes’ intervals and EMG records have been taken during exercises. After preparation of the skin, surface electrodes placed on the motor points of sternocleidomastoideus(SCM) and erector spinae(ES) muscles. After taking the average of 3 measures, the first 10 seconds of muscular activations were recorded. The average of integrated EMG(iEMG) values of each records was used for statistical data. Independent T test and Mann Whitney U test were used for the analysis of findings. Results: There was no significant difference between the right ES and left ES’s mean iEMG during isometric neck extension against therraband (p=0.06). Although there was no difference between right SCM and right ES muscles action potentials(t=-0.895; p=0.379), there was a significant difference between left SCM and left ES muscles’ action potentials (z= -2.435; p=0.01). When all the right and left SCM and ES muscle activations were compared, a significant difference was detected in favour of ES muscles ( t= -2.133; p= 0

  1. Physiotherapy for Chronic Neck Pain: Evaluation of a biopsychosocial approach

    OpenAIRE

    2010-01-01

    markdownabstract__Abstract__ Neck pain is a common complaint that causes substantial morbidity in western countries. Reported prevalence in the general population ranges from 9.5% to 22%, and the 12-month (point) prevalence estimates ranges from 30% to 50%. It is suggested that two thirds of individuals may at least once in their lifetime experience neck pain; it is more often reported by women than men. Patients with neck complaints generally also complain of neck stiffness and reduced mobil...

  2. Associations among temporomandibular disorders, chronic neck pain and neck pain disability in computer office workers: a pilot study.

    Science.gov (United States)

    Bragatto, M M; Bevilaqua-Grossi, D; Regalo, S C H; Sousa, J D; Chaves, T C

    2016-05-01

    Neck pain is the most common musculoskeletal complaint among computer office workers. There are several reports about the coexistence of neck pain and temporomandibular disorders (TMD). However, there are no studies investigating this association in the context of work involving computers. The purpose of this study was to verify the association between TMD and neck pain in computer office workers. Fifty-two female computer workers who were divided into two groups: (i) those with self-reported chronic neck pain and disability (WNP) (n = 26) and (ii) those without self-reported neck pain (WONP) (n = 26), and a control group (CG) consisting of 26 women who did not work with computers participated in this study. Clinical assessments were performed to establish a diagnosis of TMD, and craniocervical mechanical pain was assessed using manual palpation and pressure pain threshold (PPT). The results of this study showed that the WNP group had a higher percentage of participants with TMD than the WONP group (42·30% vs. 23·07%, χ(2) = 5·70, P = 0·02). PPTs in all cervical sites were significantly lower in the groups WNP and WONP compared to the CG. Regression analysis revealed TMD, neck pain and work-related factors to be good predictors of disability (R(2) = 0·93, P neck disability in computer workers is explained by the association among neck pain, TMD and unfavourable workplace conditions. Consequently, this study attempted to emphasise the importance of considering work activity for minimising neck pain-related disability.

  3. Craniosacral Therapy for the Treatment of Chronic Neck Pain

    Science.gov (United States)

    Lauche, Romy; Cramer, Holger; Rampp, Thomas; Saha, Felix J.; Ostermann, Thomas; Dobos, Gustav

    2016-01-01

    Objectives: With growing evidence for the effectiveness of craniosacral therapy (CST) for pain management, the efficacy of CST remains unclear. This study therefore aimed at investigating CST in comparison with sham treatment in chronic nonspecific neck pain patients. Materials and Methods: A total of 54 blinded patients were randomized into either 8 weekly units of CST or light-touch sham treatment. Outcomes were assessed before and after treatment (week 8) and again 3 months later (week 20). The primary outcome was the pain intensity on a visual analog scale at week 8; secondary outcomes included pain on movement, pressure pain sensitivity, functional disability, health-related quality of life, well-being, anxiety, depression, stress perception, pain acceptance, body awareness, patients’ global impression of improvement, and safety. Results: In comparison with sham, CST patients reported significant and clinically relevant effects on pain intensity at week 8 (−21 mm group difference; 95% confidence interval, −32.6 to −9.4; P=0.001; d=1.02) and at week 20 (−16.8 mm group difference; 95% confidence interval, −27.5 to −6.1; P=0.003; d=0.88). Minimal clinically important differences in pain intensity at week 20 were reported by 78% within the CST group, whereas 48% even had substantial clinical benefit. Significant between-group differences at week 20 were also found for pain on movement, functional disability, physical quality of life, anxiety and patients’ global improvement. Pressure pain sensitivity and body awareness were significantly improved only at week 8. No serious adverse events were reported. Discussion: CST was both specifically effective and safe in reducing neck pain intensity and may improve functional disability and the quality of life up to 3 months after intervention. PMID:26340656

  4. TRAPEZOID SHAPED OMOHYOIDEUS MUSCLE: An Anatomic Variation seen in Functional Neck Dissection

    Directory of Open Access Journals (Sweden)

    Lokman Uzun

    2015-12-01

    Full Text Available Omohyoid muscle (Om is an important anatomical landmark in cervical lymph node partition, neck dissection for head and neck cancers and cervical spine surgery. It consists of two bellies united at an angle by an intermediate tendon. Variations in the origin and insertion of the muscle, absence or duplication of the superior or inferior bellies, aberrant position in relation to IJV and sternocleideomastoid muscle have been reported. We report a rare anatomical variation of the Om in this report. This variation was observed during neck dissection of a 58 years-old male patient with laryngeal carcinoma. It was noticed that, the superior belly of Om was in a trapezoid shaped unilaterally.

  5. Cervical flexion-relaxation response to neck muscle fatigue in males and females.

    Science.gov (United States)

    Nimbarte, Ashish D; Zreiqat, Majed M; Chowdhury, Suman Kanti

    2014-12-01

    In this study the effect of muscle fatigue on the cervical spine flexion-relaxation response was studied. Twenty healthy participants (10 males and 10 females) were recruited for data collection. The Sorenson protocol was utilized to induce neck muscle fatigue. Surface electromyography and optical motion capture systems were used to measure neck muscle activation and head-neck posture, respectively. A post-fatigue reduction in the Flexion-Relaxation Ratio (FRR) and higher FRR for females compared to males were observed. A post-fatigue decrease was also observed in the onset and offset angles resulting in an expansion of the myoelectric silence period. Gender had no effect on the onset and offset angles of the silence period. Post-fatigue shift in the onset and offset angles and the expansion of the silence period indicate an increased contribution by the passive viscoelastic tissues in stabilizing the cervical spine under fatigued condition.

  6. Neck posture and muscle activity are different when upside down: a human volunteer study.

    Science.gov (United States)

    Newell, Robyn S; Blouin, Jean-Sébastien; Street, John; Cripton, Peter A; Siegmund, Gunter P

    2013-11-15

    Rollover crashes are dynamic and complex events in which head impacts with the roof can cause catastrophic neck injuries. Ex vivo and computational models are valuable in understanding, and ultimately preventing, these injuries. Although neck posture and muscle activity influence the resulting injury, there is currently no in vivo data describing these parameters immediately prior to a head-first impact. The specific objectives of this study were to determine the in vivo neck vertebral alignment and muscle activation levels when upside down, a condition that occurs during a rollover. Eleven human subjects (6F, 5M) were tested while seated upright and inverted in a custom-built apparatus. Vertebral alignment was measured using fluoroscopy and muscle activity was recorded using surface and indwelling electrodes in eight superficial and deep neck muscles. In vivo vertebral alignment and muscle activation levels differed between the upright and inverted conditions. When inverted and relaxed, the neck was more lordotic, C1 was aligned posterior to C7, the Frankfort plane was extended, and the activity of six muscles increased compared to upright and relaxed. When inverted subjects were asked to look forward to eliminate head extension, flexor muscle activity increased, C7 was more flexed, and C1 was aligned anterior to C7 versus upright and relaxed. Combined with the large inter-subject variability observed, these findings indicate that cadaveric or computational models designed to study injuries and prevention devices while inverted need to consider a variety of postures and muscle conditions to be relevant to the in vivo situation.

  7. The effectiveness of thoracic manipulation on patients with chronic mechanical neck pain - a randomized controlled trial.

    Science.gov (United States)

    Lau, Herman Mun Cheung; Wing Chiu, Thomas Tai; Lam, Tai-Hing

    2011-04-01

    The aim of our study was to assess the effectiveness of thoracic manipulation (TM) on patients with chronic neck pain. 120 patients aged between 18 and 55 were randomly allocated into two groups: an experimental group which received TM and a control group without the manipulative procedure. Both groups received infrared radiation therapy (IRR) and a standard set of educational material. TM and IRR were given twice weekly for 8 sessions. Outcome measures included craniovertebral angle (CV angle), neck pain (Numeric Pain Rating Scale; NPRS), neck disability (Northwick Park Neck Disability Questionnaire; NPQ), health-related quality of life status (SF36 Questionnaire) and neck mobility. These outcome measures were assessed immediately after 8 sessions of treatment, 3-months and at a 6-month follow-up. Patients that received TM showed significantly greater improvement in pain intensity (p = 0.043), CV angle (p = 0.049), NPQ (p = 0.018), neck flexion (p = 0.005), and the Physical Component Score (PCS) of the SF36 Questionnaire (p = 0.002) than the control group immediately post-intervention. All these improvements were maintained at the 6-month follow-ups. This study shows that TM was effective in reducing neck pain, improving dysfunction and neck posture and neck range of motion (ROM) for patients with chronic mechanical neck pain up to a half-year post-treatment.

  8. Understanding Muscle Dysfunction in Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Gina Rutherford

    2016-01-01

    Full Text Available Introduction. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME is a debilitating disorder of unknown aetiology, characterised by severe disabling fatigue in the absence of alternative diagnosis. Historically, there has been a tendency to draw psychological explanations for the origin of fatigue; however, this model is at odds with findings that fatigue and accompanying symptoms may be explained by central and peripheral pathophysiological mechanisms, including effects of the immune, oxidative, mitochondrial, and neuronal pathways. For example, patient descriptions of their fatigue regularly cite difficulty in maintaining muscle activity due to perceived lack of energy. This narrative review examined the literature for evidence of biochemical dysfunction in CFS/ME at the skeletal muscle level. Methods. Literature was examined following searches of PUB MED, MEDLINE, and Google Scholar, using key words such as CFS/ME, immune, autoimmune, mitochondria, muscle, and acidosis. Results. Studies show evidence for skeletal muscle biochemical abnormality in CFS/ME patients, particularly in relation to bioenergetic dysfunction. Discussion. Bioenergetic muscle dysfunction is evident in CFS/ME, with a tendency towards an overutilisation of the lactate dehydrogenase pathway following low-level exercise, in addition to slowed acid clearance after exercise. Potentially, these abnormalities may lead to the perception of severe fatigue in CFS/ME.

  9. Understanding Muscle Dysfunction in Chronic Fatigue Syndrome.

    Science.gov (United States)

    Rutherford, Gina; Manning, Philip; Newton, Julia L

    2016-01-01

    Introduction. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a debilitating disorder of unknown aetiology, characterised by severe disabling fatigue in the absence of alternative diagnosis. Historically, there has been a tendency to draw psychological explanations for the origin of fatigue; however, this model is at odds with findings that fatigue and accompanying symptoms may be explained by central and peripheral pathophysiological mechanisms, including effects of the immune, oxidative, mitochondrial, and neuronal pathways. For example, patient descriptions of their fatigue regularly cite difficulty in maintaining muscle activity due to perceived lack of energy. This narrative review examined the literature for evidence of biochemical dysfunction in CFS/ME at the skeletal muscle level. Methods. Literature was examined following searches of PUB MED, MEDLINE, and Google Scholar, using key words such as CFS/ME, immune, autoimmune, mitochondria, muscle, and acidosis. Results. Studies show evidence for skeletal muscle biochemical abnormality in CFS/ME patients, particularly in relation to bioenergetic dysfunction. Discussion. Bioenergetic muscle dysfunction is evident in CFS/ME, with a tendency towards an overutilisation of the lactate dehydrogenase pathway following low-level exercise, in addition to slowed acid clearance after exercise. Potentially, these abnormalities may lead to the perception of severe fatigue in CFS/ME.

  10. The effect of feedback respiratory exercise on muscle activity, craniovertebral angle, and neck disability index of the neck flexors of patients with forward head posture.

    Science.gov (United States)

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-09-01

    [Purpose] This study aimed to simultaneously investigate the activities of the sternocleidomastoid muscle and scalenus anterior muscle, which are agonists of neck and breathing accessory muscles, by implementing breathing exercises. [Subjects and Methods] Thirteen subjects were selected for the experimental group, which performed feedback respiratory exercises with McKenzie exercises, and 12 subjects were selected for the control group, which performed McKenzie exercises alone. The intervention program was performed for 30 minutes a session, once a day, four times a week, and for 2 weeks before conducting the experiment. Before intervention, muscle activity was measured using surface electromyogram, and the neck disability index was evaluated. [Results] There were meaningful differences in activities of the sternocleidomastoid muscle and the scalenus anterior muscle, craniovertebral angle, and neck disability index within both the experimental group and control group after intervention. There also were meaningful differences in sternocleidomastoid muscle and neck disability index changes between groups. [Conclusion] Neck flexors as accessory respiratory muscle can affect inefficient respiratory imbalance of forward head posture patients. Multimodal intervention method should be studied continually and not be exposed to upper chest breathing patterns by preventing such phenomenon.

  11. [Head and neck intensity-modulated radiation therapy: Normal tissues dose constraints. Pharyngeal constrictor muscles and larynx].

    Science.gov (United States)

    Graff, P; Woisard, V; Racadot, S; Thariat, J; Pointreau, Y

    2016-10-01

    Radio-induced pharyngolaryngeal chronic disorders may challenge the quality of life of head and neck cancer long survivors. Many anatomic structures have been identified as potentially impaired by irradiation and responsible for laryngeal edema, dysphonia and dysphagia. Some dose constraints might be plausible such as keeping the mean dose to the pharyngeal constrictor muscles under 50 to 55Gy, the mean dose to the supra-glottic larynx under 40 to 45Gy and, if feasible, the mean dose to the glottic larynx under 20Gy. A reduction of the dose delivered to the muscles of the floor of the mouth and the cervical esophagus would be beneficial as well. Nevertheless, the publications available do not provide an extensive enough level of proof. One should consider limiting as low as possible the dose delivered to these structures without compromising the quality of irradiation of the target tumor volumes.

  12. Pre- and post-operative gait analysis for evaluation of neck pain in chronic whiplash

    Directory of Open Access Journals (Sweden)

    Ginsburg Glen M

    2009-07-01

    Full Text Available Abstract Introduction Chronic neck pain after whiplash is notoriously refractory to conservative treatment, and positive radiological findings to explain the symptoms are scarce. The apparent disproportionality between subjective complaints and objective findings is significant for the planning of treatment, impairment ratings, and judicial questions on causation. However, failure to identify a symptom's focal origin with routine imaging studies does not invalidate the symptom per se. It is therefore of a general interest both to develop effective therapeutic strategies in chronic whiplash, and to establish techniques for objectively evaluation of treatment outcomes. Methods Twelve patients with chronic neck pain after whiplash underwent pre- and postoperative computerized 3D gait analysis. Results Significant improvement was found in all gait parameters, cervical range-of-motion, and self reported pain (VAS. Conclusion Chronic neck pain is associated with abnormal cervical spine motion and gait patterns. 3D gait analysis is a useful instrument to assess the outcome of treatment for neck pain.

  13. Chronic Neck Pain: Making the Connection Between Capsular Ligament Laxity and Cervical Instability

    OpenAIRE

    2014-01-01

    The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narra...

  14. Effect of neck flexion restriction on sternocleidomastoid and abdominal muscle activity during curl-up exercises.

    Science.gov (United States)

    Lee, Dong-Kyu; Moon, Dong-Chul; Hong, Ki-Hoon

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effect of neck flexion restriction on sternocleidomastoid (SCM), rectus abdominis (RA), and external oblique (EO) muscle activity during a traditional curl-up exercise and a curl-up with neck flexion restriction. [Subjects] In total, 13 healthy male subjects volunteered for this study. [Methods] All subjects performed a traditional curl-up exercise and a curl-up exercise in which neck flexion was restricted by the subject's hand. Surface electromyography (EMG) signals were recorded from the SCM, RA, and EO during the curl-up. [Results] There was significantly lower EMG activity of the SCM during the curl-up exercise with neck flexion restriction compared to the traditional curl-up exercise. Conversely, the activity of the RA and EO muscles was significantly higher in the curl-up exercise with neck flexion restriction than in the traditional curl-up exercise. [Conclusion] Neck flexion restriction is recommended to prevent excessive activation of superficial cervical flexors during the curl-up exercise.

  15. Physical exercises and functional rehabilitation for the management of chronic neck pain.

    Science.gov (United States)

    Ylinen, J

    2007-03-01

    Despite chronic neck pain being so common in the population, few randomized studies have evaluated exercise methods in treating the neck disorders. The aim of this review was to reassess the effectiveness of different exercise methods in relieving pain and improving disability in patients with chronic nonspecific neck pain. Ten randomized controlled or comparative high-quality trials were included in a more detailed analysis using patient-oriented primary outcome measures (e.g., patient's rated pain and disability) as well as pressure pain threshold and functional outcomes (neck strength and range of motion). Findings revealed moderate evidence supporting the effectiveness of both long-term dynamic as well as isometric resistance exercises of the neck and shoulder musculature for chronic or frequent neck disorders. Findings revealed no evidence supporting the long-term effectiveness of postural and proprioceptive exercises or other very low intensity exercises. Clinicians are encouraged to consider these findings and incorporate them into their practice when planning the treatment of patients with chronic neck disorders.

  16. Mechanical pain sensitivity and the severity of chronic neck pain and disability are not modulated across the menstrual cycle

    OpenAIRE

    2013-01-01

    Despite the high prevalence of neck pain among women, menstrual effects on regional pain outcomes have not been investigated in this clinical population. This study evaluated menstrual effects on mechanical pain sensitivity (Pressure Pain Threshold; PPT), neck pain intensity (Numeric Pain Rating Scale; NPRS) and neck-related disability (Neck Disability Index; NDI) in 22 normally menstruating (NM) and 17 hormonal contraceptive (HC) users with chronic neck pain. Sex hormones, PPT, and NDI were ...

  17. Use of surface electromyography to estimate neck muscle activity.

    Science.gov (United States)

    Sommerich, C M; Joines, S M; Hermans, V; Moon, S D

    2000-12-01

    This paper reviews the literature concerning the use of surface electromyography (sEMG) for the study of the neck musculature in response to work and workplace design during light work and semi-static tasks. The paper also draws upon basic research and biomechanical modeling in order to provide methodological recommendations for the use of surface electromyography in this region of the body and to identify areas which require further investigation. The paper includes review and discussion of electrode site location, methods of normalization, data reliability, and factors that can affect sEMG signals from this region, including noise, physiologic artifact, stress, visual deficiencies, and pain. General guidance for maximum exertions with the neck musculature, for sEMG normalization or other purposes, is also included.

  18. Comparison Between Neck and Shoulder Stiffness Determined by Shear Wave Ultrasound Elastography and a Muscle Hardness Meter.

    Science.gov (United States)

    Akagi, Ryota; Kusama, Saki

    2015-08-01

    The goals of this study were to compare neck and shoulder stiffness values determined by shear wave ultrasound elastography with those obtained with a muscle hardness meter and to verify the correspondence between objective and subjective stiffness in the neck and shoulder. Twenty-four young men and women participated in the study. Their neck and shoulder stiffness was determined at six sites. Before the start of the measurements, patients rated their present subjective symptoms of neck and shoulder stiffness on a 6-point verbal scale. At all measurement sites, the correlation coefficients between the values of muscle hardness indices determined by the muscle hardness meter and shear wave ultrasound elastography were not significant. Furthermore, individuals' subjective neck and shoulder stiffness did not correspond to their objective symptoms. These results suggest that the use of shear wave ultrasound elastography is essential to more precisely assess neck and shoulder stiffness.

  19. ASSESSMENT AND COMPARISION OF CERVICAL JOINT POSITION SENSE IN SUBJECTS WITH CHRONIC NECK PAIN vs NORMALS

    Directory of Open Access Journals (Sweden)

    Oberoi Mugdha

    2015-06-01

    Full Text Available Background: The abundance of mechanoreceptors in the cervical spine and their central and reflex afferent connections to the vestibular, visual and postural control system suggests that the cervical proprioceptive information provides important somatosensory information influencing postural stability, head orientation and eye movement control. Disturbances to the afferent input from the cervical region is thought to underlie symptoms of dizziness, unsteadiness, visual disturbances and signs of altered postural stability, cervical proprioception and head and eye movement control in people with chronic neck pain. This study aimed to assess and compare cervical joint position sense in subjects with chronic neck pain vs normals. Methods: Total 60 subjects, divided into two groups chronic neck pain group (n=30 (12 males and 18 females with mean age of 40.7 years and control group (n=30 with age and gender matched normal individuals were assessed for baseline data and demographic variables. Head repositioning accuracy test was used to assess cervical joint position sense in degrees. Results: The difference in the head repositioning error values were found to be extremely significant (p<0.0001 for all the neck movements for subjects with chronic neck pain as compared to normals. Conclusion: Cervical joint position sense in subjects with chronic neck pain is found to be altered as compared to age and gender matched normals.

  20. Activation of Neck and Low-Back Muscles Is Reduced with the Use of a Neck Balance System Together with a Lumbar Support in Urban Drivers.

    Directory of Open Access Journals (Sweden)

    Federica Menotti

    Full Text Available Driving is associated with high activation of low-back and neck muscles due to the sitting position and perturbations imposed by the vehicle. The aim of this study was to investigate the use of a neck balance system together with a lumbar support on the activation of low-back and neck muscles during driving. Twelve healthy male subjects (age 32±6.71 years were asked to drive in two conditions: 1 with devices; 2 without devices. During vehicle accelerations and decelerations root mean square (RMS of surface electromyography (sEMG was recorded from the erector spinae, semispinalis capitis and sternocleidomastoid muscles and expressed as a percentage of maximal voluntary contraction (MVC. The pitch of the head was obtained by means of an inertial sensor placed on the subjects' head. A visual analog scale (VAS was used to assess the level of perceived comfort. RMS of the low back muscles was lower with than without devices during both acceleration and deceleration of the vehicle (1.40±0.93% vs 29 2.32±1.90% and 1.88±1.45% vs 2.91±2.33%, respectively, while RMS of neck extensor muscles was reduced only during acceleration (5.18±1.96% vs 5.91±2.16%. There were no differences between the two conditions in RMS of neck flexor muscles, the pitch of the head and the VAS score. The use of these two ergonomic devices is therefore effective in reducing the activation of low-back and neck muscles during driving with no changes in the level of perceived comfort, which is likely due to rebalancing weight on the neck and giving a neutral position to lumbar segments.

  1. Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain

    Directory of Open Access Journals (Sweden)

    Jose V. León-Hernández

    Full Text Available ABSTRACT Background Dry needling (DN and percutaneous electrical nerve stimulation (PENS are widely used techniques in the treatment of myofascial pain. Objective To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. Method This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group and 31 received DN and PENS (DN+PENS group. The primary outcomes were neck disability index (NDI and visual analog scale for pain for both post-needling soreness (PNS and neck pain intensity (NPI. Pressure pain threshold (PPT and cervical range of motion (CROM were the secondary outcomes. Results We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. Conclusion PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain.

  2. Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone - A preliminary randomized controlled trial

    DEFF Research Database (Denmark)

    Brage, K; Ris Hansen, Inge; Falla, D

    2015-01-01

    -shoulder exercises, balance and aerobic training) (INV), or pain education alone (CTRL). Effect on neck pain, function and Global Perceived Effect (GPE) were measured. Surface electromyography (EMG) was recorded from neck flexor and extensor muscles during performance of the Cranio-Cervical Flexion Test (CCFT...

  3. Clinimetric evaluation of methods to measure muscle functioning in patients with non-specific neck pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Smits-Engelsman Bouwien CM

    2008-10-01

    Full Text Available Abstract Background Neck pain is a significant health problem in modern society. There is evidence to suggest that neck muscle strength is reduced in patients with neck pain. This article provides a critical analysis of the research literature on the clinimetric properties of tests to measure neck muscle strength or endurance in patients with non-specific neck pain, which can be used in daily practice. Methods A computerised literature search was performed in the Medline, CINAHL and Embase databases from 1980 to January 2007. Two reviewers independently assessed the clinimetric properties of identified measurement methods, using a checklist of generally accepted criteria for reproducibility (inter- and intra-observer reliability and agreement, construct validity, responsiveness and feasibility. Results The search identified a total of 16 studies. The instruments or tests included were: muscle endurance tests for short neck flexors, craniocervical flexion test with an inflatable pressure biofeedback unit, manual muscle testing of neck musculature, dynamometry and functional lifting tests (the cervical progressive iso-inertial lifting evaluation (PILE test and the timed weighted overhead test. All the articles included report information on the reproducibility of the tests. Acceptable intra- and inter-observer reliability was demonstrated for t enduranctest for short neck flexors and the cervical PILE test. Construct validity and responsiveness have hardly been documented for tests on muscle functioning. Conclusion The endurance test of the short neck flexors and the cervical PILE test can be regarded as appropriate instruments for measuring different aspects of neck muscle function in patients with non-specific neck pain. Common methodological flaws in the studies were their small sample size and an inappropriate description of the study design.

  4. Associations between psychological factors and the effect of home-based physical exercise in women with chronic neck and shoulder pain

    OpenAIRE

    2016-01-01

    Background: Exercise is often used in the treatment of chronic neck and shoulder muscle pain. It is likely that psychological aspects have an impact on the results of exercise-based treatments. Objectives: (1) To examine the associations between psychological factors and the effect of a home-based physical exercise intervention. (2) To examine differences in psychological factors at baseline between (a) subjects who continued in the trial and those who did not and (b) subjects who completed t...

  5. Forward head posture and neck mobility in chronic tension-type headache: a blinded, controlled study.

    Science.gov (United States)

    Fernández-de-las-Peñas, C; Alonso-Blanco, C; Cuadrado, M L; Pareja, J A

    2006-03-01

    Forward head posture (FHP) and neck mobility were objectively assessed in 25 patients with chronic tension-type headache (CTTH) and 25 healthy controls. Side-view pictures were taken in a sitting position to measure the cranio-vertebral angle. A cervical goniometer was employed to measure the range of all cervical motions. Patients with CTTH showed a smaller cranio-vertebral angle (45.3 degrees +/- 7.6 degrees) than controls (54.1 degrees +/- 6.3 degrees), thus presenting a greater FHP (P neck mobility for all cervical movements, except for right lateral flexion (P angle and neck mobility. Within the CTTH group, a negative correlation was found between the cranio-vertebral angle and headache frequency, but neck mobility did not correlate with headache parameters. Further research is needed to define a potential role of FHP and restricted neck mobility in the origin or maintenance of TTH.

  6. Anticipatory modulation of neck muscle reflex responses induced by mechanical perturbations of the human forehead.

    Science.gov (United States)

    Kuramochi, Rieko; Kimura, Toshitaka; Nakazawa, Kimitaka; Akai, Masami; Torii, Suguru; Suzuki, Shuji

    2004-08-12

    The aim of this study was to test whether anticipation of upcoming head blow stimuli, which elicit reflex responses in the neck muscle, makes the reflex responses greater or not. In nine healthy subjects the reflex responses were elicited in the sternocleidomastoid (SCM) muscle in the eyes-open (EO) and eyes-closed (EC) conditions, which corresponded to the predictable and unpredictable conditions, respectively. The subjects were instructed not to resist the perturbations after the impact. The results demonstrated that the reflex response of the SCM muscle was significantly smaller in the predictable EO condition than in the unpredictable EC condition (P component, which most probably mediated the stretch reflex pathway. In contrast, no significant difference was observed in the early component, which was presumed to be the vestibular-collic reflex. The reduced stretch reflex response was suggested to be functionally relevant to the task requirement, i.e., to let the neck extension movement occur, and not to resist after the impact of the head blow. It was concluded that the anticipation has an effect on reducing the stretch reflex responses in the neck muscle, but does not have any effect on the presumed vestibular-collic reflex under the present experimental paradigm. It is suggested that the gain of the stretch reflex pathway is modulated by anticipatory information of upcoming mechanical event.

  7. Discrete wavelet transform analysis of surface electromyography for the fatigue assessment of neck and shoulder muscles.

    Science.gov (United States)

    Chowdhury, Suman Kanti; Nimbarte, Ashish D; Jaridi, Majid; Creese, Robert C

    2013-10-01

    Assessment of neuromuscular fatigue is essential for early detection and prevention of risks associated with work-related musculoskeletal disorders. In recent years, discrete wavelet transform (DWT) of surface electromyography (SEMG) has been used to evaluate muscle fatigue, especially during dynamic contractions when the SEMG signal is non-stationary. However, its application to the assessment of work-related neck and shoulder muscle fatigue is not well established. Therefore, the purpose of this study was to establish DWT analysis as a suitable method to conduct quantitative assessment of neck and shoulder muscle fatigue under dynamic repetitive conditions. Ten human participants performed 40min of fatiguing repetitive arm and neck exertions while SEMG data from the upper trapezius and sternocleidomastoid muscles were recorded. The ten of the most commonly used wavelet functions were used to conduct the DWT analysis. Spectral changes estimated using power of wavelet coefficients in the 12-23Hz frequency band showed the highest sensitivity to fatigue induced by the dynamic repetitive exertions. Although most of the wavelet functions tested in this study reasonably demonstrated the expected power trend with fatigue development and recovery, the overall performance of the "Rbio3.1" wavelet in terms of power estimation and statistical significance was better than the remaining nine wavelets.

  8. Effectiveness of a behaviour graded activity program versus conventional exercise for chronic neck pain patients.

    Science.gov (United States)

    Vonk, Frieke; Verhagen, Arianne P; Twisk, Jos W; Köke, Albère J A; Luiten, Marlies W C T; Koes, Bart W

    2009-05-01

    Chronic neck pain is a common complaint in the Netherlands with a point prevalence of 14.3%. Patients with chronic neck pain are often referred to physiotherapy and, nowadays, are mostly treated with exercise therapy. It is, however, unclear which type of exercise therapy is to be preferred. Therefore, this study evaluates the effectiveness of behaviour graded activity (BGA) compared with conventional exercise (CE) for patients with chronic neck pain. Eligible patients with non-specific chronic neck were randomly allocated to either BGA or CE. Primary treatment outcome is the patient's global perceived effect concerning recovery from complaint and daily functioning. Outcome assessment was performed at baseline, and at 4, 9, 26, and 52 weeks after randomization. Effectiveness was examined with general estimating equations analyses. Baseline demographics and patient characteristics were well balanced between the two groups. Mean age was 45.7 (SD 12.4) years and the median duration of complaints was 60 months. The mean number of treatments was 6.6 (SD 3.0) in BGA and 11.2 (SD 4.1) in CE. No significant differences between treatments were found in their effectiveness of managing patients with chronic neck pain. In both BGA and CE some patients reported recovery from complaints and daily function but the proportion of recovered patients did not exceed 50% during the 12-month follow-up period. Both groups showed clinically relevant improvements in physical secondary outcomes. International Standard Randomised Controlled Trial Number: ISRCTN88733332.

  9. Effects of heart rate variability biofeedback in subjects with stress-related chronic neck pain: a pilot study.

    Science.gov (United States)

    Hallman, David M; Olsson, Erik M G; von Schéele, Bo; Melin, Lennart; Lyskov, Eugene

    2011-06-01

    Recent studies focusing on autonomic nervous system (ANS) dysfunctions, together with theoretical pathophysiological models of musculoskeletal disorders, indicate the involvement of ANS regulation in development and maintenance of chronic muscle pain. Research has demonstrated the effectiveness of heart rate variability (HRV) biofeedback (BF) in increasing HRV and reducing the symptoms of different disorders characterized by ANS aberration. The study investigated the effects of resonance frequency HRV BF on autonomic regulation and perceived health, pain, stress and disability in 24 subjects with stress-related chronic neck-shoulder pain. Twelve subjects participated in 10 weekly sessions of resonant HRV BF and were compared to a control group. Subjective reports and HRV measures during relaxation and in response to a standardized stress protocol were assessed for both groups pre- and post-intervention. Group × time interactions revealed a significantly stronger increase over time in perceived health (SF-36) for the treatment group, including vitality, bodily pain and social functioning. Interactions were also seen for HRV during relaxation and reactivity to stress. The present pilot study indicates improvement in perceived health over a 10 week intervention with HRV-biofeedback in subjects with chronic neck-pain. Increased resting HRV as well as enhanced reactivity to hand grip and cold pressor tests might reflect beneficial effects on ANS regulation, and suggest that this intervention protocol is suitable for a larger controlled trial.

  10. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: A controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Pollard Henry

    2008-05-01

    Full Text Available Abstract Background Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Methods Sixty participants presenting to a private chiropractic clinic with chronic cervical pain as their primary complaint were sequentially allocated into treatment and control groups. Participants in the treatment group received a short course of Neuro Emotional Technique that consists of muscle testing, general semantics and Traditional Chinese Medicine. The control group received a sham NET protocol. Outcome measurements included pain assessment utilizing a visual analog scale and a pressure gauge algometer. Pain sensitivity was measured at four trigger point locations: suboccipital region (S; levator scapulae region (LS; sternocleidomastoid region (SCM and temporomandibular region (TMJ. For each outcome measurement and each trigger point, we calculated the change in measurement between pre- and post- treatment. We then examined the relationships between these measurement changes and six independent variables (i.e. treatment group and the above five additional participant variables using forward stepwise General Linear Model. Results The visual analog scale (0 to 10 had an improvement of 7.6 at S, 7.2 at LS, 7.5 at SCM and 7.1 at the TMJ in the treatment group compared with no improvement of at S, and an improvement of 0.04 at LS, 0.1 at SCM and 0.1 at the TMJ point in the control group, (P Conclusion After a short course of NET treatment, measurements of visual analog scale and pressure algometer recordings of four trigger point locations in a cohort of chronic neck pain sufferers were significantly

  11. Neck proprioceptive training for balance function in patients with chronic poststroke hemiparesis: a case series.

    Science.gov (United States)

    Kim, Gyoung-Mo; Oh, Duck-Won

    2014-10-01

    [Purpose] This study investigated the effects of neck proprioceptive training on the balance of patients with chronic poststroke hemiparesis. [Subjects] Three patients with chronic stroke were recruited for this study. [Methods] The subjects underwent neck proprioceptive training using the red light of a laser pointer (30 min daily, five times per week for 4 weeks). Outcome measures included the stability and weight distribution indices measured with a Tetrax system and Timed Up and Go (TUG) and proprioception tests. [Results] For all subjects, the stability and weight distribution indices increased by 1.87-9.66% in the eyes-open and eyes-closed conditions, and the TUG and proprioception test scores improved by 2.49-15.27%. [Conclusion] Neck proprioceptive training may be a good option for improving the balance function of patients with chronic poststroke hemiparesis.

  12. Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: Design of a randomised controlled trial

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Christensen, Robin Daniel Kjersgaard; Thomsen, Bente

    2011-01-01

    is to present the design of a randomised controlled trial (RCT) aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients......ABSTRACT: BACKGROUND: Many patients suffer from chronic neck pain following a whiplash injury. A combination of cognitive, behavioural therapy with physiotherapy interventions has been indicated to be effective in the management of patients with chronic whiplash-associated disorders. The objective...... with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline. METHODS: The design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited...

  13. Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease

    OpenAIRE

    2005-01-01

    Background: Quadriceps muscle weakness is common in chronic obstructive pulmonary disease (COPD) but is not observed in a small hand muscle (adductor pollicis). Although this could be explained by reduced activity in the quadriceps, the observation could also be explained by anatomical location of the muscle or fibre type composition. However, the abdominal muscles are of a similar anatomical and fibre type distribution to the quadriceps, although they remain active in COPD. Cough gastric pre...

  14. Physiotherapy for Chronic Neck Pain: Evaluation of a biopsychosocial approach

    NARCIS (Netherlands)

    F. Vonk (Frieke)

    2010-01-01

    markdownabstract__Abstract__ Neck pain is a common complaint that causes substantial morbidity in western countries. Reported prevalence in the general population ranges from 9.5% to 22%, and the 12-month (point) prevalence estimates ranges from 30% to 50%. It is suggested that two thirds of indivi

  15. Acuity of goal-directed arm movements to visible targets in chronic neck pain

    OpenAIRE

    2008-01-01

    Objective: To evaluate end-point acuity in goal-directed arm movements in subjects with chronic neck pain, while taking the trade-off between speed and accuracy into account, and to evaluate associations between reduced acuity and self-rated characteristics. Design: Single-blinded, controlled, comparative group study. Subjects: Forty-five subjects with chronic non-traumatic, non-specific neck pain (n = 24) and whiplash-associated disorders (n = 21). Healthy subjects served as controls (n = 22...

  16. Effect of maitland mobilization in cervical and thoracic spine and therapeutic exercise on functional impairment in individuals with chronic neck pain

    Science.gov (United States)

    Lee, Keun-Su; Lee, Joon-Hee

    2017-01-01

    [Purpose] This study evaluated joint mobilization and therapeutic exercise applied to the cervical spine and upper thoracic spine for functional impairment caused by chronic neck pain. [Subjects and Methods] Eighteen study subjects were randomly assigned to two groups of nine people each. Therapeutic exercise only was applied to the cervical and upper thoracic spine for Group I, while both therapeutic exercise and joint mobilization were applied to Group II. The visual analog scale, neck disability index, active cervical range of motion, static balance capacity, and muscle tone were assessed with a pre-test. The intervention was carried out for 60 minutes a day, three times a week, for two weeks for each group, followed by a post-test using the same protocol as the pre-test. [Results] The visual analog scale, neck disability index, and active cervical range of motion improved significantly in both groups. Group II improved significantly more on right lateral flexion and rightward rotation. Muscle tone improved significantly in the upper trapezius in both groups. [Conclusion] The joint mobilization and therapeutic exercise for functional impairments caused by chronic neck pain had a significant effect on several types of functional impairment. PMID:28356648

  17. Biochemical response to chronic shortening in unloaded soleus muscles

    Science.gov (United States)

    Jaspers, S. R.; Fagan, J. M.; Tischler, M. E.

    1985-01-01

    One leg of tail-casted suspended rats was immobilized in a plantar-flexed position to test whether chronic shortening of posterior leg muscles affected the metabolic response to unloading. The immobilized plantaris and gastrocnemius muscles of these animals showed approximately 20 percent loss of muscle mass in contrast to simply a slower growth rate with unloading. Loss of mass of the soleus muscle during suspension was not accentuated by chronic shortening. Although protein degradation in the isolated soleus muscle of the plantar-flexed limb was slightly faster than in the contralateral free limb, this difference was offset by faster synthesis of the myofibrillar protein fraction of the chronically shortened muscle. Total adenine nucleotides were 17 percent lower (P less than 0.005) in the chronically shortened soleus muscle following incubation. Glutamate, glutamine, and alanine metabolism showed little response to chronic shortening. These results suggest that, in the soleus muscle, chronic shortening did not alter significantly the metabolic responses to unloading and reduced activity.

  18. Does a combination of physical training, specific exercises and pain education improve health-related quality of life in patients with chronic neck pain?

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Søgaard, Karen; Gram, Bibi

    2016-01-01

    anterior and cervical spine, Cranio-cervical Flexion, Cervical Extension muscle function, and oculomotion) were recorded at baseline and after 4 months. RESULTS: The exercise group showed statistically significant improvement in physical HR-QoL, mental HR-QoL, depression, cervical pressure pain threshold...... controlled trial of 200 neck pain patients receiving pain education. The exercise group received additional exercises for neck/shoulder, balance and oculomotor function, plus graded physical activity training. Patient-reported outcome measures (Short Form-36 Physical and Mental component summary scores, Euro......AIM: To investigate the effect of combining pain education, specific exercises and graded physical activity training (exercise) compared with pain education alone (control) on physical health-related quality of life (HR-QoL) in chronic neck pain patients. METHODS: A multicentre randomised...

  19. Neck and shoulder muscle activity and posture among helicopter pilots and crew-members during military helicopter flight.

    Science.gov (United States)

    Murray, Mike; Lange, Britt; Chreiteh, Shadi Samir; Olsen, Henrik Baare; Nørnberg, Bo Riebeling; Boyle, Eleanor; Søgaard, Karen; Sjøgaard, Gisela

    2016-04-01

    Neck pain among helicopter pilots and crew-members is common. This study quantified the physical workload on neck and shoulder muscles using electromyography (EMG) measures during helicopter flight. Nine standardized sorties were performed, encompassing: cruising from location A to location B (AB) and performing search and rescue (SAR). SAR was performed with Night Vision Goggles (NVG), while AB was performed with (AB+NVG) and without NVG (AB-NVG). EMG was recorded for: trapezius (TRA), upper neck extensors (UNE), and sternocleido-mastoid (SCM). Maximal voluntary contractions (MVC) were performed for normalization of EMG (MVE). Neck posture of pilots and crew-members was monitored and pain intensity of neck, shoulder, and back was recorded. Mean muscle activity for UNE was ∼10% MVE and significantly higher than TRA and SCM, and SCM was significantly lower than TRA. There was no significant difference between AB-NVG and AB+NVG. Muscle activity in the UNE was significantly higher during SAR+NVG than AB-NVG. Sortie time (%) with non-neutral neck posture for SAR+NVG and AB-NVG was: 80.4%, 74.5% (flexed), 55.5%, 47.9% (rotated), 4.5%, 3.7% (lateral flexed). Neck pain intensity increased significantly from pre- (0.7±1.3) to post-sortie (1.6±1.9) for pilots (p=0.028). If sustained, UNE activity of ∼10% MVE is high, and implies a risk for neck disorders.

  20. Efficacy and safety of acupuncture for chronic uncomplicated neck pain: a randomised controlled study.

    Science.gov (United States)

    Vas, Jorge; Perea-Milla, Emilio; Méndez, Camila; Sánchez Navarro, Cayetana; León Rubio, José María; Brioso, Mauricio; García Obrero, Inmaculada

    2006-12-15

    Chronic neck pain is highly prevalent. To determine the efficacy and safety of acupuncture, in comparison with transcutaneous nerve stimulation-placebo (TENS-placebo) in the treatment of chronic uncomplicated neck pain, a single blind prospective study was designed, to be carried out at a Primary Healthcare Centre, with random assignment to two parallel groups and with evaluation and analysis by independent evaluators. A random assignment was made from 123 patients of the 149 initially recruited. These patients had been diagnosed with uncomplicated neck pain and experienced neck motion-related pain intensity equal to or exceeding 30 on a visual analogue scale (VAS) from 0 to 100 mm. The treatment with acupuncture was compared with TENS-placebo, applied over 5 sessions in three weeks. The primary endpoint was the change in maximum pain intensity related to motion of the neck, one week after the final treatment. Sensitivity was analysed per protocol (PP) and variant analyses were by intention to treat (ITT). Adjustment was made for confounders by multiple linear regression, including baseline values and rescue therapy. By ITT analysis, the change in the pain-VAS variable was greater among the experimental group (28.1 (95% CI 21.4-34.7)). The improvements in quality of life (physical aspect), active neck mobility and reduced rescue medication were clinically and statistically significant. In the treatment of the intensity of chronic neck pain, acupuncture is more effective than the placebo treatment and presents a safety profile making it suitable for routine use in clinical practice.

  1. Responses of muscle spindles in feline dorsal neck muscles to electrical stimulation of the cervical sympathetic nerve.

    Science.gov (United States)

    Hellström, F; Roatta, S; Thunberg, J; Passatore, M; Djupsjöbacka, M

    2005-09-01

    Previous studies performed in jaw muscles of rabbits and rats have demonstrated that sympathetic outflow may affect the activity of muscle spindle afferents (MSAs). The resulting impairment of MSA information has been suggested to be involved in the genesis and spread of chronic muscle pain. The present study was designed to investigate sympathetic influences on muscle spindles in feline trapezius and splenius muscles (TrSp), as these muscles are commonly affected by chronic pain in humans. Experiments were carried out in cats anesthetized with alpha-chloralose. The effect of electrical stimulation (10 Hz for 90 s or 3 Hz for 5 min) of the peripheral stump of the cervical sympathetic nerve (CSN) was investigated on the discharge of TrSp MSAs (units classified as Ia-like and II-like) and on their responses to sinusoidal stretching of these muscles. In some of the experiments, the local microcirculation of the muscles was monitored by laser Doppler flowmetry. In total, 46 MSAs were recorded. Stimulation of the CSN at 10 Hz powerfully depressed the mean discharge rate of the majority of the tested MSAs (73%) and also affected the sensitivity of MSAs to sinusoidal changes of muscle length, which were evaluated in terms of amplitude and phase of the sinusoidal fitting of unitary activity. The amplitude was significantly reduced in Ia-like units and variably affected in II-like units, while in general the phase was affected little and not changed significantly in either group. The discharge of a smaller percentage of tested units was also modulated by 3-Hz CSN stimulation. Blockade of the neuromuscular junctions by pancuronium did not induce any changes in MSA responses to CSN stimulation, showing that these responses were not secondary to changes in extrafusal or fusimotor activity. Further data showed that the sympathetically induced modulation of MSA discharge was not secondary to the concomitant reduction of muscle blood flow induced by the stimulation. Hence

  2. Intensive dynamic training for females with chronic neck/shoulder pain. A randomized controlled trial

    DEFF Research Database (Denmark)

    Randløv, A; Østergaard, Mikkel; Manniche, C;

    1998-01-01

    OBJECTIVES: To compare the clinical effectiveness of an intensive three-month training programme with a less intensive programme on females suffering from chronic neck/shoulder pain. STUDY DESIGN: A prospective observer-blinded clinical trial including 12-month pretreatment follow-up. SETTING......: Patients were referred to the Departments of Rheumatology and Physical Medicine at Hvidovre Hospital by their general practitioners. Training was undertaken at a satellite clinic for physiotherapy of Hvidovre Hospital. SUBJECTS: Female patients aged 18-65 years suffering from chronic neck/shoulder pain...... for a minimum of six months. INTERVENTION: Patients were examined by a physician in order to exclude serious diseases. They were then randomized to either an intensive neck/shoulder training programme or a programme of lesser intensity but of similar duration. MAIN OUTCOME MEASURES: Scales measuring pain...

  3. Reliability, construct and discriminative validity of clinical testing in subjects with and without chronic neck pain

    DEFF Research Database (Denmark)

    Jørgensen, René; Ris Hansen, Inge; Falla, Deborah

    2014-01-01

    Flexion Test (CCFT), Range of Movement (ROM), Joint Position Error (JPE), Gaze Stability (GS), Smooth Pursuit Neck Torsion Test (SPNTT), and neuromuscular control of the Deep Cervical Extensors (DCE). Test-retest reliability was assessed for Postural Control (SWAY) and Pressure Pain Threshold (PPT) over......BACKGROUND: The reliability of clinical tests for the cervical spine has not been adequately evaluated. Six cervical clinical tests, which are low cost and easy to perform in clinical settings, were tested for intra- and inter-examiner reliability, and two performance tests were assessed for test......-retest reliability in people with and without chronic neck pain. Moreover, construct and between-group discriminative validity of the tests were examined. METHODS: Twenty-one participants with chronic neck pain and 21 asymptomatic participants were included. Intra- and inter-reliability were evaluated for the Cranio-Cervical...

  4. Possible effects of pramipexole on neck muscles in a patient with Parkinson's disease.

    Science.gov (United States)

    Filippi, Roberto; Rasetti, Mario; Lenzi, Marco; Bright, Peter

    2014-04-01

    Recent case reports suggest a possible causal correlation between antecollis and pramipexole. Here, we report the case of a 62-year-old Italian man with a 2-year history of Parkinson's disease (PD) and cervical spondylosis for which he was treated with pramipexole. He developed severe neck rigidity immediately after an inguinal hernia operation but several months after introduction of pramipexole. He was initially treated with painkillers and physiotherapy with no significant improvement. His condition deteriorated presenting disproportionate rigidity between anterior and posterior neck muscles (antecollis) to the extent that normal activities were severely restricted. However, significant improvement occurred after the withdrawal of pramipexole. The patient undertook a second cycle of physiotherapy with remarkable results and returned to function normally in everyday life. This case report suggests that neurologists should be motivated to inform the scientific community about other possible cases in which an association between antecollis and pramipexole might operate in PD.

  5. Range of motion in the upper and lower cervical spine in people with chronic neck pain.

    Science.gov (United States)

    Rudolfsson, Thomas; Björklund, Martin; Djupsjöbacka, Mats

    2012-02-01

    Reduced cervical range of motion (ROM) is a common finding in people with neck pain. With few exceptions, only the angle between head and thorax has been measured. Our aim was to use an extended model to compare active cervical flexion and extension, separate for upper and lower cervical levels, between people with chronic non-traumatic neck pain and controls. We also investigated associations between ROM measures, symptoms and self-rated functioning. In this cross-sectional study, 102 subjects with neck pain and 33 healthy controls participated. An electromagnetic tracker system was used to measure the kinematics to construct a three-segment model including the thorax, cervical spine and head. Neutral flexion/extension were defined at subjects' self-selected seated posture. We found that in the neck pain group, extension in the upper cervical levels and predominately flexion for the lower levels were reduced. The ratio between ROM for the upper and lower levels was altered in the neck pain group so that the lower levels contributed to a lesser extent to the total sagittal ROM compared to controls. These findings could not be explained by a greater forward head posture but must have other origins. For the neck pain group, ROM measures were weakly associated to pain and self-rated functioning. Altogether, this implies that using a three-segment model for assessment of ROM can be a valuable improvement for characterisation of patients and treatment evaluation.

  6. SHORT TERM EFFICACY OF KINESIOTAPING AND EXERCISES ON CHRONIC MECHANICAL NECK PAIN

    Directory of Open Access Journals (Sweden)

    Kulkarni Prachi Sanjay 1 , 2 , 3 ,

    2013-12-01

    Full Text Available Background and introduction:The purpose of study is to determine the short term effectiveness of Kinesiotapingcombined with Exercises in reducing pain and improving Cervical range of motion and functional ability forsubjects with Chronic Mechanical Neck pain.Method::Pre to post test experimental study design randomised thirty Chronic Mechanical Neck pain patientseach 15 into KT and control group. KT group received kinesiotaping with exercises and Control groupreceivedonly exercises for 3 times a week for 4 weeks.Pain, active cervical range of motion and functional ability weremeasured before and after 4 weeks of intervention.Results:Comparative analysis using Independent‘t’ test and Mann Whitney U test found that there is a statisticallysignificant difference (p<0.05 in means of NPRS, active Flexion, Extension, Rotation to right, Rotation to LeftROM, Neck Disability Index (NDI in percentage when compared post intervention means between the groups.Pre to post test within the group analysis in both the groups using Paired‘t’ test and Wilcoxon signed rank testfound that there is a statistically significant change in means of NPRS, Flexion, Extension, Rotation to right,Rotation to Left ROM, NDI.Conclusion:Kinesiotaping combined with exercises for 4 weeks found short term effect in improving pain,active cervical ROM and functional ability than exercises alone in treatment of chronic Mechanical neck pain

  7. Internal fixation and muscle pedicle bone grafting in femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Gupta A

    2008-01-01

    Full Text Available Background: The treatment of displaced intracapsular femoral neck fracture is still an unsolved problem. Non-union and avascular necrosis are the two main complications of this fracture, especially if patient presents late. Muscle pedicle bone grafting has been advocated to provide additional blood supply. We present analysis of our 32 cases of displaced femoral neck fracture treated by internal fixation and quadratus femoris based muscle pedicle bone grafting. Materials and Methods: Open reduction and internal fixation with muscle pedicle grafting was done in 32 patients. The age of patients varied from 14-62 years (average age 45 years with male to female ratio of 13:3. Twenty-nine fractures were more than three weeks old. All the cases were treated by Meyers′ procedure. The fracture was internally fixed after open reduction and then a muscle pedicle graft was applied. It was supplemented by cancellous bone graft in seven cases. Fixation was done by parallel cancellous lag screws ( n = 19, crossed Garden′s screws ( n = 7, parallel Asnis screws ( n = 5 and Moore′s pin ( n = 1.Quadratus femoris muscle pedicle graft was used in 32 cases. In the initial 12 cases the graft was fixed with circumferential proline sutures, but later, to provide a secure fixation, the graft was fixed with a cancellous screw ( n = 20. Postoperative full weight bearing was deferred to an average of 10 weeks. Results: Union was achieved in 26/29 (89.65% cases which could be followed for an average period of 3.4 years, (2-8.5 years with good functional results and had the ability to squat and sit cross-legged. Results were based on hip rating system given by Salvatti and Wilson. The results were excellent in 15 cases, good in four cases, fair in four cases and poor in six cases. Complications were avascular necrosis ( n = 2, transient foot drop ( n = 2, coxa-vara ( n = 1 and temporary loss of scrotal sensation ( n = 1. Conclusion: Muscle pedicle bone grafting with

  8. [Update on current care guidelines. Neck pain].

    Science.gov (United States)

    2009-01-01

    Neck pain is very common. Age, female gender, obesity, and several physical and psychological work related factors increase the risk while physical activity appears to decrease it. Non-specific neck pain is most common but serious or specific illness must be ruled out and neural compression identified. Patients are encouraged to remain active and improve their ergonomics. Acute neck pain often disappears without any special treatment. Paracetamol is the primary pain medication. Multidisciplinary treatment is recommended if disabling pain has lasted for two months, and intensive muscle exercises in chronic neck pain. Progressive muscle weakness and myelopathy indicate a surgical assessment.

  9. The Effect of Using Dual Screen Computer Panel to the Neck-Shoulder Muscle Activity among Group of Students

    Directory of Open Access Journals (Sweden)

    Shamsul Bahri TAMRIN

    2016-03-01

    Full Text Available Background: Workstation design has shift from using single monitor screen to dual monitor screens, which may impose some impacts towards the muscles activity. This study aimed to determine the effect of using dual monitor screen computer to the neck-shoulder muscle activity among computer user.Method: This experimental study was conducted in 2015 among 28 healthy students in University Malaysia Perlis. The muscle activity of sternocleidomastoid and trapezius were recorded using surface electromyography (sEMG as the participants perform two types of computer task: (1 proofreading task for 10 minutes (2 typing task for 20 minutes in setting; single and dual monitor screens.Results: There was a significant reduction in the median frequency of the left trapezius muscle (t=-2.515, P=0.018. Sternocleidomastoid muscle activity for both sides also showed a significant reduction in the median frequency where right SCM (t=-2.579, P=0.016 and left SCM (t=-2.345, P=0.027. When compared between both setup of screen display, it is showed that dual screen gave a lower trend of muscle activity compared to single screen.Conclusions: Using dual screen may results in increasing the movement frequency and reducing the static strain in the neck-shoulder muscle area. Keywords: Dual monitor screen, Neck-shoulder muscles, Surface electromyography

  10. A Comparison of the Deep Cervical Flexor Muscle Thicknesses in Subjects with and without Neck Pain during Craniocervical Flexion Exercises.

    Science.gov (United States)

    Jun, Ilsub; Kim, Kyoung

    2013-11-01

    [Purpose] The purpose of the present study was to examine the amount of change in the thicknesses of the deep cervical flexor (DCF) and sternocleidomastoid (SCM) muscles in subjects with neck pain and subjects without neck pain during craniocervical flexion exercise (CCFE). [Subjects] The total number of subjects was 40, comprising 20 in the no-pain group (males 11, females 9) and 20 in the pain group (males 8, females 12). [Methods] Muscle images were obtained using ultrasound, and the thicknesses of the individual muscles were measured using the NIH ImageJ software. [Results] During CCFE, as pressure increased, the no-pain group recruited the DCF more than the pain group, while the pain group recruited the SCM more. [Conclusion] Selective DCF contraction exercises are considered very useful in the treatment of patients with neck pain.

  11. Predictors of outcome in neck pain patients undergoing chiropractic care: comparison of acute and chronic patients

    Directory of Open Access Journals (Sweden)

    Peterson Cynthia

    2012-08-01

    Full Text Available Abstract Background Neck pain is a common complaint in patients presenting for chiropractic treatment. The few studies on predictors for improvement in patients while undergoing treatment identify duration of symptoms, neck stiffness and number of previous episodes as the strong predictor variables. The purpose of this study is to continue the research for predictors of a positive outcome in neck pain patients undergoing chiropractic treatment. Methods Acute ( 3 months (n = 255 neck pain patients with no chiropractic or manual therapy in the prior 3 months were included. Patients completed the numerical pain rating scale (NRS and Bournemouth questionnaire (BQ at baseline prior to treatment. At 1 week, 1 month and 3 months after start of treatment the NRS and BQ were completed along with the Patient Global Impression of Change (PGIC scale. Demographic information was provided by the clinician. Improvement at each of the follow up points was categorized using the PGIC. Multivariate regression analyses were done to determine significant independent predictors of improvement. Results Baseline mean neck pain and total disability scores were significantly (p  Conclusions The most consistent predictor of clinically relevant improvement at both 1 and 3 months after the start of chiropractic treatment for both acute and chronic patients is if they report improvement early in the course of treatment. The co-existence of either radiculopathy or dizziness however do not imply poorer prognosis in these patients.

  12. The construct validity of the Short Form-36 Health Survey for patients with nonspecific chronic neck pain

    NARCIS (Netherlands)

    Knol -de Vries, Grietje E.; Jorritsma, Wim; Dijkstra, Pieter U.; Geertzen, Jan H. B.; Reneman, Michiel F.

    2015-01-01

    Self-reported disability related to neck pain can be measured using general health questionnaires. The validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) in patients with nonspecific chronic neck pain (CNP) in a tertiary outpatient rehabilitation setting is unknown. This

  13. Efficacy of acupunture in patients with chronic neck pain--a randomised, sham controlled trial.

    Science.gov (United States)

    Sahin, Nilay; Ozcan, Emel; Sezen, Kasim; Karatas, Omer; Issever, Halim

    2010-01-01

    The aim of this study was to compare the efficacy of electroacupuncture and sham acupuncture in the treatment of patients with chronic neck pain. 31 patients with chronic neck pain were included in a randomised, controlled trial. Electric stimulation was given for 30 minutes at low frequency (1-4Hz), pulse width of 200 micros, interrupted wave form. Of the 29 patients who completed the therapy, 13 were assigned to conventional acupuncture and 16 to sham acupuncture groups, receiving 3 sessions a week for a total of 10 sessions, each lasting for 30 minutes. Patients were evaluated before and after therapy and 3 months later by Visual Analogue Scale (VAS) and the bodily pain subscale of the Short Form Health Survey-36 scale. The treating physician was different from the evaluating physician who, like the patient, was blinded. VAS scores in both groups significantly reduced after therapy and at 3 months post-therapy, but the difference between groups was not significant. In respect of bodily pain, there was a significant improvement in the acupuncture group after therapy (P<0.01). Stimulation of conventional acupuncture points was not generally superior to needling ofnonspecific points on the neck, and both treatments were associated with improvement of symptoms. Needles inserted into the neck are likely to be an inappropriate sham control for acupuncture.

  14. The effectiveness of Long's manipulation on patients with chronic mechanical neck pain: a randomized controlled trial.

    Science.gov (United States)

    Lin, Jian Hua; Shen, Tong; Chung, Raymond Chi Keung; Chiu, Thomas Tai Wing

    2013-08-01

    Long's manipulation (LM) is a representative Chinese manipulation approach incorporating both spinal manipulation and traditional Chinese massage (TCM) techniques. This randomized controlled trial (RCT) aimed to compare the immediate and short-term relative effectiveness of LM to TCM on patients with chronic neck pain. Patients were randomly assigned to either LM group or TCM group. LM group was treated with Long's manipulation, while the TCM group received TCM therapy. Patients attended 8 sessions of treatment (one session every three days). Outcome measures included neck disability (Northwick Park Neck Pain Questionnaire; NPQ), pain intensity (Numeric Pain Rating Scale; NPRS), patient perceived satisfaction of care (PPS) (11-point scale), craniovertebral angle (CV angle) and cervical range of motion (ROM). A blinded assessor performed assessment at baseline, immediate after treatment and 3 months post treatment. LM group achieved significantly greater improvement than TCM group in pain intensity (p angle and most of cervical ROM between groups (p = 0.169 ∼ 0.888) with an exception of flexion at 3-month follow-up (p = 0.005). This study shows that LM could produce better effects than TCM in relieving pain and improving disability in the management of patients with chronic mechanical neck pain.

  15. SHORT TERM RESULTS OF MUSCLE PEDICLE BONE GRAFT (MPBG IN FRACTURE NECK FEMUR: A CASE SERIES OF 7 CASES

    Directory of Open Access Journals (Sweden)

    Sarabjeet

    2016-03-01

    Full Text Available INTRODUCTION Neglected, untreated and delayed neck femur fractures are commonly encountered fractures and the treatment dilemma arises specially when the patient is physiologically young and osteosynthesis is the preferred option. Past literature creates confusion as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularised fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata (TFL and Quadratus femoris graft and vascularised bone grafting do not have clear lines of indications. We present a series of fracture neck femur cases, each with delayed presentation beyond the vascular emergency period, which were treated with osteosynthesis with MPBG using tensor fascia lata muscle pedicle graft.

  16. The effectiveness of chiropractic manipulative therapy and Spidertech therapy in the treatment of chronic neck pain

    OpenAIRE

    2012-01-01

    M.Tech. Purpose: This study aims to compare the effects of Chiropractic manipulative therapy of the cervical spine in conjunction with SpiderTech therapy in the treatment of chronic neck pain with regards to pain, disability and cervical spine range of motion. Method: This study consisted of two groups of 15 participants between the ages of eighteen and forty, ensuring equal male to female and age ratios. The potential participants were examined and accepted according to the inclusion and ...

  17. Pre- and post-operative gait analysis for evaluation of neck pain in chronic whiplash

    OpenAIRE

    Ginsburg Glen M; Nystrom Ake; Stuberg Wayne; Dejong Stacey

    2009-01-01

    Abstract Introduction Chronic neck pain after whiplash is notoriously refractory to conservative treatment, and positive radiological findings to explain the symptoms are scarce. The apparent disproportionality between subjective complaints and objective findings is significant for the planning of treatment, impairment ratings, and judicial questions on causation. However, failure to identify a symptom's focal origin with routine imaging studies does not invalidate the symptom per se. It is t...

  18. Computer mouse use predicts acute pain but not prolonged or chronic pain in the neck and shoulder

    DEFF Research Database (Denmark)

    Andersen, JH; Harhoff, M.; Grimstrup, S.

    2008-01-01

    BACKGROUND: Computer use may have an adverse effect on musculoskeletal outcomes. This study assessed the risk of neck and shoulder pain associated with objectively recorded professional computer use. METHODS: A computer programme was used to collect data on mouse and keyboard usage and weekly...... quartile increase in weekly mouse usage time. Mouse and keyboard usage time did not predict the onset of prolonged or chronic pain in the neck or shoulder. Women had higher risks for neck and shoulder pain. Number of keystrokes and mouse clicks, length of the average activity period, and micro-pauses did...... not influence reports of acute or prolonged pain. A few psychosocial factors predicted the risk of prolonged pain. CONCLUSIONS: Most computer workers have no or minor neck and shoulder pain, few experience prolonged pain, and even fewer, chronic neck and shoulder pain. Moreover, there seems...

  19. Abnormalities of skeletal muscle in patients with chronic heart failure.

    Science.gov (United States)

    Lipkin, D P; Jones, D A; Round, J M; Poole-Wilson, P A

    1988-02-01

    We have examined muscle strength, mitochondrial enzyme activity, histochemistry and fibre size in the quadriceps muscle of 9 patients with severe chronic heart failure. A needle biopsy of the quadriceps muscle was taken with patients at rest. Maximum oxygen uptake was measured during treadmill exercise. Mean maximal oxygen consumption was 11.7 ml.kg-1.min-1. Isometric maximum voluntary contraction was reduced to 55% of the predicted value for weight. Eight biopsies were abnormal. Findings included increased acid phosphatase, increased interstitial cellularity, excess intracellular lipid accumulation, atrophy of both type I and II fibres and variation in size with hypertrophy and atrophy of fibers. Muscle fibre capillary density and the activity of mitochondrial enzymes were normal. Changes in skeletal muscle strength may play a role in the limitation of exercise capacity seen in patients with congestive heart failure.

  20. [Clinical consequences of muscle dysfunction in chronic obstructive pulmonary disease].

    Science.gov (United States)

    Sauleda Roig, J

    2006-05-01

    The function of respiratory muscles, and mainly inspiratory muscles, is impaired in COPD patients. Most of these impairments are essentially due to pulmonary hyperinflation that puts these muscles in a disadvantageous situation. The main consequence of this dysfunction is respiratory muscle fatigue that may cause shortness of breath, exertion intolerance, and hypoventilation with onset of hypercapnic respiratory failure. This function may be measured at the pulmonary function laboratory by means of unspecific (spirometry, pulmonary volumes) or specific tests (maxim respiratory pressures [MIP - M], transdiaphragmatic pressure, tension-time index of the diaphragm, electromyography, or endura tests). Therapy should aim at improving hyperinflation with bronchodilator therapy, improving muscular strength with rehabilitation, and in severe cases muscle rest with mechanical ventilation. Peripheral muscle dysfunction is a common complication in moderate-severe COPD, and it may be the result of chronic inactivity, hypoxemia, electrolytic impairments, under nutrition, steroids, oxidative stress, and systemic inflammation. Besides, it may contribute to patients' quality of life worsening, disability, and even an increase in morbimortality. It may tested by impedanciometry, muscle strength tests (dynamometry), imaging tests, and even muscle biopsy in research studies. Peripheral muscle dysfunction is potentially manageable with rehabilitation, nutritional supplementation, and anabolic drugs. However, therapeutic success is often incomplete, so that further studies with new therapeutic strategies are needed.

  1. Physical workload on neck and shoulder muscles during military helicopter flight - a need for exercise training?

    DEFF Research Database (Denmark)

    Murray, Mike; Lange, Britt; Chreiteh, Shadi Samir

    neck extensors (UNE) and m. sternocleidomastoideus (SCM). Maximal Voluntary Isometric Contractions (MVC) was performed for normalization. A modified version of the observational method “Posture Activity Tools and Handling” (PATH) was used for assessing work positions during flights. For every minute.......1. The mean muscle activity in % MVC was highest during SAR flight: pilots 2.9 ± 1.7 (TRA) 12.7 ± 5.2 (UNE) 4.3 ± 2.9 (SCM), Crew members 4.1 ± 3.8 (TRA) 10.5 ± 2.4 (UNE) 2.4 ± 1.5 (SCM). Muscle activity in UNE was significantly higher than in TRA and SCM during all flights, except for crew members when.......6% (flexed) and 64.4% (rotated), and for crew members for 93.8% (flexed) and 89.9% (rotated). Discussion The mean muscle activity during flights was overall ~ 10% MVC in UNE and even higher during SAR flight, which is considered a high sustained activity level. Such high workload in combination...

  2. Evolution of chronic dysphagia following treatment for head and neck cancer.

    Science.gov (United States)

    Nguyen, Nam P; Moltz, Candace C; Frank, Cheryl; Vos, Paul; Smith, Herbert J; Karlsson, Ulf; Nguyen, Ly M; Rose, Sue; Dutta, Suresh; Sallah, Sabah

    2006-04-01

    We would like to assess the evolution of chronic dysphagia (1 year or more) following treatment for head and neck cancer. Modified barium swallow (MBS) examinations were performed in cancer-free patients who complained of dysphagia following treatment for head and neck cancer. The severity of the dysphagia was graded on a scale of 1-7. Each patient had at least 2 MBS. Severity of dysphagia was compared between the first and last MBS study to determine whether the swallowing dysfunction had returned to normal. Patients with complaint of dysphagia and normal MBS also underwent a regular barium swallow to assess the structural integrity of the pharynx and esophagus. Between 1996 and 2001, 25 patients with dysphagia underwent repeat MBS following treatment. Swallowing dysfunction did not return to normal in the majority of the patients. At a median time of 26 months following treatment (range 15-82 months), only two patient (8%) had normalization of the swallowing. The severity of dysphagia decreased in eight patients (32%), remained unchanged in 12 patients (48%), and worsened in five patients (20%). Eight patients (32%) still had aspiration problems at 12-83 months following treatment. Six patients (24%) required dilation because of pharyngeal stenosis. Three patients who required dilation had improvement of the dysphagia severity. Chronic dysphagia is a relentless process possibly due to excessive scarring. Patients with chronic dysphagia are at risk of malnutrition, and aspiration. Management of chronic dysphagia requires a team approach with nutritional support, psychological counseling, dilation, and tube feedings when indicated.

  3. Comparative short-term effects of two thoracic spinal manipulation techniques in subjects with chronic mechanical neck pain: a randomized controlled trial.

    Science.gov (United States)

    Casanova-Méndez, Amaloha; Oliva-Pascual-Vaca, Angel; Rodriguez-Blanco, Cleofás; Heredia-Rizo, Alberto Marcos; Gogorza-Arroitaonandia, Kristobal; Almazán-Campos, Ginés

    2014-08-01

    Spinal Manipulation (SM) has been purported to decrease pain and improve function in subjects with non-specific neck pain. Previous research has investigated which individuals with non-specific neck pain will be more likely to benefit from SM. It has not yet been proven whether or not the effectiveness of thoracic SM depends on the specific technique being used. This double-blind randomized trial has compared the short-term effects of two thoracic SM maneuvers in subjects with chronic non-specific neck pain. Sixty participants were distributed randomly into two groups. One group received the Dog technique (n = 30), with the subject in supine position, and the other group underwent the Toggle-Recoil technique (n = 30), with the participant lying prone, T4 being the targeted area in both cases. Evaluations were made of self-reported neck pain (Visual Analogue Scale); neck mobility (Cervical Range of Motion); and pressure pain threshold at the cervical and thoracic levels (C4 and T4 spinous process) and over the site described for location of tense bands of the upper trapezius muscle. Measurements were taken before intervention, immediately afterward, and 20 min later. Both maneuvers improved neck mobility and mechanosensitivity and reduced pain in the short term. No major or clinical differences were found between the groups. In the between-groups comparison slightly better results were observed in the Toggle-Recoil group only for cervical extension (p = 0.009), right lateral flexion (p = 0.004) and left rotation (p < 0.05).

  4. Meyer’s Muscle Pedicle Bone Graft a Novel Procedure in Treatment of Neglected Fracture Neck of Femur in Pediatric Age Group-A Case Report

    OpenAIRE

    2016-01-01

    Meyers muscle pedicle graft has been used in delayed presentation and non-union of neck femur fracture in adults with good results. Delayed presentation or non-union neck femur in children is not uncommon in children. Subtrochanteric valgus osteotomy with or without fixation has been suggested with varying results. We present meyers muscle graft being used in paediatric age group with excellent result at 3 years follow-up. There are limited report literature of meyers muscle pedicle graft bei...

  5. Neck Injuries and Disorders

    Science.gov (United States)

    ... or upper arms. Muscle strain or tension often causes neck pain. The problem is usually overuse, such as from ... or accidents, including car accidents, are another common cause of neck pain. Whiplash, a soft tissue injury to the neck, ...

  6. Cost-effectiveness of acupuncture treatment in patients with chronic neck pain.

    Science.gov (United States)

    Willich, Stefan N; Reinhold, Thomas; Selim, Dagmar; Jena, Susanne; Brinkhaus, Benno; Witt, Claudia M

    2006-11-01

    Acupuncture is increasingly used in patients with chronic pain, but there is a lack of evidence on the cost-benefit relationship of this treatment strategy. The objective of this study was to assess costs and cost-effectiveness of additional acupuncture treatment in patients with chronic neck pain compared to patients receiving routine care alone. A randomized controlled trial including patients (18 years of age) with chronic neck pain (>6 months) was carried out. We assessed the resource use and health related quality of life (SF-36) at baseline and after 3 months using complete social health insurance funds and standardized questionnaires, respectively. The main outcome parameters were direct and indirect cost differences during the 3 months study period and the incremental cost-effectiveness ratio (ICER) of acupuncture treatment. A total of 3,451 patients (1,753 acupuncture-group, 1,698 control-group) were randomized (31% men, age 53.5+/-12.9 years; 69% women, 49.2+/-12.7 years). Acupuncture treatment was associated with significantly higher costs over the 3 months study duration compared to routine care (925.53+/-1,551.06 euros vs. 648.06+/-1,459.13 euros; mean difference: 277.47 euros [95% CI: 175.71 euros-379.23 euros]). This cost increase was mainly due to costs of acupuncture (361.76+/-90.16 euros). The ICER was 12,469 euros per QALY gained and proved robust in additional sensitivity analyses. Since health insurance databases were used, private medical expenses such as over the counter medication were not included. Beyond the 3 months study duration, acupuncture might be associated with further health economic effects. According to international cost-effectiveness threshold values, acupuncture is a cost-effective treatment strategy in patients with chronic neck pain.

  7. Prism adaptation and neck muscle vibration in healthy individuals: are two methods better than one?

    Science.gov (United States)

    Guinet, M; Michel, C

    2013-12-19

    Studies involving therapeutic combinations reveal an important benefit in the rehabilitation of neglect patients when compared to single therapies. In light of these observations our present work examines, in healthy individuals, sensorimotor and cognitive after-effects of prism adaptation and neck muscle vibration applied individually or simultaneously. We explored sensorimotor after-effects on visuo-manual open-loop pointing, visual and proprioceptive straight-ahead estimations. We assessed cognitive after-effects on the line bisection task. Fifty-four healthy participants were divided into six groups designated according to the exposure procedure used with each: 'Prism' (P) group; 'Vibration with a sensation of body rotation' (Vb) group; 'Vibration with a move illusion of the LED' (Vl) group; 'Association with a sensation of body rotation' (Ab) group; 'Association with a move illusion of the LED' (Al) group; and 'Control' (C) group. The main findings showed that prism adaptation applied alone or combined with vibration showed significant adaptation in visuo-manual open-loop pointing, visual straight-ahead and proprioceptive straight-ahead. Vibration alone produced significant after-effects on proprioceptive straight-ahead estimation in the Vl group. Furthermore all groups (except C group) showed a rightward neglect-like bias in line bisection following the training procedure. This is the first demonstration of cognitive after-effects following neck muscle vibration in healthy individuals. The simultaneous application of both methods did not produce significant greater after-effects than prism adaptation alone in both sensorimotor and cognitive tasks. These results are discussed in terms of transfer of sensorimotor plasticity to spatial cognition in healthy individuals.

  8. Hypertrophy of chronically unloaded muscle subjected to resistance exercise.

    Science.gov (United States)

    Tesch, P A; Trieschmann, J T; Ekberg, A

    2004-04-01

    In an effort to simulate the compromised function and atrophy of lower limb muscles experienced by astronauts after spaceflight, 21 men and women age 30-56 yr were subjected to unilateral lower limb unloading for 5 wk. Whereas 10 of these subjects performed unilateral knee extensor resistance exercise (ULRE) two or three times weekly, 11 subjects (UL) refrained from training. The exercise regimen consisted of four sets of seven maximal actions, using an apparatus that offers concentric and eccentric resistance by utilizing the inertia of rotating flywheel(s). Knee extensor muscle strength was measured before and after UL and ULRE, and knee extensor and ankle plantar flexor muscle volumes were determined by means of magnetic resonance imaging. Surface electromyographic activity measured after UL inferred increased muscle use to perform a given motor task. UL induced an 8.8% decrease (P 0.05) strength. Ankle plantar flexor muscle volume of the unloaded limb decreased (P 0.05) in muscle volume or strength. The results of this study provide evidence that resistance exercise not only may offset muscle atrophy but is in fact capable of promoting marked hypertrophy of chronically unloaded muscle.

  9. The relation between pain extent and quality-of-life, psychological factors and neck funktion in patients with chronic neck pain

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Barbero, Marco; Falla, Deborah

    of Kinesiophobia (TSK), Beck Depression Inventory-II (BDI-ll), Neck Disability Index (NDI) and clinical tests: Craniocervical Flexion Test (CCFT), Cervical Extension Test (CE), and Cervical Range of Motion (CROM). Results: Significant positive correlations were observed between pain extent and NDI (r = 0.33; p... factors and/or decreased function of the involved body parts. Purpose: To study the relation between pain extent with 1) quality of life, 2) kinesiophobia, depression, 3) cervical muscle function and mobility and additionally the relation of pain extent with the origin of pain being traumatic or non...... to the origin being traumatic or non-traumatic. Conclusion: Pain extent extracted from pain drawings are moderately correlated with patient-reported neck function, and weakly correlated with depression, kinesiophobia and cervical clinical tests. In clinical decision-making, pain extent may indicate reduced neck...

  10. Comparative Effects of Acupressure at Local and Distal Acupuncture Points on Pain Conditions and Autonomic Function in Females with Chronic Neck Pain

    Directory of Open Access Journals (Sweden)

    Takako Matsubara

    2011-01-01

    Full Text Available Acupressure on local and distal acupuncture points might result in sedation and relaxation, thereby reducing chronic neck pain. The aim was to investigate the effect of acupressure at local (LP and distal acupuncture points (DP in females with chronic neck pain. Thirty-three females were assigned to three groups: the control group did not receive any stimuli, the LP group received acupressure at local acupuncture points, GB 21, SI 14 and SI 15, and the DP group received acupressure at distal acupuncture points, LI 4, LI 10 and LI 11. Verbal rating scale (VRS, Neck Disability Index (NDI, State-Trait Anxiety Inventory (STAI, muscle hardness (MH, salivary alpha-amylase (sAA activity, heart rate (HR, heart rate variability (HRV values and satisfaction due to acupressure were assessed. VRS, NDI, STAI and MH values decreased after acupressure in the LP and the DP group. HR decreased and the power of high frequency (HF component of HRV increased after acupressure in only the LP group. Although acupressure on not only the LP but also the DP significantly improved pain conditions, acupressure on only the LP affected the autonomic nervous system while acupuncture points per se have different physical effects according to location.

  11. CO-OCCURRENCE OF CHRONIC HEAD, FACE AND NECK PAIN, AND DEPRESSION IN WAR VETERANS WITH POST-TRAUMATIC STRESS DISORDER.

    Science.gov (United States)

    Muhvić-Urek, Miranda; Vukšić, Željka; Simonić-Kocijan, Sunčana; Braut, Vedrana; Braut, Alen; Uhač, Ivone

    2015-09-01

    This study investigated the relationship between chronic head, face and neck pain, and the level of depression in Croatian war veterans with post-traumatic stress disorder (PTSD). The presence of self-reported pain, pain on digital palpation, and pain severity in masticatory and neck muscles, temporomandibular joints and sinuses, as well as the level of depression were assessed in a group of war veterans with PTSD (n=52). Control groups consisted of war veterans without PTSD (n=50) and healthy men that were not engaged in war actions and were free from PTSD (n=50). The number of self-reported pain and number of painful sites were correlated with the level of depression. More self-reported pain and painful sites were recorded in the group of war veterans with PTSD as compared with either war veterans without PTSD or healthy men. Furthermore, PTSD patients mostly suffered from severe depression. There was a statistically significant positive correlation between all investigated pain parameters and level of depression. As the most important finding, the present study demonstrated chronic head, face and neck pain to be related to depression in PTSD patients.

  12. Ultrasound-Guided Miniscalpel-Needle Release versus Dry Needling for Chronic Neck Pain: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Yongjun Zheng

    2014-01-01

    Full Text Available Objective. To compare ultrasound-guided miniscalpel-needle (UG-MSN release versus ultrasound-guided dry needling (UG-DN for chronic neck pain. Methods. A total of 169 patients with chronic neck pain were randomized to receive either UG-MSN release or UG-DN. Before treatment and at 3 and 6 months posttreatment, pain was measured using a 10-point visual analogue scale (VAS. Neck function was examined using the neck disability index. Health-related quality of life was examined using the physical component score (PCS and mental component score (MCS of the SF-36 health status scale. Results. Patients in the UG-MSN release had greater improvement on the VAS (by 2 points at 3 months and 0.9 points at 6 months versus in the UG-DN arm; (both P<0.0001. Patients receiving UG-MSN release also showed significantly lower scores on the adjusted neck disability index, as well as significantly lower PCS. No severe complications were observed. Conclusion. UG-MSN release was superior to UG-DN in reducing pain intensity and neck disability in patients with chronic neck pain and was not associated with severe complications. The procedural aspects in the two arms were identical; however, we did not verify the blinding success. As such, the results need to be interpreted with caution.

  13. A study on the change of autophagy in skeletal muscle of patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    黄娟

    2013-01-01

    Objective To study skeletal muscle atrophy and the change of autophagy in skeletal muscle of patients with chronic kidney disease.Methods Mean muscle cross sectional area,mRNA and protein expression of

  14. Physiological Evaluation of Childcare-Associated Muscle Load on the Neck and Shoulder Region in Japanese Women

    Directory of Open Access Journals (Sweden)

    Saori Yoshinaga

    2016-01-01

    Full Text Available The awkward movements and postures associated with childcare activities can lead to musculoskeletal symptoms in the neck and shoulders. “Dakko” is a method for carrying a child in Japan, and recently it has been reported to cause shoulder stiffness. To our knowledge, the relationship between childcare activities and the physical load on the neck and shoulders is poorly understood. The present study aims to clarify the muscle load on the neck and shoulder region through dakko simulations. First, the association between dakko movements and trapezius muscle activity is clarified by image and electromyogram analyses. Based on this clarification, the distributions and intensity of the muscle load from repetitive dakko movements are clarified using myogenic potential topography. During dakko movements, trapezius muscle activity was observed when lifting up and setting down the child, but not when holding the child. For the repetitive movements, myogenic electrical potentials were observed in the trapezius region after movement load, and individual characteristics of participants were revealed in both the load distributions and the recovery process. Repetitive dakko movements likely induced sustained muscle tonus in the trapezius, which may be a factor related to shoulder stiffness.

  15. Physiological Evaluation of Childcare-Associated Muscle Load on the Neck and Shoulder Region in Japanese Women

    Science.gov (United States)

    Yoshinaga, Saori; Kiyokawa, Takuma; Kuramoto, Eriko; Kinoshita, Hiroe; Nemoto, Seiji

    2016-01-01

    The awkward movements and postures associated with childcare activities can lead to musculoskeletal symptoms in the neck and shoulders. “Dakko” is a method for carrying a child in Japan, and recently it has been reported to cause shoulder stiffness. To our knowledge, the relationship between childcare activities and the physical load on the neck and shoulders is poorly understood. The present study aims to clarify the muscle load on the neck and shoulder region through dakko simulations. First, the association between dakko movements and trapezius muscle activity is clarified by image and electromyogram analyses. Based on this clarification, the distributions and intensity of the muscle load from repetitive dakko movements are clarified using myogenic potential topography. During dakko movements, trapezius muscle activity was observed when lifting up and setting down the child, but not when holding the child. For the repetitive movements, myogenic electrical potentials were observed in the trapezius region after movement load, and individual characteristics of participants were revealed in both the load distributions and the recovery process. Repetitive dakko movements likely induced sustained muscle tonus in the trapezius, which may be a factor related to shoulder stiffness. PMID:27064421

  16. Acupuncture for chronic neck pain: a pilot for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Bland Martin J

    2006-12-01

    Full Text Available Abstract Background Acupuncture is increasingly being used for many conditions including chronic neck pain. However the evidence remains inconclusive, indicating the need for further well-designed research. The aim of this study was to conduct a pilot randomised controlled parallel arm trial, to establish key features required for the design and implementation of a large-scale trial on acupuncture for chronic neck pain. Methods Patients whose GPs had diagnosed neck pain were recruited from one general practice, and randomised to receive usual GP care only, or acupuncture (up to 10 treatments over 3 months as an adjunctive treatment to usual GP care. The primary outcome measure was the Northwick Park Neck Pain Questionnaire (NPQ at 3 months. The primary analysis was to determine the sample size for the full scale study. Results Of the 227 patients with neck pain identified from the GP database, 28 (12.3% consenting patients were eligible to participate in the pilot and 24 (10.5% were recruited to the trial. Ten patients were randomised to acupuncture, receiving an average of eight treatments from one of four acupuncturists, and 14 were randomised to usual GP care alone. The sample size for the full scale trial was calculated from a clinically meaningful difference of 5% on the NPQ and, from this pilot, an adjusted standard deviation of 15.3%. Assuming 90% power at the 5% significance level, a sample size of 229 would be required in each arm in a large-scale trial when allowing for a loss to follow-up rate of 14%. In order to achieve this sample, one would need to identify patients from databases of GP practices with a total population of 230,000 patients, or approximately 15 GP practices roughly equal in size to the one involved in this study (i.e. 15,694 patients. Conclusion This pilot study has allowed a number of recommendations to be made to facilitate the design of a large-scale trial, which in turn will help to clarify the existing evidence

  17. Cervicocephalic kinesthetic sensibility and postural balance in patients with nontraumatic chronic neck pain – a pilot study

    Directory of Open Access Journals (Sweden)

    Eriksson Magnus

    2009-06-01

    Full Text Available Abstract Background Although cervical pain is widespread, most victims are only mildly and occasionally affected. A minority, however, suffer chronic pain and/or functional impairments. Although there is abundant literature regarding nontraumatic neck pain, little focuses on diagnostic criteria. During the last decade, research on neck pain has been designed to evaluate underlying pathophysiological mechanisms, without noteworthy success. Independent researchers have investigated postural balance and cervicocephalic kinesthetic sensibility among patients with chronic neck pain, and have (in most cases concluded the source of the problem is a reduced ability in the neck's proprioceptive system. Here, we investigated cervicocephalic kinesthetic sensibility and postural balance among patients with nontraumatic chronic neck pain. Methods Ours was a two-group, observational pilot study of patients with complaints of continuous neck pain during the 3 months prior to recruitment. Thirteen patients with chronic neck pain of nontraumatic origin were recruited from an institutional outpatient clinic. Sixteen healthy persons were recruited as a control group. Cervicocephalic kinesthetic sensibility was assessed by exploring head repositioning accuracy and postural balance was measured with computerized static posturography. Results Parameters of cervicocephalic kinesthetic sensibility were not reduced. However, in one of six test movements (flexion, global repositioning errors were significantly larger in the experimental group than in the control group (p Conclusion In patients with nontraumatic chronic neck pain, we found statistically significant global repositioning errors in only one of six test movements. In this cohort, we found no evidence of impaired postural balance. Head repositioning accuracy and computerized static posturography are imperfect measures of functional proprioceptive impairments. Validity of (and procedures for using these

  18. Acupuncture for chronic neck pain--a cohort study in an NHS pain clinic.

    Science.gov (United States)

    Blossfeldt, Patrick

    2004-09-01

    The study investigates the outcome of acupuncture for chronic neck pain in a cohort of patients referred to an NHS chronic pain clinic. One hundred and seventy two patients were selected for acupuncture over a period of 6.5 years. Treatment was given by a single acupuncturist and consisted of a course of needle acupuncture for an average of seven sessions per patient. Treatment outcome was measured by an oral rating scale of improvement at the end of treatment and at follow up six months and one year after treatment. Nineteen patients were withdrawn from treatment for various reasons, two for adverse events. One hundred and fifty three patients were evaluated, of whom 68% had a successful outcome from acupuncture, reporting an improvement in pain of at least 50%. The success rate was higher in patients with a short duration of pain: 85% in patients with pain for up to three months and 78% with pain for up to six months. Long-term follow up showed that 49% of the patients who completed treatment had maintained the benefit after six months, and 40% at one year. The results indicate that acupuncture can be an effective treatment for selected patients with chronic neck pain.

  19. An Investigation into Reliability of Knee Extension Muscle Strength Measurements, and into the Relationship between Muscle Strength and Means of Independent Mobility in the Ward: Examinations of Patients Who Underwent Femoral Neck Fracture Surgery

    OpenAIRE

    Katoh, Munenori; Kaneko, Yoshihiro

    2014-01-01

    [Purpose] The purpose of the present study was to investigate the reliability of isometric knee extension muscle strength measurement of patients who underwent femoral neck fracture surgery, as well as the relationship between independent mobility in the ward and knee muscle strength. [Subjects] The subjects were 75 patients who underwent femoral neck fracture surgery. [Methods] We used a hand-held dynamometer and a belt to measure isometric knee extension muscle strength three times, and use...

  20. [Bilateral quadriceps tendon rupture and coexistent femoral neck fracture in a patient with chronic renal failure].

    Science.gov (United States)

    Kazimoğlu, Cemal; Yağdi, Serhan; Karapinar, Hasan; Sener, Muhittin

    2007-01-01

    Simultaneous bilateral quadriceps tendon rupture is a very rare injury mostly seen in patients with chronic renal failure or other systemic chronic diseases. Metabolic acidosis in chronic renal failure predisposes these patients to tendon degeneration. A 37-year-old woman who received hemodialysis for chronic renal failure for two years presented with complaints of severe pain in the left hip and inability to walk. She had a history of two consecutive falls in the past two months. On physical examination, there were joint spaces in both suprapatellar areas, active extension of both knees was inhibited, and movements of the left hip were quite painful. Knee ultrasonography and magnetic resonance imaging showed bilateral quadriceps tendon rupture from patellar attachment. At surgery, full-thickness quadriceps tendon tears were repaired with Tycron transpatellar suture anchors. Internal fixation was not considered for hip fracture due to the presence of chronic renal failure, so hemiarthroplasty with bipolar endoprosthesis was performed in the same session for femoral neck fracture. Six months after the operation, the patient was able to walk without support and almost regained her normal knee functions.

  1. Influence of Cervical Muscle Fatigue on Musculo-Tendinous Stiffness of the Head-Neck Segment during Cervical Flexion.

    Directory of Open Access Journals (Sweden)

    Raphaël Portero

    Full Text Available The aim of this study is to determine if the fatigue of cervical muscles has a significant influence on the head-neck segment musculo-tendinous stiffness.Ten men (aged 21.2 ± 1.9 years performed four quick-release trials of flexion at 30 and 50% MVC before and after the induction of muscular fatigue on cervical flexors. Electromyographic activity was recorded on the sternocleidomastoids (SCM and spinal erectors (SE, bilaterally. Musculo-tendinous stiffness was calculated through the quick-release method adapted to the head-neck segment.We noticed a significant linear increase of the head-neck segment musculo-tendinous stiffness with the increase of exertion level both before (P < 0.0001 and after the fatigue procedure (P < 0.0001. However, this linear relationship was not different before and after the fatigue procedure. EMG analysis revealed a significant increase of the root mean square for the right SCM (P = 0.0002, the left SCM (P < 0.0001, the right SE (P < 0.0001, and the left SE (P < 0.0001 and a significant decrease of the median power frequency only for the right (P = 0.0006 and the left (P = 0.0003 SCM with muscular fatigue.We did not find significant changes in the head-neck segment musculo-tendinous stiffness with fatigue of cervical muscles. We found a significant increase in EMG activity in the SCM and the SE after the induction of fatigue of the SCM. Our findings suggest that with fatigue of cervical flexors, neck muscle activity is modulated in order to maintain the musculo-tendinous stiffness at a steady state.

  2. Skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ho Cheol Kim

    2009-01-01

    Full Text Available Ho Cheol Kim1, Mahroo Mofarrahi2, Sabah NA Hussain21Department of Internal Medicine, College of Medicine, Gyeongsang National University, Gyeongsang University Hospital, Jinju, Korea; 2Critical Care and Respiratory Divisions, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, CanadaAbstract: Chronic obstructive pulmonary disease (COPD is a debilitating disease characterized by inflammation-induced airflow limitation and parenchymal destruction. In addition to pulmonary manifestations, patients with COPD develop systemic problems, including skeletal muscle and other organ-specific dysfunctions, nutritional abnormalities, weight loss, and adverse psychological responses. Patients with COPD often complain of dyspnea on exertion, reduced exercise capacity, and develop a progressive decline in lung function with increasing age. These symptoms have been attributed to increases in the work of breathing and in impairments in gas exchange that result from airflow limitation and dynamic hyperinflation. However, there is mounting evidence to suggest that skeletal muscle dysfunction, independent of lung function, contributes significantly to reduced exercise capacity and poor quality of life in these patients. Limb and ventilatory skeletal muscle dysfunction in COPD patients has been attributed to a myriad of factors, including the presence of low grade systemic inflammatory processes, nutritional depletion, corticosteroid medications, chronic inactivity, age, hypoxemia, smoking, oxidative and nitrosative stresses, protein degradation and changes in vascular density. This review briefly summarizes the contribution of these factors to overall skeletal muscle dysfunction in patients with COPD, with particular attention paid to the latest advances in the field.Keywords: skeletal muscles, chronic obstructive pulmonary disease, diaphragm, quadriceps, fatigue, disuse, atrophy, smoking, exercise

  3. Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Ge, Hong-You; Arendt-Nielsen, Lars; Cuadrado, Maria Luz; Pareja, Juan A

    2007-05-01

    Referred pain and pain characteristics evoked from the upper trapezius muscle was investigated in 20 patients with chronic tension-type headache (CTTH) and 20 age- and gender-matched controls. A headache diary was kept for 4 weeks in order to confirm the diagnosis and record the pain history. Both upper trapezius muscles were examined for the presence of myofascial trigger points (TrPs) in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold (PPT) were recorded. The results show that referred pain was evoked in 85% and 50% on the dominant and non-dominant sides in CTTH patients, much higher than 55% and 25% in controls (P<0.01). Referred pain spread to the posterior-lateral aspect of the neck ipsi-lateral to the stimulated muscle in both patients and controls, with additional referral to the temple in most patients, but none in controls. Nearly half of the CTTH patients (45%) recognized the referred pain as their usual headache sensation, i.e. active TrPs. CTTH patients with active TrPs in the right upper trapezius muscle showed greater headache intensity and frequency, and longer headache duration than those with latent TrPs. CTTH patients with bilateral TrPs reported significantly decreased PPT than those with unilateral TrP (P<0.01). Our results showed that manual exploration of TrPs in the upper trapezius muscle elicited referred pain patterns in both CTTH patients and healthy subjects. In CTTH patients, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual headache pain, consistent with active TrPs. Our results suggest that spatial summation of perceived pain and mechanical pain sensitivity exists in CTTH patients.

  4. Subcutaneous immunoglobulin preserves muscle strength in chronic inflammatory demyelinating polyneuropathy

    DEFF Research Database (Denmark)

    Markvardsen, L H; Harbo, T; Sindrup, S H;

    2014-01-01

    BACKGROUND AND PURPOSE: Subcutaneous immunoglobulin (SCIG) is superior to placebo treatment for maintenance of muscle strength during 12 weeks in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). The present study evaluated whether SCIG preserves muscle strength for 1 year...... in an open-label follow-up study. METHODS: Seventeen responders to intravenous immunoglobulin (IVIG) who had participated in the previous study of SCIG versus placebo in CIDP were included. After one IVIG infusion 2 weeks prior to baseline, all continued on SCIG treatment at weekly equal dosage and were...... remained unchanged. CONCLUSION: SCIG preserves muscle strength and functional ability in patients with CIDP who previously responded to IVIG. SCIG should be considered as an alternative in long-term treatment of CIDP patients....

  5. Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: Design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Hansen Inge

    2011-12-01

    Full Text Available Abstract Background Many patients suffer from chronic neck pain following a whiplash injury. A combination of cognitive, behavioural therapy with physiotherapy interventions has been indicated to be effective in the management of patients with chronic whiplash-associated disorders. The objective is to present the design of a randomised controlled trial (RCT aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline. Methods/Design The design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited from physiotherapy clinics and an out-patient hospital department in Denmark. Patients will be randomised to either a pain management (control group or a combined pain management and training (interventiongroup. The control group will receive four educational sessions on pain management, whereas the intervention group will receive the same educational sessions on pain management plus 8 individual training sessions for 4 months, including guidance in specific neck exercises and an aerobic training programme. Patients and physiotherapists are aware of the allocation and the treatment, while outcome assessors and data analysts are blinded. The primary outcome measures will be Medical Outcomes Study Short Form 36 (SF36, Physical Component Summary (PCS. Secondary outcomes will be Global Perceived Effect (-5 to +5, Neck Disability Index (0-50, Patient Specific Functioning Scale (0-10, numeric rating scale for pain bothersomeness (0-10, SF-36 Mental Component Summary (MCS, TAMPA scale of Kinesiophobia (17-68, Impact of Event Scale (0-45, EuroQol (0

  6. The head and neck muscles of the serval and tiger: homologies, evolution, and proposal of a mammalian and a veterinary muscle ontology.

    Science.gov (United States)

    Diogo, Rui; Pastor, Francisco; De Paz, Felix; Potau, Josep M; Bello-Hellegouarch, Gaëlle; Ferrero, Eva M; Fisher, Rebecca E

    2012-12-01

    Here we describe the head and neck muscles of members of the two extant felid subfamilies (Leptailurus serval: Felinae; Panthera tigris: Pantherinae) and compare these muscles with those of other felids, other carnivorans (e.g., domestic dogs), other eutherian mammals (e.g., rats, tree-shrews and modern humans), and noneutherian mammals including monotremes. Another major goal of the article is to discuss and help clarify nomenclatural discrepancies found in the Nomina Anatomica Veterinaria and in veterinary atlases and textbooks that use cats and dogs as models to understand the anatomy of domestic mammals and to stress differences with modern humans. We propose a unifying nomenclature that is expanded to all the head and neck muscles and to all mammalian taxa in order to help build veterinary and mammalian muscle ontologies. Our observations and comparisons and the specific use of this nomenclature point out that felids such as tigers and servals and other carnivorans such as dogs have more facial muscle structures related to the mobility of both the auricular and orbital regions than numerous other mammals, including modern humans, which might be the result of an ancient adaptation related to the remarkable predatory capacities of carnivorans. Interestingly, the skeletal differences, mainly concerning the hyoid apparatus, pharynx, and larynx, that are likely associated with the different types of vocalizations seen in the Felinae (mainly purring) and Pantherinae (mainly roaring) are not accompanied by clear differences in the musculature connected to these structures in the feline L. serval and the pantherine P. tigris.

  7. Quantify work load and muscle functional activation patterns in neck-shoulder muscles of female sewing machine operators using surface electromyogram

    Institute of Scientific and Technical Information of China (English)

    ZHANG Fei-ruo; HE Li-hua; WU Shan-shan; LI Jing-yun; YE Kang-pin; WANG Sheng

    2011-01-01

    Background Work-related musculoskeletal disorders (WMSDs) have high prevalence in sewing machine operators employed in the garment industry.Long work duration,sustained low level work and precise hand work are the main risk factors of neck-shoulder disorders for sewing machine operators.Surface electromyogram (sEMG) offers a valuable tool to determine muscle activity (internal exposure) and quantify muscular load (external exposure).During sustained and/or repetitive muscle contractions,typical changes of muscle fatigue in sEMG,as an increase in amplitude or a decrease as a shift in spectrum towards lower frequencies,can be observed.In this paper,we measured and quantified the muscle load and muscular activity patterns of neck-shoulder muscles in female sewing machine operators during sustained sewing machine operating tasks using sEMG.Methods A total of 18 healthy women sewing machine operators volunteered to participate in this study.Before their daily sewing machine operating task,we measured the maximal voluntary contractions (MVC) and 20%MVC of bilateral cervical erector spinae (CES) and upper trapezius (UT) respectively,then the sEMG signals of bilateral UT and CES were monitored and recorded continuously during 200 minutes of sustained sewing machine operating simultaneously which equals to 20 time windows with 10 minutes as one time window.After 200 minutes' work,we retest 20%MVC of four neck-shoulder muscles and recorded the sEMG signals.Linear analysis,including amplitude probability distribution frequency (APDF),amplitude analysis parameters such as roof mean square (RMS) and spectrum analysis parameter as median frequency (MF),were used to calculate and indicate muscle load and muscular activity of bilateral CES and UT.Results During 200 minutes of sewing machine operating,the median load for the left cervical erector spinae (LCES),right cervical erector spinae (RCES),left upper trapezius (LUT) and right upper trapezius (RUT) were 6.78%MVE,6.94

  8. Effectiveness of behavioural graded activity compared with physiotherapy treatment in chronic neck pain: design of a randomised clinical trial [ISRCTN88733332].

    NARCIS (Netherlands)

    F. Vonk (Frieke); A.P. Verhagen (Arianne); M. Geilen (Mario); C.J. Vos (Kees); B.W. Koes (Bart)

    2004-01-01

    textabstractBACKGROUND: Chronic neck pain is a common complaint in the Netherlands with a point prevalence of 14.3%. Patients with chronic neck pain are often referred to a physiotherapist and, although many treatments are available, it remains unclear which type of treatment is to

  9. Chronic Neck Pain and Cervico-Craniofacial Pain Patients Express Similar Levels of Neck Pain-Related Disability, Pain Catastrophizing, and Cervical Range of Motion

    Directory of Open Access Journals (Sweden)

    Daniel Muñoz-García

    2016-01-01

    Full Text Available Background. Neck pain (NP is strongly associated with cervico-craniofacial pain (CCFP. The primary aim of the present study was to compare the neck pain-related disability, pain catastrophizing, and cervical and mandibular ROM between patients with chronic mechanical NP and patients with CCFP, as well as asymptomatic subjects. Methods. A total of 64 participants formed three groups. All participants underwent a clinical examination evaluating the cervical range of motion and maximum mouth opening, neck disability index (NDI, and psychological factor of Pain Catastrophizing Scale (PCS. Results. There were no statistically significant differences between patients with NP and CCFP for NDI and PCS (P>0.05. One- way ANOVA revealed significant differences for all ROM measurements. The post hoc analysis showed no statistically significant differences in cervical extension and rotation between the two patient groups (P>0.05. The Pearson correlation analysis shows a moderate positive association between NDI and the PCS for the group of patients with NP and CCFP. Conclusion. The CCFP and NP patient groups have similar neck disability levels and limitation in cervical ROM in extension and rotation. Both groups had positively correlated the NDI with the PCS.

  10. Chronic Neck Pain and Cervico-Craniofacial Pain Patients Express Similar Levels of Neck Pain-Related Disability, Pain Catastrophizing, and Cervical Range of Motion.

    Science.gov (United States)

    Muñoz-García, Daniel; Gil-Martínez, Alfonso; López-López, Almudena; Lopez-de-Uralde-Villanueva, Ibai; La Touche, Roy; Fernández-Carnero, Josué

    2016-01-01

    Background. Neck pain (NP) is strongly associated with cervico-craniofacial pain (CCFP). The primary aim of the present study was to compare the neck pain-related disability, pain catastrophizing, and cervical and mandibular ROM between patients with chronic mechanical NP and patients with CCFP, as well as asymptomatic subjects. Methods. A total of 64 participants formed three groups. All participants underwent a clinical examination evaluating the cervical range of motion and maximum mouth opening, neck disability index (NDI), and psychological factor of Pain Catastrophizing Scale (PCS). Results. There were no statistically significant differences between patients with NP and CCFP for NDI and PCS (P > 0.05). One- way ANOVA revealed significant differences for all ROM measurements. The post hoc analysis showed no statistically significant differences in cervical extension and rotation between the two patient groups (P > 0.05). The Pearson correlation analysis shows a moderate positive association between NDI and the PCS for the group of patients with NP and CCFP. Conclusion. The CCFP and NP patient groups have similar neck disability levels and limitation in cervical ROM in extension and rotation. Both groups had positively correlated the NDI with the PCS.

  11. Chronic Neck Pain and Cervico-Craniofacial Pain Patients Express Similar Levels of Neck Pain-Related Disability, Pain Catastrophizing, and Cervical Range of Motion

    Science.gov (United States)

    Muñoz-García, Daniel; Gil-Martínez, Alfonso; López-López, Almudena; Lopez-de-Uralde-Villanueva, Ibai; La Touche, Roy; Fernández-Carnero, Josué

    2016-01-01

    Background. Neck pain (NP) is strongly associated with cervico-craniofacial pain (CCFP). The primary aim of the present study was to compare the neck pain-related disability, pain catastrophizing, and cervical and mandibular ROM between patients with chronic mechanical NP and patients with CCFP, as well as asymptomatic subjects. Methods. A total of 64 participants formed three groups. All participants underwent a clinical examination evaluating the cervical range of motion and maximum mouth opening, neck disability index (NDI), and psychological factor of Pain Catastrophizing Scale (PCS). Results. There were no statistically significant differences between patients with NP and CCFP for NDI and PCS (P > 0.05). One- way ANOVA revealed significant differences for all ROM measurements. The post hoc analysis showed no statistically significant differences in cervical extension and rotation between the two patient groups (P > 0.05). The Pearson correlation analysis shows a moderate positive association between NDI and the PCS for the group of patients with NP and CCFP. Conclusion. The CCFP and NP patient groups have similar neck disability levels and limitation in cervical ROM in extension and rotation. Both groups had positively correlated the NDI with the PCS. PMID:27119020

  12. The efficacy of intermittent cervical traction in patents with chronic neck pain.

    Science.gov (United States)

    Borman, Pinar; Keskin, Dilek; Ekici, Betul; Bodur, Hatice

    2008-10-01

    Previous studies about the usefulness of traction therapy have concluded with conflicting results. The aim of this study was to examine its efficacy in chronic neck pain. Forty-two patients with at least 6 weeks of nonspecific neck pain were selected for the study. Data about demographic characteristics including age, sex, body mass index, duration of cervical pain, working status, smoking status, and regular exercise were recorded. Each patient was randomly assigned to Group 1-receiving only standard physical therapy including hot pack, ultrasound therapy and exercise program and Group 2-treated with traction therapy in addition to standard physical therapy. The patients were reevaluated at the end of the therapy. The main outcome measures of the treatment were pain intensity by visual analog scale (VAS), disability by neck disability index (NDI), and quality of life assessed by Nottingham Health Profile (NHP). Twenty-four female and 18 male patients with mean age of 48.2+/-11.5 years and a mean disease duration of 4.3+/-2.9 years were included to the study. There were no differences between the groups in terms of age, sex, pain intensity, and scores of NHP and NDI at entry. There were 21 patients in both groups. Both groups improved significantly in pain intensity and the scores of NDI and physical subscles of NHP at the end of the therapies (ppain scores in both groups (pneck pain. We suggest the clinicians to consider this condition and to focus on exercise therapy in the management of patients suffering from this condition.

  13. Does a combination of physical training, specific exercises and pain education improve health-related quality of life in patients with chronic neck pain? A randomised control trial with a 4-month follow up

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Søgaard, Karen; Gram, Bibi;

    2016-01-01

    anterior and cervical spine, Cranio-cervical Flexion, Cervical Extension muscle function, and oculomotion) were recorded at baseline and after 4 months. Results The exercise group showed statistically significant improvement in physical HR-QoL, mental HR-QoL, depression, cervical pressure pain threshold......Qol-5D, Beck Depression Inventory-II, Neck Disability Index, Pain Bothersomeness, Patient-Specific Functioning Scale, Tampa Scale of Kinesiophobia, Global Perceived Effect) and clinical tests (Aastrand Physical Fitness, cervical Range of Motion, Pressure Pain Threshold at infraspinatus, tibialis......, cervical extension movement, muscle function, and oculomotion. Per protocol analyses confirmed these results with additional significant improvements in the exercise group compared with controls. Conclusions This multimodal intervention may be an effective intervention for chronic neck pain patients...

  14. The Effectiveness of Cupping Therapy on Relieving Chronic Neck and Shoulder Pain: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Lee-Mei Chi

    2016-01-01

    Full Text Available The research aimed to investigate the effectiveness of cupping therapy (CT in changes on skin surface temperature (SST for relieving chronic neck and shoulder pain (NSP among community residents. A single-blind experimental design constituted of sixty subjects with self-perceived NSP. The subjects were randomly allocated to two groups. The cupping group received CT at SI 15, GB 21, and LI 15 acupuncture points, and the control group received no intervention. Pain was assessed using the SST, visual analog scale (VAS, and blood pressure (BP. The main results were SST of GB 21 acupuncture point raised from 30.6°C to 32.7°C and from 30.7°C to 30.6°C in the control group. Neck pain intensity (NPI severity scores were reduced from 9.7 to 3.6 in the cupping group and from 9.7 to 9.5 in the control group. The SST and NPI differences between the groups were statistically significant (P < 0.001. One treatment of CT is shown to increase SST. In conjunction with the physiological effect the subjective experience of NSP is reduced in intensity. Further studies are required to improve the understanding and potential long-term effects of CT.

  15. The Effectiveness of Cupping Therapy on Relieving Chronic Neck and Shoulder Pain: A Randomized Controlled Trial.

    Science.gov (United States)

    Chi, Lee-Mei; Lin, Li-Mei; Chen, Chien-Lin; Wang, Shu-Fang; Lai, Hui-Ling; Peng, Tai-Chu

    2016-01-01

    The research aimed to investigate the effectiveness of cupping therapy (CT) in changes on skin surface temperature (SST) for relieving chronic neck and shoulder pain (NSP) among community residents. A single-blind experimental design constituted of sixty subjects with self-perceived NSP. The subjects were randomly allocated to two groups. The cupping group received CT at SI 15, GB 21, and LI 15 acupuncture points, and the control group received no intervention. Pain was assessed using the SST, visual analog scale (VAS), and blood pressure (BP). The main results were SST of GB 21 acupuncture point raised from 30.6°C to 32.7°C and from 30.7°C to 30.6°C in the control group. Neck pain intensity (NPI) severity scores were reduced from 9.7 to 3.6 in the cupping group and from 9.7 to 9.5 in the control group. The SST and NPI differences between the groups were statistically significant (P < 0.001). One treatment of CT is shown to increase SST. In conjunction with the physiological effect the subjective experience of NSP is reduced in intensity. Further studies are required to improve the understanding and potential long-term effects of CT.

  16. Sensory and sympathetic disorders in chronic non-specific neck pain.

    Science.gov (United States)

    Zaproudina, Nina; Ming, Zhiyong; Närhi, Matti

    2015-01-01

    The signs of sympathetic and sensory nerve-related disorders are not widely investigated in chronic nonspecific neck pain (NNP) patients. Thus, we performed skin temperature (Tsk), evaporation and touch threshold (TT) measurements to reveal possible dysfunctions at the fingertips of NNP patients (n=60) compared with healthy controls (n=11). Neck pain intensity was the main modifier of Tsk, and age the main modifier of TT in a multivariate model. On comparisons of the subgroups of NNP patients with unilateral (n=26) and bilateral (n=34) symptoms and controls, TT differed and Tsk tended to differ, the unilateral pain patients being found to demonstrate higher TT values on both sides. Interrelations between the measured parameters were found in the controls, but not in the patients. The NNP patients exhibited signs of functional impairment of innervation reflected in changes in tactile sensitivity and vasoactive sympathetic function. These changes may be based on both central and peripheral mechanisms, which possibly differ in patients with unilateral and bilateral symptoms.

  17. Effect of Chinese tuina massage therapy on resting state brain functional network of patients with chronic neck pain

    Directory of Open Access Journals (Sweden)

    Hua Zhang

    2015-01-01

    Conclusion: Chronic neck pain caused by cervical radiculopathy may influence the DMN, which plays an important role in emotion, cognition, and memory, by stimulating the sensory afferent network. Tuina not only significantly relieves pain and discomfort, but also reverses the causality between aDMN and SMN.

  18. A unilateral open door laminoplasty technique: prospective analysis of the relationship between midline extensor muscle preservation and postoperative neck pain.

    Science.gov (United States)

    Park, Jin Hoon; Jeong, Eui-Kyun; Lee, Moon Kyu; Chul Rhim, Seung; Roh, Sung Woo; Kim, Jeoung Hee; Jeon, Sang Ryong

    2015-02-01

    Since laminoplasty was first introduced, several techniques have been developed to reduce postoperative neck pain and progressive kyphosis following this procedure. We describe the importance of deep muscle preservation to prevent postoperative neck pain following cervical posterior surgery, using the inter-muscular plane. We performed cervical laminoplasty on 10 patients from March to July 2012. The mean follow-up duration was 14.6 (range 12-18) months, and the mean age was 58.8 (48-68) years. There were eight men and two women in the study cohort, which consisted of eight cases of cervical spondylotic myelopathy and two cases of ossification of the posterior longitudinal ligament. The Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) score were assessed before and at 6 and 12 months after surgery. The numeric rating scale (NRS) for neck pain was evaluated at 1, 3, 6, and 12 months after surgery. CT scan was performed immediately after the operation, and a radiograph was performed preoperatively and during the follow-up evaluation at 1, 3, 6, and 12 months after surgery. The preoperative JOA and NDI scores improved in all patients. Although there were two patients who complained of moderate postoperative neck pain (NRS 4 and 5), their condition gradually improved. Seven patients had mild or no neck pain (below NRS 3) at the 12 month follow-up. In addition, the cervical alignment was well maintained in all but one patient. Although larger prospective cohorts, longer follow-up periods, and comparative analyses are still needed, the clinical and radiological outcomes observed in the short 12 month period in this small cohort are promising.

  19. Neck pain

    OpenAIRE

    2002-01-01

    Non-specific neck pain has a postural or mechanical basis, and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but becomes chronic in about 10% of people.Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident.

  20. The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Simons, David; Cuadrado, Maria Luz; Pareja, Juan

    2007-10-01

    Neck and head pain syndromes are common problems seen in clinical practice. Pain features of commonly designated idiopathic neck pain and some primary headaches (ie, tension-type headache or migraine) fit the descriptions of referred pain originating in muscle trigger points (TrPs). This article discusses the scientific evidence supporting the role of muscle TrPs in chronic musculo-skeletal disorders of the neck and head. The relevance of referred pain elicited by muscle TrPs in patients with neck pain has been investigated in few studies. Some authors found that both muscle TrPs in neck-shoulder muscles and cervical joint dysfunctions contribute at the same time to neck pain perception. Furthermore, it seems that referred pain originated in muscle TrPs could also contribute to neck symptoms perceived by subjects after a rear-end crash. In addition, several recent studies reported that both TTH and migraine are associated with referred pain from TrPs in the suboccipital, upper trapezius, sternocleidomastoid, temporalis, or superior oblique muscles. Referred pain elicited by active TrPs mimics the pain areas observed during head pain attacks in these primary headaches. Based on available data, it seems that the pain profile of neck and head syndromes may be provoked referred pain from TrPs in the posterior cervical, head, and shoulder muscles. Additional studies are needed to delineate more information on the relation between muscle TrPs and musculoskeletal pain syndromes of the head and neck.

  1. Neck of Femur Fracture in a Patient with a Chronic Osteomyelitis of the Ipsilateral Foot

    Directory of Open Access Journals (Sweden)

    Anne-Carolin Döring

    2016-01-01

    Full Text Available This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis. Treating patients with this type of comorbidities is challenging; therapeutic dilemmas can be major. The management in cases like these requires a thorough evaluation and a clear surgical and medical treatment plan, preferably conducted by a multidisciplinary orthogeriatric team.

  2. Neck of Femur Fracture in a Patient with a Chronic Osteomyelitis of the Ipsilateral Foot

    Science.gov (United States)

    Döring, Anne-Carolin; Vochteloo, Anne J. H.; van Doorn, Kees; Huis in 't Veld, Rianne M. H. A.

    2016-01-01

    This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis. Treating patients with this type of comorbidities is challenging; therapeutic dilemmas can be major. The management in cases like these requires a thorough evaluation and a clear surgical and medical treatment plan, preferably conducted by a multidisciplinary orthogeriatric team. PMID:27843662

  3. Single cell morphology of muscle in patients with chronic muscle pain

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Bartels, E M; Danneskiold-Samsøe, B

    1991-01-01

    In 119 patients referred with suspected fibromyalgia, biopsies from the quadriceps muscle were analyzed for "rubber band" morphology, and isokinetic quadriceps strength was measured. Eighty-four fulfilled the criteria for fibromyalgia, 26 had chronic myofascial pain (CMP) and 9 had other diseases...... to the biopsy score. "Rubber band" morphology is seen more often in fibromyalgia patients than in CMP patients. The exact genesis of this phenomenon is still unknown but theories connected with the possible pathogenesis of the syndrome are presented....

  4. Meyer’s Muscle Pedicle Bone Graft a Novel Procedure in Treatment of Neglected Fracture Neck of Femur in Pediatric Age Group-A Case Report

    Science.gov (United States)

    Ponnanna, KM; Mannual, Sunil

    2016-01-01

    Meyers muscle pedicle graft has been used in delayed presentation and non-union of neck femur fracture in adults with good results. Delayed presentation or non-union neck femur in children is not uncommon in children. Subtrochanteric valgus osteotomy with or without fixation has been suggested with varying results. We present meyers muscle graft being used in paediatric age group with excellent result at 3 years follow-up. There are limited report literature of meyers muscle pedicle graft being used in children. PMID:27790536

  5. Interactive cervical motion kinematics: sensitivity, specificity and clinically significant values for identifying kinematic impairments in patients with chronic neck pain.

    Science.gov (United States)

    Sarig Bahat, Hilla; Chen, Xiaoqi; Reznik, David; Kodesh, Einat; Treleaven, Julia

    2015-04-01

    Chronic neck pain has been consistently shown to be associated with impaired kinematic control including reduced range, velocity and smoothness of cervical motion, that seem relevant to daily function as in quick neck motion in response to surrounding stimuli. The objectives of this study were: to compare interactive cervical kinematics in patients with neck pain and controls; to explore the new measures of cervical motion accuracy; and to find the sensitivity, specificity, and optimal cutoff values for defining impaired kinematics in those with neck pain. In this cross-section study, 33 patients with chronic neck pain and 22 asymptomatic controls were assessed for their cervical kinematic control using interactive virtual reality hardware and customized software utilizing a head mounted display with built-in head tracking. Outcome measures included peak and mean velocity, smoothness (represented by number of velocity peaks (NVP)), symmetry (represented by time to peak velocity percentage (TTPP)), and accuracy of cervical motion. Results demonstrated significant and strong effect-size differences in peak and mean velocities, NVP and TTPP in all directions excluding TTPP in left rotation, and good effect-size group differences in 5/8 accuracy measures. Regression results emphasized the high clinical value of neck motion velocity, with very high sensitivity and specificity (85%-100%), followed by motion smoothness, symmetry and accuracy. These finding suggest cervical kinematics should be evaluated clinically, and screened by the provided cut off values for identification of relevant impairments in those with neck pain. Such identification of presence or absence of kinematic impairments may direct treatment strategies and additional evaluation when needed.

  6. Abdominal muscle fatigue following exercise in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Moxham John

    2010-02-01

    Full Text Available Abstract Background In patients with chronic obstructive pulmonary disease, a restriction on maximum ventilatory capacity contributes to exercise limitation. It has been demonstrated that the diaphragm in COPD is relatively protected from fatigue during exercise. Because of expiratory flow limitation the abdominal muscles are activated early during exercise in COPD. This adds significantly to the work of breathing and may therefore contribute to exercise limitation. In healthy subjects, prior expiratory muscle fatigue has been shown itself to contribute to the development of quadriceps fatigue. It is not known whether fatigue of the abdominal muscles occurs during exercise in COPD. Methods Twitch gastric pressure (TwT10Pga, elicited by magnetic stimulation over the 10th thoracic vertebra and twitch transdiaphragmatic pressure (TwPdi, elicited by bilateral anterolateral magnetic phrenic nerve stimulation were measured before and after symptom-limited, incremental cycle ergometry in patients with COPD. Results Twenty-three COPD patients, with a mean (SD FEV1 40.8(23.1% predicted, achieved a mean peak workload of 53.5(15.9 W. Following exercise, TwT10Pga fell from 51.3(27.1 cmH2O to 47.4(25.2 cmH2O (p = 0.011. TwPdi did not change significantly; pre 17.0(6.4 cmH2O post 17.5(5.9 cmH2O (p = 0.7. Fatiguers, defined as having a fall TwT10Pga ≥ 10% had significantly worse lung gas transfer, but did not differ in other exercise parameters. Conclusions In patients with COPD, abdominal muscle but not diaphragm fatigue develops following symptom limited incremental cycle ergometry. Further work is needed to establish whether abdominal muscle fatigue is relevant to exercise limitation in COPD, perhaps indirectly through an effect on quadriceps fatigability.

  7. High-Intensity Strength Training Improves Function of Chronically Painful Muscles: Case-Control and RCT Studies

    Directory of Open Access Journals (Sweden)

    Lars L. Andersen

    2014-01-01

    Full Text Available Aim. This study investigates consequences of chronic neck pain on muscle function and the rehabilitating effects of contrasting interventions. Methods. Women with trapezius myalgia (MYA, n=42 and healthy controls (CON, n=20 participated in a case-control study. Subsequently MYA were randomized to 10 weeks of specific strength training (SST, n=18, general fitness training (GFT, n=16, or a reference group without physical training (REF, n=8. Participants performed tests of 100 consecutive cycles of 2 s isometric maximal voluntary contractions (MVC of shoulder elevation followed by 2 s relaxation at baseline and 10-week follow-up. Results. In the case-control study, peak force, rate of force development, and rate of force relaxation as well as EMG amplitude were lower in MYA than CON throughout all 100 MVC. Muscle fiber capillarization was not significantly different between MYA and CON. In the intervention study, SST improved all force parameters significantly more than the two other groups, to levels comparable to that of CON. This was seen along with muscle fiber hypertrophy and increased capillarization. Conclusion. Women with trapezius myalgia have lower strength capacity during repetitive MVC of the trapezius muscle than healthy controls. High-intensity strength training effectively improves strength capacity during repetitive MVC of the painful trapezius muscle.

  8. The therapeutic effects of acupuncture on patients with chronic neck myofascial pain syndrome: a single-blind randomized controlled trial.

    Science.gov (United States)

    Sun, Mei-Yuan; Hsieh, Ching-Liang; Cheng, Yung-Yen; Hung, Hung-Chang; Li, Tsai-Chung; Yen, Sch-May; Huang, I-Shin

    2010-01-01

    Chronic neck myofascial pain syndrome (MPS) is a common disorder seen in clinics. There is no gold standard method to treat myofascial pain. We investigated the effects of acupuncture on patients with chronic neck MPS by a single-blind randomized controlled trial. A total of 35 patients were randomly allocated to an acupuncture group (AG) or a sham acupuncture group (SG). Each subject received acupuncture treatment twice per week for three consecutive weeks. The primary outcome measure was quality of life as assessed with Short Form-36, and secondary outcome measures were neck range of motion (ROM), motion-related pain, and Short-Form McGill Pain Questionnaire (SF-MPQ), as determined by a blinded investigator. The clinical assessments were made before treatment (BT) and after six acupuncture treatments (AT), as well as four weeks (F1) and 12 weeks (F2) after the end of the treatment. A total of 34 patients completed the trial. The results indicated that there is no significant difference in the ROM, motion-related pain, and SF-MPQ scores between AG and SG at AT, F1 and F2 (all p > 0.05). However, AG has greater improvement in physical functioning and role emotional of Short Form-36 quality of life at F2. The results indicate that acupuncture may be used to improve the quality of life in patients with chronic neck MPS.

  9. Psychiatric disorders and muscle tenderness in episodic and chronic migraine.

    Science.gov (United States)

    Mongini, Franco; Deregibus, Andrea; Rota, Eugenia

    2005-09-01

    This review first reports on the data concerning the relationship between migraine and personality traits and psychiatric disorders. The relationship between migraine and tenderness of the pericranial and cervical muscles is then discussed. In one study, a psychologic assessment was performed in 56 women with migraine, and the Minnesota Multiphase Personality Inventory (MMPI) and State Trait Anxiety Inventory were administered at baseline (T0) and after 6-7 years (T2). Frequency, severity and duration of migraine were recorded at T0, after treatment (T1) and at T2, and their relationship to the prevalence of depression, MMPI and State Trait Anxiety Inventory data were examined. Pain parameters improved in all patients in T0-1, but were higher at T2 in patients with depression at T0. The patients whose migraine improved at T2 had significantly lower MMPI and State Trait Anxiety Inventory scores at T0 and T2. Moreover, the prevalence of depression of the patients whose migraine improved at T2 was 37.5% at T0 and decreased to 12.5% at T2. The authors subsequently studied the function of the frontal lobe in 23 female patients previously treated for chronic migraine and 23 controls by applying three neuropsychologic tests (gambling task, tower of hanoi-3 and object alternation test). The patient group performed significantly worse on the tower of hanoi-3 and the object alternation test. In order to assess the extent to which muscle tenderness may relate to psychiatric disorders in patients with migraine and tension-type headache, diagnosed according International Headache Society criteria [2004], a psychologic assessment was performed and palpation tenderness scores calculated for the pericranial and cervical muscles in 459 patients. In total, 125 patients had frequent episodic migraine, 97 had chronic migraine, 82 had frequent episodic tension-type headache and chronic tension-type headache was present in 83. In a further 72 patients, both episodic migraine and

  10. More gain less pain: balance control learning shifts the activation patterns of leg and neck muscles and increases muscular parsimony.

    Science.gov (United States)

    Iodice, Pierpaolo; Cesinaro, Stefano; Romani, Gian Luca; Pezzulo, Giovanni

    2015-07-01

    Athletes such as skaters or surfers maintain their balance on very unstable platforms. Remarkably, the most skilled athletes seem to execute these feats almost effortlessly. However, the dynamics that lead to the acquisition of a defined and efficient postural strategy are incompletely known. To understand the posture reorganization process due to learning and expertise, we trained twelve participants in a demanding balance/posture maintenance task for 4 months and measured their muscular activity before and after a (predictable) disturbance cued by an auditory signal. The balance training determined significant delays in the latency of participants' muscular activity: from largely anticipatory muscular activity (prior to training) to a mixed anticipatory-compensatory control strategy (after training). After training, the onset of activation was delayed for all muscles, and the sequence of activation systematically reflected the muscle position in the body from top to bottom: neck/upper body muscles were recruited first and in an anticipatory fashion, whereas leg muscles were recruited after the disturbance onset, producing compensatory adjustments. The resulting control strategy includes a mixture of anticipatory and compensatory postural adjustments, with a systematic sequence of muscular activation reflecting the different demands of neck and leg muscles. Our results suggest that subjects learned the precise timing of the disturbance onset and used this information to deploy postural adjustments just-in-time and to transfer at least part of the control of posture from anticipatory to less-demanding feedback-based strategies. In turn, this strategy shift increases the cost-efficiency of muscular activity, which is a key signature of skilled performance.

  11. Elite swimmers with and without unilateral shoulder pain: mechanical hyperalgesia and active/latent muscle trigger points in neck-shoulder muscles.

    Science.gov (United States)

    Hidalgo-Lozano, A; Fernández-de-las-Peñas, C; Calderón-Soto, C; Domingo-Camara, A; Madeleine, P; Arroyo-Morales, M

    2013-02-01

    Our aim was to investigate the presence of mechanical hypersensitivity and active trigger points (TrPs) in the neck-shoulder muscles in elite swimmers with/without unilateral shoulder pain. Seventeen elite swimmers with shoulder pain; 18 swimmers without shoulder pain; and 15 elite athletes matched controls were recruited. Pressure pain thresholds (PPT) were assessed over the levator scapulae, sternocleidomastoid, upper trapezius, infraspinatus, scalene, subscapularis and tibialis anterior muscles. TrPs in the levator scapulae, upper trapezius, infraspinatus, scalene, sternocleidomastoid and subscapularis muscles were also explored. Swimmers with shoulder pain showed significant lower PPT in all muscles compared with controls (Ppain, underlining widespread mechanical hypersensitivity. The mean number of TrPs for elite swimmer with and without shoulder pain was, respectively, 4.7 ± 1 (2.1 ± 1.5 active; 2.6 ± 1.4 latent) and 4.7 ± 1.3 (1.3 ± 1.3 active; 3.4 ± 1.5 latent), whereas healthy athletes only showed latent TrPs (2.4 ± 1.2). Elite swimmers with shoulder pain showed higher number of active TrPs than swimmers without pain, whereas it was the opposite for the number of latent muscle TrP (Pmechanical hypersensitivity suggests that active TrPs play a role in the development of shoulder pain in elite swimmers.

  12. The efficacy of utilizing Kinesio® taping in isolation or in combination with spinal manipulation in the treatment of chronic neck pain

    OpenAIRE

    2014-01-01

    M.Tech. (Chiropractic) Introduction: Neck pain is a common condition which affects up to 70 percent of people at some point in their lives, and at any given time about 10 to 20 percent of the population reports neck problems. Although spinal manipulation on its own is effective in the treatment of chronic neck pain, chiropractors continue to search adjunctive modalities to improve the positive outcomes of their treatment. Therefore, it is important to look for the best possible treatment p...

  13. The envelope of motion of the cervical spine and its influence on the maximum torque generating capability of the neck muscles.

    Science.gov (United States)

    Siegler, Sorin; Caravaggi, Paolo; Tangorra, James; Milone, Mary; Namani, Ramya; Marchetto, Paul A

    2015-10-15

    The posture of the head and neck is critical for predicting and assessing the risk of injury during high accelerations, such as those arising during motor accidents or in collision sports. Current knowledge suggests that the head's range-of-motion (ROM) and the torque-generating capability of neck muscles are both dependent and affected by head posture. A deeper understanding of the relationship between head posture, ROM and maximum torque-generating capability of neck muscles may help assess the risk of injury and develop means to reduce such risks. The aim of this study was to use a previously-validated device, known as Neck Flexibility Tester, to quantify the effects of head's posture on the available ROM and torque-generating capability of neck muscles. Ten young asymptomatic volunteers were enrolled in the study. The tri-axial orientation of the subjects' head was controlled via the Neck Flexibility Tester device. The head ROM was measured for each flexed, extended, axially rotated, and laterally bent head's orientation and compared to that in unconstrained neutral posture. Similarly, the torque applied about the three anatomical axes during Isometric Maximum Voluntary Contraction (IMVC) of the neck muscles was measured in six head's postures and compared to that in fully-constrained neutral posture. The further from neutral the neck posture was the larger the decrease in ROM and IMVC. Head extension and combined two-plane rotations postures, such as extension with lateral bending, produced the largest decreases in ROM and IMVC, thus suggesting that these postures pose the highest potential risk for injury.

  14. Acute and chronic response of skeletal muscle to resistance exercise.

    Science.gov (United States)

    Abernethy, P J; Jürimäe, J; Logan, P A; Taylor, A W; Thayer, R E

    1994-01-01

    Skeletal muscle tissue is sensitive to the acute and chronic stresses associated with resistance training. These responses are influenced by the structure of resistance activity (i.e. frequency, load and recovery) as well as the training history of the individuals involved. There are histochemical and biochemical data which suggest that resistance training alters the expression of myosin heavy chains (MHCs). Specifically, chronic exposure to bodybuilding and power lifting type activity produces shifts towards the MHC I and IIb isoforms, respectively. However, it is not yet clear which training parameters trigger these differential expressions of MHC isoforms. Interestingly, many programmes undertaken by athletes appear to cause a shift towards the MHC I isoform. Increments in the cross-sectional area of muscle after resistance training can be primarily attributed to fibre hypertrophy. However, there may be an upper limit to this hypertrophy. Furthermore, significant fibre hypertrophy appears to follow the sequence of fast twitch fibre hypertrophy preceding slow twitch fibre hypertrophy. Whilst some indirect measures of fibre number in living humans suggest that there is no interindividual variation, postmortem evidence suggests that there is. There are also animal data arising from investigations using resistance training protocols which suggest that chronic exercise can increase fibre number. Furthermore, satellite cell activity has been linked to myotube formation in the human. However, other animal models (i.e. compensatory hypertrophy) do not support the notion of fibre hyperplasia. Even if hyperplasia does occur, its effect on the cross-sectional area of muscle appears to be small. Phosphagen and glycogen metabolism, whilst important during resistance activity appear not to normally limit the performance of resistance activity. Phosphagen and related enzyme adaptations are affected by the type, structure and duration of resistance training. Whilst endogenous

  15. The ratio of change in muscle thickness between superficial and deep cervical flexor muscles during the craniocervical flexion test and a suggestion regarding clinical treatment of patients with musculoskeletal neck pain.

    Science.gov (United States)

    Goo, Miran; Kim, Seong-Gil; Jun, Deokhoon

    2015-08-01

    [Purpose] The purpose of this study was to identify the imbalance of muscle recruitment in cervical flexor muscles during the craniocervical flexion test by using ultrasonography and to propose the optimal level of pressure in clinical craniocervical flexion exercise for people with neck pain. [Subjects and Methods] A total of 18 students (9 males and 9 females) with neck pain at D University in Gyeongsangbuk-do, South Korea, participated in this study. The change in muscle thickness in superficial and deep cervical flexor muscles during the craniocervical flexion test was measured using ultrasonography. The ratio of muscle thickness changes between superficial and deep muscles during the test were obtained to interpret the imbalance of muscle recruitment in cervical flexor muscles. [Results] The muscle thickness ratio of the sternocleidomastoid muscle/deep cervical flexor muscles according to the incremental pressure showed significant differences between 22 mmHg and 24 mmHg, between 24 mmHg and 28 mmHg, between 24 mmHg and 30 mmHg, and between 26 mmHg and 28 mmHg. [Conclusion] Ultrasonography can be applied for examination of cervical flexor muscles in clinical environment, and practical suggestion for intervention exercise of craniocervical flexors can be expected on the pressure level between 24 mmHg and 26 mmHg enabling the smallest activation of the sternocleidomastoid muscle.

  16. Effects of Miniscalpel-Needle Release on Chronic Neck Pain: A Retrospective Analysis with 12-Month Follow-Up.

    Directory of Open Access Journals (Sweden)

    Shuming Li

    Full Text Available Chronic neck pain is a highly prevalent condition, and is often treated with non-steroidal anti-inflammatory drugs. Limited clinical studies with short-term follow-up have shown promising efficacy of acupuncture as well as miniscalpel-needle (MSN release. In this retrospective study, we examined whether MSN release could produce long-lasting relief in patients with chronic neck pain.We retrieved the medical records of all patients receiving weekly MSN release treatment for chronic neck pain at this institution during a period from May 2012 to December 2013. Only cases with the following information at prior to, and 1, 6, and 12 months after the treatment, were included in the analysis: neck disability index (NDI, numerical pain rating scale (NPRS, and active cervical range of motion (CROM. The primary analysis of interest is comparison of the 12-month measures with the baseline. Patients who took analgesic drugs or massage within 2 weeks prior to assessment were excluded from the analysis. For MSN release, tender points were identified manually by an experienced physician, and did not necessarily follow the traditional acupuncture system. MSN was inserted vertically (parallel to the spine until breaking through resistance and patient reporting of distention, soreness or heaviness. The depth of the needling ranged from 10 to 50 mm. The release was carried out by moving the MSN up and down 3-5 times without rotation.A total of 559 cases (patients receiving weekly MSN release treatment for chronic neck pain were screened. The number of cases with complete information (NDI, NPRS, and CROM at baseline, 1, 6 and 12 months after last treatment was 180. After excluding the cases with analgesic treatment or massage within 2 weeks of assessment (n = 53, a total of 127 cases were included in data analysis. The number of MSN release session was 7 (range: 4-11. At 12 months after the treatment, both NPRS and NDI were significantly lower [3 (0, 9 vs. 7 (5, 10

  17. Surface electromyographic patterns of masticatory, neck, and trunk muscles in temporomandibular joint dysfunction patients undergoing anterior repositioning splint therapy.

    Science.gov (United States)

    Tecco, Simona; Tetè, Stefano; D'Attilio, Michele; Perillo, Letizia; Festa, Felice

    2008-12-01

    The aim of this study was to investigate the surface electromyographic (sEMG) activity of neck, trunk, and masticatory muscles in subjects with temporomandibular joint (TMJ) internal derangement treated with anterior mandibular repositioning splints. sEMG activities of the muscles in 34 adult subjects (22 females and 12 males; mean age 30.4 years) with TMJ internal derangement were compared with a control group of 34 untreated adults (20 females and 14 males; mean age 31.8 years). sEMG activities of seven muscles (anterior and posterior temporalis, masseter, posterior cervicals, sternocleidomastoid, and upper and lower trapezius) were studied bilaterally, with the mandible in the rest position and during maximal voluntary clenching (MVC), at the beginning of therapy (T0) and after 10 weeks of treatment (T1). Paired and Student's t-tests were undertaken to determine differences between the T0 and T1 data and in sEMG activity between the study and control groups. At T0, paired masseter, sternocleidomastoid, and cervical muscles, in addition to the left anterior temporal and right lower trapezius, showed significantly greater sEMG activity (P = 0.0001; P = 0.0001; for left cervical, P = 0.03; for right cervical, P = 0.0001; P = 0.006 and P = 0.007 muscles, respectively) compared with the control group. This decreased over the remaining study period, such that after treatment, sEMG activity revealed no statistically significant difference when compared with the control group. During MVC at T0, paired masseter and anterior and posterior temporalis muscles showed significantly lower sEMG activity (P = 0.03; P = 0.005 and P = 0.04, respectively) compared with the control group. In contrast, at T1 sEMG activity significantly increased (P = 0.02; P = 0.004 and P = 0.04, respectively), but no difference was observed in relation to the control group. Splint therapy in subjects with internal disk derangement seems to affect sEMG activity of the masticatory, neck, and trunk

  18. Restricted neck mobility in children with chronic tension type headache: a blinded, controlled study.

    Science.gov (United States)

    Fernández-Mayoralas, Daniel M; Fernández-de-las-Peñas, César; Palacios-Ceña, Domingo; Cantarero-Villanueva, Irene; Fernández-Lao, Carolina; Pareja, Juan A

    2010-10-01

    The main purpose of this study was to analyze the differences in neck mobility between children with chronic tension type headache (CTTH) and healthy children, and to determine the influence of cervical mobility on headache intensity, frequency and duration. Fifty children, 13 boys and 37 girls (mean age 8.5 ± 1.6 years) with CTTH associated to peri-cranial tenderness (IHS 2.3.1) and 50 age- and sex matched children without headache (13 boys, 37 girls, mean age 8.5 ± 1.8 years, P = 0.955) participated. Cervical range of motion (CROM) was objectively assessed with a cervical goniometer by an assessor blinded to the children's condition. Children completed a headache diary for 4 weeks to confirm the diagnosis. Children with CTTH showed decreased CROM as compared to children without headache for flexion (z = -6.170; P 0.125) or gender (P > 0.250) did not influence CROM in either children with CTTH or without headache. Current results support the hypothesis that the cervical spine should be explored in children with headache. Further research is also needed to clearly define the potential role of the cervical spine in the genesis or maintenance of CTTH.

  19. Effectiveness of behavioural graded activity compared with physiotherapy treatment in chronic neck pain: design of a randomised clinical trial [ISRCTN88733332

    OpenAIRE

    2004-01-01

    Abstract Background Chronic neck pain is a common complaint in the Netherlands with a point prevalence of 14.3%. Patients with chronic neck pain are often referred to a physiotherapist and, although many treatments are available, it remains unclear which type of treatment is to be preferred. The objective of this article is to present the design of a randomised clinical trial, Ephysion, which examines the clinical and cost effectiveness of behavioural graded activity compared with a physiothe...

  20. Chronic Mechanical Neck Pain in Adults Treated by Manual Therapy: A Systematic Review of Change Scores in Randomized Controlled Trials of a Single Session

    OpenAIRE

    Vernon, Howard; Humphreys, Barry Kim

    2008-01-01

    We report a systematic analysis of group change scores of subjects with chronic neck pain not due to whiplash and without headache or arm pain, in randomized clinical trials of a single session of manual therapy. A comprehensive literature search of clinical trials of chronic neck pain treated with manual therapies up to December 2006 was conducted. Trials that scored above 60% on the PEDro Scale were included. Change scores were analyzed for absolute, percentage change and effect size (ES) w...

  1. Comparative Effects of Acupressure at Local and Distal Acupuncture Points on Pain Conditions and Autonomic Function in Females with Chronic Neck Pain

    OpenAIRE

    Matsubara, Takako; Arai, Young-Chang P.; Shiro, Yukiko; Shimo, Kazuhiro; Nishihara, Makoto; Sato, Jun; Ushida, Takahiro

    2010-01-01

    Acupressure on local and distal acupuncture points might result in sedation and relaxation, thereby reducing chronic neck pain. The aim was to investigate the effect of acupressure at local (LP) and distal acupuncture points (DP) in females with chronic neck pain. Thirty-three females were assigned to three groups: the control group did not receive any stimuli, the LP group received acupressure at local acupuncture points, GB 21, SI 14 and SI 15, and the DP group received acupressure at dista...

  2. Comparative Effects of Acupressure at Local and Distal Acupuncture Points on Pain Conditions and Autonomic Function in Females with Chronic Neck Pain

    OpenAIRE

    Matsubara, Takako; Arai, Young-Chang P.; Shiro, Yukiko; Shimo, Kazuhiro; Nishihara, Makoto; Sato, Jun; Ushida, Takahiro

    2011-01-01

    Acupressure on local and distal acupuncture points might result in sedation and relaxation, thereby reducing chronic neck pain. The aim was to investigate the effect of acupressure at local (LP) and distal acupuncture points (DP) in females with chronic neck pain. Thirty-three females were assigned to three groups: the control group did not receive any stimuli, the LP group received acupressure at local acupuncture points, GB 21, SI 14 and SI 15, and the DP group received acupressure at dista...

  3. Molecular signatures of age-associated chronic degeneration of shoulder muscles.

    Science.gov (United States)

    Raz, Yotam; Henseler, Jan Ferdinand; Kolk, Arjen; Tatum, Zuotian; Groosjohan, Niels Kuipers; Verwey, Nisha E; Arindrarto, Wibowo; Kielbasa, Szymon M; Nagels, Jochem; 't Hoen, Peter A C; Nelissen, Rob G H H; Raz, Vered

    2016-02-23

    Chronic muscle diseases are highly prevalent in the elderly causing severe mobility limitations, pain and frailty. The intrinsic molecular mechanisms are poorly understood due to multifactorial causes, slow progression with age and variations between individuals. Understanding the underlying molecular mechanisms could lead to new treatment options which are currently limited. Shoulder complaints are highly common in the elderly, and therefore, muscles of the shoulder's rotator cuff could be considered as a model for chronic age-associated muscle degeneration. Diseased shoulder muscles were characterized by muscle atrophy and fatty infiltration compared with unaffected shoulder muscles. We confirmed fatty infiltration using histochemical analysis. Additionally, fibrosis and loss of contractile myosin expression were found in diseased muscles. Most cellular features, including proliferation rate, apoptosis and cell senescence, remained unchanged and genome-wide molecular signatures were predominantly similar between diseased and intact muscles. However, we found down-regulation of a small subset of muscle function genes, and up-regulation of extracellular region genes. Myogenesis was defected in muscle cell culture from diseased muscles but was restored by elevating MyoD levels. We suggest that impaired muscle functionality in a specific environment of thickened extra-cellular matrix is crucial for the development of chronic age-associated muscle degeneration.

  4. Chronic Stimulation-Induced Changes in the Rodent Thyroarytenoid Muscle

    Science.gov (United States)

    McMullen, Colleen A.; Butterfield, Timothy A.; Dietrich, Maria; Andreatta, Richard D.; Andrade, Francisco H.; Fry, Lisa; Stemple, Joseph C.

    2011-01-01

    Purpose: Therapies for certain voice disorders purport principles of skeletal muscle rehabilitation to increase muscle mass, strength, and endurance. However, applicability of limb muscle rehabilitation to the laryngeal muscles has not been tested. In this study, the authors examined the feasibility of the rat thyroarytenoid muscle to remodel as a…

  5. Acute effects of single and multiple level thoracic manipulations on chronic mechanical neck pain: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Puntumetakul R

    2015-01-01

    Full Text Available Rungthip Puntumetakul,1,2 Thavatchai Suvarnnato,1,3 Phurichaya Werasirirat,1 Sureeporn Uthaikhup,2 Junichiro Yamauchi,4,5 Rose Boucaut6 1School of Physical Therapy, Faculty of Associated Medical Sciences, 2Research Center in Back, Neck, Other Joint Pain and Human Performance, 3Physical Therapy Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 4Graduate School of Human Health Sciences, Tokyo Metropolitan University, 5Future Institute for Sport Sciences, Tokyo, Japan; 6School of Health Sciences (Physiotherapy, University of South Australia, Adelaide, SA, Australia Background: Thoracic spine manipulation has become a popular alternative to local cervical manipulative therapy for mechanical neck pain. This study investigated the acute effects of single-level and multiple-level thoracic manipulations on chronic mechanical neck pain (CMNP.Methods: Forty-eight patients with CMNP were randomly allocated to single-level thoracic manipulation (STM at T6–T7 or multiple-level thoracic manipulation (MTM, or to a control group (prone lying. Cervical range of motion (CROM, visual analog scale (VAS, and the Thai version of the Neck Disability Index (NDI-TH scores were measured at baseline, and at 24-hour and at 1-week follow-up.Results: At 24-hour and 1-week follow-up, neck disability and pain levels were significantly (P<0.05 improved in the STM and MTM groups compared with the control group. CROM in flexion and left lateral flexion were increased significantly (P<0.05 in the STM group when compared with the control group at 1-week follow-up. The CROM in right rotation was increased significantly after MTM compared to the control group (P<0.05 at 24-hour follow-up. There were no statistically significant differences in neck disability, pain level at rest, and CROM between the STM and MTM groups.Conclusion: These results suggest that both single-level and multiple-level thoracic manipulation improve neck disability

  6. Regenerative defect in vastus lateralis muscle of patients with chronic obstructive pulmonary disease

    OpenAIRE

    Thériault, Marie-Eve; Paré, Marie-Ève; Lemire, Bruno B; Maltais, François; Debigaré, Richard

    2014-01-01

    Background Impaired skeletal muscle regeneration could contribute to the progression of muscle atrophy in patients with chronic obstructive pulmonary disease (COPD). Methods Satellite cells and myogenesis-related proteins were compared between healthy subjects and patients with COPD, with or without muscle atrophy. Satellite cells were isolated and cultured to assess their proliferative and differentiation aptitudes. Results Although satellite cell numbers in muscle samples were similar betwe...

  7. The outcome of control groups in clinical trials of conservative treatments for chronic mechanical neck pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Hagino Carol

    2006-07-01

    Full Text Available Abstract Background Chronic neck pain is highly prevalent in Western societies, with about 15% of females and 10% of males suffering with it at any time. The course of untreated chronic neck pain patients in clinical trials has not been well-defined and the placebo effect has not been clarified. Methods A systematic review of RCT's of conservative treatments for chronic mechanical neck pain was conducted. Studies were excluded if they did not include a control group, if they involved subjects with whiplash injuries, a predominance of headache or arm pain associated with chronic neck pain and if only one treatment was reported. Only studies scoring 3–5 out of 5 on the Jadad Scale for quality were included in the final analysis. Data on change in pain scores of subjects in both placebo (PL as well as no-treatment (NT control groups were analyzed. Mean changes in pain scores as well as effect sizes were calculated, summarized and compared between these groups. Results Twenty (20 studies, 5 in the NT group and 15 in the PL group, with outcome intervals ranging from 1–52 weeks were included in the final analysis. The mean [95% CI] effect size of change in pain ratings in the no-treatment control studies at outcome points up to 10 weeks was 0.18 [-0.05, 0.41] and for outcomes from 12–52 weeks it was 0.4 [0.12, 0.68]. In the placebo control groups it was 0.50 [0.10, 0.90] at up to 10 weeks and 0.33. [-1.97, 2.66] at 12–24 weeks. None of the comparisons between the no-treatment and placebo groups were statistically significant. Conclusion It appears that the changes in pain scores in subjects with chronic neck pain not due to whiplash who are enrolled in no-treatment and placebo control groups were similarly small and not significantly different. As well, they do not appear to increase over longer-term follow-up.

  8. Effects of neck exercise on high-school students' neck-shoulder posture.

    Science.gov (United States)

    Lee, Myoung-Hyo; Park, Su-Jin; Kim, Jin-Sang

    2013-05-01

    [Purpose] This study examined the effects of deep flexor muscle-strengthening exercise on the neck-shoulder posture, and the strength and endurance of the deep flexor muscles of high-school students. [Subjects] The subjects were 30 seventeen-year-old female high-school students who complained about bad posture and chronic neck-shoulder pain. They were randomly divided into an experimental group of 15 subjects, who performed a deep flexor muscle-strengthening exercise and a control group of 15 subjects, who performed a basic stretching exercise. [Methods] The experimental group of 15 subjects performed a deep flexor muscle-strengthening exercise consisting of low-load training of the cranio-cervical flexor muscle, and the control group of 15 subjects performed a basic stretching exercise consisting of seven motions. [Results] The experimental group showed statistically significant changes in head tilt angle, neck flexion angle, forward shoulder angle, and the result of the cranio-cervical flexion test after the training. In contrast, the control group showed no statistically significant changes in these measures following the training. When the results of the groups were compared, statistically significant differences were found for all items between the experimental group and the control group. [Conclusion] Strengthening cranio-cervical flexor muscles is important for the adjustment of neck posture, and maintaining their stability is required to improve neck-shoulder posture.

  9. Bone, blood vessels, and muscle detection algorithm and creating database based on dynamic and non-dynamic multi-slice CT image of head and neck

    Science.gov (United States)

    Shabbir Ahamed, Mohammed; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Iwasaki, Hirokazu

    2007-03-01

    Nowadays, dental CT images play more and more important roles in oral clinical applications. Our research is important particularly in the field of dentistry. We are using non-dynamic and dynamic CT image for our research. We are creating our database of bone, blood vessels and muscles of head and neck. This database contains easy case and difficult case of head and neck's bone, blood vessels and muscle. There are lots of difficult cases in our database. Teeth separation and condylar process separation is difficult case. External carotid artery has many branches and they are attached with vain so it is difficult to separate. All muscle threshold value is same and they are attaching with each other so muscle separation is very difficult. These databases also contain different age's patients. For this reason our database becomes an important tool for dental students and also important assets for diagnosis. After completion our database we can link it with other dental application.

  10. Effect of scapular function training on chronic pain in the neck/shoulder region

    DEFF Research Database (Denmark)

    Andersen, Christoffer H; Andersen, Lars L; Zebis, Mette K;

    2014-01-01

    supervision or to a control group. At baseline and at follow-up the participants were tested for maximum isometric shoulder strength by a blinded tester. Further, once a week participants reported pain intensity of the neck/shoulder during the previous week. RESULTS: In intention-to-treat analysis neck...

  11. Spinal Manipulative Therapy and Exercise for Seniors with Chronic Neck Pain

    DEFF Research Database (Denmark)

    Maiers, Michele; Bronfort, Gert; Evans, Roni

    2014-01-01

    Neck pain, common among the elderly population, has considerable implications on health and quality of life. Evidence supports the use of spinal manipulative therapy and exercise to treat neck pain; however, no studies to date have evaluated the effectiveness of these therapies specifically...

  12. Cervical kinematic training with and without interactive VR training for chronic neck pain - a randomized clinical trial.

    Science.gov (United States)

    Sarig Bahat, Hilla; Takasaki, Hiroshi; Chen, Xiaoqi; Bet-Or, Yaheli; Treleaven, Julia

    2015-02-01

    Impairments in cervical kinematics are common in patients with neck pain. A virtual reality (VR) device has potential to be effective in the management of these impairments. The objective of this study was to investigate the effect of kinematic training (KT) with and without the use of an interactive VR device. In this assessor-blinded, allocation-concealed pilot clinical trial, 32 participants with chronic neck pain were randomised into the KT or kinematic plus VR training (KTVR) group. Both groups completed four to six training sessions comprising of similar KT activities such as active and quick head movements and fine head movement control and stability over five weeks. Only the KTVR group used the VR device. The primary outcome measures were neck disability index (NDI), cervical range of motion (ROM), head movement velocity and accuracy. Kinematic measures were collected using the VR system that was also used for training. Secondary measures included pain intensity, TAMPA scale of kinesiophobia, static and dynamic balance, global perceived effect and participant satisfaction. The results demonstrated significant (p neck pain in a larger cohort.

  13. Test-retest repeatability of strength capacity, aerobic power and pericranial tenderness of neck and shoulder muscles in children - relevant for tension-type headache

    Directory of Open Access Journals (Sweden)

    Tornøe B

    2013-08-01

    Full Text Available Birte Tornøe,1,2,5,6 Lars L Andersen,3 Jørgen H Skotte,3 Rigmor Jensen,4 Gunvor Gard,1 Liselotte Skov,2 Inger Hallström1 1Department of Health Sciences, Lund University, Scania, Sweden; 2Children's Headache Clinic, Department of Pediatrics, University of Copenhagen, Herlev Hospital, Herlev, Denmark; 3National Research Centre for the Working Environment, Copenhagen, Denmark; 4Danish Headache Center, Department of Neurology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark; 5Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark; 6Department of Physiotherapy, Medical Department, University of Copenhagen, Herlev Hospital, Herlev, Denmark Background: Frequent or chronic tension-type headache in children is a prevalent and debilitating condition for the child, often leading to medication overuse. To explore the relationship between physical factors and tension-type headache in children, the quality of repeated measures was examined. The aim of the present study was to determine the test-retest repeatability of parameters determining isometric neck and shoulder strength and stability, aerobic power, and pericranial tenderness in children. Methods: Twenty-five healthy children, 9 to 18 years of age, participated in test-retest procedures within a 1-week interval. A computerized padded force transducer was used for testing. The tests included the isometric maximal voluntary contraction and force steadiness of neck flexion and extension, and the isometric maximal voluntary contraction and rate of force of the dominant shoulder. Pericranial tenderness was recorded by means of standardized manual palpation, and a submaximal cycle ergometer test predicted maximal oxygen uptake (VO2 max. The measurements were evaluated in steps, using the intraclass correlation coefficient (ICC; changes in the mean between the two test occasions; the levels of agreement, visualized in Bland

  14. Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study

    Directory of Open Access Journals (Sweden)

    Häger-Ross Charlotte

    2010-09-01

    Full Text Available Abstract Background Assessment of sensorimotor function is useful for classification and treatment evaluation of neck pain disorders. Several studies have investigated various aspects of cervical motor functions. Most of these have involved slow or self-paced movements, while few have investigated fast cervical movements. Moreover, the reliability of assessment of fast cervical axial rotation has, to our knowledge, not been evaluated before. Methods Cervical kinematics was assessed during fast axial head rotations in 118 women with chronic nonspecific neck pain (NS and compared to 49 healthy controls (CON. The relationship between cervical kinematics and symptoms, self-rated functioning and fear of movement was evaluated in the NS group. A sub-sample of 16 NS and 16 CON was re-tested after one week to assess the reliability of kinematic variables. Six cervical kinematic variables were calculated: peak speed, range of movement, conjunct movements and three variables related to the shape of the speed profile. Results Together, peak speed and conjunct movements had a sensitivity of 76% and a specificity of 78% in discriminating between NS and CON, of which the major part could be attributed to peak speed (NS: 226 ± 88 °/s and CON: 348 ± 92 °/s, p Conclusions Peak speed of fast cervical axial rotations is reduced in people with chronic neck pain, and even further reduced in subjects with concomitant low back pain. Fast cervical rotation test seems to be a reliable and valid tool for assessment of neck pain disorders on group level, while a rather large between subject variation and overlap between groups calls for caution in the interpretation of individual assessments.

  15. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review

    Directory of Open Access Journals (Sweden)

    Kuldip Salgotra

    2016-04-01

    Full Text Available Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7% men and 1 (14.3% women among the patients. Overall 5 (71.5% patients had transcervical and 2 (28.5% had subcapital fractures. At the end of 6 months, 6 (85.7% patients were pain free and on plain radiographs fracture union was noted. One (14.3% patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures.

  16. Cervical Muscle Dysfunction in the Chronic Whiplash Associated Disorder Grade II (WAD-II)

    NARCIS (Netherlands)

    Nederhand, Marc J.; IJzerman, Maarten J.; Hermens, Hermie J.; Baten, Chris T.M.; Zilvold, Gerrit

    2000-01-01

    Study Design: In a cross-sectional study, surface electromyography measurements of the upper trapezius muscles were obtained during different functional tasks in patients with a chronic whiplash associated disorder Grade II and healthy control subjects. - Objectives: To investigate whether muscle d

  17. Single Dose of Fluoxetine Increases Muscle Activation in Chronic Stroke Patients

    NARCIS (Netherlands)

    Genderen, van Hanneke Irene; Nijlant, Juliette M.M.; Putten, van Michel J.A.M; Movig, Kris L.L.; IJzerman, Maarten J.

    2009-01-01

    Objectives: This pilot study explores the influence of a single dose of fluoxetine (20 mg) on the muscle activation patterns and functional ability of the muscles in the lower part of the arm in chronic stroke patients. Methods: A crossover, placebo-controlled clinical trial was conducted in 10

  18. The effect of traditional cupping on pain and mechanical thresholds in patients with chronic nonspecific neck pain : a randomised controlled pilot study

    OpenAIRE

    2012-01-01

    Introduction. Cupping has been used since antiquity in the treatment of pain conditions. In this pilot study, we investigated the effect of traditional cupping therapy on chronic nonspecific neck pain (CNP) and mechanical sensory thresholds. Methods. Fifty CNP patients were randomly assigned to treatment (TG, n = 25) or waiting list control group (WL, n = 25). TG received a single cupping treatment. Pain at rest (PR), pain related to movement (PM), quality of life (SF-36), Neck Disability Ind...

  19. Can muscle regeneration fail in chronic inflammation: a weakness in inflammatory myopathies?

    Science.gov (United States)

    Loell, I; Lundberg, I E

    2011-03-01

    Idiopathic inflammatory myopathies (IIMs), collectively termed myositis, include three major subgroups: polymyositis, dermatomyositis and inclusion body myositis. IIMs are characterized clinically by muscle weakness and reduced muscle endurance preferentially affecting the proximal skeletal muscle. In typical cases, inflammatory cell infiltrates and proinflammatory cytokines, alarmins and eicosanoids are present in muscle tissue. Treatment with glucocorticoids and other immunosuppressants results in improved performance, but complete recovery is rarely seen. The mechanisms that cause muscle weakness and reduced muscle endurance are multi-factorial, and different mechanisms predominate in different phases of disease. It is likely that a combination of immune-mediated and nonimmune-mediated mechanisms contributes to clinical muscle symptoms. Immune-mediated mechanisms include immune cell-mediated muscle fibre necrosis as well as direct effects of various cytokines on muscle fibre contractility. Among the nonimmune-mediated mechanisms, an acquired metabolic myopathy and so-called endoplasmic reticulum stress may be important. There is also a possibility of defective repair mechanisms, with an influence of both disease-related factors and glucocorticoid treatment. Several proinflammatory molecules observed in muscle tissue of myositis patients, including interleukin (IL)-1, IL-15, tumour necrosis factor, high-mobility group box-1 and eicosanoids, have a role in muscle fibre regeneration, and blocking these molecule may impair muscle repair and recovery. The delicate balance between immunosuppressive treatment to downregulate proinflammatory molecules and an inhibitory effect on muscle fibre regeneration needs to be further understood. This would also be relevant for other chronic inflammatory diseases.

  20. Surgical fasciectomy of the trapezius muscle combined with neurolysis of the Spinal accessory nerve; results and long-term follow-up in 30 consecutive cases of refractory chronic whiplash syndrome

    Directory of Open Access Journals (Sweden)

    Freeman Michael

    2010-04-01

    Full Text Available Abstract Background Chronic problems from whiplash trauma generally include headache, pain and neck stiffness that may prove refractory to conservative treatment modalities. As has previously been reported, such afflicted patients may experience significant temporary relief with injections of local anesthetic to painful trigger points in muscles of the shoulder and neck, or lasting symptomatic improvement through surgical excision of myofascial trigger points. In a subset of patients who present with chronic whiplash syndrome, the clinical findings suggest an affliction of the spinal accessory nerve (CN XI, SAN by entrapment under the fascia of the trapezius muscle. The present study was undertaken to assess the effectiveness of SAN neurolysis in chronic whiplash syndrome. Methods A standardized questionnaire and a linear visual-analogue scale graded 0-10 was used to assess disability related to five symptoms (pain, headache, insomnia, weakness, and stiffness before, and one year after surgery in a series of thirty consecutive patients. Results The preoperative duration of symptoms ranged from seven months to 13 years. The following changes in disability scores were documented one year after surgery: Overall pain decreased from 9.5 +/- 0.9 to 3.2 +/- 2.6 (p Conclusions Entrapment of the spinal accessory nerve and/or chronic compartment syndrome of the trapezius muscle may cause chronic debilitating pain after whiplash trauma, without radiological or electrodiagnostic evidence of injury. In such cases, surgical treatment may provide lasting relief.

  1. Physical Workload On Neck And Shoulder Muscles During Military Helicopter Flight

    DEFF Research Database (Denmark)

    Murray, Mike; Lange, Britt; Olsen, Henrik Baare

    was normalized using Maximal Voluntary Contractions (MVC) and analyzed for changes in amplitude and distribution of muscle activity by an Amplitude Probability Distribution Function (APDF). RESULTS: MVC for shoulder elevation (right/left) was: 136.8±41.3 / 120.6±47.0 Nm, and for cervical-flexion and extension...

  2. Efficacy of Deep Muscle Stimulator (DMS) with Hot Magner Instrument for Chronic Non-specific Neck Pain%电动深层肌肉刺激仪联合热磁治疗慢性非特异性颈痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵丹

    2016-01-01

    目的:观察电动深层肌肉刺激仪(DMS)联合热磁对慢性非特异性颈痛患者的临床疗效.方法:将60例慢性非特异性颈痛的患者随机分为治疗组30例,采用电动深层肌肉刺激仪联合热磁治疗;对照组30例,给予热磁治疗.1周后比较两组疗效,利用颈部残障指数量表(Neck disabilitv index,NDI)指数评分及视觉模拟量表(Visualanalogue pain scal,VAS)评分及颈部关节活动度的评定对比两组治疗效果.结果:治疗组治疗后NDI、VAS评分降低程度明显大于对照组,并且治疗组显效19例(63.33%),总有效率93.33%,对照组显效11例(36.67%),总有效率66.67%,治疗组明显优于对照组,差异有显著性(P<0.05).结论:DMS联合热磁治疗慢性非特异性颈痛效果显著,能帮助患者恢复颈部功能,缓解疼痛症状,值得临床推广应用.

  3. A Method to Develop Neck Injury Criteria to Aid Design and Test of Escape Systems Incorporating Helmet Mounted Displays

    Science.gov (United States)

    2014-09-01

    electromyography (EMG), neck strength (via Maximum Voluntary Contraction or MVC testing), neck endurance, neck discomfort surveys, and cognitive performance via...dependent variables; neck muscle fatigue via electromyography (EMG), neck strength (via Maximum Voluntary Contraction or MVC testing), neck endurance

  4. Effects of Chronic Pyridostigmine Administration on Muscle Fatigue and Morphology.

    Science.gov (United States)

    1987-07-01

    1, the Experimental Paradigm. Figure 9. Muscle force, EMG and tension production, of triceps surae from anesthetized rats which had been treated with...The electrophysiological program of stimulation was chosen to test the maximal output of the running muscles ( triceps surae ), which includes the... triceps surae , gastro- cnemius, plantaris and soleus muscles) and attached to a Grass FT03 force displacement transducer. The knees and ankles were

  5. Evaluation of the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain: study protocol for a randomized controlled trial

    OpenAIRE

    2015-01-01

    Background Nonspecific neck pain can cause considerable suffering, possible disability and reductions in quality of life and productivity. The aim of the proposed study is to evaluate the immediate effect of acupuncture on pain, cervical range of motion and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain. Methods/Design A total of 12 patients with nonspecific neck pain and 12 healthy subjects will be enrolled in a randomized, single-blind crosso...

  6. Ubiquitination and proteolysis in limb and respiratory muscles of patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Debigaré, Richard; Côté, Claude H; Maltais, François

    2010-02-01

    Peripheral muscle dysfunction associated with chronic diseases is undeniably a growing problem as one of its main causes, chronic obstructive pulmonary disease (COPD), progresses. Among others, muscle atrophy is one component building the concept of muscle dysfunction. Muscle atrophy has a significant impact on patient clinical status, independent of the impairment in lung function. A lot of effort has been devoted lately to increasing our understanding of the relationship between COPD and the initiation and the development of muscle atrophy. A growing body of evidence is showing that the ubiquitin-proteasome system, an ATP-dependent proteolytic pathway, is playing a crucial role in the cascade leading to degradation of contractile proteins, thus promoting the development of muscle atrophy. Interestingly, this system is also involved in essential cellular processes such as response to hypoxemia and muscle tissue regeneration. In this review, existing evidence linking the activity of the ubiquitin-proteasome system and the cellular events taking place in respiratory and peripheral muscles of patients with COPD are reported. Based on this information, the reader should be able to understand the essential role of this pathway in the context of muscle homeostasis and to picture the coming research in this area.

  7. The Evolution of and Risk Factors for Neck Muscle Atrophy and Weakness in Nasopharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy: A Retrospective Study in an Endemic Area.

    Science.gov (United States)

    Zhang, Lu-Lu; Mao, Yan-Ping; Zhou, Guan-Qun; Tang, Ling-Long; Qi, Zhen-Yu; Lin, Li; Yao, Ji-Jin; Ma, Jun; Lin, Ai-Hua; Sun, Ying

    2015-08-01

    The aim of this study was to investigate the evolution of sternocleidomastoid muscle (SCM) atrophy in nasopharyngeal carcinoma (NPC) patients following intensity-modulated radiotherapy (IMRT), and the relationship between SCM atrophy and neck weakness.Data were retrospectively analyzed from 223 biopsy-proven NPC patients with no distant metastasis who underwent IMRT with or without chemotherapy. The volume of SCM was measured on pretreatment magnetic resonance imaging (MRI), and MRIs were conducted 1, 2, and 3 years after the completion of IMRT. Change in SCM volume was calculated and classified using the late effects of normal tissues-subjective, objective, management, and analytic system. The grade of neck muscle weakness, classified by the Common Terminology Criteria for Adverse Events V 3.0, was measured 3 years after the completion of IMRT.The average SCM atrophy ratio was -10.97%, -18.65%, and -22.25% at 1, 2, and 3 years postirradiation, respectively. Multivariate analysis indicated N stage and the length of time after IMRT were independent prognostic variables. There were significant associations between the degree of SCM atrophy and neck weakness.Radical IMRT can cause significant SCM atrophy in NPC patients. A more advanced N stage was associated with more severe SCM atrophy, but no difference was observed between N2 and N3. SCM atrophy progresses over time during the 3 years following IMRT. Grade of SCM atrophy is significantly associated with neck weakness.

  8. Dosing study of massage for chronic neck pain: protocol for the dose response evaluation and analysis of massage [DREAM] trial

    Directory of Open Access Journals (Sweden)

    Sherman Karen J

    2012-09-01

    Full Text Available Abstract Background Despite the growing popularity of massage, its effectiveness for treating neck pain remains unclear, largely because of the poor quality of research. A major deficiency of previous studies has been their use of low “doses” of massage that massage therapists consider inadequate. Unfortunately, the number of minutes per massage session, sessions per week, or weeks of treatment necessary for massage to have beneficial or optimal effects are not known. This study is designed to address these gaps in our knowledge by determining, for persons with chronic neck pain: 1 the optimal combination of number of treatments per week and length of individual treatment session, and 2 the optimal number of weeks of treatment. Methods/design In this study, 228 persons with chronic non-specific neck pain will be recruited from primary health care clinics in a large health care system in the Seattle area. Participants will be randomized to a wait list control group or 4 weeks of treatment with one of 5 different dosing combinations (2 or 3 30-min treatments per week or 1, 2, or 3 60-min treatments per week. At the end of this 4-week primary treatment period, participants initially receiving each of the 5 dosing combinations will be randomized to a secondary treatment period of either no additional treatment or 6 weekly 60-min massages. The primary outcomes, neck-related dysfunction and pain, will be assessed by blinded telephone interviewers 5, 12, and 26 weeks post-randomization. To better characterize the trajectory of treatment effects, these interview data will be supplemented with outcomes data collected by internet questionnaire at 10, 16, 20 and 39 weeks. Comparisons of outcomes for the 6 groups during the primary treatment period will identify the optimal weekly dose, while comparisons of outcomes during the secondary treatment period will determine if 10 weeks of treatment is superior to 4 weeks. Discussion A broad dosing schedule

  9. Effectiveness of the Gaze Direction Recognition Task for Chronic Neck Pain and Cervical Range of Motion: A Randomized Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Satoshi Nobusako

    2012-01-01

    Full Text Available We developed a mental task with gaze direction recognition (GDR by which subjects observed neck rotation of another individual from behind and attempted to recognize the direction of gaze. A randomized controlled trial was performed in test (=9 and control (=8 groups of subjects with chronic neck pain undergoing physical therapy either with or without the GDR task carried out over 12 sessions during a three-week period. Primary outcome measures were defined as the active range of motion and pain on rotation of the neck. Secondary outcome measures were reaction time (RT and response accuracy in the GDR task group. ANOVA indicated a main effect for task session and group, and interaction of session. Post hoc testing showed that the GDR task group exhibited a significant simple main effect upon session, and significant sequential improvement of neck motion and relief of neck pain. Rapid effectiveness was significant in both groups. The GDR task group had a significant session-to-session reduction of RTs in correct responses. In conclusion, the GDR task we developed provides a promising rehabilitation measure for chronic neck pain.

  10. The Evolution of and Risk Factors for Neck Muscle Atrophy and Weakness in Nasopharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy

    OpenAIRE

    Zhang, Lu-lu; Mao, Yan-Ping; Zhou, Guan-Qun; Tang, Ling-Long; Qi, Zhen-Yu; Lin, Li; Yao, Ji-Jin; Ma, Jun; Lin, Ai-Hua; Sun, Ying

    2015-01-01

    Abstract The aim of this study was to investigate the evolution of sternocleidomastoid muscle (SCM) atrophy in nasopharyngeal carcinoma (NPC) patients following intensity-modulated radiotherapy (IMRT), and the relationship between SCM atrophy and neck weakness. Data were retrospectively analyzed from 223 biopsy-proven NPC patients with no distant metastasis who underwent IMRT with or without chemotherapy. The volume of SCM was measured on pretreatment magnetic resonance imaging (MRI), and MRI...

  11. The effect of kinesiotape on dynamic balance following muscle fatigue in individuals with chronic ankle instability.

    Science.gov (United States)

    Kodesh, Einat; Dar, Gali

    2015-01-01

    This study aimed to evaluate the effect of kinesiotape (KT) on dynamic stability following ankle muscle fatigue among individuals with chronic ankle instability (CAI). Twenty participants with CAI participated in the study. Participants were tested under three conditions: KT, non-elastic tape, and no tape pre- and post-fatigue of the ankle muscles. Ankle muscles fatigue was induced using an isokinetic apparatus, activity of the fibularis muscle was recorded using one-channel vibromyography (VMG), and dynamic balance and neuromuscular control were assessed using the Y-Balance Test. Following fatigue exercises, the VMG signal significantly decreased in all groups (p < 0.01), without differences between groups. No significant difference in dynamic balance test scores was found between the pre- and post-fatigue condition for each group and between groups. Our results demonstrate that KT had no significant effects on dynamic balance and muscle activity following ankle muscle fatigue among individuals with CAI.

  12. Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study

    Directory of Open Access Journals (Sweden)

    Irene Campa-Moran

    2015-01-01

    Full Text Available Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT, dry needling and stretching (DN-S, and soft tissue techniques (STT. All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM, pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale. Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation and DN-S (i.e., side-bending and rotation groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.

  13. Comparison of Dry Needling versus Orthopedic Manual Therapy in Patients with Myofascial Chronic Neck Pain: A Single-Blind, Randomized Pilot Study.

    Science.gov (United States)

    Campa-Moran, Irene; Rey-Gudin, Etelvina; Fernández-Carnero, Josué; Paris-Alemany, Alba; Gil-Martinez, Alfonso; Lerma Lara, Sergio; Prieto-Baquero, Almudena; Alonso-Perez, José Luis; La Touche, Roy

    2015-01-01

    Objective. The aim of this study was to compare the efficacy of three interventions for the treatment of myofascial chronic neck pain. Methods. Thirty-six patients were randomly assigned to one of three intervention groups: orthopedic manual therapy (OMT), dry needling and stretching (DN-S), and soft tissue techniques (STT). All groups received two treatment sessions with a 48 h time interval. Outcome measures included neck pain intensity measured using a visual analogue scale, cervical range of motion (ROM), pressure pain threshold for measuring mechanical hyperalgesia, and two self-reported questionnaires (neck disability index and pain catastrophizing scale). Results. The ANOVA revealed significant differences for the group × time interaction for neck disability, neck pain intensity, and pain catastrophizing. The DN-S and OMT groups reduced neck disability. Only the OMT group showed decreases in mechanical hyperalgesia and pain catastrophizing. The cervical ROM increased in OMT (i.e., flexion, side-bending, and rotation) and DN-S (i.e., side-bending and rotation) groups. Conclusions. The three interventions are all effective in reducing pain intensity. Reduction in mechanical hyperalgesia and pain catastrophizing was only observed in the OMT group. Cervical ROM improved in the DN-S and OMT groups and also neck disability being only clinically relevant for OMT group.

  14. DOES ELECTROMYOGRAPHY BIOFEEDBACK TRAINING REDUCE WORK-RELATED NECK PAIN?

    Directory of Open Access Journals (Sweden)

    Mohamed Faisal.C.K

    2014-10-01

    Full Text Available Purpose: The purpose of this study is to investigate the use of Electromyography (EMG biofeedback training in dental professionals to reduce upper trapezius muscle tension and thereby to reduce the work related neck pain. By reducing muscle activity in the neck and shoulder postural stabilizing muscles, EMG biofeedback training would be an effective mode of treatment in dental professionals for the management of work related neck pain. Subjects and Methods: This RCT included a total of 50 dental professionals (29 males and 21 females aged between 27-44 years (mean age of 36.4.They were randomly allocated equally into either experimental group who received EMG Biofeedback or the control group who received the conventional physiotherapy management. Patients in the control group were given Hot Packs, IFT and neck care advice. In addition to conventional Physiotherapy treatments, patients in the experimental group received an EMG Biofeedback training program for the bilateral trapezius. The treatments were given for 30-45 minutes/ day / 5 days in a week for 2 weeks. The outcome tools used were; Visual Analogue Scale (VAS and Neck Disability Scale (NDI and both were measured before starting the treatment and at end of 2 weeks. Results & Conclusion: Adding EMG biofeedback training for the trapezius muscles along with conventional physiotherapy management is found to be an effective method of treatment in the management of chronic non specific neck pain patients.

  15. Mixed dummy model with neck muscle force activation simulation%能够模拟颈部肌肉主动力的混合假人模型

    Institute of Scientific and Technical Information of China (English)

    李凡; 胡伟; 粟思橙; 曹迎春

    2015-01-01

    A mixed ifnite element (FE) dummy model was developed with precise neck muscle geometry as wel as active and passive muscle behavior to investigate neck injury mechanism with muscle activation in front colision which is important to the design of occupant safety. The model was based on the 50th Hybrid III dummy with the head and neck replaced by a wel-validated biomechanical model. The data of volunteer troley colision experiments with a deceleration of 15g, conducted by US Navy Biomechanics Laboratory, was used for model validation. The results show that the model has a good bioifdelity, according to the outputs of head linear acceleration, angular acceleration and rotational angles of head and neck compared to the volunteer tests. Therefore, the model can be used to investigate the head-neck injury biomechanics in vehicle frontal impact considering the activation behavior of neck muscle system.%构建了具有颈部肌肉精确几何结构和主被动响应的混合假人有限元(FE)模型,以便研究前碰撞形式下,肌肉作用下的颈部损伤机理,这对于汽车乘员保护安全性设计很重要。用已建立并验证的50百分位男性有限元头颈部生物力学模型,来替换50百分位男性Hybrid Ⅲ假人原有头颈部;采用美国海军生物力学实验室15g前碰撞志愿者台车实验数据,对该模型进行验证。结果表明:模型输出的头部质心线加速度、角加速度、头部转动角度、以及颈部转动角度,均能较好地拟合实验通道曲线。因此,该模型可用于车辆交通事故中人体头颈部损伤生物力学研究。

  16. Effects of proprioceptive neuromuscular facilitation neck pattern exercise on the ability to control the trunk and maintain balance in chronic stroke patients.

    Science.gov (United States)

    Hwangbo, Pil Neo; Don Kim, Kyoung

    2016-03-01

    [Purpose] The aim of this study was to investigate the effects of proprioceptive neuromuscular facilitation neck pattern exercise on the ability to control the trunk and balance in chronic stroke patients. [Subjects and Methods] A total of 30 study subjects were selected and randomly divided into an experimental group of 15 subjects, who received the proprioceptive neuromuscular facilitation neck pattern exercise, and a control group of 15 subjects, who received a traditional rehabilitation treatment. [Results] Statistically significant changes in all the items of the Trunk Impairment Scale, the Trunk Impairment Scale total score, and the Berg Balance Scale were observed in both the experimental group and the control group. significant between-group differences were found in all items among the subitems of the Trunk Impairment Scale except the static sitting balance. [Conclusion] Proprioceptive neuromuscular facilitation neck pattern exercise was shown to have a positive effect on increasing the ability to control the trunk and maintain balance in chronic stroke patients.

  17. Chronic Prosopis glandulosa treatment blunts neutrophil infiltration and enhances muscle repair after contusion injury.

    Science.gov (United States)

    George, Cindy; Smith, Carine; Isaacs, Ashwin W; Huisamen, Barbara

    2015-01-23

    The current treatment options for soft tissue injuries remain suboptimal and often result in delayed/incomplete recovery of damaged muscle. The current study aimed to evaluate the effects of oral Prosopis glandulosa treatment on inflammation and regeneration in skeletal muscle after contusion injury, in comparison to a conventional treatment. The gastrocnemius muscle of rats was subjected to mass-drop injury and muscle samples collected after 1-, 3 h, 1- and 7 days post-injury. Rats were treated with P. glandulosa (100 mg/kg/day) either for 8 weeks prior to injury (up until day 7 post-injury), only post-injury, or with topically applied diclofenac post-injury (0.57 mg/kg). Neutrophil (His48-positive) and macrophage (F4/80-positive) infiltration was assessed by means of immunohistochemistry. Indicators of muscle satellite cell proliferation (ADAM12) and regeneration (desmin) were used to evaluate muscle repair. Chronic P. glandulosa and diclofenac treatment (p<0.0001) was associated with suppression of the neutrophil response to contusion injury, however only chronic P. glandulosa treatment facilitated more effective muscle recovery (increased ADAM12 (p<0.05) and desmin (p<0.001) expression), while diclofenac treatment had inhibitory effects on repair, despite effective inhibition of neutrophil response. Data indicates that P. glandulosa treatment results in more effective muscle repair after contusion.

  18. Muscle dysfunction in chronic obstructive pulmonary disease: update on causes and biological findings.

    Science.gov (United States)

    Gea, Joaquim; Pascual, Sergi; Casadevall, Carme; Orozco-Levi, Mauricio; Barreiro, Esther

    2015-10-01

    Respiratory and/or limb muscle dysfunction, which are frequently observed in chronic obstructive pulmonary disease (COPD) patients, contribute to their disease prognosis irrespective of the lung function. Muscle dysfunction is caused by the interaction of local and systemic factors. The key deleterious etiologic factors are pulmonary hyperinflation for the respiratory muscles and deconditioning secondary to reduced physical activity for limb muscles. Nonetheless, cigarette smoke, systemic inflammation, nutritional abnormalities, exercise, exacerbations, anabolic insufficiency, drugs and comorbidities also seem to play a relevant role. All these factors modify the phenotype of the muscles, through the induction of several biological phenomena in patients with COPD. While respiratory muscles improve their aerobic phenotype (percentage of oxidative fibers, capillarization, mitochondrial density, enzyme activity in the aerobic pathways, etc.), limb muscles exhibit the opposite phenotype. In addition, both muscle groups show oxidative stress, signs of damage and epigenetic changes. However, fiber atrophy, increased number of inflammatory cells, altered regenerative capacity; signs of apoptosis and autophagy, and an imbalance between protein synthesis and breakdown are rather characteristic features of the limb muscles, mostly in patients with reduced body weight. Despite that significant progress has been achieved in the last decades, full elucidation of the specific roles of the target biological mechanisms involved in COPD muscle dysfunction is still required. Such an achievement will be crucial to adequately tackle with this relevant clinical problem of COPD patients in the near-future.

  19. Chronic expanding hematoma extending over multiple gluteal muscles associated with piriformis syndrome.

    Science.gov (United States)

    Kitagawa, Yasuyuki; Yokoyama, Munehiro; Tamai, Kensuke; Takai, Shinro

    2012-01-01

    We report on a patient with an unusual, slowly enlarging hematoma of the left buttock. A 62-year-old man presented with a 6-year history of an enlarging mass of the left buttock. He had first noted the mass 6 years earlier and had had sciatica of the left lower limb for the last 2 months. He denied any history of antecedent trauma. The lesion extended over 3 gluteal muscles (the gluteus medius, gluteus minimus, and piriformis). On microscopic examination, the lesion showed typical signs of chronic expanding hematoma. The sciatica was relieved after surgical removal of the lesion. The lesion had not recurred at the last follow-up 4 years after the operation. The present case suggested that chronic expanding hematoma can extend into multiple muscles due, perhaps, to long-term growth and the anatomical and functional conditions of the affected muscles. Our case also suggests that chronic expanding hematoma can be a cause of piriformis syndrome.

  20. Is one better than another?: A randomized clinical trial of manual therapy for patients with chronic neck pain.

    Science.gov (United States)

    Izquierdo Pérez, Honorio; Alonso Perez, Jose Luis; Gil Martinez, Alfonso; La Touche, Roy; Lerma-Lara, Sergio; Commeaux Gonzalez, Noelia; Arribas Perez, Hector; Bishop, Mark D; Fernández-Carnero, Josue

    2014-06-01

    Our purpose was to compare the effectiveness of three manual therapy techniques: high velocity, low amplitude (HVLA), mobilization (Mob) and sustained natural apophyseal glide (SNAG) in patients with chronic neck pain (CNP). The randomized controlled trial included patients with mechanically reproducible CNP, who were randomized to the treatment group. Outcome measures were the Visual Analogue scale (VAS), Neck Disability Index (NDI), Global Rating of Change (GROC) and Cervical Range of Motion (CROM). Two-way repeated measures analysis of variance compared outcomes at baseline, at the end of treatment and 1, 2 and 3 months after treatment. A total of 51 subjects completed the trial. No significant differences were found between HVLA, Mob and SNAG at the end of treatment and during the follow-up in any of the analysed outcomes. There were no differences in satisfaction for all techniques. The results lead to the conclusion that there is no long-term difference between the application of HVLA, Mob and SNAG in pain, disability and cervical range of motion for patients with CNP.

  1. Effects of inspiratory muscle training on balance ability and abdominal muscle thickness in chronic stroke patients.

    Science.gov (United States)

    Oh, Dongha; Kim, Gayeong; Lee, Wanhee; Shin, Mary Myong Sook

    2016-01-01

    [Purpose] This study evaluated the effects of inspiratory muscle training on pulmonary function, deep abdominal muscle thickness, and balance ability in stroke patients. [Subjects] Twenty-three stroke patients were randomly allocated to an experimental (n = 11) or control group (n = 12). [Methods] The experimental group received inspiratory muscle training-based abdominal muscle strengthening with conventional physical therapy; the control group received standard abdominal muscle strengthening with conventional physical therapy. Treatment was conducted 20 minutes per day, 3 times per week for 6 weeks. Pulmonary function testing was performed using an electronic spirometer. Deep abdominal muscle thickness was measured by ultrasonography. Balance was measured using the Berg balance scale. [Results] Forced vital capacity, forced expiratory volume in 1 second, deep abdominal muscle thickness, and Berg balance scale scores were significantly improved in the experimental group than in the control group. [Conclusion] Abdominal muscle strengthening accompanied by inspiratory muscle training is recommended to improve pulmonary function in stroke patients, and may also be used as a practical adjunct to conventional physical therapy.

  2. Increased oxidative metabolism and myoglobin expression in zebrafish muscle during chronic hypoxia

    Directory of Open Access Journals (Sweden)

    Richard T. Jaspers

    2014-07-01

    Full Text Available Fish may be extremely hypoxia resistant. We investigated how muscle fibre size and oxidative capacity in zebrafish (Danio rerio adapt during severe chronic hypoxia. Zebrafish were kept for either 3 or 6 weeks under chronic constant hypoxia (CCH (10% air/90%N2 saturated water. We analyzed cross-sectional area (CSA, succinate dehydrogenase (SDH activity, capillarization, myonuclear density, myoglobin (Mb concentration and Mb mRNA expression of high and low oxidative muscle fibres. After 3 weeks of CCH, CSA, SDH activity, Mb concentration, capillary and myonuclear density of both muscle fibre types were similar as under normoxia. In contrast, staining intensity for Mb mRNA of hypoxic high oxidative muscle fibres was 94% higher than that of normoxic controls (P<0.001. Between 3 and 6 weeks of CCH, CSA of high and low oxidative muscle fibres increased by 25 and 30%, respectively. This was similar to normoxic controls. Capillary and myonuclear density were not changed by CCH. However, in high oxidative muscle fibres of fish maintained under CCH, SDH activity, Mb concentration as well as Mb mRNA content were higher by 86%, 138% and 90%, respectively, than in muscle fibres of fish kept under normoxia (P<0.001. In low oxidative muscle fibres, SDH activity, Mb and Mb mRNA content were not significantly changed. Under normoxia, the calculated interstitial oxygen tension required to prevent anoxic cores in muscle fibres (PO2crit of high oxidative muscle fibres was between 1.0 and 1.7 mmHg. These values were similar at 3 and 6 weeks CCH. We conclude that high oxidative skeletal muscle fibres of zebrafish continue to grow and increase oxidative capacity during CCH. Oxygen supply to mitochondria in these fibres may be facilitated by an increased Mb concentration, which is regulated by an increase in Mb mRNA content per myonucleus.

  3. Increased oxidative metabolism and myoglobin expression in zebrafish muscle during chronic hypoxia

    Science.gov (United States)

    Jaspers, Richard T.; Testerink, Janwillem; Della Gaspera, Bruno; Chanoine, Christophe; Bagowski, Christophe P.; van der Laarse, Willem J.

    2014-01-01

    ABSTRACT Fish may be extremely hypoxia resistant. We investigated how muscle fibre size and oxidative capacity in zebrafish (Danio rerio) adapt during severe chronic hypoxia. Zebrafish were kept for either 3 or 6 weeks under chronic constant hypoxia (CCH) (10% air/90%N2 saturated water). We analyzed cross-sectional area (CSA), succinate dehydrogenase (SDH) activity, capillarization, myonuclear density, myoglobin (Mb) concentration and Mb mRNA expression of high and low oxidative muscle fibres. After 3 weeks of CCH, CSA, SDH activity, Mb concentration, capillary and myonuclear density of both muscle fibre types were similar as under normoxia. In contrast, staining intensity for Mb mRNA of hypoxic high oxidative muscle fibres was 94% higher than that of normoxic controls (P<0.001). Between 3 and 6 weeks of CCH, CSA of high and low oxidative muscle fibres increased by 25 and 30%, respectively. This was similar to normoxic controls. Capillary and myonuclear density were not changed by CCH. However, in high oxidative muscle fibres of fish maintained under CCH, SDH activity, Mb concentration as well as Mb mRNA content were higher by 86%, 138% and 90%, respectively, than in muscle fibres of fish kept under normoxia (P<0.001). In low oxidative muscle fibres, SDH activity, Mb and Mb mRNA content were not significantly changed. Under normoxia, the calculated interstitial oxygen tension required to prevent anoxic cores in muscle fibres (PO2crit) of high oxidative muscle fibres was between 1.0 and 1.7 mmHg. These values were similar at 3 and 6 weeks CCH. We conclude that high oxidative skeletal muscle fibres of zebrafish continue to grow and increase oxidative capacity during CCH. Oxygen supply to mitochondria in these fibres may be facilitated by an increased Mb concentration, which is regulated by an increase in Mb mRNA content per myonucleus. PMID:25063194

  4. Increased oxidative metabolism and myoglobin expression in zebrafish muscle during chronic hypoxia.

    Science.gov (United States)

    Jaspers, Richard T; Testerink, Janwillem; Della Gaspera, Bruno; Chanoine, Christophe; Bagowski, Christophe P; van der Laarse, Willem J

    2014-07-25

    Fish may be extremely hypoxia resistant. We investigated how muscle fibre size and oxidative capacity in zebrafish (Danio rerio) adapt during severe chronic hypoxia. Zebrafish were kept for either 3 or 6 weeks under chronic constant hypoxia (CCH) (10% air/90%N2 saturated water). We analyzed cross-sectional area (CSA), succinate dehydrogenase (SDH) activity, capillarization, myonuclear density, myoglobin (Mb) concentration and Mb mRNA expression of high and low oxidative muscle fibres. After 3 weeks of CCH, CSA, SDH activity, Mb concentration, capillary and myonuclear density of both muscle fibre types were similar as under normoxia. In contrast, staining intensity for Mb mRNA of hypoxic high oxidative muscle fibres was 94% higher than that of normoxic controls (P<0.001). Between 3 and 6 weeks of CCH, CSA of high and low oxidative muscle fibres increased by 25 and 30%, respectively. This was similar to normoxic controls. Capillary and myonuclear density were not changed by CCH. However, in high oxidative muscle fibres of fish maintained under CCH, SDH activity, Mb concentration as well as Mb mRNA content were higher by 86%, 138% and 90%, respectively, than in muscle fibres of fish kept under normoxia (P<0.001). In low oxidative muscle fibres, SDH activity, Mb and Mb mRNA content were not significantly changed. Under normoxia, the calculated interstitial oxygen tension required to prevent anoxic cores in muscle fibres (PO2crit) of high oxidative muscle fibres was between 1.0 and 1.7 mmHg. These values were similar at 3 and 6 weeks CCH. We conclude that high oxidative skeletal muscle fibres of zebrafish continue to grow and increase oxidative capacity during CCH. Oxygen supply to mitochondria in these fibres may be facilitated by an increased Mb concentration, which is regulated by an increase in Mb mRNA content per myonucleus.

  5. Multi-channel array EMG in chronic neck-shoulder pain

    NARCIS (Netherlands)

    Kallenberg, Laura Anna Cornelia

    2007-01-01

    Chronic muscular pain has become an important problem, affecting a considerable part of the working population in the industrialised countries. Chronic muscular pain is a multifactorial problem and comprises a range of conditions that are not all clinically welldefined. Subjective symptoms include c

  6. Strength improvement of knee extensor muscles in patients with chronic heart failure by neuromuscular electrical stimulation.

    Science.gov (United States)

    Quittan, M; Sochor, A; Wiesinger, G F; Kollmitzer, J; Sturm, B; Pacher, R; Mayr, W

    1999-05-01

    Patients with severe chronic heart failure (CHF) suffer from marked weakness of skeletal muscles. Neuromuscular electrical stimulation (NMES) proved to be an alternative to active strength training. The objective of this study was to test the feasibility and effectiveness of NMES in patients with chronic heart failure. Seven patients (56.0 +/- 5.0 years, CHF for 20 +/- 4 months, left ventricular ejection fraction 20.1 +/- 10.0%) finished an 8 week course of NMES of the knee extensor muscles. The stimulator delivered biphasic, symmetric, constant voltage impulses of 0.7 ms pulse width with a frequency of 50 Hz, 2 s on and 6 s off. No adverse effects occurred. After the stimulation period, the isokinetic peak torque of the knee extensor muscles increased by 13% from 101.0 +/- 8.7 Nm to 113.5 +/- 7.2 Nm (p = 0.004). The maximal isometric strength increased by 20% from 294.3 +/- 19.6 N to 354.14 +/- 15.7 N (p = 0.04). This increased muscle strength could be maintained in a 20 min fatigue test indicating decreased muscle fatigue. These results demonstrate that NMES of skeletal muscles in patients with severe chronic heart failure is a promising method for strength training in this group of patients.

  7. Test-retest repeatability of strength capacity, aerobic power and pericranial tenderness of neck and shoulder muscles in children - relevant for tension-type headache

    DEFF Research Database (Denmark)

    Tornøe, Birte; Andersen, Lars L; Skotte, J H;

    2013-01-01

    Frequent or chronic tension-type headache in children is a prevalent and debilitating condition for the child, often leading to medication overuse. To explore the relationship between physical factors and tension-type headache in children, the quality of repeated measures was examined. The aim...... of the present study was to determine the test-retest repeatability of parameters determining isometric neck and shoulder strength and stability, aerobic power, and pericranial tenderness in children....

  8. Deficits in muscle strength, mass, quality and mobility in people with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Roig, Marc; Eng, Janice J; MacIntyre, Donna L;

    2011-01-01

    strength, mass, and IF were not associated with mobility measures. CONCLUSIONS: Compared with healthy controls, patients with moderate to severe COPD show marked deficits in muscle strength, mass, quality, and mobility. More studies with larger sample size are required to elucidate whether any......PURPOSE: Midthigh intramuscular fat (IF), a feature of reduced muscle quality, is an important predictor of self-reported mobility loss in the elderly. This study compared measures of muscle strength, mass, IF, and mobility in patients with chronic obstructive pulmonary disease (COPD) and healthy...

  9. A systems biology approach identifies molecular networks defining skeletal muscle abnormalities in chronic obstructive pulmonary disease.

    Directory of Open Access Journals (Sweden)

    Nil Turan

    2011-09-01

    Full Text Available Chronic Obstructive Pulmonary Disease (COPD is an inflammatory process of the lung inducing persistent airflow limitation. Extensive systemic effects, such as skeletal muscle dysfunction, often characterize these patients and severely limit life expectancy. Despite considerable research efforts, the molecular basis of muscle degeneration in COPD is still a matter of intense debate. In this study, we have applied a network biology approach to model the relationship between muscle molecular and physiological response to training and systemic inflammatory mediators. Our model shows that failure to co-ordinately activate expression of several tissue remodelling and bioenergetics pathways is a specific landmark of COPD diseased muscles. Our findings also suggest that this phenomenon may be linked to an abnormal expression of a number of histone modifiers, which we discovered correlate with oxygen utilization. These observations raised the interesting possibility that cell hypoxia may be a key factor driving skeletal muscle degeneration in COPD patients.

  10. Subcutaneous injection of Mycobacterium ulcerans causes necrosis, chronic inflammatory response and fibrosis in skeletal muscle.

    Science.gov (United States)

    Houngbédji, Mabèrou Germain; Boissinot, Maurice; Bergeron, G Michel; Frenette, Jérôme

    2008-10-01

    Mycobacterium ulcerans (M. ulcerans) causes Buruli ulcer, a very debilitating disease that affects the skin and other tissues. The disease occurs mainly in children in sub-Sahara Africa. While contracture, fibrosis and functional limitation of range of motion are frequent complications of Buruli ulcer, no fundamental or clinical studies have investigated the impact of M. ulcerans infections on skeletal muscle. In the present study, we subcutaneously infected mice in the proximity of the right biceps muscle to evaluate the histological, biochemical and functional impact of M. ulcerans on skeletal muscles. The concentration of mast cells decreased but the number of neutrophils and macrophages increased steadily in proximate-infected biceps muscles. Pro- and anti-inflammatory cytokines as well as fibrogenic growth factor mRNA also increased. Significantly more membrane damage and fibrosis occurred in proximate-infected biceps muscles than in control and sham muscles. Passive biomechanical testing also revealed that the presence of M. ulcerans increased muscle stiffness. These findings show for the first time that M. ulcerans can induce local and chronic inflammatory responses in skeletal muscles that are associated with muscle fiber damage and fibrosis.

  11. 颈肩肌劳损60例综合康复治疗体会%Experience of comprehensive rehabilitation treatment on 60 cases of muscle strain at neck and shoulder

    Institute of Scientific and Technical Information of China (English)

    史永莉

    2003-01-01

    @@ BACKGROUND:In treatment of muscle strain at neck and shoulder,dynamic balance disturbance must be dealed with and needle can detach adhesion,relax muscle,resume local blood circulation.Combined physiotherapy can improve local circulation and promote absortion of exudation.

  12. Effectiveness of behavioural graded activity compared with physiotherapy treatment in chronic neck pain: design of a randomised clinical trial [ISRCTN88733332

    Directory of Open Access Journals (Sweden)

    Vos Cees J

    2004-10-01

    Full Text Available Abstract Background Chronic neck pain is a common complaint in the Netherlands with a point prevalence of 14.3%. Patients with chronic neck pain are often referred to a physiotherapist and, although many treatments are available, it remains unclear which type of treatment is to be preferred. The objective of this article is to present the design of a randomised clinical trial, Ephysion, which examines the clinical and cost effectiveness of behavioural graded activity compared with a physiotherapy treatment for patients with chronic non-specific neck pain. Methods Eligible patients with non-specific neck pain persisting longer than 3 months will be randomly allocated to either the behavioural graded activity programme or to the physiotherapy treatment. The graded activity programme is based on an operant approach, which uses a time-contingent method to increase the patient's activity level. This treatment is compared with physiotherapy treatment using a pain-contingent method. Primary treatment outcome is the patient's global perceived effect concerning recovery from the complaint. Global perceived effect on daily functioning is also explored as primary outcome to establish the impact of treatment on daily activity. Direct and indirect costs will also be assessed. Secondary outcomes include the patient's main complaints, pain intensity, medical consumption, functional status, quality of life, and psychological variables. Recruitment of patients will take place up to the end of the year 2004 and follow-up measurement will continue until end 2005.

  13. Efficacy and safety of Myofascial-meridian Release Acupuncture (MMRA) for chronic neck pain: a study protocol for randomized, patient- and assessor-blinded, sham controlled trial

    OpenAIRE

    Lee, Seunghoon; Nam, Dongwoo; Leem, Jungtae; Han, Gajin; Lee, Seungmin; Lee,Junhee

    2016-01-01

    Background The purpose of this study is to evaluate the efficacy and safety of myofascial-meridian release acupuncture (MMRA) in the treatment of chronic neck pain compared with sham acupuncture. Methods/design A protocol for a randomized, patient- and assessor-blinded, sham controlled parallel trial is presented. Seventy-four participants with a ≥3 month history of neck pain and a score of ≥4 on the 11-point pain intensity numerical rating scale (PI-NRS) will be randomly assigned to the MMRA...

  14. Pelvic floor muscle dysfunctions are prevalent in female chronic pelvic pain

    DEFF Research Database (Denmark)

    Loving, S; Thomsen, Thordis; Jaszczak, Poul P.

    2014-01-01

    BACKGROUND: No current standardized set of pelvic floor muscle (PFM) outcome measures have been specifically tested for their applicability in a general female chronic pelvic pain (CPP) population. We aimed to compare PFM function between a randomly selected population-based sample of women...

  15. Changes in Muscle Activation after Reach Training with Gravity Compensation in Chronic Stroke Patients

    Science.gov (United States)

    Prange, Gerdienke B.; Krabben, Thijs; Renzenbrink, Gerbert J.; Ijzerman, Maarten J.; Hermens, Hermie J.; Jannink, Michiel J. A.

    2012-01-01

    The objective of this study is to examine the effect of gravity compensation training on reaching and underlying changes in muscle activation. In this clinical trial, eight chronic stroke patients with limited arm function received 18 sessions (30 min) of gravity-compensated reach training (during 6 weeks) in combination with a rehabilitation…

  16. Vocal Cord Paralysis and Respiratory Muscle Weakness: An Unusual Presentation of Chronic Polyneuropathy

    Directory of Open Access Journals (Sweden)

    LKL Chau

    1998-01-01

    Full Text Available A case of chronic polyneuropathy that manifested with an unusual combination of vocal cord paralysis and respiratory muscle weakness is reported. In addition, results of an exercise test carried out to assess the severity and mechanisms of exertional breathlessness in this unique condition with combined obstructive and restrictive disorders are described.

  17. [Two case reports of recurrent mediastinitis with chronic mediastinal fistula successfully treated with muscle flap re-transposition].

    Science.gov (United States)

    Hashimoto, Y; Kanazawa, H; Kasuya, S; Irisawa, T; Ohzeki, H; Kuraoka, S; Goto, S; Sakashita, I; Takahashi, H

    1994-04-01

    We experienced two cases of recurrent poststernotomy mediastinitis with chronic mediastinal fistula. Both cases had already received muscle flaps for post operative mediastinitis. However, chronic mediastinal fistula appeared after nine months in the first case, and eleven months in the second case. We removed the infected tissue and the predgets, which were used on the ascending aorta. Then closed the wound by the muscle flap closure. The chronic fistula were closed, and the functional and cosmetic results were excellent.

  18. The construct validity of the Short Form-36 Health Survey for patients with nonspecific chronic neck pain.

    Science.gov (United States)

    de Vries, Grietje E; Jorritsma, Wim; Dijkstra, Pieter U; Geertzen, Jan H B; Reneman, Michiel F

    2015-06-01

    Self-reported disability related to neck pain can be measured using general health questionnaires. The validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) in patients with nonspecific chronic neck pain (CNP) in a tertiary outpatient rehabilitation setting is unknown. This study investigates construct validity of the SF-36 in these patients using 16 a-priori formulated hypotheses. Ninety-one patients admitted for rehabilitation completed the SF-36 before the rehabilitation program. SF-36 domain scores of patients with CNP were compared with general population reference values and standardized differences were calculated. For both the SF-36 physical and the mental component summary (PCS and MCS), differences between primary and tertiary care setting, men and women, age groups, litigants and nonlitigants, patients with and without compensation, and with ≥3 versus≤2 concomitant complaints were analyzed using independent t-tests. Differences between PCS and MCS scores were analyzed using a paired t-test. Twelve hypotheses were not rejected and four were rejected. All SF-36 domain scores were significantly lower than the general population references values. The domain scores 'role physical', 'bodily pain', 'vitality', 'social functioning,' and 'role emotional' were relevantly (≥1 SD) lower. SF-36-PCS and SF-36-MCS scores were significantly lower in tertiary care. The SF-36-PCS score was significantly lower for patients with workers compensation and patients with at least three concomitant complaints. The SF-36-MCS score was significantly lower for the age group of at least 39 years. The SF-36 has good construct validity and can be used to measure self-reported general health in patients with nonspecific CNP in outpatient tertiary rehabilitation.

  19. [Efficacy of levocarnitine for tyrosine kinase inhibitor-induced painful muscle cramps in patients with chronic myelogenous leukemia].

    Science.gov (United States)

    Yamada, Michiko; Kuroda, Hiroyuki; Shimoyama, Saori; Ito, Ryo; Sugama, Yusuke; Sato, Ken; Yamauchi, Natsumi; Horiguchi, Hiroto; Nakamura, Hajime; Hamaguchi, Kota; Abe, Tomoyuki; Fujii, Shigeyuki; Maeda, Masahiro; Kato, Junji

    2016-04-01

    Muscle cramps are side effects commonly associated with tyrosine kinase inhibitor (TKI) treatment. Patients suffering from muscle cramps are treated with various medications such as calcium, magnesium and vitamin supplements, but these therapies are often ineffective. We report two patients with chronic myelogenous leukemia who developed muscle cramps caused by TKI. These patients were treated successfully with levocarnitine. Both of our cases revealed the beneficial effects of levocarnitine treatment on TKI-induced muscle cramps.

  20. Fluoroscopic cervical epidural injections in chronic axial or disc-related neck pain without disc herniation, facet joint pain, or radiculitis

    Directory of Open Access Journals (Sweden)

    Manchikanti L

    2012-07-01

    Full Text Available Laxmaiah Manchikanti, Kimberly A Cash, Vidyasagar Pampati, Yogesh MallaPain Management Center of Paducah, Paducah, KY, USABackground: While chronic neck pain is a common problem in the adult population, with a typical 12-month prevalence of 30%–50%, there is a lack of consensus regarding its causes and treatment. Despite limited evidence, cervical epidural injections are one of the commonly performed nonsurgical interventions in the management of chronic neck pain.Methods: A randomized, double-blind, active, controlled trial was conducted to evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of chronic neck pain with or without upper extremity pain in patients without disc herniation, radiculitis, or facet joint pain.Results: One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of two treatment groups, ie, injection of local anesthetic only (group 1 or local anesthetic mixed with nonparticulate betamethasone (group 2. The primary outcome of significant pain relief and improvement in functional status (≥50% was demonstrated in 72% of group 1 and 68% of group 2. The overall average number of procedures per year was 3.6 in both groups with an average total relief per year of 37–39 weeks in the successful group over a period of 52 weeks.Conclusion: Cervical interlaminar epidural injections of local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic or axial pain.Keywords: chronic neck pain, cervical disc herniation, cervical discogenic pain, cervical epidural injections, epidural steroids, local anesthetics

  1. Nitrosative stress in human skeletal muscle attenuated by exercise countermeasure after chronic disuse

    Directory of Open Access Journals (Sweden)

    Michele Salanova

    2013-01-01

    Full Text Available Activity-induced nitric oxide (NO imbalance and “nitrosative stress” are proposed mechanisms of disrupted Ca2+ homeostasis in atrophic skeletal muscle. We thus mapped S-nitrosylated (SNO functional muscle proteins in healthy male subjects in a long-term bed rest study (BBR2-2 Study without and with exercise as countermeasure in order to assess (i the negative effects of chronic muscle disuse by nitrosative stress, (ii to test for possible attenuation by exercise countermeasure in bed rest and (iii to identify new NO target proteins. Muscle biopsies from calf soleus and hip vastus lateralis were harvested at start (Pre and at end (End from a bed rest disuse control group (CTR, n=9 and two bed rest resistive exercise groups either without (RE, n=7 or with superimposed vibration stimuli (RVE, n=7. At subcellular compartments, strong anti-SNO-Cys immunofluorescence patterns in control muscle fibers after bed rest returned to baseline following vibration exercise. Total SNO-protein levels, Nrf-2 gene expression and nucleocytoplasmic shuttling were changed to varying degrees in all groups. Excess SNO-protein levels of specific calcium release/uptake proteins (SNO-RyR1, –SERCA1 and –PMCA and of contractile myosin heavy chains seen in biopsy samples of chronically disused skeletal muscle were largely reduced by vibration exercise. We also identified NOS1 as a novel NO target in human skeletal muscle controlled by activity driven auto-nitrosylation mechanisms. Our findings suggest that aberrant levels of functional SNO-proteins represent signatures of uncontrolled nitrosative stress management in disused human skeletal muscle that can be offset by exercise as countermeasure.

  2. Neuromodulation of the cervical spinal cord in the treatment of chronic intractable neck and upper extremity pain: a case series and review of the literature.

    Science.gov (United States)

    Vallejo, Ricardo; Kramer, Jeffery; Benyamin, Ramsin

    2007-03-01

    Electrical spinal neuromodulation in the form of spinal cord stimulation is currently used for treating chronic painful conditions such as complex regional pain syndrome, diabetic neuropathy, postherpetic neuralgia, peripheral ischemia, low back pain, and other conditions refractory to more conservative treatments. To date, there are very few published reports documenting the use of spinal cord stimulation in the treatment of head/neck and upper limb pain. This paper reports a case series of 5 consecutive patients outlining the use of spinal cord stimulation to treat upper extremity pain. All subjects had previously undergone cervical fusion surgery to treat chronic neck and upper limb pain. Patients were referred following failure of the surgery to manage their painful conditions. Spinal cord stimulators were placed in the cervical epidural space through a thoracic needle placement. Stimulation parameters were adjusted to capture as much of the painful area(s) as possible. In total, 4 out of 5 patients moved to implantation. In all cases, patients reported significant (70-90%) reductions in pain, including axial neck pain and upper extremity pain. Interestingly, 2 patients with associated headache and lower extremity pain obtained relief after paresthesia-steering reportedly covered those areas. Moreover, 2 patients reported that cervical spinal cord stimulation significantly improved axial low back pain. Patients continue to report excellent pain relief up to 9 months following implantation. This case series documents the successful treatment of neck and upper extremity pain following unsuccessful cervical spine fusion surgery. Given this initial success, prospective, controlled studies are warranted to more adequately assess the long term utility and cost effectiveness of electrical neuromodulation treatment of chronic neck and upper extremity pain.

  3. Sex differences in function and structure of the quadriceps muscle in chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    Ausín, Pilar; Martínez-Llorens, Juana; Sabaté-Bresco, Marina; Casadevall, Carme; Barreiro, Esther; Gea, Joaquim

    2016-12-06

    Chronic obstructive pulmonary disease (COPD) is a complex disorder with extrapulmonary manifestations. Even though there is some knowledge regarding sex differences in the lung disease, little is known about extrapulmonary manifestations. Our aim was to analyze the specific profile of muscle dysfunction, structure, and biology in COPD women. Twenty-one women and 19 men with stable COPD as well as 15 controls were included. Nutritional status, physical activity, lung and muscle function, exercise capacity, and quality of life were assessed. In addition, blood, breath condensate, and quadriceps muscle samples were tested for inflammatory markers. Moreover, fiber phenotype, signs of damage-regeneration, and the expression of key genes linked to myogenesis and inflammation were assessed in the muscle. Inflammatory markers were increased in all body compartments but no correlation was found among them. Muscle dysfunction was present in both COPD groups but was more marked in women. The opposite occurred with the increase in the percentage of type II fibers that was lower in women despite a similar level of airway obstruction as in men. Female COPD also showed higher signs of muscle damage than COPD men who, in contrast, exhibited slightly higher signs of regeneration. We conclude that sex influences muscle phenotype and function in COPD.

  4. Emerging therapies for the treatment of skeletal muscle wasting in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Passey, Samantha L; Hansen, Michelle J; Bozinovski, Steven; McDonald, Christine F; Holland, Anne E; Vlahos, Ross

    2016-10-01

    Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that constitutes a major global health burden. A significant proportion of patients experience skeletal muscle wasting and loss of strength as a comorbidity of their COPD, a condition that severely impacts on their quality of life and survival. At present, the lung pathology is considered to be largely irreversible; however, the inherent adaptability of muscle tissue offers therapeutic opportunities to tackle muscle wasting and potentially reverse or delay the progression of this aspect of the disease, to improve patients' quality of life. Muscle wasting in COPD is complex, with contributions from a number of factors including inflammatory cytokines, oxidative stress, growth and anabolic hormones, nutritional status, and physical activity. In this review, we discuss current and emerging therapeutic approaches to treat muscle wasting in COPD, including a number of pharmacological therapies that are in development for muscle atrophy in other pathological states that could be of relevance for treating muscle wasting in COPD patients.

  5. Chronic hypobaric hypoxia mediated skeletal muscle atrophy: role of ubiquitin-proteasome pathway and calpains.

    Science.gov (United States)

    Chaudhary, Pooja; Suryakumar, Geetha; Prasad, Rajendra; Singh, Som Nath; Ali, Shakir; Ilavazhagan, Govindsamy

    2012-05-01

    The most frequently reported symptom of exposure to high altitude is loss of body mass and decreased performance which has been attributed to altered protein metabolism affecting skeletal muscles mass. The present study explores the mechanism of chronic hypobaric hypoxia mediated skeletal muscle wasting by evaluating changes in protein turnover and various proteolytic pathways. Male Sprague-Dawley rats weighing about 200 g were exposed to hypobaric hypoxia (7,620 m) for different durations of exposure. Physical performance of rats was measured by treadmill running experiments. Protein synthesis, protein degradation rates were determined by (14)C-Leucine incorporation and tyrosine release, respectively. Chymotrypsin-like enzyme activity of the ubiquitin-proteasome pathway and calpains were studied fluorimetrically as well as using western blots. Declined physical performance by more than 20%, in terms of time taken in exhaustion on treadmill, following chronic hypobaric hypoxia was observed. Compared to 1.5-fold increase in protein synthesis, the increase in protein degradation was much higher (five-folds), which consequently resulted in skeletal muscle mass loss. Myofibrillar protein level declined from 46.79 ± 1.49 mg/g tissue at sea level to 37.36 ± 1.153 (P calpains (three-fold) has been found to be important factors for the enhanced protein degradation rate. The study provided strong evidences suggesting that elevated protein turnover rate lead to skeletal muscle atrophy under chronic hypobaric hypoxia via ubiquitin-proteasome pathway and calpains.

  6. Duration of chronic inflammation alters gene expression in muscle from untreated girls with juvenile dermatomyositis

    Directory of Open Access Journals (Sweden)

    Gordish-Dressman Heather

    2008-07-01

    Full Text Available Abstract Background To evaluate the impact of the duration of chronic inflammation on gene expression in skeletal muscle biopsies (MBx from untreated children with juvenile dermatomyositis (JDM and identify genes and biological processes associated with the disease progression, expression profiling data from 16 girls with active symptoms of JDM greater than or equal to 2 months were compared with 3 girls with active symptoms less than 2 months. Results Seventy-nine genes were differentially expressed between the groups with long or short duration of untreated disease. Genes involved in immune responses and vasculature remodelling were expressed at a higher level in muscle biopsies from children with greater or equal to 2 months of symptoms, while genes involved in stress responses and protein turnover were expressed at a lower level. Among the 79 genes, expression of 9 genes showed a significant linear regression relationship with the duration of untreated disease. Five differentially expressed genes – HLA-DQA1, smooth muscle myosin heavy chain, clusterin, plexin D1 and tenomodulin – were verified by quantitative RT-PCR. The chronic inflammation of longer disease duration was also associated with increased DC-LAMP+ and BDCA2+ mature dendritic cells, identified by immunohistochemistry. Conclusion We conclude that chronic inflammation alters the gene expression patterns in muscle of untreated children with JDM. Symptoms lasting greater or equal to 2 months were associated with dendritic cell maturation and anti-angiogenic vascular remodelling, directly contributing to disease pathophysiology.

  7. Metabolic characteristics and oxidative damage to skeletal muscle in broiler chickens exposed to chronic heat stress.

    Science.gov (United States)

    Azad, M A K; Kikusato, M; Maekawa, T; Shirakawa, H; Toyomizu, M

    2010-03-01

    Emerging evidence has shown that acute heat exposure affects metabolic characteristics and causes oxidative damage to skeletal muscle in birds. Little is known, however, about such phenomena under chronic heat stress conditions. To address this, we designed the present study to determine the influence of cyclic (32 to 24 to 32 degrees C: 32 degrees C for 8 h/d, 32-24-32HS ), and constant (32 and 34 degrees C, 32HS and 34HS, respectively) heat exposure on the metabolic and peroxide status in skeletal muscle of 4-wk-old male broiler chickens. Heat stress, particularly in the 32HS and 34HS groups, depressed feed intake and growth, while cyclic high temperature gave rise to a less severe stress response in performance terms. Malondialdehyde (MDA) levels in skeletal muscle were enhanced (Pstress model. The 3HADH (3-hydroxyacyl CoA dehydrogenase related to fatty acid oxidation) and CS (citrate synthase) enzyme activities were lowered (Pchickens. On exposure to chronic heat stress, GPx activity remained relatively constant, though a temperature-dependent elevation in Cu/Zn-SOD activity was observed, implying that anti-oxidation ability was disturbed by the chronic stress condition. From these results it can be concluded that chronic heat stress did not induce oxidative damage to a major extent. This may probably be due to a decrease in metabolic oxidation capacity or due to a self-propagating scavenging system, though the system was not fully activated.

  8. Chronic sleep deprivation alters the myosin heavy chain isoforms in the masseter muscle in rats.

    Science.gov (United States)

    Cao, Ruihua; Huang, Fei; Wang, Peihuan; Chen, Chen; Zhu, Guoxiong; Chen, Lei; Wu, Gaoyi

    2015-05-01

    To investigate the changes in myosin heavy chain (MyHC) isoforms of rat masseter muscle fibres caused by chronic sleep deprivation and a possible link with the pathogenesis of disorders of the temporomandibular joint (TMJ). A total of 180 male rats were randomly divided into three groups (n=60 in each): cage controls, large platform controls, and chronic sleep deprivation group. Each group was further divided into three subgroups with different observation periods (7, 14, and 21 days). We investigated he expression of MyHC isoforms in masseter muscle fibres by real-time quantitative polymerase chain reaction (PCR), Western blotting, and immunohistochemical staining. In rats with chronic sleep deprivation there was increased MyHC-I expression in layers of both shallow and deep muscles at 7 and 21 days compared with the control groups, whereas sleep deprivation was associated with significantly decreased MyHC-II expression. At 21 days, there were no differences in MyHC-I or MyHC-II expression between the groups and there were no differences between the two control groups at any time point. These findings suggest that chronic sleep deprivation alters the expression of MyHC isoforms, which may contribute to the pathogenesis of disorders of the TMJ.

  9. Chronic stress effects in contralateral medial pterygoid muscle of rats with occlusion alteration.

    Science.gov (United States)

    Loyola, Bruno Melo; Nascimento, Glauce Crivelaro; Fernández, Rodrigo Alberto Restrepo; Iyomasa, Daniela Mizusaki; Pereira, Yamba Carla Lara; Leite-Panissi, Christie Ramos Andrade; Issa, João Paulo Mardegan; Iyomasa, Mamie Mizusaki

    2016-10-01

    Temporomandibular disorder (TMD) has a high prevalence in our society, characterized by a severe pain condition of the masticatory muscles and temporomandibular joint. Despite the indication of multiple factor initiators of TMD, there is still controversy about its etiology and its pathophysiology is poorly understood. Using rats as experimental animals we investigated the effect of unpredictable chronic stress with or without unilateral molar extraction on the contralateral medial pterygoid muscle. Our hypothesis is that these two factors induce changes in morphology, oxidative metabolism and oxidative stress of muscle fibers. Young adult male Wistar rats (±200g) were divided into four groups: a group with extraction and unpredictable chronic stress (E+US); with extraction and without stress (E+C); without extraction and with unpredictable chronic stress (NO+US); and a control group without either extraction or stress (NO+C). The animals were subjected to unilateral extraction of the upper left molars, under intraperitoneal anesthesia with 4% Xylazine (10mg/kg) and 10% Ketamine (80mg/kg) on day zero. The rats of groups E+US and NO+US were submitted to different protocols of stress, from the 14th day after the extraction. The protocols were different every day for five consecutive days, which were repeated from the 6th day for five days more. Contralateral medial pterygoid muscles were obtained on the 24th day after the start of the experiment for morphological, metabolic, capillary density, and oxidative stress analysis. The data from capillary density showed a decrease of capillaries in animals subjected to dental extraction, compared with those without extraction and an increase of laminin expression in the group submitted to the unpredictable chronic stress when compared to the unexposed to stress. SDH test revealed a decrease of light fibers in the group submitted to unilateral extraction of molars, compared with this area in the control group. In E+US and NO

  10. Glycogen depletion and resynthesis during 14 days of chronic low-frequency stimulation of rabbit muscle

    DEFF Research Database (Denmark)

    Prats, C; Bernal, C; Cadefau, J A;

    2002-01-01

    Electro-stimulation alters muscle metabolism and the extent of this change depends on application intensity and duration. The effect of 14 days of chronic electro-stimulation on glycogen turnover and on the regulation of glycogen synthase in fast-twitch muscle was studied. The results showed...... synthase was determined during electro-stimulation. The activity of this enzyme was measured at low UDPG concentration with either high or low Glu-6-P content. Western blots were performed against glycogen synthase over a range of stimulation periods. Activation of this enzyme was maximum before the net...

  11. Chronic Neck Pain Associated with an Old Odontoid Fracture: A Rare Presentation

    Directory of Open Access Journals (Sweden)

    Mauricio Avila-Guerra

    2013-01-01

    Full Text Available Cervical spine injuries represent a minority of injury cases in motor vehicles accidents but are a real threat to a patient’s life. In the wide range of cervical spine injuries, odontoid (dens fractures represent the most common findings. These fractures are more usually found in the elderly population due to the changes associated with age. Neurological deficit is not frequently found in these injuries. The following is a case presentation of a chronic odontoid fracture with neurological deficit in a young man that was discovered 23 years after he sustained a motor vehicle accident.

  12. Chronically ischemic mouse skeletal muscle exhibits myopathy in association with mitochondrial dysfunction and oxidative damage.

    Science.gov (United States)

    Pipinos, Iraklis I; Swanson, Stanley A; Zhu, Zhen; Nella, Aikaterini A; Weiss, Dustin J; Gutti, Tanuja L; McComb, Rodney D; Baxter, B Timothy; Lynch, Thomas G; Casale, George P

    2008-07-01

    A myopathy characterized by mitochondrial pathology and oxidative stress is present in patients with peripheral arterial disease (PAD). Patients with PAD differ in disease severity, mode of presentation, and presence of comorbid conditions. In this study, we used a mouse model of hindlimb ischemia to isolate and directly investigate the effects of chronic inflow arterial occlusion on skeletal muscle microanatomy, mitochondrial function and expression, and oxidative stress. Hindlimb ischemia was induced by staged ligation/division of the common femoral and iliac arteries in C57BL/6 mice, and muscles were harvested 12 wk later. Muscle microanatomy was examined by bright-field microscopy, and mitochondrial content was determined as citrate synthase activity in muscle homogenates and ATP synthase expression by fluorescence microscopy. Electron transport chain (ETC) complexes I through IV were analyzed individually by respirometry. Oxidative stress was assessed as total protein carbonyls and 4-hydroxy-2-nonenal (HNE) adducts and altered expression and activity of manganese superoxide dismutase (MnSOD). Ischemic muscle exhibited histological features of myopathy and increased mitochondrial content compared with control muscle. Complex-dependent respiration was significantly reduced for ETC complexes I, III, and IV in ischemic muscle. Protein carbonyls, HNE adducts, and MnSOD expression were significantly increased in ischemic muscle. MnSOD activity was not significantly changed, suggesting MnSOD inactivation. Using a mouse model, we have demonstrated for the first time that inflow arterial occlusion alone, i.e., in the absence of other comorbid conditions, causes myopathy with mitochondrial dysfunction and increased oxidative stress, recapitulating the muscle pathology of PAD patients.

  13. Influence of the actions observed on cervical motion in patients with chronic neck pain: a pilot study

    Science.gov (United States)

    de-la-Puente-Ranea, Lucía; García-Calvo, Beatriz; La Touche, Roy; Fernández-Carnero, Josué; Gil-Martínez, Alfonso

    2016-01-01

    The aim of the present pilot study was to prove if the action-observation (AOb) improved the cervical range of motion (CROM) in patients with nonspecific chronic neck pain (CNP). Double blind pilot study. A total of 28 subjects were randomly assigned to an effective-movement group (n=14) and an ineffective-movement group (n=14). The follow-up consisted of: pretreatment, posttreatment and 10 min after second measurement (motor imagery). Outcome measures were CROM, and pres-sure pain detection thresholds (PPDTs). No statistical differences were found in baseline on CROM and on the PPDT. Test for independent groups revealed significant changes in cervical rotation movement. Both groups in posttreatment (P=0.042; Cohen d=0.81) and after 10 min (P=0.019; Cohen d=0.9). For intragroup PPDT, the Wilcoxon test revealed significant effects in the effective movement at C2 of the pre to 10-min post (P=0.040). However, the ineffective movement revealed a significant reduction in PPDT in zygapophyseal joint of C5–C6 as the pre to post (P=0.010) as the pre to 10-min post (P=0.041) periods. In conclusions this pilot study demonstrated that the effective AOb produced significant changes versus ineffective AOb in the CROM and it could influences in PPT in subject with CNP immediately. PMID:27656633

  14. Developmental biomechanics of neck musculature.

    Science.gov (United States)

    Lavallee, Amy V; Ching, Randal P; Nuckley, David J

    2013-02-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A factorial study was performed on 91 human subjects measuring head-and-neck anthropometry and neck strength and endurance in three bending directions (flexion, extension, and lateral) as a function of age (6-23 years). Using a custom device, neck maximum voluntary contraction (MVC) force was measured in triplicate. Next, neck muscle endurance (sustained effort) was measured as the subjects' ability to maintain 70% of peak force over 30s. Linear regression of peak force and endurance as a function of age revealed each direction to significantly (pNeck muscle strength, similar between young males and females, becomes disparate in adolescence and adulthood with males exhibiting greater strength. Bending direction differences were also found with extension strength being the greatest regardless of age and sex. Furthermore, neck circumference appears predictive of neck strength and endurance in children. Together, these relationships may facilitate improved design of injury prevention interventions.

  15. Acupuncture with non-steroidal anti-inflammatory drugs (NSAIDs) versus acupuncture or NSAIDs alone for the treatment of chronic neck pain: an assessor-blinded randomised controlled pilot study

    OpenAIRE

    2013-01-01

    Objective To investigate the feasibility and sample size required for a full-scale randomised controlled trial of the effectiveness of acupuncture with non-steroidal anti-inflammatory drugs (NSAIDs) for chronic neck pain compared with acupuncture or NSAID treatment alone. Methods A total of 45 patients with chronic neck pain participated in the study. For 3 weeks the acupuncture with NSAIDs treatment group took NSAIDs (zaltoprofen, 80 mg) daily while receiving acupuncture treatment three time...

  16. The Effect of Neck-specific Exercise With, or Without a Behavioral Approach, on Pain, Disability, and Self-Efficacy in Chronic Whiplash-associated Disorders : A Randomized Clinical Trial

    OpenAIRE

    2015-01-01

    OBJECTIVES:: The aim of this study was to compare the effect on self-rated pain, disability and self-efficacy of three interventions for the management of chronic Whiplash Associated Disorders (WAD): physiotherapist-led neck-specific exercise, physiotherapist-led neck-specific exercise with the addition of a behavioral approach, or prescription of physical activity. METHODS:: Two hundred and sixteen volunteers with chronic WAD participated in this randomized, assessor blinded, clinical trial ...

  17. The influence of a semi-reclined seated posture on head and neck kinematics and muscle activity while reading a tablet computer.

    Science.gov (United States)

    Douglas, Ethan C; Gallagher, Kaitlin M

    2017-04-01

    Increased tablet computer usage calls for a proper understanding of potential injury risks from these devices. The purpose of this study was to assess the influence of tablet computer reading postures on head and neck flexion and muscle activity. Nineteen participants completed read a tablet computer in four different postures (standard computer monitor, tablet on a desk, tablet in the lap, semi-reclined with tablet in the lap). Reading the tablet in a semi-reclined trunk posture with the tablet in one's lap increased (p computer monitor (6.39%ROM). Head flexion in the semi-reclined posture (19.7%ROM) and muscle activity (8.88%MVC) were similar to when reading from a standard computer monitor. Despite potentially reducing the gravitational moment produced by the head, the semi-reclined position could still compromise the force capabilities of the neck extensor musculature and result in increased strain on the passive tissues of the spine. Future work should assess how the semi-reclined position influences cervical intervertebral angles and passive tissue properties of the cervical spine. Overall, more research needs to be conducted on thoracic spine kinematics while reading a tablet computer.

  18. Psychosocial work stress, leisure time physical exercise and the risk of chronic pain in the neck/shoulders: Longitudinal data from the Norwegian HUNT Study

    Directory of Open Access Journals (Sweden)

    Rannveig Fanavoll

    2016-08-01

    Full Text Available Objectives: To prospectively investigate if the risk of chronic neck/shoulder pain is associated with work stress and job control, and to assess if physical exercise modifies these associations. Material and Methods: The study population comprised 29 496 vocationally active women and men in the Norwegian Nord-Trøndelag Health Study (HUNT Study without chronic pain at baseline in 1984–1986. Chronic neck/shoulder pain was assessed during a follow-up in 1995–1997. A generalized linear model (Poisson regression was used to calculate adjusted relative risks (RRs. Results: Work stress was dosedependently associated with the risk of neck/shoulder pain (ptrend < 0.001 in both sexes. The women and men who perceived their work as stressful “almost all the time” had multi-adjusted RRs = 1.27 (95% confidence interval (CI: 1.1–1.47 and 1.71 (95% CI: 1.46–2, respectively, referencing those with no stressful work. Work stress interacted with sex (p < 0.001. Poor job control was not associated with the risk of neck/shoulder pain among the women (RR = 1.04, 95% CI: 0.92–1.19 nor the men (RR = 1.09, 95% CI: 0.95–1.26. Combined analyses showed an inverse dose-dependent association between hours of physical exercise/week and the risk of neck/shoulder pain in the men with no stressful work (ptrend = 0.05 and among the men who perceived their work as “rarely stressful” (ptrend < 0.02. This effect was not statistically significant among the women or among men with more frequent exposure to work stress. Conclusions: Work stress is an independent predictor of chronic neck/shoulder pain and the effect is stronger in men than in women. Physical exercise does not substantially reduce the risk among the persons with frequent exposure to work stress.

  19. The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain

    DEFF Research Database (Denmark)

    Sørensen, Tina Juul; Langberg, Henning; Enoch, Flemming;

    2013-01-01

    trials are often performed. However, when muscle performance tests are applied in the clinical setting, clinicians often only conduct a muscle performance test once as repeated testing may produce fatigue and pain, thus variation in test results. We aimed to investigate whether cervical muscle...

  20. Inspiratory Muscle Training and Arterial Blood Oxygen Saturation in Patients With Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Bakhshandeh Bavarsad

    2015-01-01

    Full Text Available Background One of the problems of the patients with chronic obstructive pulmonary disease (COPD is the weakness of the respiratory muscles that causes oxygen desaturation at rest and activity and decreases exercise tolerance. Objectives This study aimed to investigate the effect of inspiratory muscle training on arterial oxygen saturation (SPO2. Patients and Methods Forty patients with mild to very severe COPD were recruited for this study, which is a randomized control trail. The patients were randomized to IMT (inspiratory muscle training and control group. Training was performed with Respivol (a kind of inspiratory muscle trainer for 8 weeks (15 min/d for 6 d/week. SPSS software version 16 was used to analyze the data by performing independent t test, paired t test, and Fisher exact test. Results Results showed that, after 8 weeks of inspiratory muscle training, there was a little increase (but not statistically significant improvement in SPO2 (from 92.6 ± 8.71 % to 95.13 ± 7.08 %, with P = 0.06, whereas it remained unchanged in the control group (from 96.0 ± 3.46 % to 96.4 ± 3.35 % with P = 0.51. No statistically significant difference was seen between the two groups (P > 0.05. Conclusions Although inspiratory muscles training can prevent desaturation, which is caused by activity, it fails to improve it.

  1. Reversing Age Related Changes of the Laryngeal Muscles by Chronic Electrostimulation of the Recurrent Laryngeal Nerve

    Science.gov (United States)

    Karbiener, Michael; Jarvis, Jonathan C.; Perkins, Justin D.; Lanmüller, Hermann; Schmoll, Martin; Rode, Hanna S.; Gerstenberger, Claus; Gugatschka, Markus

    2016-01-01

    Age related atrophy of the laryngeal muscles -mainly the thyroarytenoid muscle (TAM)- leads to a glottal gap and consequently to a hoarse and dysphonic voice that significantly affects quality of life. The aim of our study was to reverse this atrophy by inducing muscular hypertrophy by unilateral functional electrical stimulation (FES) of the recurrent laryngeal nerve (RLN) in a large animal model using aged sheep (n = 5). Suitable stimulation parameters were determined by fatiguing experiments of the thyroarytenoid muscle in an acute trial. For the chronic trial an electrode was placed around the right RLN and stimulation was delivered once daily for 29 days. We chose a very conservative stimulation pattern, total stimulation time was two minutes per day, or 0.14% of total time. Overall, the mean muscle fiber diameter of the stimulated right TAM was significantly larger than the non-stimulated left TAM (30μm±1.1μm vs. 28μm±1.1 μm, p<0.001). There was no significant shift in fiber type distribution as judged by immunohistochemistry. The changes of fiber diameter could not be observed in the posterior cricoarytenoid muscle (PCAM). FES is a possible new treatment option for reversing the effects of age related laryngeal muscle atrophy. PMID:27893858

  2. The Effect of Dry Needling on Range of Motion of Neck Lateral Flexion in Subjects With Active Trigger Point in Upper Trapezius Muscle

    Directory of Open Access Journals (Sweden)

    Ziaeifar

    2014-12-01

    Full Text Available Background Myofascial trigger point is one of the most common causes of musculoskeletal disorders. Myofascial trigger point in upper trapezius has been reported as a symptom in patients with neck and upper thoracic pain. Objectives The purpose of this study was to investigate the effect of dry needling compared with ischemic pressure on trigger point in upper trapezius muscle. Materials and Methods 28 subjects with myofascial trigger point in upper trapezius participated in this study. The subjects were randomly assigned to two groups: dry needling (n = 13 and ischemic pressure (n = 15. The neck lateral flexion range of motion was measured before and after treatment in both groups using a standard goniometer. Paired t-test was used to determine any significant difference in range of motion after treatment sessions compared with pre-treatment score in control and experimental group. Analysis of Covariance (ANCOVA was calculated to determine the significance of differences between the control and experimental groups in post-test scores, with pre-treatment scores used as covariates in the analysis. Results Statistical analysis (paired t-test revealed significant increase in neck lateral flexion range of motion in contra-lateral side after treatment sessions in control and experimental group compared with pre-treatment score (P < 0.05. However, only dry needling was effective in increase of range of motion in Ipsi-lateral side (P = 0.001. In the ANCOVA, controlling for pre-test scores, no significant difference was found between the two groups in the after treatment sessions (P = 0.06 and (P = 0.15. Conclusions The application of DN produces an improvement in ILF and CLF can be prescribed for subjects with MTP in UT muscles.

  3. EFFICACY OF KALTENBORN GRADE III MOBILIZATIONS, MUSCLE ENERGY TECHNIQUES AND THEIR COMBINATION TO IMPROVE RANGE AND FUNCTIONAL ABILITY IN ADULTS WITH MECHANICAL NECK PAIN

    Directory of Open Access Journals (Sweden)

    Naveed Anwar

    2016-08-01

    Full Text Available Background: Physiotherapy is an essentialtreatment in the management of Mechanical Neck ache, still there was lack of literature seen supporting the effectiveness of Physiotherapy interventions with their doses targeting specific group of population. The focus of study was to see the effectiveness of Kaltenborn Grade III mobilization, Muscle Energy Techniques and their combination to improve range and functional ability in patients with Mechanical Neck ache. Methods: 72 patients with Mechanical Neck achewere randomly categorized in 3 groups (Mobilization, METs and Combination group. NDI scale and goniometry was used as an assessment tool to measure the outcome before and after treatment (follow up 1 week. Results: According to the results there was significant improvement seen in Combination group (Mobilization and METs in terms of pain, which decreased from 7.70±0.69 to 1.25±1.93 (p=0.00, gain in ROM e.g. Cervical Flexion (27.29±2.38 to 37.54±3.14. Whereas, marked significance (p=0.00 was seen in the NDI score and percentage of Combination group. ANOVA tells us that difference was significant in all three groups in categories of pain (VAS, gain in cervical ranges and NDI score and percentage as p=0.00. Combination group had significant difference within the groups then METs and Mobilization group in all categories of VAS, Cervical ranges, NDI score and percentage. Conclusion: Combination of (Grade III Kaltenborn and METs was seen more effective in terms of improving Mechanical Neck Pain, in smaller treatment session (7 days only.

  4. Position of document holder and work related risk factors for neck pain among computer users: a narrative review.

    Science.gov (United States)

    Ambusam, S; Baharudin, O; Roslizawati, N; Leonard, J

    2015-01-01

    Document holder is used as a remedy to address occupational neck pain among computer users. An understanding on the effects of the document holder along with other work related risk factors while working in computer workstation requires attention. A comprehensive knowledge on the optimal location of the document holder in computer use and associated work related factors that may contribute to neck pain reviewed in this article. A literature search has been conducted over the past 14 years based on the published articles from January 1990 to January 2014 in both Science Direct and PubMed databases. Medical Subject Headings (MeSH) keywords for search were neck muscle OR head posture OR muscle tension' OR muscle activity OR work related disorders OR neck pain AND/OR document location OR document holder OR source document OR copy screen holder.Document holder placed lateral to the screen was most preferred to reduce neck discomfort among occupational typists. Document without a holder was placed flat on the surface is least preferred. The head posture and muscle activity increases when the document is placed flat on the surface compared to when placed on the document holder. Work related factors such as static posture, repetitive movement, prolong sitting and awkward positions were the risk factors for chronic neck pain. This review highlights the optimal location for document holder for computer users to reduce neck pain. Together, the importance of work related risk factors for to neck pain on occupational typist is emphasized for the clinical management.

  5. Myopathological features in skeletal muscle of patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Gosker, H R; Kubat, B; Schaart, G; van der Vusse, G J; Wouters, E F M; Schols, A M W J

    2003-08-01

    Despite the fact that muscle weakness is a major problem in chronic obstructive pulmonary disease (COPD), detailed information on myopathological changes at the microscopic level in these patients is scarce, if indeed available at all. Vastus lateralis biopsies of 15 COPD weight-stable patients (body mass index (BMI) 23.9+/-1.0 kg x m(-2); fat-free mass index (FFMI) 17.2+/-1.7 kg x m(-2)) and 16 healthy age-matched controls (BMI 26.3+/-0.8 kg x m(-2); FFMI 19.6+/-2.2 kg x m(-2)) were evaluated. Histochemistry was used to evaluate myopathological features. Immunohistochemistry was used for the detection of macrophages and leukocytes, and active caspase 3 and terminal deoxynucleotidyl transferase deoxyuridine triphosphate (dUTP) nick-end labelling (TUNEL) as markers of apoptosis. Fatty cell replacement and fibrosis were observed in both groups, the latter being slightly, but significantly, more pronounced in COPD. No differences between COPD and controls were found with respect to central nuclei, necrosis, regeneration, or fibre splitting. Signs of mitochondrial abnormalities were absent and normal numbers of inflammatory cells were found. Active caspase 3 positive myocytes were not observed and no difference was found in the number of TUNEL-positive myonuclei between controls and COPD patients (1.1% versus 1.0%, respectively). The cross-sectional area of type-IIX muscle fibres was smaller in COPD than in controls (2,566 versus 4,248 microm2). Except for the I to IIX shift in fibre types, the selective type-IIX atrophy and a slight accompanying increase in fibrosis and fat cell replacement in chronic obstructive pulmonary disease relative to age-matched controls, no other morphological abnormalities were observed in the muscle biopsies of chronic obstructive pulmonary disease patients. Also, in this group of clinically and weight stable chronic obstructive pulmonary disease patients, apoptosis appeared not to be involved in muscle pathology.

  6. Clinical features in patients with chronic muscle pain--with special reference to fibromyalgia

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Petersen, I S; Danneskiold-Samsøe, B

    1993-01-01

    Clinical characteristics were studied in patients with chronic muscle pain, divided into three groups according to the characteristics of their pain; "fibromyalgia" (n = 23), "widespread muscle pain" (n = 21), and "regional muscle pain" (n = 28). Typical fibromyalgia features were also seen...... in the other groups of patients, but not to the same extent. In particular, sleep disturbance, subjective swelling, cold and exercise intolerance and low self-reported physical performance were significantly related to fibromyalgia. The major components of fibromyalgia were not wholly different compared...... with other European and North American studies, except for sleep disturbance and subjective swelling, which was somewhat more pronounced in this study. The most used medications in fibromyalgia patients at referral were analgesics, anxiolytic drugs and female sex hormones. Medication in fibromyalgia...

  7. 战斗机飞行员颈肌强度训练效果%EFFECT OF NECK MUSCLE STRENGTH TRAINING IN FIGHTER PILOTS

    Institute of Scientific and Technical Information of China (English)

    夏凌; 陈琼; 李交杰; 季思菊

    2012-01-01

    Objective To evaluate the effect of neck muscle strength training, so as to provide the basis for studying the measures for improving neck muscle strength and reducing neck injuries in fighter pilots. Methods Twenty-four fighter pilots, performed neck muscle strength training by CME-1 neck muscle trainer three times one week for 3 weeks. Isometric mode training was performed at the 1st,3rd,4th,6th,7th,9th time; and variable velocity, and resistance (WR) mode at the 2nd,5th,8th time.Resutls The mean of peak neck muscle strength in the front flexion,back extension, left lateral flexion, right lateral flexion direction after training 2 weeks was 38.9%, 48.9,66.6%, 55.8% more respectively than before training;and after training 3 weeks,49.0% ,60.1% ,79.9% ,71.9% more respectively than before training(P <0.01) .The mean of peak impulse after training 2 weeks was 39.6% ,49.6% ,69.7% ,52.7% higher respectively; and after training 3 weeks 51.2%, 59.9%, 82.5%, 65.7% higher respectively than before training( P < 0. 01). Conclusions CME-1 neck muscle trainer is safe and effective for improving neck muscle strength of fighter pilots.%目的 评价颈肌强度训练提高战斗机飞行员颈肌力量的效果,为寻求减少飞行员颈部损伤发生、提高战斗力的措施提供依据.方法 应用CME-1型飞行员颈肌训练器对24名战斗机飞行员进行每周3次、连续3周共9次的颈肌强度训练(第1、3、4、6、7、9次为等长训练模式,第2、5、8次为可变阻力和可变速度训练模式),记录每次等长训练前、后、左、右肌群的峰值肌力均值、峰值总冲量均值,对训练前、训练2周(第6次)、训练3周(第9次)数值进行统计分析.结果 训练2周,24名战斗机飞行员的前、后、左、右各肌群峰值肌力均值较训练前分别增加了38.9%、48.9%、66.6%、55.8%;训练3周较训练前分别增加49.0%、60.1%、79.9%、71.9%,差异均有显著性(P<0.01).训练2周后,24名

  8. Inspiratory muscle training protocol for patients with chronic obstructive pulmonary disease (IMTCO study): a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Charususin, N.; Gosselink, R.; Decramer, M.; McConnell, A.; Saey, D.; Maltais, F.; Derom, E.; Vermeersch, S.; Helvoort, H.A. van; Heijdra, Y.F.; Klaassen, M.; Glockl, R.; Kenn, K.; Langer, D.

    2013-01-01

    INTRODUCTION: Inspiratory muscle training (IMT) has been applied during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). However, it remains unclear if the addition of IMT to a general exercise training programme leads to additional clinically relevant improvem

  9. Role of manual therapy with exercise regime versus exercise regime alone in the management of non-specific chronic neck pain.

    Science.gov (United States)

    Akhter, Saeed; Khan, Muhammad; Ali, Syed Shahzad; Soomro, Rabial Rani

    2014-11-01

    To evaluate the role of manual therapy with exercise regime versus exercise regime alone in the management of non-specific chronic neck pain. In this 62 subjects randomized controlled trial 31 subjects in group A received manual therapy (manipulation) with supervised exercise regime whilst 31 subjects in group B performed only supervised exercise regime for the period of 3 weeks. Both groups had a home exercise program consisted of strengthening exercises for neck/scapuluar stability, stretching and general range of motion exercises for neck with advice regarding posture awareness and correction for 3 months. The results suggested significant reduction in pain intensity level in both groups; over 3 weeks and 12 weeks' time period in relation to baseline on visual analog scale (p=0.001). Similarly, statistically significant improvements noticed in Neck Disability Index (NDI) (p=0.0001) in both groups while looking at baseline data with reference to 12 weeks' time period. On closer inspection, the manual therapy (manipulation) with exercise regime appeared as a favorable treatment preference compared with exercise regime alone.

  10. Diminished Foot and Ankle Muscle Volumes in Young Adults With Chronic Ankle Instability

    Science.gov (United States)

    Feger, Mark A.; Snell, Shannon; Handsfield, Geoffrey G.; Blemker, Silvia S.; Wombacher, Emily; Fry, Rachel; Hart, Joseph M.; Saliba, Susan A.; Park, Joseph S.; Hertel, Jay

    2016-01-01

    Background: Patients with chronic ankle instability (CAI) have demonstrated altered neuromuscular function and decreased muscle strength when compared with healthy counterparts without a history of ankle sprain. Up to this point, muscle volumes have not been analyzed in patients with CAI to determine whether deficits in muscle size are present following recurrent sprain. Purpose: To analyze intrinsic and extrinsic foot and ankle muscle volumes and 4-way ankle strength in young adults with and without CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Five patients with CAI (mean age, 23.0 ± 4 years; 1 male, 4 females) and 5 healthy controls (mean age, 23.8 ± 4.5 years; 1 male, 4 females) volunteered for this study. Novel fast-acquisition magnetic resonance imaging (MRI) was used to scan from above the femoral condyles through the foot and ankle. The perimeter of each muscle was outlined on each axial slice and then the 2-dimensional area was multiplied by the slice thickness (5 mm) to calculate the muscle volume. Plantar flexion, dorsiflexion, inversion, and eversion isometric strength were measured using a handheld dynamometer. Patients with CAI were compared with healthy controls on all measures of muscle volume and strength. Extrinsic muscle volumes of patients with CAI were also compared with a normative database of healthy controls (n = 24) by calculating z scores for each muscle individually for each CAI subject. Results: The CAI group had smaller total shank, superficial posterior compartment, soleus, adductor hallucis obliqus, and flexor hallucis brevis muscle volumes compared with healthy controls as indicated by group means and associated 90% CIs that did not overlap. Cohen d effect sizes for the significant group differences were all large and ranged from 1.46 to 3.52, with 90% CIs that did not cross zero. The CAI group had lower eversion, dorsiflexion, and 4-way composite ankle strength, all with group means and associated 90

  11. Insulin modulates energy and substrate sensing and protein catabolism induced by chronic peritonitis in skeletal muscle of neonatal pigs

    Science.gov (United States)

    Acute infection promotes skeletal muscle wasting and insulin resistance, but the effect of insulin on energy and substrate sensing in skeletal muscle of chronically infected neonates has not been studied. Eighteen 2-d-old pigs underwent cecal ligation and puncture (CLP) or sham surgery (CON) to ind...

  12. Distribution of myogenic progenitor cells and myonuclei is altered in women with vs. those without chronically painful trapezius muscle

    DEFF Research Database (Denmark)

    Mackey, Abigail; Andersen, Lars L; Frandsen, Ulrik

    2010-01-01

    It is hypothesized that repeated recruitment of low-threshold motor units is an underlying cause of chronic pain in trapezius myalgia. This study investigated the distribution of satellite cells (SCs), myonuclei, and macrophages in muscle biopsies from the trapezius muscle of 42 women performing ...

  13. Trunk strength and lumbar paraspinal muscle activity during isometric exercise in chronic low-back pain patients and controls.

    Science.gov (United States)

    Cassisi, J E; Robinson, M E; O'Conner, P; MacMillan, M

    1993-02-01

    The purpose of this study was to describe trunk strength and lumbar paraspinal muscle activity across five angles of flexion during isometric exercise and rest in chronic low-back pain patients and control subjects. High muscle tension as measured by surface integrated electromyography is predicted by a muscle spasm model, and low muscle tension is predicted by a muscle deficiency model. Prior lumbar surgery had no affect on peak torque or maximum surface integrated electromyography data. Both groups produced greater torque and less surface integrated electromyography in more flexed positions. Chronic low-back pain patients exhibited lower peak torque and lower maximum surface integrated electromyography bilaterally during isometric extension effort across all angles. A muscle deficiency model of chronic low back pain was supported by these data and a muscle spasm model was not supported. Discriminant analyses indicated that monitoring maximum surface integrated electromyography of lumbar muscles during isometric effort facilitates classification of chronic low-back pain patients. Future directions are discussed in terms of applying psychophysiologic methods to pain rehabilitation.

  14. Creatinine excretion rate, a marker of muscle mass, is related to clinical outcome in patients with chronic systolic heart failure

    NARCIS (Netherlands)

    ter Maaten, Jozine M.; Damman, Kevin; Hillege, Hans L.; Bakker, Stephan J.; Anker, Stefan D.; Navis, Gerjan; Voors, Adriaan A.

    2014-01-01

    Aims In chronic heart failure (CHF), low body mass as a reflection of low muscle mass has been associated with poor outcome. Urinary creatinine excretion rate (CER) is an established marker of muscle mass, but has not been investigated in CHF. This study aims to evaluate urinary CER as a marker of m

  15. Histoenzymatic and Morphometric Analysis of Muscle Fiber Type Transformation during the Postnatal Development of the Chronically Food-Deprived Rat

    OpenAIRE

    2013-01-01

    We analyze the effect of chronic undernourishment on extensor digitorum longus (EDL) muscle maturation in the rat. Cytochrome c oxidase (COX) and alkaline ATPase histoenzymatic techniques were used to determine the relative proportion of different fiber types (oxidative/glycolytic and type I, IIa/IId, or IIb, respectively) and their cross-sectional area in control and undernourished EDL muscles at several postnatal (PN) ages. From PN days 15 to 45, undernourished EDL muscles showed predominan...

  16. 主动抗阻运动疗法治疗慢性颈部疼痛的临床研究%Effect of Active Resistance Exercise Therapy on Chronic Neck Pain

    Institute of Scientific and Technical Information of China (English)

    杜良杰; 李建军

    2011-01-01

    目的 观察主动抗阻运动疗法对于慢性颈部疼痛患者的治疗效果。方法 门诊选择39例病程超过6个月的女性慢性颈部疼痛的患者作为治疗组;选择21例正常女性作为对照组。对照组不进行功能锻炼。治疗组应用主动抗阻运动疗法进行功能锻炼。治疗前、治疗后12个月,观察颈椎生理曲度、项背肌肌肉CT值、项背肌肌力和耐力、颈部疼痛视觉模拟评分。结果 与对照组相比,治疗组治疗前颈椎生理曲度降低(P<0.05),治疗前后无显著性差异(P>0.05)。年长对照组的颈椎后部肌肉总体平均CT值较年轻对照组降低(P<0.05);治疗组项背肌肌肉总体平均CT值比对照组降低(P<0.05);治疗组治疗前后项背肌肌肉总体平均CT值无显著性差异(P>0.05)。治疗组较对照组项背肌肌肉的肌力和耐力降低(P<0.05);治疗后治疗组项背肌肌力和耐力都较治疗前提高(P<0.05)。治疗组在治疗后1个月疼痛评分改善(P<0.05),治疗后1年所有患者疼痛完全消失。结论 主动抗阻运动疗法能够提高项背肌肌力和耐力,消除疼痛。%Objective To explore the effect of active resistance exercise therapy on patients with chronic neck pain. Methods 39 female patients with neck pain more than 6 months were recruited in treatment group and received active resistance exercise therapy. 21 healthy women were recruited in control group without any treatment. They were assessed with cervical curve (C2-7 Cobb's angle), CT attenuation value of cervical back muscle, neck muscular strength and endurance and visual analog scale (VAS) before and 12 months after treatment. Results Compared with the control group, the cervical curve of the treatment group was obviously less (P0.05). The CT attenuation value of cervical back muscle was obviously less in the elder controls than in the middle aged ones (P0.05). Compared with the control group, neck muscular strength

  17. Neck and shoulder muscle activity and posture among helicopter pilots and crew-members during military helicopter flight

    DEFF Research Database (Denmark)

    Murray, Mike; Lange, Britt; Chreiteh, Shadi Samir

    2016-01-01

    ) and performing search and rescue (SAR). SAR was performed with Night Vision Goggles (NVG), while AB was performed with (AB+NVG) and without NVG (AB-NVG). EMG was recorded for: trapezius (TRA), upper neck extensors (UNE), and sternocleido-mastoid (SCM). Maximal voluntary contractions (MVC) were performed...

  18. Treatment of femoral neck fracture with muscle-bone flap of both tensor fasciae latae and sartorius

    Institute of Scientific and Technical Information of China (English)

    刘国平; 康斌; 曾晖; 唐嫄科; 唐新宇; 熊奡; 解笑宸; 黄伟

    2003-01-01

    Objective: To evaluate the effect of muscular pedicle bone grafts with sartorius or tensor fasciae latae and sartorius in fresh transcervical or subcapital fractures of the femoral neck. Methods: Thirty cases of fresh transcervical and subcapital fractures of the femoral neck were treated by the tail breakable screws and sartorius pedicle bone grafts (single muscular pedicle, SMP group). The other 23 cases were treated by cannulated pressure screws and bone grafts with the muscular pedicles of both sartorius and tensor fasciae latae (double muscular pedicles, DMP group). Results: Fifty-two cases were followed up for 3 to 5 years (mean, 4 years). In SMP group, ten cases showed poor therapeutic results. Excellent therapeutic effects were achieved in all cases of DMP group. Conclusions: The transcervical or subcapital fractures of the femoral neck can be treated by double muscular pedicles bone graft. The bone graft with double muscular pedicles is more effective than single sartorius muscular pedicles for fresh transcervical and subcapital fractures of the femoral neck during short and medium terms.

  19. Chronic progressive external ophthalmoplegia: II. A qualitative and quantitative electronmicroscopy study of skeletal muscles

    Directory of Open Access Journals (Sweden)

    Elza Dias-Tosta

    1988-06-01

    Full Text Available This study quantifies the maior electron microscopic changes in limb muscle biopsies from 31 out of 34 patients with the syndrome of chronic progressive external ophthalmoplegia. Patients were divided into three clinical groups - A 10 sporadic cases with muscle weakness only; B 9 familial cases with muscle weakness only; C 15 cases with muscle weakness and one or more of the following features: pigmentary retinopathy, cerebellar ataxia, pyramidal signs and peripheral neuropathy. Electron microscopic mitochondrial abnormalities were found in all groups (8 patients from group A, 3 from group B, 14 from group C. Quantitative measurements of certain muscle fibre constituents, using a point-counting technique, revealed decreased myofibril volume-fractions and increased volume-fractions of mitochondria, glycogen and lipid in some biopsies from each group. Mitochondrial volume-fractions correlated positively with lipid content, the proportion of type 1 fibres, and the percentage of fibres with increased oxidative enzyme activity. The three groups defined clinically showed no significant differences in terms of the relative proportions of these measured constituents.

  20. The Benefit of a Mechanical Needle Stimulation Pad in Patients with Chronic Neck and Lower Back Pain: Two Randomized Controlled Pilot Studies

    Directory of Open Access Journals (Sweden)

    Claudia Hohmann

    2012-01-01

    Full Text Available Objectives. The objective was to investigate whether a treatment with a needle stimulation pad (NSP changes perceived pain and/or sensory thresholds in patients with chronic neck (NP and lower back pain (BP. Methods. 40 patients with chronic NP and 42 patients with chronic BP were equally randomized to either treatment or waiting list control group. The treatment group self-administered a NSP over a period of 14 days. Pain ratings were recorded on numerical rating scales (NRSs. Mechanical detection thresholds (MDTs and pressure pain thresholds (PPTs were determined at the site of maximal pain and in the adjacent region, vibration detection thresholds (VDT were measured at close spinal processes. The Northwick Park Neck Pain Questionnaire (NPQ and the Oswestry Disability Index (ODI were utilized for the NP and BP study, respectively. Results. NRS ratings were significantly reduced for the treatment groups compared to the control groups (NP: P=.021 and BP: P<.001, accompanied by a significant increase of PPT at pain maximum (NP: P=.032 and BP: P=.013. There was no effect on VDT and MDT. The NPQ showed also a significant improvement, but not the ODI. Conclusions. The mechanical NSP seems to be an effective treatment method for chronic NP and BP.

  1. Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis.

    Science.gov (United States)

    Lee, Dae Wook; Lim, Chang Hun; Han, Jae Young; Kim, Woong Mo

    2016-10-01

    Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

  2. Chronic delivery of a thrombospondin-1 mimetic decreases skeletal muscle capillarity in mice.

    Science.gov (United States)

    Audet, Gerald N; Fulks, Daniel; Stricker, Janelle C; Olfert, I Mark

    2013-01-01

    Angiogenesis is an essential process for normal skeletal muscle function. There is a growing body of evidence suggesting that thrombospondin-1 (TSP-1), a potent antiangiogenic protein in tumorigenesis, is an important regulator of both physiological and pathological skeletal muscle angiogenesis. We tested the hypothesis that chronic exposure to a TSP-1 mimetic (ABT-510), which targets the CD36 TSP-1 receptor, would decrease skeletal muscle capillarity as well as alter the balance between positive and negative angiogenic proteins under basal conditions. Osmotic minipumps with either ABT-510 or vehicle (5% dextrose) were implanted subcutaneously in the subscapular region of C57/BL6 mice for 14 days. When compared to the vehicle treated mice, the ABT-510 group had a 20% decrease in capillarity in the superficial region of the gastrocnemius (GA), 11% decrease in the plantaris (PLT), and a 35% decrease in the soleus (SOL). ABT-510 also decreased muscle protein expression of vascular endothelial growth factor (VEGF) in both the GA (-140%) and SOL (-62%); however there was no change in VEGF in the PLT. Serum VEGF was not altered in ABT-510 treated animals. Endogenous TSP-1 protein expression in all muscles remained unaltered. Tunnel staining revealed no difference in muscle apoptosis between ABT-510 and vehicle treated groups. These data provide evidence that the anti-angiogenic effects of TSP-1 are mediated, at least in part, via the CD36 receptor. It also suggests that under physiologic conditions the TSP-1/CD36 axis plays a role in regulating basal skeletal muscle microvessel density.

  3. Chronic delivery of a thrombospondin-1 mimetic decreases skeletal muscle capillarity in mice.

    Directory of Open Access Journals (Sweden)

    Gerald N Audet

    Full Text Available Angiogenesis is an essential process for normal skeletal muscle function. There is a growing body of evidence suggesting that thrombospondin-1 (TSP-1, a potent antiangiogenic protein in tumorigenesis, is an important regulator of both physiological and pathological skeletal muscle angiogenesis. We tested the hypothesis that chronic exposure to a TSP-1 mimetic (ABT-510, which targets the CD36 TSP-1 receptor, would decrease skeletal muscle capillarity as well as alter the balance between positive and negative angiogenic proteins under basal conditions. Osmotic minipumps with either ABT-510 or vehicle (5% dextrose were implanted subcutaneously in the subscapular region of C57/BL6 mice for 14 days. When compared to the vehicle treated mice, the ABT-510 group had a 20% decrease in capillarity in the superficial region of the gastrocnemius (GA, 11% decrease in the plantaris (PLT, and a 35% decrease in the soleus (SOL. ABT-510 also decreased muscle protein expression of vascular endothelial growth factor (VEGF in both the GA (-140% and SOL (-62%; however there was no change in VEGF in the PLT. Serum VEGF was not altered in ABT-510 treated animals. Endogenous TSP-1 protein expression in all muscles remained unaltered. Tunnel staining revealed no difference in muscle apoptosis between ABT-510 and vehicle treated groups. These data provide evidence that the anti-angiogenic effects of TSP-1 are mediated, at least in part, via the CD36 receptor. It also suggests that under physiologic conditions the TSP-1/CD36 axis plays a role in regulating basal skeletal muscle microvessel density.

  4. The Association Between Neck Pain and Pulmonary Function: A Systematic Review.

    Science.gov (United States)

    Kahlaee, Amir Hossein; Ghamkhar, Leila; Arab, Amir Massoud

    2017-03-01

    The aim of this study was to systematically review the evidence on respiratory function changes in patients with chronic neck pain. MEDLINE, Elsevier, ProQuest, PubMed, Scopus, Springer, and Google scholar electronic databases were explored thorough December 2015. English-language studies investigating cervical musculoskeletal and respiratory parameters in patients with chronic neck pain were included. Characteristics of the patients, sampling method and size, musculoskeletal and respiratory parameters studied, and appropriateness of the statistical tests were considered. Studies were rated based on study design and performance. Of the 68 studies reviewed, 9 observational studies met our inclusion criteria. Significant difference in maximum inspiratory and expiratory pressures were reported in patients with chronic neck pain compared to asymptomatic subjects. Some of the respiratory volumes were found to be lower in patients with chronic neck pain. Muscle strength and endurance, cervical range of motion, and psychological states were found to be significantly correlated with respiratory parameters. Lower Pco2 in patients and significant relationship between chest expansion and neck pain were also shown. Respiratory retraining was found to be effective in improving some cervical musculoskeletal and respiratory impairment. Functional pulmonary impairments accompany chronic neck pain. Based on the observed association, investigation of the effectiveness of management of CNP on respiratory function is strongly suggested.

  5. Changes in Disability, Physical/Mental Health States and Quality of Life during an 8-Week Multimodal Physiotherapy Programme in Patients with Chronic Non-Specific Neck Pain: A Prospective Cohort Study

    Science.gov (United States)

    Cuesta-Vargas, Antonio Ignacio; González-Sánchez, Manuel

    2015-01-01

    Aim The aim of this study was to analyse the effect of an 8-week multimodal physiotherapy programme (MPP), integrating physical land-based therapeutic exercise (TE), adapted swimming and health education, as a treatment for patients with chronic non-specific neck pain (CNSNP), on disability, general health/mental states and quality of life. Methods 175 CNSNP patients from a community-based centre were recruited to participate in this prospective study. Intervention: 60-minute session (30 minutes of land-based exercise dedicated to improving mobility, motor control, resistance and strengthening of the neck muscles, and 30 minutes of adapted swimming with aerobic exercise keeping a neutral neck position using a snorkel). Health education was provided using a decalogue on CNSNP and constant repetition of brief advice by the physiotherapist during the supervision of the exercises in each session. Study outcomes: primary: disability (Neck Disability Index); secondary: physical and mental health states and quality of life of patients (SF-12 and EuroQoL-5D respectively). Differences between baseline data and that at the 8-week follow-up were calculated for all outcome variables. Results Disability showed a significant improvement of 24.6% from a mean (SD) of 28.2 (13.08) at baseline to 16.88 (11.62) at the end of the 8-week intervention. All secondary outcome variables were observed to show significant, clinically relevant improvements with increase ranges between 13.0% and 16.3% from a mean of 0.70 (0.2) at baseline to 0.83 (0.2), for EuroQoL-5D, and from a mean of 40.6 (12.7) at baseline to 56.9 (9.5), for mental health state, at the end of the 8-week intervention. Conclusion After 8 weeks of a MPP that integrated land-based physical TE, health education and adapted swimming, clinically-relevant and statistically-significant improvements were observed for disability, physical and mental health states and quality of life in patients who suffer CNSNP. The clinical

  6. Changes in disability, physical/mental health states and quality of life during an 8-week multimodal physiotherapy programme in patients with chronic non-specific neck pain: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Antonio Ignacio Cuesta-Vargas

    Full Text Available The aim of this study was to analyse the effect of an 8-week multimodal physiotherapy programme (MPP, integrating physical land-based therapeutic exercise (TE, adapted swimming and health education, as a treatment for patients with chronic non-specific neck pain (CNSNP, on disability, general health/mental states and quality of life.175 CNSNP patients from a community-based centre were recruited to participate in this prospective study.60-minute session (30 minutes of land-based exercise dedicated to improving mobility, motor control, resistance and strengthening of the neck muscles, and 30 minutes of adapted swimming with aerobic exercise keeping a neutral neck position using a snorkel. Health education was provided using a decalogue on CNSNP and constant repetition of brief advice by the physiotherapist during the supervision of the exercises in each session.primary: disability (Neck Disability Index; secondary: physical and mental health states and quality of life of patients (SF-12 and EuroQoL-5D respectively. Differences between baseline data and that at the 8-week follow-up were calculated for all outcome variables.Disability showed a significant improvement of 24.6% from a mean (SD of 28.2 (13.08 at baseline to 16.88 (11.62 at the end of the 8-week intervention. All secondary outcome variables were observed to show significant, clinically relevant improvements with increase ranges between 13.0% and 16.3% from a mean of 0.70 (0.2 at baseline to 0.83 (0.2, for EuroQoL-5D, and from a mean of 40.6 (12.7 at baseline to 56.9 (9.5, for mental health state, at the end of the 8-week intervention.After 8 weeks of a MPP that integrated land-based physical TE, health education and adapted swimming, clinically-relevant and statistically-significant improvements were observed for disability, physical and mental health states and quality of life in patients who suffer CNSNP. The clinical efficacy requires verification using a randomised controlled study

  7. Developmental biomechanics of neck musculature

    OpenAIRE

    Lavallee, Amy V.; Ching, Randal P.; Nuckley, David J.

    2012-01-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A fa...

  8. Direction-Specific Impairments in Cervical Range of Motion in Women with Chronic Neck Pain: Influence of Head Posture and Gravitationally Induced Torque

    Science.gov (United States)

    Björklund, Martin; Svedmark, Åsa; Srinivasan, Divya; Djupsjöbacka, Mats

    2017-01-01

    Background Cervical range of motion (ROM) is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension) or a movement strategy to avoid large gravitationally induced torques on the cervical spine. Methods Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition) and maximal protraction (low torque condition) in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM), from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure. Findings Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour. Interpretation The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments. PMID:28099504

  9. Effects of Abdominal Stimulation during Inspiratory Muscle Training on Respiratory Function of Chronic Stroke Patients.

    Science.gov (United States)

    Jung, Ju-Hyeon; Shim, Je-Myung; Kwon, Hae-Yeon; Kim, Ha-Roo; Kim, Bo-In

    2014-01-01

    [Purpose] The purpose of the present study was to verify a new method for improving respiratory functions by applying both abdominal stimulation and inspiratory muscle training (IMT) to train the inspiratory muscle and the expiratory muscle simultaneously, to improve the efficiency of IMT of chronic stroke patients. [Subjects] Eighteen stroke patients were randomly assigned to an experimental group (n = 9) and a control group (n = 9). [Methods] The experimental group was administered IMT with abdominal stimulation, and the control group was administered only IMT. During the intervention period, the experimental group and control group received training 20 min/day, 3 times/wk, for 4 weeks. To examine the lung functions of the subjects, FVC, FEV1, PEF, and FEF25-75 were measured using an electronic spirometer. The diaphragm thickness ratio was calculated from measurements made with a 7.5-MHz linear probe ultrasonic imaging system. [Result] The experimental group and the control group showed significant increases in diaphragm thickness ratio on the paretic side, but not on the non-paretic side. With regard to lung function, the experimental group showed significant increases in FEV1, PEF, and FEF25-75. The changes between before and after the intervention in the two groups were compared with each other, and the results showed significant differences in FEV1 and PEF. [Conclusion] The present study identified that IMT accompanied by abdominal stimulation improved the pulmonary function of chronic stroke patients.

  10. 颈、腰肌训练的效果研究%Effects of muscle training on improving neck/lumbar functions

    Institute of Scientific and Technical Information of China (English)

    邓略; 王全; 卫晓阳; 王海霞; 李宝辉; 金朝; 马月欣; 成海平; 耿喜臣

    2015-01-01

    ,保持颈、腰运动功能.训练计划对于改善颈、腰损伤的效果还需进一步研究.%Objective To provide measure for preventing and rehabilitating neck and lumbar injury in fighter pilots by 6-wk program of neck and psoas muscle isometric training cooperated with healing setting-up exercises.Methods Six male healthy volunteers were trained in isometric contractions twice a week for 6 weeks by using self-designed Neck and Psoas Muscle Isometric Training Cooperated Equipment.During training,subjects seated and kept the same posture as in flight.They performed 2 sets of neck and lumbar extension exercises with 60% maximal voluntary contraction (MVC) strength for 10 times.Subjects also completed healing setting-up exercises before equipment training.They were also asked to perform additional healing setting-up exercises by themselves at least twice a week.The setting-up exercises included:relax in prone posture,prone posture stretching,prostrate straight on back,sit-up,and standing stretching.The pre-and posttraining tests consisted of the isometric MVC strength in neck extension,neck left lateral flexion (Ltflx) and right lateral flexion (Rtflx),lumbar extension,10 s maximal strength impulse and 90 s maximal strength total impulse in neck/lumbar extension test,electromyography in impulse test,spine active range-of-motion (ROM) in flexion and extension,Ltflx and Rtflx,left and right rotation.The software package SPSS 18.0 was applied for paired t-test.Results Compared with those before training,post-training neck isometric MVC in extension and Ltflx improved significantly (t=4.140,3.125,P<0.05).Lumbar extension isometric MVC mean value increased 10%.10 s maximal strength impulse and 90 s maximal strength total impulse in neck and lumbar extension increased significantly (t=2.631-3.202,P<0.05).ROM in neck extension,lumbar flexion and left rotation improved significantly (t=4.011-6.343,P<0.01).In SEMG,median frequency in 90 s neck extension and

  11. The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients.

    Science.gov (United States)

    Jeong, Ui-Cheol; Sim, Jae-Heon; Kim, Cheol-Yong; Hwang-Bo, Gak; Nam, Chan-Woo

    2015-12-01

    [Purpose] The aim of this study was to examine the effects of exercise to strengthen the muscles of the hip together with lumbar segmental stabilization exercise on the lumbar disability index, lumbar muscle strength, and balance. [Subjects and Methods] This study randomly and equally assigned 40 participants who provided written consent to participate in this study to a lumbar segmental stabilization exercise plus exercise to strengthen the muscles of the gluteus group (SMG + LES group) and a lumbar segmental stabilization exercise group. [Results] Each evaluation item showed a statistically significant effect. [Conclusion] Clinical application of exercise in this study showed that lumbar segmental stabilization exercise plus exercise to strengthen the muscles of the gluteus resulted in a greater decrease in low back pain disability index and increase in lumbar muscle strength and balance ability than lumbar segmental stabilization exercise in chronic low back pain patients receiving the exercise treatments during the same period.

  12. Exercise training in chronic heart failure: improving skeletal muscle O2 transport and utilization.

    Science.gov (United States)

    Hirai, Daniel M; Musch, Timothy I; Poole, David C

    2015-11-01

    Chronic heart failure (CHF) impairs critical structural and functional components of the O2 transport pathway resulting in exercise intolerance and, consequently, reduced quality of life. In contrast, exercise training is capable of combating many of the CHF-induced impairments and enhancing the matching between skeletal muscle O2 delivery and utilization (Q̇mO2 and V̇mO2 , respectively). The Q̇mO2 /V̇mO2 ratio determines the microvascular O2 partial pressure (PmvO2 ), which represents the ultimate force driving blood-myocyte O2 flux (see Fig. 1). Improvements in perfusive and diffusive O2 conductances are essential to support faster rates of oxidative phosphorylation (reflected as faster V̇mO2 kinetics during transitions in metabolic demand) and reduce the reliance on anaerobic glycolysis and utilization of finite energy sources (thus lowering the magnitude of the O2 deficit) in trained CHF muscle. These adaptations contribute to attenuated muscle metabolic perturbations (e.g., changes in [PCr], [Cr], [ADP], and pH) and improved physical capacity (i.e., elevated critical power and maximal V̇mO2 ). Preservation of such plasticity in response to exercise training is crucial considering the dominant role of skeletal muscle dysfunction in the pathophysiology and increased morbidity/mortality of the CHF patient. This brief review focuses on the mechanistic bases for improved Q̇mO2 /V̇mO2 matching (and enhanced PmvO2 ) with exercise training in CHF with both preserved and reduced ejection fraction (HFpEF and HFrEF, respectively). Specifically, O2 convection within the skeletal muscle microcirculation, O2 diffusion from the red blood cell to the mitochondria, and muscle metabolic control are particularly susceptive to exercise training adaptations in CHF. Alternatives to traditional whole body endurance exercise training programs such as small muscle mass and inspiratory muscle training, pharmacological treatment (e.g., sildenafil and pentoxifylline), and dietary

  13. Isokinetic imbalance of adductor-abductor hip muscles in professional soccer players with chronic adductor-related groin pain.

    Science.gov (United States)

    Belhaj, K; Meftah, S; Mahir, L; Lmidmani, F; Elfatimi, A

    2016-11-01

    This study aims to compare the isokinetic profile of hip abductor and adductor muscle groups between soccer players suffering from chronic adductor-related groin pain (ARGP), soccer players without ARGP and healthy volunteers from general population. Study included 36 male professional soccer players, who were randomly selected and followed-up over two years. Of the 21 soccer players eligible to participate in the study, 9 players went on to develop chronic ARGP and 12 players did not. Ten healthy male volunteers were randomly selected from the general population as a control group. Comparison between the abductor and adductor muscle peak torques for players with and without chronic ARGP found a statistically significant difference on the dominant and non-dominant sides (p muscle significantly stronger than the adductor muscle. In the group of healthy volunteers, the adductor muscle groups were significantly stronger than the abductor muscle groups on both dominant and non-dominant sides (p muscle strength was also significantly decreased on the affected side. This imbalance appears to be a risk factor for adductor-related groin injury. Therefore, restoring the correct relationship between these two agonist and antagonist hip muscles may be an important preventative measure that should be a primary concern of training and rehabilitation programmes.

  14. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review

    Science.gov (United States)

    Salgotra, Kuldip; Kohli, Sarabjeet; Vishwakarma, Nilesh

    2016-01-01

    Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft) and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG) using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7%) men and 1 (14.3%) women among the patients. Overall 5 (71.5%) patients had transcervical and 2 (28.5%) had subcapital fractures. At the end of 6 months, 6 (85.7%) patients were pain free and on plain radiographs fracture union was noted. One (14.3%) patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures. PMID:27331067

  15. Chronic mechanical neck pain in adults treated by manual therapy: a systematic review of change scores in randomized controlled trials of a single session.

    Science.gov (United States)

    Vernon, Howard; Humphreys, Barry Kim

    2008-01-01

    We report a systematic analysis of group change scores of subjects with chronic neck pain not due to whiplash and without headache or arm pain, in randomized clinical trials of a single session of manual therapy. A comprehensive literature search of clinical trials of chronic neck pain treated with manual therapies up to December 2006 was conducted. Trials that scored above 60% on the PEDro Scale were included. Change scores were analyzed for absolute, percentage change and effect size (ES) whenever possible. Nine trials were identified: 6 for spinal manipulation, 4 for spinal mobilization or non-manipulative manual therapy (2 overlapping trials), and 1 trial using ischemic compression. No trials were identified for massage therapy or manual traction. Four manipulation trials (five groups) reported mean immediate changes in 100-mm VAS of -18.94 (9.28) mm. ES for these changes ranged from .33 to 2.3. Two mobilization trials reported immediate VAS changes of -11.5 and -4 mm (ES of .36 and .22, respectively); one trial reported no difference in immediate pain scores versus sham mobilization. The ischemic compression study showed statistically significant immediate decreases in 100-mm pain VAS (average = -14.6 mm). There is moderate-to-high quality evidence that immediate clinically important improvements are obtained from a single session of spinal manipulation. The evidence for mobilization is less substantial, with fewer studies reporting smaller immediate changes. There is insufficient evidence for ischemic compression to draw conclusions. There is no evidence for a single session of massage or manual traction for chronic neck pain.

  16. Chronic elevated calcium blocks AMPK-induced GLUT-4 expression in skeletal muscle.

    Science.gov (United States)

    Park, S; Scheffler, T L; Gunawan, A M; Shi, H; Zeng, C; Hannon, K M; Grant, A L; Gerrard, D E

    2009-01-01

    Muscle contraction stimulates glucose transport independent of insulin. Glucose uptake into muscle cells is positively related to skeletal muscle-specific glucose transporter (GLUT-4) expression. Therefore, our objective was to determine the effects of the contraction-mediated signals, calcium and AMP-activated protein kinase (AMPK), on glucose uptake and GLUT-4 expression under acute and chronic conditions. To accomplish this, we used pharmacological agents, cell culture, and pigs possessing genetic mutations for increased cytosolic calcium and constitutively active AMPK. In C2C12 myotubes, caffeine, a sarcoplasmic reticulum calcium-releasing agent, had a biphasic effect on GLUT-4 expression and glucose uptake. Low-concentration (1.25 to 2 mM) or short-term (4 h) caffeine treatment together with the AMPK activator, 5-aminoimidazole-4-carboxamide-1-beta-D-ribonucleoside (AICAR), had an additive effect on GLUT-4 expression. However, high-concentration (2.5 to 5 mM) or long-term (4 to 30 h) caffeine treatment decreased AMPK-induced GLUT-4 expression without affecting cell viability. The negative effect of caffeine on AICAR-induced GLUT-4 expression was reduced by dantrolene, which desensitizes the ryanodine receptor. Consistent with cell culture data, increases in GLUT-4 mRNA and protein expression induced by AMPK were blunted in pigs possessing genetic mutations for both increased cytosolic calcium and constitutively active AMPK. Altogether, these data suggest that chronic exposure to elevated cytosolic calcium concentration blocks AMPK-induced GLUT-4 expression in skeletal muscle.

  17. Exercise prevents development of autonomic dysregulation and hyperalgesia in a mouse model of chronic muscle pain.

    Science.gov (United States)

    Sabharwal, Rasna; Rasmussen, Lynn; Sluka, Kathleen A; Chapleau, Mark W

    2016-02-01

    Chronic musculoskeletal pain (CMP) conditions, like fibromyalgia, are associated with widespread pain and alterations in autonomic functions. Regular physical activity prevents the development of CMP and can reduce autonomic dysfunction. We tested if there were alterations in autonomic function of sedentary mice with CMP, and whether exercise reduced the autonomic dysfunction and pain induced by CMP. Chronic musculoskeletal pain was induced by 2 intramuscular injections of pH 5.0 in combination with a single fatiguing exercise task. A running wheel was placed into cages so that the mouse had free access to it for either 5 days or 8 weeks (exercise groups) and these animals were compared to sedentary mice without running wheels. Autonomic function and nociceptive withdrawal thresholds of the paw and muscle were assessed before and after induction of CMP in exercised and sedentary mice. In sedentary mice, we show decreased baroreflex sensitivity, increased blood pressure variability, decreased heart rate variability, and decreased withdrawal thresholds of the paw and muscle 24 hours after induction of CMP. There were no sex differences after induction of the CMP in any outcome measure. We further show that both 5 days and 8 weeks of physical activity prevent the development of autonomic dysfunction and decreases in withdrawal threshold induced by CMP. Thus, this study uniquely shows the development of autonomic dysfunction in animals with chronic muscle hyperalgesia, which can be prevented with as little as 5 days of physical activity, and suggest that physical activity may prevent the development of pain and autonomic dysfunction in people with CMP.

  18. Time-Course of Muscle Mass Loss, Damage, and Proteolysis in Gastrocnemius following Unloading and Reloading: Implications in Chronic Diseases

    Science.gov (United States)

    Chacon-Cabrera, Alba; Lund-Palau, Helena; Gea, Joaquim; Barreiro, Esther

    2016-01-01

    Background Disuse muscle atrophy is a major comorbidity in patients with chronic diseases including cancer. We sought to explore the kinetics of molecular mechanisms shown to be involved in muscle mass loss throughout time in a mouse model of disuse muscle atrophy and recovery following immobilization. Methods Body and muscle weights, grip strength, muscle phenotype (fiber type composition and morphometry and muscle structural alterations), proteolysis, contractile proteins, systemic troponin I, and mitochondrial content were assessed in gastrocnemius of mice exposed to periods (1, 2, 3, 7, 15 and 30 days) of non-invasive hindlimb immobilization (plastic splint, I cohorts) and in those exposed to reloading for different time-points (1, 3, 7, 15, and 30 days, R cohorts) following a seven-day period of immobilization. Groups of control animals were also used. Results Compared to non-exposed controls, muscle weight, limb strength, slow- and fast-twitch cross-sectional areas, mtDNA/nDNA, and myosin content were decreased in mice of I cohorts, whereas tyrosine release, ubiquitin-proteasome activity, muscle injury and systemic troponin I levels were increased. Gastrocnemius reloading following splint removal improved muscle mass loss, strength, fiber atrophy, injury, myosin content, and mtDNA/nDNA, while reducing ubiquitin-proteasome activity and proteolysis. Conclusions A consistent program of molecular and cellular events leading to reduced gastrocnemius muscle mass and mitochondrial content and reduced strength, enhanced proteolysis, and injury, was seen in this non-invasive mouse model of disuse muscle atrophy. Unloading of the muscle following removal of the splint significantly improved the alterations seen during unloading, characterized by a specific kinetic profile of molecular events involved in muscle regeneration. These findings have implications in patients with chronic diseases including cancer in whom physical activity may be severely compromised. PMID

  19. Chronic alcohol ingestion exacerbates skeletal muscle myopathy in HIV-1 transgenic rats

    Directory of Open Access Journals (Sweden)

    Bratina Margaux A

    2011-08-01

    Full Text Available Abstract Background Separately, chronic alcohol ingestion and HIV-1 infection are associated with severe skeletal muscle derangements, including atrophy and wasting, weakness, and fatigue. One prospective cohort study reported that 41% of HIV-infected patients met the criteria for alcoholism, however; few reports exist on the co-morbid effects of these two disease processes on skeletal muscle homeostasis. Thus, we analyzed the atrophic effects of chronic alcohol ingestion in HIV-1 transgenic rats and identified alterations to several catabolic and anabolic factors. Findings Relative plantaris mass, total protein content, and fiber cross-sectional area were reduced in each experimental group compared to healthy, control-fed rats. Alcohol abuse further reduced plantaris fiber area in HIV-1 transgenic rats. Consistent with previous reports, gene levels of myostatin and its receptor activin IIB were not increased in HIV-1 transgenic rat muscle. However, myostatin and activin IIB were induced in healthy and HIV-1 transgenic rats fed alcohol for 12 weeks. Catabolic signaling factors such as TGFβ1, TNFα, and phospho-p38/total-p38 were increased in all groups compared to controls. There was no effect on IL-6, leukemia inhibitory factor (LIF, cardiotrophin-1 (CT-1, or ciliary neurotrophic factor (CNTF in control-fed, transgenic rats. However, the co-morbidity of chronic alcohol abuse and HIV-1-related protein expression decreased expression of the two anabolic factors, CT-1 and CNTF. Conclusions Consistent with previous reports, alcohol abuse accentuated skeletal muscle atrophy in an animal model of HIV/AIDS. While some catabolic pathways known to drive alcoholic or HIV-1-associated myopathies were also elevated in this co-morbid model (e.g., TGFβ1, consistent expression patterns were not apparent. Thus, specific alterations to signaling mechanisms such as the induction of the myostatin/activin IIB system or reductions in growth factor signaling via

  20. The role of exercise-induced myokines in muscle homeostasis and the defense against chronic diseases

    DEFF Research Database (Denmark)

    Brandt, Claus; Pedersen, Bente K

    2010-01-01

    and exert their effects on signalling pathways involved in fat oxidation and glucose uptake. By mediating anti-inflammatory effects in the muscle itself, myokines may also counteract TNF-driven insulin resistance. In conclusion, exercise-induced myokines appear to be involved in mediating both systemic......Chronic inflammation is involved in the pathogenesis of insulin resistance, atherosclerosis, neurodegeneration, and tumour growth. Regular exercise offers protection against type 2 diabetes, cardiovascular diseases, colon cancer, breast cancer, and dementia. Evidence suggests that the protective...

  1. The transcriptional coactivator PGC-1α is dispensable for chronic overload-induced skeletal muscle hypertrophy and metabolic remodeling.

    Science.gov (United States)

    Pérez-Schindler, Joaquín; Summermatter, Serge; Santos, Gesa; Zorzato, Francesco; Handschin, Christoph

    2013-12-10

    Skeletal muscle mass loss and dysfunction have been linked to many diseases. Conversely, resistance exercise, mainly by activating mammalian target of rapamycin complex 1 (mTORC1), promotes skeletal muscle hypertrophy and exerts several therapeutic effects. Moreover, mTORC1, along with peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), regulates skeletal muscle metabolism. However, it is unclear whether PGC-1α is required for skeletal muscle adaptations after overload. Here we show that although chronic overload of skeletal muscle via synergist ablation (SA) strongly induces hypertrophy and a switch toward a slow-contractile phenotype, these effects were independent of PGC-1α. In fact, SA down-regulated PGC-1α expression and led to a repression of energy metabolism. Interestingly, however, PGC-1α deletion preserved peak force after SA. Taken together, our data suggest that PGC-1α is not involved in skeletal muscle remodeling induced by SA.

  2. Chronic alcohol exposure induces muscle atrophy (myopathy) in zebrafish and alters the expression of microRNAs targeting the Notch pathway in skeletal muscle.

    Science.gov (United States)

    Khayrullin, Andrew; Smith, Lauren; Mistry, Dhwani; Dukes, Amy; Pan, Y Albert; Hamrick, Mark W

    2016-10-21

    Muscle wasting is estimated to affect 40-60% of alcoholics, and is more common than cirrhosis among chronic alcohol abusers. The molecular and cellular mechanisms underlying alcohol-related musculoskeletal dysfunction are, however, poorly understood. Muscle-specific microRNAs (miRNAs) referred to as myoMirs are now known to play a key role in both myogenesis and muscle atrophy. Yet, no studies have investigated a role for myoMirs in alcohol-related skeletal muscle damage. We developed a zebrafish model of chronic ethanol exposure to better define the mechanisms mediating alcohol-induced muscle atrophy. Adult fish maintained at 0.5% ethanol for eight weeks demonstrated significantly reduced muscle fiber cross-sectional area (∼12%, P < 0.05) compared to fish housed in normal water. Zebrafish miRNA microarray revealed marked changes in several miRNAs with ethanol treatment. Importantly, miR-140, a miRNA that shows 100% sequence homology with miR-140 from both mouse and human, is decreased 10-fold in ethanol treated fish. miR-140 targets several members of the Notch signaling pathway such as DNER, JAG1, and Hey1, and PCR data show that both Hey1 and Notch 1 are significantly up-related (3-fold) in muscle of ethanol treated fish. In addition, miR-146a, which targets the Notch antagonist Numb, is elevated in muscle from ethanol-treated fish. Upregulation of Notch signaling suppresses myogenesis and maintains muscle satellite cell quiescence. These data suggest that miRNAs targeting Notch are likely to play important roles in alcohol-related myopathy. Furthermore, zebrafish may serve as a useful model for better understanding the role of microRNAs in alcohol-related tissue damage.

  3. Attenuated fatigue in slow twitch skeletal muscle during isotonic exercise in rats with chronic heart failure.

    Directory of Open Access Journals (Sweden)

    Morten Munkvik

    Full Text Available During isometric contractions, slow twitch soleus muscles (SOL from rats with chronic heart failure (chf are more fatigable than those of sham animals. However, a muscle normally shortens during activity and fatigue development is highly task dependent. Therefore, we examined the development of skeletal muscle fatigue during shortening (isotonic contractions in chf and sham-operated rats. Six weeks following coronary artery ligation, infarcted animals were classified as failing (chf if left ventricle end diastolic pressure was >15 mmHg. During isoflurane anaesthesia, SOL with intact blood supply was stimulated (1s on 1s off at 30 Hz for 15 min and allowed to shorten isotonically against a constant afterload. Muscle temperature was maintained at 37°C. In resting muscle, maximum isometric force (F(max and the concentrations of ATP and CrP were not different in the two groups. During stimulation, F(max and the concentrations declined in parallel sham and chf. Fatigue, which was evident as reduced shortening during stimulation, was also not different in the two groups. The isometric force decline was fitted to a bi-exponential decay equation. Both time constants increased transiently and returned to initial values after approximately 200 s of the fatigue protocol. This resulted in a transient rise in baseline tension between stimulations, although this effect which was less prominent in chf than sham. Myosin light chain 2s phosphorylation declined in both groups after 100 s of isotonic contractions, and remained at this level throughout 15 min of stimulation. In spite of higher energy demand during isotonic than isometric contractions, both shortening capacity and rate of isometric force decline were as well or better preserved in fatigued SOL from chf rats than in sham. This observation is in striking contrast to previous reports which have employed isometric contractions to induce fatigue.

  4. Chronic hypoxia impairs muscle function in the Drosophila model of Duchenne's muscular dystrophy (DMD.

    Directory of Open Access Journals (Sweden)

    Matias Mosqueira

    Full Text Available Duchenne's muscular dystrophy (DMD is a severe progressive myopathy caused by mutations in the DMD gene leading to a deficiency of the dystrophin protein. Due to ongoing muscle necrosis in respiratory muscles late-stage DMD is associated with respiratory insufficiency and chronic hypoxia (CH. To understand the effects of CH on dystrophin-deficient muscle in vivo, we exposed the Drosophila model for DMD (dmDys to CH during a 16-day ascent to the summit of Mount Denali/McKinley (6194 meters above sea level. Additionally, dmDys and wild type (WT flies were also exposed to CH in laboratory simulations of high altitude hypoxia. Expression profiling was performed using Affymetrix GeneChips® and validated using qPCR. Hypoxic dmDys differentially expressed 1281 genes, whereas the hypoxic WT flies differentially expressed 56 genes. Interestingly, a number of genes (e.g. heat shock proteins were discordantly regulated in response to CH between dmDys and WT. We tested the possibility that the disparate molecular responses of dystrophin-deficient tissues to CH could adversely affect muscle by performing functional assays in vivo. Normoxic and CH WT and dmDys flies were challenged with acute hypoxia and time-to-recover determined as well as subjected to climbing tests. Impaired performance was noted for CH-dmDys compared to normoxic dmDys or WT flies (rank order: Normoxic-WT ≈ CH-WT> Normoxic-dmDys> CH-dmDys. These data suggest that dystrophin-deficiency is associated with a disparate, pathological hypoxic stress response(s and is more sensitive to hypoxia induced muscle dysfunction in vivo. We hypothesize that targeting/correcting the disparate molecular response(s to hypoxia may offer a novel therapeutic strategy in DMD.

  5. Development and Validation of a Neck Muscle FE Model for Rear Impact Study%后碰撞中乘员颈部肌肉有限元模型的建立与验证

    Institute of Scientific and Technical Information of China (English)

    李凡; 曹迎春; 粟思橙; 黄晶

    2016-01-01

    建立并验证了具有主动力响应的乘员颈部肌肉有限元模型,用于研究颈部肌肉主被动响应对后碰撞载荷下乘员头颈部动力学响应及颈部损伤的影响。运用50百分位成年男性颈部的MRI数据重建了人体颈部肌肉三维数值模型,采用克里格插值方法将其与头颈基础模型进行匹配。肌肉材料定义采用 Ogden材料和 Hill材料相耦合的办法以分别模拟肌肉的被动和主动特性。根据Davidsson等人开展的后碰撞台车志愿者试验数据对该颈部肌肉模型进行了验证。结果表明,肌肉激活状态下与未激活时比较,头部质心相对 T1位移减小了12 mm,头部角位移减小了4°,肌肉主动力影响显著。该模型的数值模拟结果与志愿者试验结果吻合较好,模型具有较高的生物逼真度,可应用于后碰撞中的乘员颈部损伤研究。%The aim of the present study was to develop and validate an FE model of neck muscle system according to human anatomy structure in order to analyze the influence of neck muscle activation on head-neck dynamic responses and biomechanical responses under rear impact loading condition.A three-dimen-sional neck muscle model was developed on the basis of the MRI data of a 50th percentile male.The model was then combined with a previously developed and well-validated head-neck FE model in Kriging method. The passive and active behavior of a single neck muscle was defined by coupling Ogden and Hill material models.The neck muscle FE model was validated through volunteer tests of rear-impact conducted in Chalmers University of Technology.The result has shown that,compared with non-activation muscle be-havior,the displacement of head CDG to T1 decreases by 12mm while the angle displacement decreases by 4°,which indicates the significant effect of muscle activation on head kinetic responses.The head-neck dy-namic responses from the simulations are consistent with the test results

  6. Changed activation, oxygenation, and pain response of chronically painful muscles to repetitive work after training interventions: a randomized controlled trial

    DEFF Research Database (Denmark)

    Søgaard, Karen; Blangsted, Anne Katrine; Nielsen, Pernille Kofoed;

    2012-01-01

    The aim of this randomized controlled trial was to assess changes in myalgic trapezius activation, muscle oxygenation, and pain intensity during repetitive and stressful work tasks in response to 10 weeks of training. In total, 39 women with a clinical diagnosis of trapezius myalgia were randomly...... assigned to: (1) general fitness training performed as leg-bicycling (GFT); (2) specific strength training of the neck/shoulder muscles (SST) or (3) reference intervention without physical exercise. Electromyographic activity (EMG), tissue oxygenation (near infrared spectroscopy), and pain intensity were...... to improved oxygenation of the painful muscles. SST lowered the overall level of pain both during rest and work, possibly due to a lowered relative exposure as evidenced by a lowered relative EMG. The results demonstrate differential adaptive mechanisms of contrasting physical exercise interventions...

  7. Effect of intermittent, supine cervical traction on the myoelectric activity of the upper trapezius muscle in subjects with neck pain.

    Science.gov (United States)

    Jette, D U; Falkel, J E; Trombly, C

    1985-08-01

    This study was undertaken to compare the myoelectric activity of the upper trapezius muscle before, during, and after intermittent, supine cervical traction. Twelve people with diagnosed disease or injury of the cervical spine served as subjects. Electromyographic recordings were taken from the upper trapezius muscle with bipolar surface electrodes. The subjects were treated with 20 minutes of intermittent, cervical traction at a force of 8% of their body weight. Recordings were taken with the subjects in the supine position before the traction, during one pull and release phase of the 10th and 20th minutes of traction, and after completion of the traction treatment. An analysis of variance with repeated measures showed no significant differences in the myoelectrical activity during the six time periods measured. The results of this study do not support the clinical use of intermittent, supine traction to produce cervical muscle relaxation.

  8. 办公室人群慢性颈痛流行病学调查研究%Epidemiological investigation of chronic neck pain in office workers

    Institute of Scientific and Technical Information of China (English)

    关福源; 杨欢野; 王泽民; 张小红

    2015-01-01

    Objective To investigate the morbidity and influencing factors of chronic neck pain in office workers and propose intervention measures to prevent neck pain.Methods Sedentary office workers in Dongguan were taken as study objects.Office workers from 18 medical establishments in Dongguan and outpatients that met the inclusion criteria and treated at our hospital from May to December,2013 were randomly selected.All subjects were asked to fill in the epidemiological investigation questionnaire.Results Sedentary office workers in Dongguan had a high prevalence of chronic neck pain.The risk factors of chronic neck pain included less comfortable tables and chairs,long hours at the desk every day,too long duration of working at the desk,age,keeping the head in a fixed posture or position for over half an hour,no habit of moving the head during work time,forward-leaning sitting position,tilting the head during work time,and different working planes of two hands when operating a computer,and there were statistical differences.Conclusions For those sedentary office workers with or without chronic neck pain,they should keep a good sitting position,establish a good habit of resting and neck movement during work time,reduce hours at the desk,and take intervention measure to improve the layouts of tables,chairs,mice and keyboards,so as to prevent the occurrence of cervical spondylosis.%目的 调查分析办公室人群慢性颈痛的发病情况及影响因素,提出预防颈椎疼痛的干预措施.方法 以东莞市低头伏案工作者为研究对象.随机抽取东莞市18家医疗机构办公室工作人员以及2013年5月至2013年12月在我院门诊就诊的符合纳入标准的患者进行问卷调查,所有调查对象需填写颈椎病流行病学调查问卷.结果 东莞市伏案工作者慢性颈痛患病率较高.桌椅不舒适、每天伏案时间长、持续伏案时间过长、年龄以及坐姿行为习惯中头部通常保持一种姿势或动作(半小

  9. A pilot study using Tissue Velocity Ultrasound Imaging (TVI to assess muscle activity pattern in patients with chronic trapezius myalgia

    Directory of Open Access Journals (Sweden)

    Brodin Lars-Åke

    2008-09-01

    Full Text Available Abstract Background Different research techniques indicate alterations in muscle tissue and in neuromuscular control of aching muscles in patients with chronic localized pain. Ultrasound can be used for analysis of muscle tissue dynamics in clinical practice. Aim This study introduces a new muscle tissue sensitive ultrasound technique in order to provide a new methodology for providing a description of local muscle changes. This method is applied to investigate trapezius muscle tissue response – especially with respect to specific regional deformation and deformation rates – during concentric shoulder elevation in patients with chronic trapezius myalgia and healthy controls before and after pain provocation. Methods Patients with trapezius myalgia and healthy controls were analyzed using an ultrasound system equipped with tissue velocity imaging (TVI. The patients performed a standardized 3-cm concentric shoulder elevation before and after pain provocation/exercise at a standardized elevation tempo (30 bpm. A standardized region of interest (ROI, an ellipsis with a size that captures the upper and lower fascia of the trapezius muscle (4 cm width at rest, was placed in the first frame of the loop registration of the elevation. The ROI was re-anchored frame by frame following the same anatomical landmark in the basal fascia during all frames of the concentric phase. In cardiac measurement, tissue velocities are measured in the axial projection towards and against the probe where red colour represents shortening and red lengthening. In the case of measuring the trapezius muscle, tissue deformation measurements are made orthogonally, thus, indirectly. Based on the assumption of muscle volume incompressibility, blue represents tissue contraction and red relaxation. Within the ROI, two variables were calculated as a function of time: deformation and deformation rate. Hereafter, max, mean, and quadratic mean values (RMS of each variable were

  10. Skin displacement analysis (SDA: a tool for the quantitative evaluation of skin movements elicited by underlying muscles in the face and neck area

    Directory of Open Access Journals (Sweden)

    Proebstle TM

    2011-04-01

    Full Text Available Thomas M ProebstleDepartment of Dermatology, University Clinic of Mainz, Mainz, GermanyBackground: Quantitative numerical analysis of skin displacement triggered by muscles inserting the overlaying skin would be useful for monitoring the inhibition of mimetic muscles.Methods: By using removable grid markings and digital photographs, skin displacement analysis (SDA was performed on 13 patients pre-treatment and on Days 1, 2, 3, and 7 after injection of 18 units of botulinum toxin type A (BoNT/A in the fronto-glabellar area.Results: At baseline, amplitudes of horizontal skin displacement with fronto-glabellar contraction showed a linear increase along the eyebrow laterally from the midline; mean values (±standard deviation [SD] 15 and 30 mm lateral to the midline were 3.2 ± 1.0 mm (range, 1.9–4.9 mm and 6.5 ± 1.4 mm (range 4.0–8.5 mm, respectively. After injection of BoNT/A, maximum horizontal skin displacement 30 mm lateral to the midline showed a mean reduction (±SD to 62% ± 23% at Day 2 and to 17% ± 16% at Day 7; corresponding values 15 mm lateral to the midline were 62% ± 29% and 15% ± 20%, respectively. In all cases, the reduction in horizontal skin displacement compared with pre-injection levels was statistically significant (P < 0.001.Conclusion: SDA is a feasible method for the quantitative evaluation of skin movements elicited by muscles inserting the overlaying skin in the face and neck area.Keywords: botulinum toxin type A, fronto-glabellar contraction, skin displacement analysis, glabellar lines

  11. Therapeutic prospects to treat skeletal muscle wasting in COPD (chronic obstructive lung disease).

    Science.gov (United States)

    Hansen, Michelle J; Gualano, Rosa C; Bozinovski, Steve; Vlahos, Ross; Anderson, Gary P

    2006-01-01

    Chronic obstructive pulmonary disease (COPD) is an incurable group of lung diseases characterised by progressive airflow limitation and loss of lung function, which lead to profound disability. It is mostly caused by cigarette smoke. Although COPD is one of the most prevalent diseases worldwide and its incidence is increasing, current therapies do little to improve the condition. Much current research focuses on strategies to halt the accelerated rate of decline in lung function that occurs in the disease. However, as most symptoms occur when the lungs are already extensively and irreversibly damaged, it is uncertain whether an agent able to slow or halt decline in lung function would actually provide relief to COPD patients. As lung function worsens, systemic comorbidities contribute markedly to disability. Loss of lean body mass (skeletal muscle) has recently been identified as a major determinant of disability in COPD and an independent predictor of mortality. In contrast to lung structure damage, skeletal muscle retains regenerative capacity in COPD. In this review, we discuss mechanisms of wasting in COPD, focusing on therapeutic strategies that might improve the health and productive life expectancy of COPD patients by improving skeletal muscle mass and function. Single or combination approaches exploiting the suppression of procatabolic inflammatory mediators, inhibition of ubiquitin ligases, repletion of anabolic hormones and growth factors, inhibition of myoblast apoptosis, remediation of systemic oxidative stress and promotion of repair, and regeneration via stimulation of satellite cell differentiation hold considerable therapeutic promise.

  12. The influence of occlusion on jaw and neck muscle activity: a surface EMG study in healthy young adults.

    Science.gov (United States)

    Ferrario, V F; Tartaglia, G M; Galletta, A; Grassi, G P; Sforza, C

    2006-05-01

    The electromyographic (EMG) characteristics of masseter, temporalis and sternocleidomastoid (SCM) muscles during maximum voluntary teeth clench were assessed in 27 male and 35 female healthy young adults. Subjects were divided into two groups: (i) 'complete' Angle Class I (bilateral, symmetric canine and molar Class I relationships), and (ii) 'partial' Angle Class I (one to three canine/molar Class I relationships, the remaining relationships were Class II or Class III). On average, standardized muscular symmetry ranged 80.7-87.9%. During maximum voluntary teeth clench, average co-contraction of SCM muscle was 13.7-23.5% of its maximum contraction. On average, all torque coefficients (potential lateral displacing component) were >90%, while all antero-posterior coefficients (relative activities of masseter and temporalis muscles) were >85%. The average integrated areas of the masseter and temporalis EMG potentials over time ranged 87.4-106.8 muV/muV s%. Standardized contractile muscular activities did not differ between 'complete' and 'partial' Angle Class I, and between sexes (two-way analysis of variance). A trend toward a larger intragroup variability in EMG indices was observed in the subjects with 'partial' Angle Class I than in those with 'complete' Angle Class I (significant difference for the temporalis muscle symmetry, P = 0.013, analysis of variance). In conclusion, the presence of a complete or partial Angle occlusal Class I did not seem to influence the standardized contractile activities of masseter, temporalis and SCM muscles during a maximum voluntary clench. Subjects with a 'complete' Angle Class I were somewhat a more homogenous group than subjects with 'partial' Angle Class I.

  13. Effects of home-based respiratory muscle training in children and adolescents with chronic lung disease

    Directory of Open Access Journals (Sweden)

    Iván Rodríguez

    2014-12-01

    Full Text Available OBJECTIVE: Respiratory muscle weakness is a functional repercussion of chronic lung disease (CLD. The objective of this study was to assess the effects of home-based respiratory muscle training (RMT in children and adolescents with CLD or neuromuscular disease (NMD. METHODS: This was a quasi-experimental study involving children and adolescents with CLD or NMD. Before and after 6 months of home-based RMT, we measured respiratory muscle strength (MIP and MEP, PEF, and peak cough flow (PCF. We made statistical comparisons between the pre-RMT and post-RMT values, as well as evaluating the correlation between the duration and effect of RMT. RESULTS: The study included 29 patients, with a mean age of 12 years (range, 5-17 years, of whom 18 (62.1% were male. The CLD group comprised 11 patients (37.9%, and the NMD group comprised 18 (62.1%. The mean duration of the RMT was 60 weeks (range, 46-90 weeks in the CLD group and 39 weeks (range, 24-89 weeks in the NMD group. In comparison with the pre-RMT values, the post-RMT values for MIP and MEP were significantly higher in both groups, whereas those for PEF and PCF were significantly higher only in the NMD group. We found no correlation between the duration and the effect of RMT. CONCLUSIONS: Home-based RMT appears to be an effective strategy for increasing respiratory muscle strength in children and adolescents with CLD or NMD, although it increased the ability to cough effectively only in those with NMD.

  14. Deep breathing heart rate variability is associated with respiratory muscle weakness in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Michel Silva Reis

    2010-01-01

    Full Text Available BACKGROUND: A synchronism exists between the respiratory and cardiac cycles. However, the influence of the inspiratory muscle weakness in chronic obstructive pulmonary disease (COPD on cardiac autonomic control is unknown. The purpose of the present investigation was to evaluate the influence of respiratory muscle strength on autonomic control in these patients. METHODS: Ten chronic obstructive pulmonary disease patients (69±9 years; FEV1/FVC 59±12% and FEV1 41±11% predicted and nine age-matched healthy volunteers (64±5 years participated in this study. Heart-rate variability (HRV was obtained at rest and during respiratory sinusal arrhythmia maneuver (RSA-M by electrocardiograph. RESULTS: Chronic obstructive pulmonary disease patients demonstrated impaired cardiac autonomic modulation at rest and during RSA-M when compared with healthy subjects (p<0.05. Moreover, significant and positive correlations between maximal inspiratory pressure (MIP and the inspiratory-expiratory difference (ΔIE (r = 0.60, p<0.01 were found. CONCLUSION: Patients with chronic obstructive pulmonary disease presented impaired sympathetic-vagal balance at rest. In addition, cardiac autonomic control of heart rate was associated with inspiratory muscle weakness in chronic obstructive pulmonary disease. Based on this evidence, future research applications of respiratory muscle training may bring to light a potentially valuable target for rehabilitation.

  15. Head and neck pain review: traditional and new perspectives.

    Science.gov (United States)

    Friedman, M H; Nelson, A J

    1996-10-01

    A variety of conditions are frequently associated with the occurrence of head and neck pain. The purposes of this review are: to describe the characteristics of several musculoskeletal, neurological, and systemic conditions frequently cited as possible causes of head and neck pain and to suggest a new technique for treating head and neck pain. The characteristics of musculoskeletal conditions, such as muscle spasm, tendinitis, trigger points, and joint inflammation, and their relationship to head and neck pain are considered. The features and clinical implications of neurologic conditions, such as atypical facial pain, trigeminal and glossopharyngeal neuralgia, reflex sympathetic dystrophy, and neurogenic inflammation, are also described. The distinguishing characteristics of headaches, including cluster, tension, chronic daily, rebound, posttraumatic, and postlumbar puncture, are detailed. This review also addresses the contributions of systemic disorders, such as osteoarthritis, rheumatoid arthritis and the variants, and rheumatoid-related conditions, like dermatomyositis, temporal arteritis, Lyme's disease, and fibromyalgia, to head and neck pain. The results of a recent pilot study of the effectiveness of intraoral circulating ice water for resolving symptoms related to head and neck pain secondary to neurogenic inflammation are presented in this work. Ice water circulating through hollow metal tubes was placed intraorally for 15 minutes in the posterior maxillary area on 12 individuals with cervical pain and muscle spasm. In nine of these individuals, reduced cervical pain perception, upper trapezius electromyography signal reduction, and increased cervical range of motion was produced. Six out of 12 individuals had accompanying headache, which was reduced or eliminated in four cases. These findings suggest a strong trigemino-cervical relationship to neck pain and headache.

  16. Effects of Gestational and Postnatal Exposure to Chronic Intermittent Hypoxia on Diaphragm Muscle Contractile Function in the Rat

    Science.gov (United States)

    McDonald, Fiona B.; Dempsey, Eugene M.; O'Halloran, Ken D.

    2016-01-01

    Alterations to the supply of oxygen during early life presents a profound stressor to physiological systems with aberrant remodeling that is often long-lasting. Chronic intermittent hypoxia (CIH) is a feature of apnea of prematurity, chronic lung disease, and sleep apnea. CIH affects respiratory control but there is a dearth of information concerning the effects of CIH on respiratory muscles, including the diaphragm—the major pump muscle of breathing. We investigated the effects of exposure to gestational CIH (gCIH) and postnatal CIH (pCIH) on diaphragm muscle function in male and female rats. CIH consisted of exposure in environmental chambers to 90 s of hypoxia reaching 5% O2 at nadir, once every 5 min, 8 h a day. Exposure to gCIH started within 24 h of identification of a copulation plug and continued until day 20 of gestation; animals were studied on postnatal day 22 or 42. For pCIH, pups were born in normoxia and within 24 h of delivery were exposed with dams to CIH for 3 weeks; animals were studied on postnatal day 22 or 42. Sham groups were exposed to normoxia in parallel. Following gas exposures, diaphragm muscle contractile, and endurance properties were examined ex vivo. Neither gCIH nor pCIH exposure had effects on diaphragm muscle force-generating capacity or endurance in either sex. Similarly, early life exposure to CIH did not affect muscle tolerance of severe hypoxic stress determined ex vivo. The findings contrast with our recent observation of upper airway dilator muscle weakness following exposure to pCIH. Thus, the present study suggests a relative resilience to hypoxic stress in diaphragm muscle. Co-ordinated activity of thoracic pump and upper airway dilator muscles is required for optimal control of upper airway caliber. A mismatch in the force-generating capacity of the complementary muscle groups could have adverse consequences for the control of airway patency and respiratory homeostasis. PMID:27462274

  17. Avoidable costs of physical treatments for chronic back, neck and shoulder pain within the Spanish National Health Service: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Serrano-Aguilar Pedro

    2011-12-01

    Full Text Available Abstract Background Back, neck and shoulder pain are the most common causes of occupational disability. They reduce health-related quality of life and have a significant economic impact. Many different forms of physical treatment are routinely used. The objective of this study was to estimate the cost of physical treatments which, despite the absence of evidence supporting their effectiveness, were used between 2004 and 2007 for chronic and non-specific neck pain (NP, back pain (BP and shoulder pain (SP, within the Spanish National Health Service in the Canary Islands (SNHSCI. Methods Chronic patients referred from the SNHSCI to private physical therapy centres for NP, BP or SP, between 2004 and 2007, were identified. The cost of providing physical therapies to these patients was estimated. Systematic reviews (SRs and clinical practice guidelines (CPGs for NP, BP and SP available in the same period were searched for and rated according to the Oxman and AGREE criteria, respectively. Those rated positively for ≥70% of the criteria, were used to categorise physical therapies as Effective; Ineffective; Inconclusive; and Insufficiently Assessed. The main outcome was the cost of physical therapies included in each of these categories. Results 8,308 chronic cases of NP, 4,693 of BP and 5,035 of SP, were included in this study. Among prescribed treatments, 39.88% were considered Effective (physical exercise and manual therapy with mobilization; 23.06% Ineffective; 13.38% Inconclusive, and 23.66% Insufficiently Assessed. The total cost of treatments was € 5,107,720. Effective therapies accounted for € 2,069,932. Conclusions Sixty percent of the resources allocated by the SNHSCI to fund physical treatment for NP, BP and SP in private practices are spent on forms of treatment proven to be ineffective, or for which there is no evidence of effectiveness.

  18. Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report

    DEFF Research Database (Denmark)

    Sørensen, Jens Christian Hedemann; Meier, Kaare; Perinpam, Larshan;

    Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report......Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report...

  19. PEAK AND END RANGE ECCENTRIC EVERTOR/CONCENTRIC INVERTOR MUSCLE STRENGTH RATIOS IN CHRONICALLY UNSTABLE ANKLES: COMPARISON WITH HEALTHY INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    Mahmut Komurcu

    2003-09-01

    Full Text Available The aim of this study was to evaluate the alterations in eccentric evertor/concentric invertor strength ratio and their importance in the chronically unstable ankle. Eight patients with chronic ankle instability (CAI and nine healthy individuals participated in this study. Isokinetic concentric and eccentric invertor and evertor muscle strength measurement was carried out at an angular velocity of 120°·sec-1 by measuring maximal force moments (torque during isokinetic ankle inversion and eversion movements. Functionally, evertor/invertor muscle strength ratios (E/I strength ratio were calculated separately based on peak moment and angle-specific moments obtained at 0°, 5°, 10°, 15°, 20° ankle joint angles. Peak and angle-specific eccentric evertor strength values at 0°, 5°, 10°, 15°, 20° were significantly lower in the chronic ankle instability (CAI group. In spite of this, no differences were obtained for peak and angle-specific concentric invertor torque values. Eccentric evertor/concentric invertor strength (Eecc/Icon ratios were also significantly lower in the CAI group, but only at 15° and 20°. Eccentric evertor muscle torque and end range (15°-20° Eecc/Icon strength ratio for the chronically unstable ankle were significantly different from those for the healthy ankle. For this reason, measurements of end range eccentric/concentric strength ratios are more valuable in monitoring chronic ankle injuries and rehabilitation should include not only concentric muscle strengthening but also eccentric muscle strengthening, particularly for the evertor muscles

  20. Can angiogenesis induced by chronic electrical stimulation enhance latissimus dorsi muscle flap survival for application in cardiomyoplasty?

    Science.gov (United States)

    Overgoor, Max L E; Carroll, Sean M; Papanicolau, George; Carroll, Camilla M A; Ustüner, Tuncay E T; Stremel, Richard W; Anderson, Gary L; Franken, Ralph J P M; Kon, Moshe; Barker, John H

    2003-01-01

    In cardiomyoplasty, the latissimus dorsi muscle is lifted on its primary neurovascular pedicle and wrapped around a failing heart. After 2 weeks, it is trained for 6 weeks using chronic electrical stimulation, which transforms the latissimus dorsi muscle into a fatigue-resistant muscle that can contract in synchrony with the beating heart without tiring. In over 600 cardiomyoplasty procedures performed clinically to date, the outcomes have varied. Given the data obtained in animal experiments, the authors believe these variable outcomes are attributable to distal latissimus dorsi muscle flap necrosis. The aim of the present study was to investigate whether the chronic electrical stimulation training used to transform the latissimus dorsi muscle into fatigue-resistant muscle could also be used to induce angiogenesis, increase perfusion, and thus protect the latissimus dorsi muscle flap from distal necrosis. After 14 days of chronic electrical stimulation (10 Hz, 330 microsec, 4 to 6 V continuous, 8 hours/day) of the right or left latissimus dorsi muscle (randomly selected) in 11 rats, both latissimus dorsi muscles were lifted on their thoracodorsal pedicles and returned to their anatomical beds. Four days later, the resulting amount of distal flap necrosis was measured. Also, at predetermined time intervals throughout the experiment, muscle surface blood perfusion was measured using scanning laser Doppler flowmetry. Finally, latissimus dorsi muscles were excised in four additional stimulated rats, to measure angiogenesis (capillary-to-fiber ratio), fiber type (oxidative or glycolytic), and fiber size using histologic specimens. The authors found that chronic electrical stimulation (1) significantly (p < 0.05) increased angiogenesis (mean capillary-to-fiber ratio) by 82 percent and blood perfusion by 36 percent; (2) did not reduce the amount of distal flap necrosis compared with nonchronic electrical stimulation controls (29 +/- 5.3 percent versus 26.6 +/- 5

  1. Effects of respiratory muscle unloading on leg muscle oxygenation and blood volume during high-intensity exercise in chronic heart failure.

    Science.gov (United States)

    Borghi-Silva, Audrey; Carrascosa, Cláudia; Oliveira, Cristino Carneiro; Barroco, Adriano C; Berton, Danilo C; Vilaça, Debora; Lira-Filho, Edgar B; Ribeiro, Dirceu; Nery, Luiz Eduardo; Neder, J Alberto

    2008-06-01

    Blood flow requirements of the respiratory muscles (RM) increase markedly during exercise in chronic heart failure (CHF). We reasoned that if the RM could subtract a fraction of the limited cardiac output (QT) from the peripheral muscles, RM unloading would improve locomotor muscle perfusion. Nine patients with CHF (left ventricle ejection fraction = 26 +/- 7%) undertook constant-work rate tests (70-80% peak) receiving proportional assisted ventilation (PAV) or sham ventilation. Relative changes (Delta%) in deoxy-hemoglobyn, oxi-Hb ([O2Hb]), tissue oxygenation index, and total Hb ([HbTOT], an index of local blood volume) in the vastus lateralis were measured by near infrared spectroscopy. In addition, QT was monitored by impedance cardiography and arterial O2 saturation by pulse oximetry (SpO2). There were significant improvements in exercise tolerance (Tlim) with PAV. Blood lactate, leg effort/Tlim and dyspnea/Tlim were lower with PAV compared with sham ventilation (P 0.05). Unloaded breathing, however, was related to enhanced leg muscle oxygenation and local blood volume compared with sham, i.e., higher Delta[O2Hb]% and Delta[HbTOT]%, respectively (P < 0.05). We conclude that RM unloading had beneficial effects on the oxygenation status and blood volume of the exercising muscles at similar systemic O2 delivery in patients with advanced CHF. These data suggest that blood flow was redistributed from respiratory to locomotor muscles during unloaded breathing.

  2. Effect of Scapular Function Training on Chronic Pain in the Neck/Shoulder Region: A Randomized Controlled Trial

    OpenAIRE

    2013-01-01

    Purpose Neck and shoulder complaints are common among employees in occupations characterized by intensive computer use. Treatment has varied from passive rest to active treatments and active treatments have often been divided into either training of the painful area or the surrounding musculature avoiding direct training of the painful area. Our study investigates the effect of the latter approach. The purpose of this study was in a randomised controlled trial to investigate if intensive scap...

  3. Neck Pain

    Science.gov (United States)

    ... antidepressants for pain relief. Therapy Physical therapy. A physical therapist can teach you correct posture, alignment and neck- ... therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially ...

  4. The proteasome inhibitor MG132 attenuates skeletal muscle atrophy in a rat model of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    马碧蔓

    2013-01-01

    Objective To investigate the effect of the proteasome inhibitor MG-132 on skeletal muscle atrophy in a rat model of chronic obstructive pulmonary disease (COPD) and is potential mechanisms.Methods The COPD rat model was established by instillation of LPS and exposure

  5. Chronic overload induced hypertrophy is associated with age-related muscle mass loss and diminished mTOR signaling

    Science.gov (United States)

    The purpose of this study was to assess activation of the mTOR signaling pathway in young and aging rats in response to chronic muscle overload. Young (6 mo; n = 16) and older (30 mo; n = 23) male rats (F344xBN) were subjected to 4 weeks of bilateral surgical ablation (SA) of two-thirds of the gastr...

  6. Acute electromyostimulation decreases muscle sympathetic nerve activity in patients with advanced chronic heart failure (EMSICA Study.

    Directory of Open Access Journals (Sweden)

    Marc Labrunée

    Full Text Available BACKGROUND: Muscle passive contraction of lower limb by neuromuscular electrostimulation (NMES is frequently used in chronic heart failure (CHF patients but no data are available concerning its action on sympathetic activity. However, Transcutaneous Electrical Nerve Stimulation (TENS is able to improve baroreflex in CHF. The primary aim of the present study was to investigate the acute effect of TENS and NMES compared to Sham stimulation on sympathetic overactivity as assessed by Muscle Sympathetic Nerve Activity (MSNA. METHODS: We performed a serie of two parallel, randomized, double blinded and sham controlled protocols in twenty-two CHF patients in New York Heart Association (NYHA Class III. Half of them performed stimulation by TENS, and the others tested NMES. RESULTS: Compare to Sham stimulation, both TENS and NMES are able to reduce MSNA (63.5 ± 3.5 vs 69.7 ± 3.1 bursts / min, p < 0.01 after TENS and 51.6 ± 3.3 vs 56.7 ± 3.3 bursts / min, p < 0, 01 after NMES. No variation of blood pressure, heart rate or respiratory parameters was observed after stimulation. CONCLUSION: The results suggest that sensory stimulation of lower limbs by electrical device, either TENS or NMES, could inhibit sympathetic outflow directed to legs in CHF patients. These properties could benefits CHF patients and pave the way for a new non-pharmacological approach of CHF.

  7. Inspiratory muscle training during pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomized trial.

    Science.gov (United States)

    Beaumont, M; Mialon, P; Le Ber-Moy, C; Lochon, C; Péran, L; Pichon, R; Gut-Gobert, C; Leroyer, C; Morelot-Panzini, C; Couturaud, F

    2015-11-01

    Although recommended by international guidelines, the benefit of inspiratory muscle training (IMT) in addition to rehabilitation remains uncertain. The objective was to demonstrate the effectiveness of IMT on dyspnea using Borg scale and multidimensional dyspnea profile questionnaire at the end of a 6-minute walk test (6MWT) in patients with chronic obstructive pulmonary disease (COPD) with preserved average maximum inspiratory pressure (PImax) of 85 cm H2O (95% of predicted (pred.) value) and admitted for a rehabilitation program in a dedicated center. In a randomized trial, comparing IMT versus no IMT in 32 COPD patients without inspiratory muscle weakness (PImax >60 cm H2O) who were admitted for pulmonary rehabilitation (PR) for 3 weeks, we evaluated the effect of IMT on dyspnea, using both Borg scale and multidimensional dyspnea profile (MDP) at the end of the 6MWT, and on functional parameters included inspiratory muscle function (PImax) and 6MWT. All testings were performed at the start and the end of PR. In unadjusted analysis, IMT was not found to be associated with an improvement of either dyspnea or PImax. After adjustment on confounders (initial Borg score) and variables of interaction (forced expiratory volume in 1 second (FEV1)), we found a trend toward an improvement of "dyspnea sensory intensity", items from MDP and a significant improvement on the variation in the 2 items of MDP ("tight or constricted" and "breathing a lot"). In the subgroup of patients with FEV1 50% pred. IMT did not significantly improve dyspnea or functional parameter in COPD patients with PImax > 60 cm H2O. However, in the subgroup of patients with FEV1 < 50% pred., MDP was significantly improved.

  8. Comparison of electromyographic activity and range of neck motion in violin students with and without neck pain during playing.

    Science.gov (United States)

    Park, Kyue-nam; Kwon, Oh-yun; Ha, Sung-min; Kim, Su-jung; Choi, Hyun-jung; Weon, Jong-hyuck

    2012-12-01

    Neck pain is common in violin students during a musical performance. The purpose of this study was to compare electromyographic (EMG) activity in superficial neck muscles with neck motion when playing the violin as well as neck range of motion (ROM) at rest, between violin students with and without neck pain. Nine violin students with neck pain and nine age- and gender-matched subjects without neck pain were recruited. Muscle activity of the bilateral upper trapezius, sternocleidomastoid, and superficial cervical extensor muscles was measured using surface EMG. Kinematic data on neck motion while playing and active neck ROM were also measured using a three-dimensional motion analysis system. Independent t-tests were used to compare EMG activity with kinematic data between groups. These analyses revealed that while playing, both the angle of left lateral bending and leftward rotation of the cervical spine were significantly greater in the neck pain group than among those without neck pain. Similarly, EMG activity of the left upper trapezius, both cervical extensors, and both sternocleidomastoid muscles were significantly greater in the neck pain group. The active ROM of left axial rotation was significantly lower in the neck pain group. These results suggest that an asymmetric playing posture and the associated increased muscle activity as well as decreased neck axial rotation may contribute to neck pain in violin students.

  9. Head and neck position sense.

    Science.gov (United States)

    Armstrong, Bridget; McNair, Peter; Taylor, Denise

    2008-01-01

    Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or

  10. The effect of traditional cupping on pain and mechanical thresholds in patients with chronic nonspecific neck pain: a randomised controlled pilot study.

    Science.gov (United States)

    Lauche, Romy; Cramer, Holger; Hohmann, Claudia; Choi, Kyung-Eun; Rampp, Thomas; Saha, Felix Joyonto; Musial, Frauke; Langhorst, Jost; Dobos, Gustav

    2012-01-01

    Introduction. Cupping has been used since antiquity in the treatment of pain conditions. In this pilot study, we investigated the effect of traditional cupping therapy on chronic nonspecific neck pain (CNP) and mechanical sensory thresholds. Methods. Fifty CNP patients were randomly assigned to treatment (TG, n = 25) or waiting list control group (WL, n = 25). TG received a single cupping treatment. Pain at rest (PR), pain related to movement (PM), quality of life (SF-36), Neck Disability Index (NDI), mechanical detection (MDT), vibration detection (MDT), and pressure pain thresholds (PPT) were measured before and three days after a single cupping treatment. Patients also kept a pain and medication diary (PaDi, MeDi) during the study. Results. Baseline characteristics were similar in the two groups. After cupping TG reported significantly less pain (PR: -17.9 mm VAS, 95%CI -29.2 to -6.6; PM: -19.7, 95%CI -32.2 to -7.2; PaDi: -1.5 points on NRS, 95%CI -2.5 to -0.4; all P cupping might be an effective treatment for improving pain, quality of life, and hyperalgesia in CNP.

  11. Efficacy of high-intensity laser therapy in the treatment of chronic neck pain: a randomized double-blind placebo-control trial.

    Science.gov (United States)

    Alayat, Mohamed Salaheldien Mohamed; Mohamed, Ashraf Abdelaal; Helal, Omar Farouk; Khaled, Osama Ahmed

    2016-05-01

    The aim of the study was to investigate the effect of high-intensity laser therapy (HILT) in treatment of patients with chronic neck pain (CNP) on cervical range of motion (ROM), pain, and functional activity. Sixty male patients participated in this study with mean (SD) age of 35.47 (4.18) years. Patients were randomly assigned into two groups and treated with HILT plus exercise (HILT + EX) and placebo laser plus exercise (PL + EX) in groups 1 and 2, respectively. The outcomes measured were cervical ROM, pain level by visual analog scale (VAS), and functional activity by neck disability index (NDI) score. Statistical analyses were performed to compare the differences between baseline and post-treatment. The level of statistical significance was set as p treatment in all groups. VAS and NDI results showed significant decrease post-treatment in both groups. HILT + EX effectively increased cervical ROM and decreased VAS and NDI scores after 6 weeks of treatment compared to PL + EX. HILT + EX is an effective physical therapy modality for patients with CNP compared to PL + EX therapy. The combination of HILT + EX effectively increased cervical ROM, functional activity, and reduced pain after 6 weeks of treatment.

  12. Applying Joint Mobilization at Different Cervical Vertebral Levels does not Influence Immediate Pain Reduction in Patients with Chronic Neck Pain: A Randomized Clinical Trial.

    Science.gov (United States)

    Aquino, Rafaela L; Caires, Priscila M; Furtado, Fernanda C; Loureiro, Aline V; Ferreira, Paulo H; Ferreira, Manuela L

    2009-01-01

    The aim of the present study was to compare the effects of applying joint mobilization at symptomatic and asymptomatic cervical levels in patients with chronic nonspecific neck pain. Forty-eight patients aged between 18 and 65 years and presenting nonspecific neck pain with a minimum duration of 3 months were recruited for the study. Included patients were randomized to one of two treatment groups: (i) control group: the most symptomatic vertebral level was mobilized; (ii) experimental group: a randomly selected vertebral level was chosen and mobilized. All patients received one treatment session. Pain intensity in resting position during the most painful active cervical movement as well as during vertebral palpation was quantified using an 11-point pain scale. Follow-up measures were taken immediately after intervention by a blinded assessor. The results showed no significant difference in pain intensity immediately after treatment between groups (symptomatic level treated vs. randomly chosen cervical vertebral level treated) during resting position, painful active movement, or vertebral palpation. Within-group comparisons showed significant pain relief after treatment during the most painful active movement as well as during vertebral palpation for both groups, but not during resting position. Significant change in immediate pain intensity during painful active movement and vertebral palpation was achieved after vertebral mobilization. however, both groups presented similar pain reductions suggesting that pain reduction due to joint mobilization is not specific to the vertebral level being mobilized.

  13. Treatment and long-term outcome of chronic radiation esophagitis after radiation therapy for head and neck tumors: A report of 13 cases

    Energy Technology Data Exchange (ETDEWEB)

    Silvain, C.; Barrioz, T.; Besson, I.; Babin, P.; Fontanel, J.P.; Daban, A.; Matuchansky, C.; Beauchant, M. (CHU J Bernard, Poitiers (France))

    1993-05-01

    The natural history of chronic radiation esophagitis occurring in previously normal esophagus is still unknown. The authors describe here the long-term outcome of chronic esophagitis arising after neck irradiation for oropharynx and larynx carcinomas in 13 consecutive adult patients. The first clinical signs of radiation esophagitis were dysphagia or impossibility of oral intake, which appeared within 26 months (range 2--120 months) after the end of radiation for pyriform fossae carcinoma (N = 5), tonsil carcinoma (N = 2), larynx carcinoma (N = 2), pharynx carcinoma (N = 2), base of the tongue (N = 1), and thyroid carcinomas (N = 1). During upper endoscopy, an esophageal stenosis was found in 11 cases and was associated with ulceration in three cases. An isolated esophageal ulceration was present in only two cases. Chronic radiation esophagitis diagnosis was confirmed by histology and surgery in seven cases. In the last six cases, diagnosis was supported by the absence of first cancer relapses within a median follow-up of two years (16 months to nine years) and by endoscopic findings. Seven patients received parenteral or enteral nutrition. Ten patients were treated by peroral dilatations. These treatments allowed nearly normal oral diet in 11/13 patients. Only one patient was lost of follow-up after 20 months. Four patients died from chronic radiation esophagitis. One of these patients died from massive hemorrhage after peroral dilatation. Four patients died of a second carcinoma with no first cancer recurrence. Four patients were alive after six months to nine years of follow-up. Moderate dysphagia was still present, allowing nearly normal oral feeding. In conclusion, chronic radiation esophagitis is a severe disease with an underestimated frequency. In this study, peroral dilatations appeared to be necessary and were not associated with an increased morbidity. 21 refs., 1 tab.

  14. Airway smooth muscle cell tone amplifies contractile function in the presence of chronic cyclic strain.

    Science.gov (United States)

    Fairbank, Nigel J; Connolly, Sarah C; Mackinnon, James D; Wehry, Kathrin; Deng, Linhong; Maksym, Geoffrey N

    2008-09-01

    Chronic contractile activation, or tone, in asthma coupled with continuous stretching due to breathing may be involved in altering the contractile function of airway smooth muscle (ASM). Previously, we (11) showed that cytoskeletal remodeling and stiffening responses to acute (2 h) localized stresses were modulated by the level of contractile activation of ASM. Here, we investigated if altered contractility in response to chronic mechanical strain was dependent on repeated modulation of contractile tone. Cultured human ASM cells received 5% cyclic (0.3 Hz), predominantly uniaxial strain for 5 days, with once-daily dosing of either sham, forskolin, carbachol, or histamine to alter tone. Stiffness, contractility (KCl), and "relaxability" (forskolin) were then measured as was cell alignment, myosin light-chain phosphorylation (pMLC), and myosin light-chain kinase (MLCK) content. Cells became aligned and baseline stiffness increased with strain, but repeated lowering of tone inhibited both effects (P negative tone-modulation dependence of MLCK, observed in static conditions in agreement with previous reports, with strain and tone together increasing both MLCK and pMLC. Furthermore, contractility increased 176% (SE 59) with repeated tone elevation. These findings indicate that with strain, and not without, repeated tone elevation promoted contractile function through changes in cytoskeletal organization and increased contractile protein. The ability of repeated contractile activation to increase contractility, but only with mechanical stretching, suggests a novel mechanism for increased ASM contractility in asthma and for the role of continuous bronchodilator and corticosteroid therapy in reversing airway hyperresponsiveness.

  15. Non-specific neck pain in preadolescent to adolescent populations

    OpenAIRE

    2014-01-01

    Neck pain is a common health problem globally. In addition to individual suffering, it causes a huge burden on societies. Some evidence suggests that neck pain in adolescence predicts frequent neck symptoms also in adulthood. A steady increase in prevalence of frequent and persistent neck pain among Finnish adolescents was observed in the 1990s, which might predict an increasing amount of adults with chronic neck pain in the near future. Thus, better understanding neck pain in children and ad...

  16. Evaluation of skeletal and cardiac muscle function after chronic administration of thymosin beta-4 in the dystrophin deficient mouse.

    Directory of Open Access Journals (Sweden)

    Christopher F Spurney

    Full Text Available Thymosin beta-4 (Tbeta4 is a ubiquitous protein with many properties relating to cell proliferation and differentiation that promotes wound healing and modulates inflammatory mediators. We studied the effects of chronic administration of Tbeta4 on the skeletal and cardiac muscle of dystrophin deficient mdx mice, the mouse model of Duchenne muscular dystrophy. Female wild type (C57BL10/ScSnJ and mdx mice, 8-10 weeks old, were treated with 150 microg of Tbeta4 twice a week for 6 months. To promote muscle pathology, mice were exercised for 30 minutes twice a week. Skeletal and cardiac muscle function were assessed via grip strength and high frequency echocardiography. Localization of Tbeta4 and amount of fibrosis were quantified using immunohistochemistry and Gomori's tri-chrome staining, respectively. Mdx mice treated with Tbeta4 showed a significant increase in skeletal muscle regenerating fibers compared to untreated mdx mice. Tbeta4 stained exclusively in the regenerating fibers of mdx mice. Although untreated mdx mice had significantly decreased skeletal muscle strength compared to untreated wild type, there were no significant improvements in mdx mice after treatment. Systolic cardiac function, measured as percent shortening fraction, was decreased in untreated mdx mice compared to untreated wild type and there was no significant difference after treatment in mdx mice. Skeletal and cardiac muscle fibrosis were also significantly increased in untreated mdx mice compared to wild type, but there was no significant improvement in treated mdx mice. In exercised dystrophin deficient mice, chronic administration of Tbeta4 increased the number of regenerating fibers in skeletal muscle and could have a potential role in treatment of skeletal muscle disease in Duchenne muscular dystrophy.

  17. Muscle Energy Technique and Static Stretching for Treatment of Mechanical Neck Pain 16 July 2012 International Journal of Health and Rehabilitation Sciences Volume 1 Number 1 O RIGINAL R ESEARCH Comparative Effectiveness of Muscle Energy Technique and Static Stretching for Treatment of Subacute Mechanical N eck Pain

    Directory of Open Access Journals (Sweden)

    Richa Mahajan

    2012-07-01

    Full Text Available Background: Neck pain is a common problem within our society. Upper trapezius and the levator scapulae are the most common postural muscles that tends to get shorten leading to restricted neck mobility. If these group of muscles are treated it may provide with best results. There is lack of evidence to allow conclusions to be drawn about the effectiveness of Muscle energy technique (MET when compared with stretching exercises for relieving mechanical neck pain. It would be interesting to study if these two techniques yield comparable outcomes and if one technique is superior to the next which should be the alternate choice of therapy Objective: To evaluate the comparative effectiveness of Muscle energy technique and static stretching on pain and active cervical range of motion (ROM in subacute mechanical neck pain Subjects and methods: 45 patients with subacute mechanical neck pain were randomly assigned to receive Muscle Energy Technique plus conventional physiotherapy (group 1, n = 15, static stretching plus conventional exercise program (group 2, n = 15 and conventional physiotherapy only (group 3, n = 15. Intervention: Group 1 received 6 sessions of Muscle Energy Technique and 10 sessions of conventional physiotherapy. Group 2 received 6 sessions of static stretching and 10 sessions of conventional physiotherapy. Group 3 received 10 sessions of conventional physiotherapy. All groups were treated for 2 weeks.Outcome measures:Pain intensity on 100mm VAS, active cervical lateral flexion range of motion, active cervical rotation range of motion. Results: Paired t-test was used for within group analysis. ANOVA followed by post hoc analysis was employed for between group comparisons. No significant difference was found in any of the outcome measure between MET and static stretching groups (p > 0.05 while both were found to be significantly better than the conventional exercise group (p < 0.05 between the 3 groups. Statistically significant

  18. The effect of Video Display Terminal (VDT) mouse use on muscle contractions in the neck and forearm.

    Science.gov (United States)

    Baker, Nancy A.; Jacobs, Karen; Trombly, Catherine

    1999-01-01

    This study used surface electromyography (EMG) to examine the percent of maximum voluntary contraction (%MVC) of the upper trapezius, the flexors of the wrist/fingers and extensors of the wrist/fingers during Video Display Terminal (VDT) mouse use with the mouse positioned either next to the computer or on a lapdesk. Thirty participants, between the ages of 18 and 40, used a VDT mouse to follow a prescribed pattern for three trials at each location. Although there was a trend towards the lapdesk location producing lower %MVC than the computer location for the trapezius and wrist/finger flexors (lapdesk: trapezius M 4.71%, wrist/finger flexors M 3.53%; computer: trapezius M 5.74%, wrist/finger flexors M 3.94%) a two way ANOVA controlling for sequence and order found no significant difference between the means. There was no trend for the effects of location for the wrist/finger extensors. These results suggest that changing the position of the mouse may not significantly reduce muscle contractions.

  19. Individuals with chronic low back pain do not modulate the level of transversus abdominis muscle contraction across different postures.

    Science.gov (United States)

    Miura, Takuya; Yamanaka, Masanori; Ukishiro, Kengo; Tohyama, Harukazu; Saito, Hiroshi; Samukawa, Mina; Kobayashi, Takumi; Ino, Takumi; Takeda, Naoki

    2014-12-01

    The aim of this study was to evaluate the thickness of the transversus abdominis (TrA) muscle in three basic postures in subjects with and without chronic low back pain. Subjects were classified into a chronic low back pain group (n = 27) and a healthy control group (n = 23). The thickness of the TrA muscle was measured at rest and during the abdominal drawing-in manoeuvre (ADIM) in supine, sitting and standing postures using B-mode ultrasound imaging. Contraction ratio (TrA thickness during the ADIM/TrA thickness at rest) was calculated for each posture. At rest, the TrA thickness in the sitting and standing postures was significantly greater than in the supine posture (p contraction ratio was also significantly higher in the control group than in the chronic low back pain group in all three postures. These results indicate that the automatic postural contraction of the TrA observed in the control subjects in the sitting and standing postures was not demonstrated in subjects with chronic low back pain. The present study revealed the one aspect of different response of the TrA muscle to changing posture between two groups.

  20. The Eccentric Torque Production Capacity of the Ankle, Knee, and Hip Muscle Groups in Patients with Unilateral Chronic Ankle Instability

    Science.gov (United States)

    Negahban, Hossein; Moradi-Bousari, Aida; Naghibi, Saeed; Sarrafzadeh, Javad; Shaterzadeh-Yazdi, Mohammad-Jafar; Goharpey, Shahin; Etemadi, Malihe; Mazaheri, Masood; Feizi, Awat

    2013-01-01

    Purpose The aim of this study was to investigate eccentric torque production capacity of the ankle, knee and hip muscle groups in patients with unilateral chronic ankle instability (CAI) as compared to healthy matched controls. Methods In this case-control study, 40 participants (20 with CAI and 20 controls) were recruited based on convenient non-probability sampling. The average peak torque to body weight (APT/BW) ratio of reciprocal eccentric contraction of ankle dorsi flexor/plantar flexor, ankle evertor/invertor, knee flexor/extensor, hip flexor/extensor and hip abductor/adductor was determined using an isokinetic dynamometer. All subjects participated in two separate sessions with a rest interval of 48 to 72 hours. In each testing session, the torque production capacity of the ankle, knee, and hip muscle groups of only one lower limb was measured. At first, 3 repetitions of maximal eccentric-eccentric contraction were performed for the reciprocal muscles of a joint in a given movement direction. Then, the same procedure of practice and testing trials was repeated for the next randomly-ordered muscle group or joint of the same limb. Results There was no significant interaction of group (CAI and healthy controls) by limb (injured and non-injured) for any muscle groups. Main effect of limb was not significant. Main effect of group was only significant for eccentric torque production capacity of ankle dorsi flexor and hip flexor muscle groups. The APT/BW ratio of these muscles was significantly lower in the CAI group than the healthy controls (P<0.05). Conclusion CAI is associated with eccentric strength deficit of ankle dorsi flexor and hip flexor muscles as indicated by reduction in torque production capacity of these muscles compared to healthy controls. This strength deficit appeared to exist in both the injured and non-injured limbs of the patients. PMID:23802057

  1. A 7-year follow-up of multidisciplinary rehabilitation among chronic neck and back pain patients. Is sick leave outcome dependent on psychologically derived patient groups?

    Science.gov (United States)

    Bergström, Gunnar; Bergström, Cecilia; Hagberg, Jan; Bodin, Lennart; Jensen, Irene

    2010-04-01

    A valid method for classifying chronic pain patients into more homogenous groups could be useful for treatment planning, that is, which treatment is effective for which patient, and as a marker when evaluating treatment outcome. One instrument that has been used to derive subgroups of patients is the Multidimensional Pain Inventory (MPI). The primary aim of this study was to evaluate a classification method based on the Swedish version of the MPI, the MPI-S, to predict sick leave among chronic neck and back pain patients for a period of 7 years after vocational rehabilitation. As hypothesized, dysfunctional patients (DYS), according to the MPI-S, showed a higher amount of sickness absence and disability pension expressed in days than adaptive copers (AC) during the 7-years follow-up period, even when adjusting for sickness absence prior to rehabilitation (355.8days, 95% confidence interval, 71.7; 639.9). Forty percent of DYS patients and 26.7% of AC patients received disability pension during the follow-up period. However, this difference was not statistically significant. Further analyses showed that the difference between patient groups was most pronounced among patients with more than 60days of sickness absence prior to rehabilitation. Cost-effectiveness calculations indicated that the DYS patients showed an increase in production loss compared to AC patients. The present study yields support for the prognostic value of this subgroup classification method concerning long-term outcome on sick leave following this type of vocational rehabilitation.

  2. Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: A prospective, randomised controlled trial.

    Science.gov (United States)

    Celenay, Seyda Toprak; Kaya, Derya Ozer; Akbayrak, Turkan

    2016-02-01

    This study was planned to assess and compare the effectiveness of cervical and scapulothoracic stabilization exercise treatment with and without connective tissue massage (CTM) on pain, anxiety, and the quality of life in patients with chronic mechanical neck pain (MNP). Sixty patients with chronic MNP (18-65 years) were recruited and randomly allocated into stabilization exercise with (Group 1, n = 30) and without the CTM (Group 2, n = 30). The program was carried out for 12 sessions, 3 days/week in 4 weeks. Pain intensity with Visual Analog Scale, pressure pain threshold with digital algometer (JTech Medical Industries, ZEVEX Company), level of anxiety with Spielberger State Trait Anxiety Inventory, and quality of life with Short Form-36 were evaluated before and after the treatment. After the program, pain intensity and the level of anxiety decrease, physical health increase in Group 1 and 2 were found (p pain threshold and mental health increase were detected in only Group 1 (p pain intensity at night, pressure pain threshold, state anxiety and mental health were seen in favor of Group 1 (p pain intensity at night, pressure pain threshold, state anxiety and mental health compared to stabilization exercise alone.

  3. The perspectives of older women with chronic neck pain on perceived effects of qigong and exercise therapy on aging: a qualitative interview study

    Directory of Open Access Journals (Sweden)

    Holmberg C

    2014-03-01

    Full Text Available Christine Holmberg,1,2 Julia Rappenecker,1 Julia J Karner,1 Claudia M Witt1,3 1Institute for Social Medicine, Epidemiology, and Health Economics, 2Berlin School of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany; 3Center for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland Abstract: Chronic pain is prevalent in elderly populations. The goals of this study were 1 to understand the results of a randomized clinical trial – Qigong and Exercise Therapy for Elderly Patients with Chronic Neck Pain (QIBANE – that showed no difference between qigong, exercise therapy, and no-treatment on quality of life, and 2 to understand how elderly individuals with chronic pain experience interventions of qigong and exercise therapy. A qualitative interview study was conducted with 20 QIBANE participants. Interviews asked about motivation for and expectations of trial participation, experiences with the exercise classes (qigong or exercise therapy, and changes in pain experience. Interviews were transcribed, entered into the software program ATLAS.ti, and coded thematically by two coders. Content analysis was performed. All interviewees reflected positively on their QIBANE experience and described their participation in QIBANE as helpful. However, what was discussed in both groups when they talked about “positive experiences” in the study differed between the two groups. For example, themes that emerged in the exercise-therapy group related to difficulties associated with aging and staying physically active. In the interviews with qigong group members, emergent themes related to qigong as a method that improved bodily experiences and influenced daily activities. The effects that exercise therapy and qigong have on an elderly population cannot be captured by health-related quality-of-life measurements, such as the Short Form (36 Health Survey. Broader concepts of quality of life that include the

  4. Simulation of rear end impact with a full body human model with a detailed neck: role of passive muscle properties and initial seating posture

    NARCIS (Netherlands)

    Happee, R.; Wismans, J.S.H.M.; Horst, M.J. van der; Bovendeerd, P.H.M.; Kingma, H.

    2001-01-01

    To study the mechanics of the neck during rear end impact, in this paper an existing global human body model and an existing detailed submodel of the neck were combined into a new model. The combined model is validated with responses of volunteers and post mortem human subjects (PMHSs) subjected to

  5. Eccentric Ergometer Training Promotes Locomotor Muscle Strength but Not Mitochondrial Adaptation in Patients with Severe Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    MacMillan, Norah J.; Kapchinsky, Sophia; Konokhova, Yana; Gouspillou, Gilles; de Sousa Sena, Riany; Jagoe, R Thomas; Baril, Jacinthe; Carver, Tamara E.; Andersen, Ross E.; Richard, Ruddy; Perrault, Hélène; Bourbeau, Jean; Hepple, Russell T.; Taivassalo, Tanja

    2017-01-01

    Eccentric ergometer training (EET) is increasingly being proposed as a therapeutic strategy to improve skeletal muscle strength in various cardiorespiratory diseases, due to the principle that lengthening muscle actions lead to high force-generating capacity at low cardiopulmonary load. One clinical population that may particularly benefit from this strategy is chronic obstructive pulmonary disease (COPD), as ventilatory constraints and locomotor muscle dysfunction often limit efficacy of conventional exercise rehabilitation in patients with severe disease. While the feasibility of EET for COPD has been established, the nature and extent of adaptation within COPD muscle is unknown. The aim of this study was therefore to characterize the locomotor muscle adaptations to EET in patients with severe COPD, and compare them with adaptations gained through conventional concentric ergometer training (CET). Male patients were randomized to either EET (n = 8) or CET (n = 7) for 10 weeks and matched for heart rate intensity. EET patients trained on average at a workload that was three times that of CET, at a lower perception of leg fatigue and dyspnea. EET led to increases in isometric peak strength and relative thigh mass (p eccentric followed by concentric cycling as a means of augmenting the training response and attenuating skeletal muscle dysfunction in patients with advanced COPD. PMID:28316572

  6. Focusing on Increasing Velocity during Heavy Resistance Knee Flexion Exercise Boosts Hamstring Muscle Activity in Chronic Stroke Patients

    Science.gov (United States)

    Jakobsen, Markus D.

    2016-01-01

    Background. Muscle strength is markedly reduced in stroke patients, which has negative implications for functional capacity and work ability. Different types of feedback during strength training exercises may alter neuromuscular activity and functional gains. Objective. To compare levels of muscle activity during conditions of blindfolding and intended high contraction speed with a normal condition of high-intensity knee flexions. Methods. Eighteen patients performed unilateral machine knee flexions with a 10-repetition maximum load. Surface electromyography (EMG) was recorded from the quadrics and hamstring muscles and normalized to maximal EMG (nEMG) of the nonparetic limb. Results. For the paretic leg, the speed condition showed higher values of muscle activity compared with the normal and blindfolded conditions for both biceps femoris and semitendinosus. Likewise, the speed condition showed higher co-contraction values compared with the normal and blindfolded conditions for the vastus lateralis. No differences were observed between exercise conditions for the nonparetic leg. Conclusion. Chronic stroke patients are capable of performing heavy resistance training with intended high speed of contraction. Focusing on speed during the concentric phase elicited higher levels of muscle activity of the hamstrings compared to normal and blindfolded conditions, which may have implications for regaining fast muscle strength in stroke survivors. PMID:27525118

  7. Resistance exercise and the mechanisms of muscle mass regulation in humans: acute effects on muscle protein turnover and the gaps in our understanding of chronic resistance exercise training adaptation.

    Science.gov (United States)

    Murton, A J; Greenhaff, P L

    2013-10-01

    Increasing muscle mass is important when attempting to maximize sports performance and achieve physique augmentation. However, the preservation of muscle mass is essential to maintaining mobility and quality of life with aging, and also impacts on our capacity to recover from illness. Nevertheless, our understanding of the processes that regulate muscle mass in humans during resistance exercise training, chronic disuse and rehabilitation training following atrophy remains very unclear. Here, we report on some of the recent developments in the study of those processes thought to be responsible for governing human muscle protein turnover in response to intense physical activity. Specifically, the effects of acute and chronic resistance exercise in healthy volunteers and also in response to rehabilitation resistance exercise training following muscle atrophy will be discussed, with discrepancies and gaps in our understanding highlighted. In particular, ubiquitin-proteasome mediated muscle proteolysis (Muscle Atrophy F-box/Atrogin-1 and Muscle RING Finger 1), translation initiation of muscle protein synthesis (mammalian target of rapamycin signaling), and satellite cell mediated myogenesis are highlighted as pathways of special relevance to muscle protein metabolism in response to acute resistance exercise. Furthermore, research focused on quantifying signaling and molecular events that modulate muscle protein synthesis and protein degradation under conditions of chronic resistance training is highlighted as being urgently needed to improve knowledge gaps. These studies need to include multiple time-point measurements over the course of any training intervention and must include dynamic measurements of muscle protein synthesis and degradation and sensitive measures of muscle mass. This article is part of a Directed Issue entitled Molecular basis of muscle wasting.

  8. Damage Control Orthopedics Management as Vital Procedure in Elderly Patients with Femoral Neck Fractures Complicated with Chronic Renal Failure: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Chenhui Dong

    Full Text Available Chronic renal failure (CRF predisposes to hip fractures in elderly patients, with high subsequent mortality. Selection and timing of the surgical procedure of such patients is a serious challenge. Many clinicians believe in earlier surgery as preferable and providing better outcomes. Damage control orthopedics (DCO aids to adjust and optimize the overall condition of patients.In 32 patients with femoral neck fractures complicated with CRF, we evaluated how the timing of the surgery determines the mortality rates if the DCO approach is applied. Preoperative ASA grading, POSSUM score, P-POSSUM score and DCO were carried out. Based on the assessment, timing of the surgery was ascertained.Of a total of 32 patients, twenty-nine patients were accepted for either early (< 48 hours; n = 18 or delayed (3-10 days; n = 10 surgery. Hip arthroplasty (total hip arthroplasty and hemiarthroplasty was the principal surgery option. All patients survived operation and were followed up postoperatively with the average time of 30 days. Postoperative complications tended to occur at higher rates in the early vs. delayed surgery group (7/18 vs. 5/10. During follow up, a total of 3 patients died in both groups (2/18 in the early surgery and 1/10 in the delayed surgery group, mostly from multi-organ failures and acute respiratory distress syndrome. There was no significant difference in complication rates and Harris hip score between both groups.In patients with femoral neck fracture complicated with CRF, delaying the surgery for several days does not increase the incidence of postoperative adverse events.

  9. The perspectives of older women with chronic neck pain on perceived effects of qigong and exercise therapy on aging: a qualitative interview study.

    Science.gov (United States)

    Holmberg, Christine; Rappenecker, Julia; Karner, Julia J; Witt, Claudia M

    2014-01-01

    Chronic pain is prevalent in elderly populations. The goals of this study were 1) to understand the results of a randomized clinical trial - Qigong and Exercise Therapy for Elderly Patients with Chronic Neck Pain (QIBANE) - that showed no difference between qigong, exercise therapy, and no-treatment on quality of life, and 2) to understand how elderly individuals with chronic pain experience interventions of qigong and exercise therapy. A qualitative interview study was conducted with 20 QIBANE participants. Interviews asked about motivation for and expectations of trial participation, experiences with the exercise classes (qigong or exercise therapy), and changes in pain experience. Interviews were transcribed, entered into the software program ATLAS.ti, and coded thematically by two coders. Content analysis was performed. All interviewees reflected positively on their QIBANE experience and described their participation in QIBANE as helpful. However, what was discussed in both groups when they talked about "positive experiences" in the study differed between the two groups. For example, themes that emerged in the exercise-therapy group related to difficulties associated with aging and staying physically active. In the interviews with qigong group members, emergent themes related to qigong as a method that improved bodily experiences and influenced daily activities. The effects that exercise therapy and qigong have on an elderly population cannot be captured by health-related quality-of-life measurements, such as the Short Form (36) Health Survey. Broader concepts of quality of life that include the concepts of self-efficacy and positive affect may be more appropriate. The results presented in this study suggest that for this population group, the approach of patient-centered outcomes is especially pertinent in order to design meaningful intervention studies in the elderly. This means that research questions, interventions, and outcome measurements need to take

  10. Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index

    NARCIS (Netherlands)

    Reneman, Michiel F.; Geertzen, Jan H. B.; Jorritsma, Wim; Knol-de Vries, Grietje; Dijkstra, Pieter U.

    2012-01-01

    To investigate relevant change on the Neck Pain and Disability Scale (NPAD) and Neck Disability Index (NDI) and which questionnaire is the most responsive in patients with non-specific chronic neck pain (CNP). Seventy-six patients with non-specific CNP in an outpatient tertiary rehabilitation settin

  11. Botulinum neurotoxin and chronic migraine: muscle fiber chemodenervation or nociceptic system modulation?

    Directory of Open Access Journals (Sweden)

    A. R. Artemenko

    2013-01-01

    Full Text Available The results of controlled investigations suggest that botulinumtoxin type A (BTA leads to decrease headache intensity and prevent migraine attacks. The antinociceptive mechanisms of BTA action remain unclear. Modern and previous hypothesis of antinociceptive action BTA in chronic migraine (CM are discussed in details. Recent experimental and clinical evidence strongly suggest that BTA has aspecific antinociceptive effect realized through inhibition of proinflammatory neurotransmitters release not only from the sensory terminals but from muscle nociceptors. The mechanism of the action of BTA in CM has more than one target and is considered to involve different pathophysiological levels CM: neurogenic inflammation, peripheral and central sensitization. The administration of BTA on the PREEMPT principle (paradigm ensures optimal neurotoxin distribution in the anatomic areas in accordance with their sensory innervation by cervical segments and sensory fibers in the trigeminal system, the terminal branches which are the major target of BTA in the treatment of CM.

  12. Dispersion of compound muscle action potential in hereditary neuropathies and chronic inflammatory demyelinating polyneuropathy.

    Science.gov (United States)

    Stanton, Michael; Pannoni, Valerie; Lewis, Richard A; Logigian, Eric L; Naguib, Demian; Shy, Michael E; Cleland, James; Herrmann, David N

    2006-10-01

    Distal compound muscle action potential (DCMAP) dispersion, defined as a DCMAP duration > or = 9 ms, and proximal-distal (P-D) CMAP dispersion are considered useful in the electrodiagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). Distal and P-D CMAP dispersion have not been fully studied in hereditary neuropathies, and it is not known whether these measures distinguish hereditary from acquired demyelination. We compared DCMAP duration and P-D CMAP dispersion in 91 genetically characterized hereditary neuropathies and 33 subjects with CIDP. DCMAP dispersion was more frequent in nerves affected by CIDP (41.5%) than in Charcot-Marie-Tooth disease (CMT)1A (24.4%), CMT1B (7.4%), hereditary neuropathy with liability to pressure palsies (HNPP) (10.5%), or CMTX (9.8%). P-D CMAP dispersion was more frequent in CIDP (27.7% of nerves) than in hereditary neuropathies (16.3%) when applying American Academy of Neurology (AAN) criteria; however, its frequency was similar in CIDP and the hereditary neuropathies using the more restrictive criteria of the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM). Although dispersion is more common in CIDP than in the hereditary neuropathies, DCMAP and P-D dispersion occur in at least one motor nerve in a significant proportion of hereditary neuropathies, and cannot be used in isolation to distinguish acquired from hereditary demyelination.

  13. Effects of exercise training on circulating and skeletal muscle renin-angiotensin system in chronic heart failure rats.

    Directory of Open Access Journals (Sweden)

    Igor Lucas Gomes-Santos

    Full Text Available BACKGROUND: Accumulated evidence shows that the ACE-AngII-AT1 axis of the renin-angiotensin system (RAS is markedly activated in chronic heart failure (CHF. Recent studies provide information that Angiotensin (Ang-(1-7, a metabolite of AngII, counteracts the effects of AngII. However, this balance between AngII and Ang-(1-7 is still little understood in CHF. We investigated the effects of exercise training on circulating and skeletal muscle RAS in the ischemic model of CHF. METHODS/MAIN RESULTS: Male Wistar rats underwent left coronary artery ligation or a Sham operation. They were divided into four groups: 1 Sedentary Sham (Sham-S, 2 exercise-trained Sham (Sham-Ex, sedentary CHF (CHF-S, and exercise-trained CHF (CHF-Ex. Angiotensin concentrations and ACE and ACE2 activity in the circulation and skeletal muscle (soleus and plantaris were quantified. Skeletal muscle ACE and ACE2 protein expression, and AT1, AT2, and Mas receptor gene expression were also evaluated. CHF reduced ACE2 serum activity. Exercise training restored ACE2 and reduced ACE activity in CHF. Exercise training reduced plasma AngII concentration in both Sham and CHF rats and increased the Ang-(1-7/AngII ratio in CHF rats. CHF and exercise training did not change skeletal muscle ACE and ACE2 activity and protein expression. CHF increased AngII levels in both soleus and plantaris muscle, and exercise training normalized them. Exercise training increased Ang-(1-7 in the plantaris muscle of CHF rats. The AT1 receptor was only increased in the soleus muscle of CHF rats, and exercise training normalized it. Exercise training increased the expression of the Mas receptor in the soleus muscle of both exercise-trained groups, and normalized it in plantaris muscle. CONCLUSIONS: Exercise training causes a shift in RAS towards the Ang-(1-7-Mas axis in skeletal muscle, which can be influenced by skeletal muscle metabolic characteristics. The changes in RAS circulation do not necessarily

  14. DOES ELECTROMYOGRAPHY BIOFEEDBACK TRAINING REDUCE WORK-RELATED NECK PAIN?

    OpenAIRE

    2014-01-01

    Purpose: The purpose of this study is to investigate the use of Electromyography (EMG) biofeedback training in dental professionals to reduce upper trapezius muscle tension and thereby to reduce the work related neck pain. By reducing muscle activity in the neck and shoulder postural stabilizing muscles, EMG biofeedback training would be an effective mode of treatment in dental professionals for the management of work related neck pain. Subjects and Methods: This RCT included a total of 50...

  15. Effects of 12-wk eccentric calf muscle training on muscle-tendon glucose uptake and SEMG in patients with chronic Achilles tendon pain

    DEFF Research Database (Denmark)

    Masood, Tahir; Kalliokoski, Kari; Magnusson, S Peter

    2014-01-01

    High-load eccentric exercises have been a key component in the conservative management of chronic Achilles tendinopathy. This study investigated the effects of a 12-wk progressive, home-based eccentric rehabilitation program on ankle plantar flexors' glucose uptake (GU) and myoelectric activity....... The results indicated that the symptomatic leg was weaker (P eccentric rehabilitation. Additionally, the rehabilitation resulted in greater GU in both soleus (P ... within- or between-group differences. Eccentric rehabilitation was effective in decreasing subjective severity of Achilles tendinopathy. It also resulted in redistribution of relative electrical activity, but not metabolic activity, within the triceps surae muscle....

  16. Predictors of short- and long-term outcome in patients with chronic non-specific neck pain undergoing an exercise-based rehabilitation program: a prospective cohort study with 1-year follow-up.

    Science.gov (United States)

    Cecchi, Francesca; Molino-Lova, Raffaele; Paperini, Anita; Boni, Roberta; Castagnoli, Chiara; Gentile, Jacopo; Pasquini, Guido; Macchi, Claudio

    2011-10-01

    The aim of this study was to describe the clinical course of patients with chronic, non-specific neck pain undergoing a public health covered, exercise-based rehabilitation program and to identify predictors of poor outcome. A prospective cohort study was carried out on patients with non-specific neck pain (6 months or longer), referred by their general practitioner to a 6-session program, including education and individually tailored exercise. The primary outcome measure for the course of neck pain was the Northwick neck pain questionnaire (NPQ) administered on baseline, discharge, and 1 year from discharge. Poor outcome was defined as NPQ score improving neck pain history, and the clinical features described by NPQ. From January 2008 to June 2009, 212 patients were consecutively assessed for eligibility: 178 were enrolled and 162 completed follow-up (mean age = 65.3; 75% women). Baseline NPQ average score (40.7 + 17.1) improved by MCID on discharge (26.1 + 16.3) and at 1 year (28.5 + 17.3%). The poor outcome was reported by 45% patients on discharge and by 56% at follow-up. Pain-related medication intake independently predicted poor short- (OR 4.24; 95% CI 1.83-9.84; p = 0.001) and long-term (OR 2.69; 95% CI 1.19-6.06; p = 0.017) outcome, and catastrophizing (OR 2.91; 95% CI 1.31-6.48; p = 0.009) predicted poor outcome at 1 year. Our cohort of patients with chronic neck pain undergoing an exercise-based rehabilitation program reported improvement by or beyond MICD-NPQ in 55% cases on discharge and in 44% cases at 1 year. Poor outcome was predicted by pain-related medication intake in the short and long term, and by catastrophizing in the long term.

  17. Evaluation of the Immediate Effect of Auricular Acupuncture on Pain and Electromyographic Activity of the Upper Trapezius Muscle in Patients with Nonspecific Neck Pain: A Randomized, Single-Blinded, Sham-Controlled, Crossover Study

    Directory of Open Access Journals (Sweden)

    Andréia Cristina de Oliveira Silva

    2015-01-01

    Full Text Available Background. The aim of the present study was to assess the immediate effects of auricular acupuncture (AA on the electromyographic (EMG activity of the upper trapezius muscle and pain in nonspecific neck pain (NS-NP patients. Twelve patients with NS-NP (NS-NP group and 12 healthy subjects (HS Group were enrolled in a randomized, single-blinded, crossover study. Each subject received a single session of AA and sham AA (SAA. Surface EMG activity was measured in the upper trapezius muscle at different “step contractions” of isometric shoulder elevation (15%, 20%, 25%, and 30% MVC. The outcome measure in patients with NS-NP was based on the numerical pain rating scale (NRS. AA treatment led to a significant decrease in EMG activity in both groups (NS-NP group: p = 0.0001; HS group: p < 0.0001—ANOVA test. This was not the case for the SAA treatment (NS-NP group: p = 0.71; HS group: p < 0.54. Significant decreases (p < 0.001 in the NRS were found for both treatments (AA and SAA. This study demonstrated the immediate effect of auricular acupuncture on the electromyographic activity of the upper trapezius muscle but the effect of this intervention on pain symptoms in patients with nonspecific neck pain was inconclusive.

  18. Evaluation of the Immediate Effect of Auricular Acupuncture on Pain and Electromyographic Activity of the Upper Trapezius Muscle in Patients with Nonspecific Neck Pain: A Randomized, Single-Blinded, Sham-Controlled, Crossover Study.

    Science.gov (United States)

    Silva, Andréia Cristina de Oliveira; Biasotto-Gonzalez, Daniela Aparecida; Dos Santos, Douglas Meira; Melo, Nivea Cristina De; Gomes, Cid André Fidelis de Paula; Amorim, César Ferreira; Politti, Fabiano

    2015-01-01

    Background. The aim of the present study was to assess the immediate effects of auricular acupuncture (AA) on the electromyographic (EMG) activity of the upper trapezius muscle and pain in nonspecific neck pain (NS-NP) patients. Twelve patients with NS-NP (NS-NP group) and 12 healthy subjects (HS Group) were enrolled in a randomized, single-blinded, crossover study. Each subject received a single session of AA and sham AA (SAA). Surface EMG activity was measured in the upper trapezius muscle at different "step contractions" of isometric shoulder elevation (15%, 20%, 25%, and 30% MVC). The outcome measure in patients with NS-NP was based on the numerical pain rating scale (NRS). AA treatment led to a significant decrease in EMG activity in both groups (NS-NP group: p = 0.0001; HS group: p treatment (NS-NP group: p = 0.71; HS group: p treatments (AA and SAA). This study demonstrated the immediate effect of auricular acupuncture on the electromyographic activity of the upper trapezius muscle but the effect of this intervention on pain symptoms in patients with nonspecific neck pain was inconclusive.

  19. Neck lump

    Science.gov (United States)

    ... the neck lump treated. When to Contact a Medical Professional Call your health care provider if you have an abnormal neck swelling or ... to Expect at Your Office Visit The health care provider will take your medical history and do a physical exam. You may ...

  20. Head and neck squamous cell carcinoma in chronic areca nut chewing Indian women: Case series and review of literature

    Directory of Open Access Journals (Sweden)

    Sidramesh Shivanand Muttagi

    2012-01-01

    Full Text Available Background: Head and neck squamous cell carcinoma (HNSCC is an important public health problem in India. Several risk factors such as tobacco, human papilloma virus, alcohol, areca nut usage have been extensively studied as causative agents. Though Areca nut chewing is known cause of oral cancer, its association with hypopharynx cancer has not been previously reported. Since areca nut is mostly consumed along with tobacco, it is uncommon to find patients who consume the areca nut alone. Materials and Methods: This is a prospective case series of ten women who presented to us with HNSCC with history of chewing of areca nut alone for several years. We have excluded all those cases where areca nut was consumed along with tobacco in any form. The data were prospectively collected with regard to clinical parameters, duration and frequency of areca nut usage, the socio-economic status and education level. Results: All ten females had varying degree of submucous fibrosis and coexisting squamous cell carcinoma either in the oral cavity or hypopharynx. Submucous fibrosis was characterized by burning mouth, unhealthy oral mucosa, buried third molars, trismus, poor oral hygiene, etc. The disease presented in an advanced stage in majority of the cases. All patients were unaware of areca nut′s deleterious effects. Conclusion: Areca nut chewing is an important risk factor for HNSCC in females. Despite plethora of information, little importance is given to areca nut control in cancer prevention campaigns in India.

  1. EFFECT OF THE CERVICAL ENDURANCE TRAINING PROGRAMME IN MECHANICAL NECK PAIN

    Directory of Open Access Journals (Sweden)

    Pranjal Gogoi

    2015-10-01

    Full Text Available Background: Mechanical neck pain commonly arises insidiously and is generally multifactorial in origin. Regardless of the primary source of pain, the prognosis for individual experiencing chronic neck pain is poor. Exercise interventions are important for effective management of patients with neck pain.the objective of the study is to compare the efficacy of cervical endurance training programme with cervical isometric exercise in alleviating symptoms of mechanical neck pain. Methods: 40 subjects were assessed and identified with Mechanical Neck Pain and recruited for the study and were randomly divided into two groups. In one group endurance training for cervical muscles and in another group resisted isometric had been given for 3 weeks. The post treatment scores regarding endurance, pain intensity, disability, Range of motion and muscle power were compared with the pre treatment scores. Results: Paired‘t’ test was done to compare the pretreatment scores with the post treatment scores .Unpaired ‘t’ test was done to compare the post treatment scores of both the groups. The pain intensity, disability were found to be significantly decreased in experimental group than the control group (p<0.001. While the endurance was found to be significantly increased in experimental group than the control group (p < 0.001. The muscle power was found to be slightly increased in the control group than the experimental group .The post treatment cervical range of motion does not have significant difference in between the groups (Flexion- p=0.35 and Extension-p=0.40. Conclusion: This study showed that the progressive endurance exercise is beneficial in alleviating mechanical neck pain and should be incorporated along with the conventional physiotherapy treatment for mechanical neck pain.

  2. The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT

    Directory of Open Access Journals (Sweden)

    van Assen Luite

    2010-01-01

    Full Text Available Abstract Background Manual Therapy applied to patients with non specific neck pain has been investigated several times. In the Netherlands, manual therapy as applied according to the Utrecht School of Manual Therapy (MTU has not been the subject of a randomized controlled trial. MTU differs in diagnoses and treatment from other forms of manual therapy. Methods/Design This is a single blind randomized controlled trial in patients with sub-acute and chronic non specific neck pain. Patients with neck complaints existing for two weeks (minimum till one year (maximum will participate in the trial. 180 participants will be recruited in thirteen primary health care centres in the Netherlands. The experimental group will be treated with MTU during a six week period. The control group will be treated with physical therapy (standard care, mainly active exercise therapy, also for a period of six weeks. Primary outcomes are Global Perceived Effect (GPE and functional status (Neck Disability Index (NDI-DV. Secondary outcomes are neck pain (Numeric Rating Scale (NRS, Eurocol, costs and quality of life (SF36. Discussion This paper presents details on the rationale of MTU, design, methods and operational aspects of the trial. Trial registration ClinicalTrials.gov Identifier: NCT00713843

  3. Expression profiling of skeletal muscle following acute and chronic β2-adrenergic stimulation: implications for hypertrophy, metabolism and circadian rhythm

    Directory of Open Access Journals (Sweden)

    Lynch Gordon S

    2009-09-01

    Full Text Available Abstract Background Systemic administration of β-adrenoceptor (β-AR agonists has been found to induce skeletal muscle hypertrophy and significant metabolic changes. In the context of energy homeostasis, the importance of β-AR signaling has been highlighted by the inability of β1-3-AR-deficient mice to regulate energy expenditure and susceptibility to diet induced obesity. However, the molecular pathways and gene expression changes that initiate and maintain these phenotypic modulations are poorly understood. Therefore, the aim of this study was to identify differential changes in gene expression in murine skeletal muscle associated with systemic (acute and chronic administration of the β2-AR agonist formoterol. Results Skeletal muscle gene expression (from murine tibialis anterior was profiled at both 1 and 4 hours following systemic administration of the β2-AR agonist formoterol, using Illumina 46K mouse BeadArrays. Illumina expression profiling revealed significant expression changes in genes associated with skeletal muscle hypertrophy, myoblast differentiation, metabolism, circadian rhythm, transcription, histones, and oxidative stress. Differentially expressed genes relevant to the regulation of muscle mass and metabolism (in the context of the hypertrophic phenotype were further validated by quantitative RT-PCR to examine gene expression in response to both acute (1-24 h and chronic administration (1-28 days of formoterol at multiple timepoints. In terms of skeletal muscle hypertrophy, attenuation of myostatin signaling (including differential expression of myostatin, activin receptor IIB, phospho-Smad3 etc was observed following acute and chronic administration of formoterol. Acute (but not chronic administration of formoterol also significantly induced the expression of genes involved in oxidative metabolism, including hexokinase 2, sorbin and SH3 domain containing 1, and uncoupling protein 3. Interestingly, formoterol

  4. Lumbar and abdominal muscle activity during walking in subjects with chronic low back pain: Support of the “guarding” hypothesis?

    NARCIS (Netherlands)

    Hulst, van der M.; Vollenbroek-Hutten, M.M.R.; Rietman, J.S.; Hermens, H.J.

    2010-01-01

    It has been hypothesized that changes in trunk muscle activity in chronic low back pain (CLBP) reflect an underlying “guarding” mechanism, which will manifest itself as increased superficial abdominal – and lumbar muscle activity. During a functional task like walking, it may be further provoked at

  5. Evidence for the presence of an autoimmune component to the chronic muscle wasting disease characteristic of calves infected with Aarcocystis cruzi

    Science.gov (United States)

    Infection with Sarcocystis spp. often resolves in a progressive decline in muscle integrity. The underlying cause for this has remained undetermined. Previously, we described the presence of proinflammatory muscle protein nitration (PMPN) in calves (ScI) chronically infected with Sarcocystis cruzi. ...

  6. A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome

    OpenAIRE

    2006-01-01

    Abstract Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral...

  7. The Role of Inspiratory Muscle Training in the Process of Rehabilitation of Patients with Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Majewska-Pulsakowska, M; Wytrychowski, K; Rożek-Piechura, K

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) adversely affects the quality of life and life expectancy of patients. Shortness of breath, cough, and fatigue in lower limbs are the main reasons limiting physical activities of patients. The lack of physical activity results in poorer muscle strength. The latest guidelines regarding breathing rehabilitation in COPD patients emphasize a significant role of inspiratory muscle exercises. The objective of the present study was to evaluate the effects of an 8-week long inspiratory muscle training, interval training on a cycle ergometer, and training combining both kinds of rehabilitation, on pulmonary function, health-related quality of life, and the tolerance to exercise in patients with COPD. The study was conducted in a group of 43 patients with diagnosed COPD stage II and III according to GOLD. They were randomly divided into four training groups: inspiratory muscle training (Group 1), cycle ergometer training (Group 2), cycle ergometer and inspiratory muscle training (Group 3), control group - patients who did not participate in any rehabilitation programs (Group 4 - control). Before the rehabilitation process and after its completion the patients were medically examined, they completed a health-related quality of life questionnaire, performed a 6-min walk test, spirometry, and a treadmill exercise test according to the modified Bruce protocol. The results demonstrate a significant improvement in the quality of life measured for Group 3 in comparison with the control group.

  8. Neck pain causes respiratory dysfunction.

    Science.gov (United States)

    Kapreli, Eleni; Vourazanis, Evangelos; Strimpakos, Nikolaos

    2008-01-01

    This paper describes a presumptive mechanism for the development of changes in respiratory function due to chronic neck pain. The patient with neck pain presents a number of factors that could constitute a predisposition of leading to a respiratory dysfunction: (a) the decreased strength of deep neck flexors and extensors, (b) the hyperactivity and increased fatigability of superficial neck flexors, (c) the limitation of range of motion, (d) the decrease in proprioception and disturbances in neuromuscular control, (e) the existence of pain and (f) the psychosocial influence of dysfunction. The possible connection of neck pain and respiratory function could have a great impact on various clinical aspects notably patient assessment, rehabilitation and pharmacological prescription.

  9. Chronic electrical stimulation drives mitochondrial biogenesis in skeletal muscle of a lizard, Varanus exanthematicus.

    Science.gov (United States)

    Schaeffer, Paul J; Nichols, Scott D; Lindstedt, Stan L

    2007-10-01

    We investigated the capacity for phenotypic plasticity of skeletal muscle from Varanus exanthematicus, the savannah monitor lizard. Iliofibularis muscle from one leg of each lizard was electrically stimulated for 8 weeks. Both stimulated and contralateral control muscles were collected and processed for electron microscopy. We used stereological analysis of muscle cross-sections to quantify the volume densities of contractile elements, sarcoplasmic reticulum, mitochondria and intracellular lipids. We found that mitochondrial volume density was approximately fourfold higher in the stimulated muscle compared to controls, which were similar to previously reported values. Sarcoplasmic reticulum volume density was reduced by an amount similar to the increase in mitochondrial volume density while the volume density of contractile elements remained unchanged. Intracellular lipid accumulation was visibly apparent in many stimulated muscle sections but the volume density of lipids did not reach a significant difference. Although monitor lizards lack the highly developed aerobic metabolism of mammals, they appear to possess the capacity for muscle plasticity.

  10. Subacute and chronic, non-specific back and neck pain: cognitive-behavioural rehabilitation versus primary care. A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Strender Lars-Erik

    2008-12-01

    Full Text Available Abstract Background In the industrial world, non-specific back and neck pain (BNP is the largest diagnostic group underlying sick-listing. For patients with subacute and chronic (= full-time sick-listed for 43 – 84 and 85 – 730 days, respectively BNP, cognitive-behavioural rehabilitation was compared with primary care. The specific aim was to answer the question: within an 18-month follow-up, will the outcomes differ in respect of sick-listing and number of health-care visits? Methods After stratification by age (≤ 44/≥ 45 years and subacute/chronic BNP, 125 Swedish primary-care patients were randomly allocated to cognitive-behavioural rehabilitation (rehabilitation group or continued primary care (primary-care group. Outcome measures were Return-to-work share (percentage and Return-to-work chance (hazard ratios over 18 months, Net days (crude sick-listing days × degree, and the number of Visits (to physicians, physiotherapists etc. over 18 months and the three component six-month periods. Descriptive statistics, Cox regression and mixed-linear models were used. Results All patients: Return-to-work share and Return-to-work chance were equivalent between the groups. Net days and Visits were equivalent over 18 months but decreased significantly more rapidly for the rehabilitation group over the six-month periods (p Return-to-work share was equivalent. Return-to-work chance was significantly greater for the rehabilitation group (hazard ratio 3.5 [95%CI1.001 – 12.2]. Net days were equivalent over 18 months but decreased significantly more rapidly for the rehabilitation group over the six-month periods and there were 31 days fewer in the third period. Visits showed similar though non-significant differences and there were half as many in the third period. Chronic patients: Return-to-work share, Return-to-work chance and Net days were equivalent. Visits were equivalent over 18 months but tended to decrease more rapidly for the

  11. A STUDY TO INVESTIGATE THE ROLE OF PELVIC FLOOR MUSCLE IN CHRONIC NONRESPONSIVE BACK ACHE IN FEMALES

    Directory of Open Access Journals (Sweden)

    Sadaf Subhi

    2016-02-01

    Full Text Available Background: Chronic low back pain remains a major health problem. Unfortunately, the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25–50% of patients respond to exercise. At present, however, there are no guidelines regarding the best treatment to help clinicians. As a result, time and money are wasted on treatment which ultimately fail to help the patient. A backache is described as annoying and gripping pain. It can be caused by poor posture, lack of manual handling skills, change in the center of gravity due to expanding abdomen, lack of exercise, or the weight of the baby and the stretching ligaments. Pelvic floor muscle weakness is one of the major cause of chronic backache. Weakness in the pelvic floor muscles is common in females which can lead to debilitating urinary symptoms, affect sexual function and cause chronic backache. Methods: In 3 months, 31 female subjects with mean age of 28 who had taken treatment for their chronic backache, were improvised with pelvic floor strength at our setup, with dramatically good results. 31 subjects with non-responsive chronic back pain who had taken conventional physiotherapy were included in the study. Both married and unmarried were included. Any sign of radiculopathy or inflammation were excluded. After assessing pain using Visual Analogue Scale, the Dr Glazer’s program and Kegel’s contractions were taught. Results: There was significant improvement by 50% on reassessment after 7 days. Then exercises for transverse abdominals were included to get a better response. On completion of the treatment sessions, reduction in pain was 92% on VAS and functional abilities increased by 89%. There was a significant improvement in the quality of life and in pelvic-floor muscle strength. Conclusion: Non-responsive chronic back pain in females when treated with pelvic floor muscle strengthening program showed 40

  12. Physical, psychosocial, and individual risk factors for neck/shoulder pain with pressure tenderness in the muscles among workers performing monotonous, repetitive work

    DEFF Research Database (Denmark)

    Andersen, JH; Kaergaard, A.; Frost, P.

    2002-01-01

    with reduced health-related quality of life. CONCLUSIONS: Work-related physical and psychosocial factors, as well as several individual risk factors, are important in the understanding of neck/shoulder pain. The findings suggest that neck/shoulder pain has a multifactorial nature. Reduced health...... force (2.3, 1.4-4.0). The strongest work-related psychosocial risk was high job demands (1.8, 1.2-2.7). Increased risk was also associated with neck/shoulder injury (2.6, 1.6-4.1), female gender (1.8, 1.2-2.8), and low pressure pain threshold (1.6, 1.1-2.3). Neck/shoulder pain was strongly associated...

  13. Chronic endocannabinoid system stimulation induces muscle macrophage and lipid accumulation in type 2 diabetic mice independently of metabolic endotoxaemia.

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    Lucie Geurts

    Full Text Available AIMS: Obesity and type 2 diabetes are characterised by low-grade inflammation, metabolic endotoxaemia (i.e., increased plasma lipopolysaccharides [LPS] levels and altered endocannabinoid (eCB-system tone. The aim of this study was to decipher the specific role of eCB-system stimulation or metabolic endotoxaemia in the onset of glucose intolerance, metabolic inflammation and altered lipid metabolism. METHODS: Mice were treated with either a cannabinoid (CB receptor agonist (HU210 or low-dose LPS using subcutaneous mini-pumps for 6 weeks. After 3 weeks of the treatment under control (CT diet, one-half of each group of mice were challenged with a high fat (HF diet for the following 3-week period. RESULTS: Under basal conditions (control diet, chronic CB receptor agonist treatment (i.e., 6 weeks induced glucose intolerance, stimulated metabolic endotoxaemia, and increased macrophage infiltration (CD11c and F4/80 expression in the muscles; this phenomenon was associated with an altered lipid metabolism (increased PGC-1α expression and decreased CPT-1b expression in this tissue. Chronic LPS treatment tended to increase the body weight and fat mass, with minor effects on the other metabolic parameters. Challenging mice with an HF diet following pre-treatment with the CB agonist exacerbated the HF diet-induced glucose intolerance, the muscle macrophage infiltration and the muscle's lipid content without affecting the body weight or the fat mass. CONCLUSION: Chronic CB receptor stimulation under basal conditions induces glucose intolerance, stimulates metabolic inflammation and alters lipid metabolism in the muscles. These effects worsen following the concomitant ingestion of an HF diet. Here, we highlight the central roles played by the eCB system and LPS in the pathophysiology of several hallmarks of obesity and type 2 diabetes.

  14. Extraocular muscle atrophy and central nervous system involvement in chronic progressive external ophthalmoplegia.

    Directory of Open Access Journals (Sweden)

    Cynthia Yu-Wai-Man

    Full Text Available Chronic progressive external ophthalmoplegia (CPEO is a classical mitochondrial ocular disorder characterised by bilateral progressive ptosis and ophthalmoplegia. These ocular features can develop either in isolation or in association with other prominent neurological deficits (CPEO+. Molecularly, CPEO can be classified into two distinct genetic subgroups depending on whether patients harbour single, large-scale mitochondrial DNA (mtDNA deletions or multiple mtDNA deletions secondary to a nuclear mutation disrupting mtDNA replication or repair. The aim of this magnetic resonance imaging (MRI study was to investigate whether the ophthalmoplegia in CPEO is primarily myopathic in origin or whether there is evidence of contributory supranuclear pathway dysfunction.Ten age-matched normal controls and twenty patients with CPEO were recruited nine patients with single, large-scale mtDNA deletions and eleven patients with multiple mtDNA deletions secondary to mutations in POLG, PEO1, OPA1, and RRM2B. All subjects underwent a standardised brain and orbital MRI protocol, together with proton magnetic resonance spectroscopy in two voxels located within the parietal white matter and the brainstem.There was evidence of significant extraocular muscle atrophy in patients with single or multiple mtDNA deletions compared with controls. There was no significant difference in metabolite concentrations between the patient and control groups in both the parietal white matter and brainstem voxels. Volumetric brain measurements revealed marked cortical and cerebellar atrophy among patients with CPEO+ phenotypes.The results of this study support a primary myopathic aetiology for the progressive limitation of eye movements that develops in CPEO.

  15. Inner and outer portions of colonic circular muscle: ultrastructural and immunohistochemical changes in rat chronically treated with otilonium bromide.

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    Chiara Traini

    Full Text Available Rat colonic circular muscle, main target of otilonium bromide (OB spasmolytic activity, is subdivided in an inner and outer portion. Since the inner one is particularly rich in organelles involved in calcium availability (caveolae, smooth endoplasmic reticulum, mitochondria, the expression of specific markers (Caveolin-1, eNOS, calreticulin, calsequestrin in comparison with the outer portion was investigated. The possible changes of these organelles and related markers, and of muscarinic receptors (Mr2 were then studied after OB chronic exposition. Rats were treated with 2-20 mg/kg/OB for 10 or 30 days. Proximal colon was processed by electron microscopy, immunohistochemistry, and western blot. In colon strips the stimulated contractility response to muscarinic agonist was investigated. The inner portion showed a higher expression of Caveolin-1 and Mr2, but not of eNOS, calreticulin and calsequestrin, compared to the outer portion. Chronic OB treatment caused similar ultrastructural and immunohistochemical changes in both portions. Organelles and some related markers were increased at 10 days; Mr2 expression and muscle contractility induced by methacholine was increased at 30 days. The present findings: 1 provide new information on the immunohistochemical properties of the inner portion of the circular layer that are in favour of a role it might play in colonic motility distinct from that of the outer portion; 2 demonstrate that chronically administered OB interferes with cell structures and molecules responsible for calcium handling and storage, and modifies cholinergic transmission. In conclusion, chronic OB administration in the colonic circular muscle layer directly interacts with the organelles and molecules calcium-related and with the Mr2.

  16. Cervical Spondylosis (Arthritis of the Neck)

    Science.gov (United States)

    ... and fingers • Trouble walking, loss of balance, or weakness in the hands or legs • Muscle spasms in the neck and shoulders Doctor Examination Physical Examination After discussing your medical ...

  17. Surgical desensitisation of the mechanoreceptors in Müller's muscle relieves chronic tension-type headache caused by tonic reflexive contraction of the occipitofrontalis muscle in patients with aponeurotic blepharoptosis.

    Science.gov (United States)

    Matsuo, Kiyoshi; Ban, Ryokuya

    2013-02-01

    Proprioceptively innervated intramuscular connective tissues in Müller's muscle function as exterior mechanoreceptors to induce reflex contraction of the levator and occipitofrontalis muscles. In aponeurotic blepharoptosis, since the levator aponeurosis is disinserted from the tarsus, stretching of the mechanoreceptors in Müller's muscle is increased even on primary gaze to induce phasic and tonic reflexive contraction of the occipitofrontalis muscle. It was hypothesised that in certain patients with aponeurotic blepharoptosis, the presence of tonic reflexive contraction of the occipitofrontalis muscle due to the sensitised mechanoreceptors in Müller's muscle, can cause chronic tension-type headache (CTTH) associated with occipitofrontalis tenderness. To verify this hypothesis, this study evaluated (1) what differentiates patients with CTTH from patients without CTTH, (2) how pharmacological contraction of Müller's smooth muscle fibres as a method for desensitising the mechanoreceptors in Müller's muscle affects electromyographic activity of the frontalis muscle, and (3) how surgical aponeurotic reinsertion to desensitise the mechanoreceptors in Müller's muscle electromyographically or subjectively affects activities of the occipitofrontalis muscle or CTTH. It was found that patients had sustained CTTH when light eyelid closure did not markedly reduce eyebrow elevation. However, pharmacological contraction of Müller's smooth muscle fibres or surgery to desensitise the mechanoreceptor electromyographically reduced the tonic contraction of the occipitofrontalis muscle on primary gaze and subjectively relieved aponeurotic blepharoptosis-associated CTTH. Over-stretching of the mechanoreceptors in Müller's muscle on primary gaze may induce CTTH due to tonic reflexive contraction of the occipitofrontalis muscle. Therefore, surgical desensitisation of the mechanoreceptors in Müller's muscle appears to relieve CTTH.

  18. Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain

    DEFF Research Database (Denmark)

    Gross, Anita R; Kaplan, Faith; Huang, Stacey

    2013-01-01

    To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain.......To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain....

  19. NSE-1飞行员颈肌训练器的研制及其应用%Research, Design and Application of Model NSE-1 Neck Muscle Training Machine for Pilots

    Institute of Scientific and Technical Information of China (English)

    成海平; 王致洁; 柳松杨; 杨毅; 赵广; 丛红; 韩学平; 刘敏; 俞梦孙

    2011-01-01

    空军飞行员暴露于高G载荷下导致颈部疼痛是一个特殊的职业问题,为了减少这方面的问题有必要进行特殊的颈肌强度训练.为了安全有效地进行颈肌强度训练,提供颈肌强度训练的最佳阻抗是非常重要的.本研究设计了NSE-1型飞行员颈肌训练器.为实现可变阻力和可变速度(CVR)肌力训练以及等长训练,本研究采用了自适应液压技术、传感技术、视觉和听觉生物反馈技术和信号处理技术,系统由机械部分(前屈后伸和左右侧屈训练器座椅、液压组件、力矩传递组件)、信号处理和生物反馈软件组成.为验证该训练器的有效性和安全性,对11名志愿者进行前屈后伸和左右侧屈的CVR训练和等长训练,每周三次,共6周.前屈、后伸、左右侧屈肌群的相对强度分别增长70.8%、83.7%、78.6%和75.2%.结果表明:应用NSE-1飞行员颈肌训练器进行颈肌训练,能安全高效地提高颈肌各肌群的强度.%Pain in the cervical region of air force pilots, who are exposed to high G-forces, is a specifically occupational health problem. To minimize neck problems, the cervical muscles need specific strength exercise. It is important that the training for the neck must be carried out with optimal resistance in exercises. The model NSE-1 neck training machine for pilots was designed for neck strengthening exercises under safe and effective conditions. In order to realize the functions of changeable velocity and resistant (CVR) training and neck isometric contractive exercises, the techniques of adaptive hydraulics, sensor, optic and auditory biological feedback, and signal processing were applied to this machine. The training system mainly consists of mechanical parts (including the chair of flexion and extension, the chair of right and left lateral flexion, the components of hydraulics and torque transformer, etc. ) , and the software of signal processing and biological feedback. Eleven

  20. Trunk Muscle Characteristics of the Multifidi, Erector Spinae, Psoas, and Quadratus Lumborum in Older Adults With and Without Chronic Low Back Pain.

    Science.gov (United States)

    Sions, J Megan; Elliott, James M; Pohlig, Ryan T; Hicks, Gregory E

    2017-03-01

    Study Design Cross-sectional study. Objective To determine whether there are differences in trunk muscle characteristics between older adults with and without chronic low back pain (LBP), while controlling for age, sex, and body mass index. Background Muscle support for the trunk is provided by the multifidi, erector spinae, psoas, and quadratus lumborum. Trunk muscle characteristics may be altered with aging and/or chronic LBP. To date, most trunk muscle research has been conducted among younger adults. Given age-related muscle changes, such as reduced size and increased intramuscular fat, studies are needed in older adults, including those comparing older adults with and without LBP. Methods One hundred two older adults with (n = 53) and without (n = 49) chronic LBP were included. Cross-sectional area (CSA) measurements were taken by tracing inside the fascial borders on magnetic resonance images. Pixel intensity summaries were obtained to compute muscle-to-fat indices and relative muscle CSA, that is, CSA void of fat. Right/left averages for levels L2 through L5 were determined. Mixed-design analyses of covariance were used to test for differences between groups, based on LBP presence and sex, across levels (P≤.05). Results Older adults with LBP had a greater average multifidus muscle-to-fat index (0.51 versus 0.49) and smaller average erector spinae relative muscle CSA (8.56 cm(2) versus 9.26 cm(2)) when compared to control participants without LBP. No interactions between LBP status and average muscle characteristics were found for the psoas or quadratus lumborum (P>.05). Conclusion Up to 54% of older adult trunk muscle CSA may be fat. Women have smaller muscles and greater intramuscular fat (at lower spinal levels) than men. J Orthop Sports Phys Ther 2017;47(3):173-179. Epub 3 Feb 2017. doi:10.2519/jospt.2017.7002.

  1. The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Romy Lauche

    2012-01-01

    Full Text Available Introduction. Cupping has been used since antiquity in the treatment of pain conditions. In this pilot study, we investigated the effect of traditional cupping therapy on chronic nonspecific neck pain (CNP and mechanical sensory thresholds. Methods. Fifty CNP patients were randomly assigned to treatment (TG, n=25 or waiting list control group (WL, n=25. TG received a single cupping treatment. Pain at rest (PR, pain related to movement (PM, quality of life (SF-36, Neck Disability Index (NDI, mechanical detection (MDT, vibration detection (MDT, and pressure pain thresholds (PPT were measured before and three days after a single cupping treatment. Patients also kept a pain and medication diary (PaDi, MeDi during the study. Results. Baseline characteristics were similar in the two groups. After cupping TG reported significantly less pain (PR: −17.9 mm VAS, 95%CI −29.2 to −6.6; PM: −19.7, 95%CI −32.2 to −7.2; PaDi: −1.5 points on NRS, 95%CI −2.5 to −0.4; all P<0.05 and higher quality of life than WL (SF-36, Physical Functioning: 7.5, 95%CI 1.4 to 13.5; Bodily Pain: 14.9, 95%CI 4.4 to 25.4; Physical Component Score: 5.0, 95%CI 1.4 to 8.5; all P<0.05. No significant effect was found for NDI, MDT, or VDT, but TG showed significantly higher PPT at pain-areas than WL (in lg(kPa; pain-maximum: 0.088, 95%CI 0.029 to 0.148, pain-adjacent: 0.118, 95%CI 0.038 to 0.199; both P<0.01. Conclusion. A single application of traditional cupping might be an effective treatment for improving pain, quality of life, and hyperalgesia in CNP.

  2. A randomised controlled trial of preventive spinal manipulation with and without a home exercise program for patients with chronic neck pain

    Directory of Open Access Journals (Sweden)

    Descarreaux Martin

    2011-02-01

    Full Text Available Abstract Background Evidence indicates that supervised home exercises, combined or not with manual therapy, can be beneficial for patients with non-specific chronic neck pain (NCNP. The objective of the study is to investigate the efficacy of preventive spinal manipulative therapy (SMT compared to a no treatment group in NCNP patients. Another objective is to assess the efficacy of SMT with and without a home exercise program. Methods Ninety-eight patients underwent a short symptomatic phase of treatment before being randomly allocated to either an attention-group (n = 29, a SMT group (n = 36 or a SMT + exercise group (n = 33. The preventive phase of treatment, which lasted for 10 months, consisted of meeting with a chiropractor every two months to evaluate and discuss symptoms (attention-control group, 1 monthly SMT session (SMT group or 1 monthly SMT session combined with a home exercise program (SMT + exercise group. The primary and secondary outcome measures were represented by scores on a 10-cm visual analog scale (VAS, active cervical ranges of motion (cROM, the neck disability index (NDI and the Bournemouth questionnaire (BQ. Exploratory outcome measures were scored on the Fear-avoidance Behaviour Questionnaire (FABQ and the SF-12 Questionnaire. Results Our results show that, in the preventive phase of the trial, all 3 groups showed primary and secondary outcomes scores similar to those obtain following the non-randomised, symptomatic phase. No group difference was observed for the primary, secondary and exploratory variables. Significant improvements in FABQ scores were noted in all groups during the preventive phase of the trial. However, no significant change in health related quality of life (HRQL was associated with the preventive phase. Conclusions This study hypothesised that participants in the combined intervention group would have less pain and disability and better function than participants from the 2 other groups during the

  3. Chronic nicotine modifies skeletal muscle Na,K-ATPase activity through its interaction with the nicotinic acetylcholine receptor and phospholemman.

    Directory of Open Access Journals (Sweden)

    Alexander V Chibalin

    Full Text Available Our previous finding that the muscle nicotinic acetylcholine receptor (nAChR and the Na,K-ATPase interact as a regulatory complex to modulate Na,K-ATPase activity suggested that chronic, circulating nicotine may alter this interaction, with long-term changes in the membrane potential. To test this hypothesis, we chronically exposed rats to nicotine delivered orally for 21-31 days. Chronic nicotine produced a steady membrane depolarization of ∼3 mV in the diaphragm muscle, which resulted from a net change in electrogenic transport by the Na,K-ATPase α2 and α1 isoforms. Electrogenic transport by the α2 isoform increased (+1.8 mV while the activity of the α1 isoform decreased (-4.4 mV. Protein expression of Na,K-ATPase α1 or α2 isoforms and the nAChR did not change; however, the content of α2 subunit in the plasma membrane decreased by 25%, indicating that its stimulated electrogenic transport is due to an increase in specific activity. The physical association between the nAChR, the Na,K-ATPase α1 or α2 subunits, and the regulatory subunit of the Na,K-ATPase, phospholemman (PLM, measured by co-immuno precipitation, was stable and unchanged. Chronic nicotine treatment activated PKCα/β2 and PKCδ and was accompanied by parallel increases in PLM phosphorylation at Ser(63 and Ser(68. Collectively, these results demonstrate that nicotine at chronic doses, acting through the nAChR-Na,K-ATPase complex, is able to modulate Na,K-ATPase activity in an isoform-specific manner and that the regulatory range includes both stimulation and inhibition of enzyme activity. Cholinergic modulation of Na,K-ATPase activity is achieved, in part, through activation of PKC and phosphorylation of PLM.

  4. Eccentric Ergometer Training Promotes Locomotor Muscle Strength but Not Mitochondrial Adaptation in Patients with Severe Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    MacMillan, Norah J; Kapchinsky, Sophia; Konokhova, Yana; Gouspillou, Gilles; de Sousa Sena, Riany; Jagoe, R Thomas; Baril, Jacinthe; Carver, Tamara E; Andersen, Ross E; Richard, Ruddy; Perrault, Hélène; Bourbeau, Jean; Hepple, Russell T; Taivassalo, Tanja

    2017-01-01

    Eccentric ergometer training (EET) is increasingly being proposed as a therapeutic strategy to improve skeletal muscle strength in various cardiorespiratory diseases, due to the principle that lengthening muscle actions lead to high force-generating capacity at low cardiopulmonary load. One clinical population that may particularly benefit from this strategy is chronic obstructive pulmonary disease (COPD), as ventilatory constraints and locomotor muscle dysfunction often limit efficacy of conventional exercise rehabilitation in patients with severe disease. While the feasibility of EET for COPD has been established, the nature and extent of adaptation within COPD muscle is unknown. The aim of this study was therefore to characterize the locomotor muscle adaptations to EET in patients with severe COPD, and compare them with adaptations gained through conventional concentric ergometer training (CET). Male patients were randomized to either EET (n = 8) or CET (n = 7) for 10 weeks and matched for heart rate intensity. EET patients trained on average at a workload that was three times that of CET, at a lower perception of leg fatigue and dyspnea. EET led to increases in isometric peak strength and relative thigh mass (p hypertrophy, as morphometric analysis of muscle biopsies showed no increase in mean fiber cross-sectional area (p = 0.82), with variability in the direction and magnitude of fiber-type responses (20% increase in Type 1, p = 0.18; 4% decrease in Type 2a, p = 0.37) compared to CET (26% increase in Type 1, p = 0.04; 15% increase in Type 2a, p = 0.09). EET had no impact on mitochondrial adaptation, as revealed by lack of change in markers of mitochondrial biogenesis, content and respiration, which contrasted to improvements (p hypertrophy and associated underlying molecular signaling pathways in COPD locomotor muscle, our findings promote the implementation of this strategy to improve muscle strength. Furthermore, contrasting mitochondrial adaptations

  5. Deoxygenated hemoglobin/myoglobin kinetics of forearm muscles from rest to exercise in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Kutsuzawa, Tomoko; Shioya, Sumie; Kurita, Daisaku; Haida, Munetaka

    2009-01-01

    Exercise capacity is frequently decreased in patients with chronic obstructive pulmonary disease (COPD), and muscle dysfunction is one factor in this reduction. Studies using (31)-phosphorus magnetic resonance spectroscopy ((31)P-MRS) have shown that phosphocreatine (PCr) and muscle pH (pHi) are significantly decreased in patients with COPD during mild exercise, suggesting the early activation of anaerobic glycolysis in their muscles. Thus, muscle oxygenation states during exercise might differ between patients with COPD and healthy individuals. We simultaneously measured oxygenation state and pHi in the muscles of patients with COPD during the transition from rest to exercise (on-transition) using near infrared spectroscopy (NIRS) and (31)P-MRS. Sixteen patients with COPD (aged 68.6 +/- 7.5 years) and 7 healthy males (controls; aged 63.3 +/- 7.5 years) performed dynamic handgrip exercise (lifting a weight by gripping at a rate of 20 grips per min for 3 min). Patients were classified based on pHi data at the completion of exercise as having a normal (>or= 6.9; n = 8) or a low (< 6.9; n = 8) pHi. The deoxygenated hemoglobin/myoglobin (deoxy-Hb/Mb) in NIRS recordings remained constant or slightly decreased initially (time delay), then increased to reach a plateau. We calculated the time delay and the time constant of deoxy-Hb/Mb kinetics during the on-transition. The time delay was shorter in the group with a low pHi than in the controls. These findings might reflect a slower increase in O(2) delivery in patients with a low pHi, which might partly account for altered muscle energy metabolism.

  6. The effect of pelvic floor muscle exercise on women with chronic non-specific low back pain.

    Science.gov (United States)

    Mohseni-Bandpei, Mohammad A; Rahmani, Nahid; Behtash, Hamid; Karimloo, Masoud

    2011-01-01

    Dysfunction of spinal stability seems to be one of the causes of low back pain (LBP). It is thought that a large number of muscles have a role in spinal stability including the pelvic floor muscle (PFM). The purpose of this study was to investigate the effect of PFM exercise in the treatment of chronic LBP. After ethical approval, a randomized controlled clinical trial was carried out on 20 women with chronic LBP. Patients were randomly allocated into two groups: an experimental and a control group. The control group was given routine treatment including electrotherapy and general exercises; and the experimental group received routine treatment and additional PFM exercise. Pain intensity, functional disability and PFM strength and endurance were measured before, immediately after intervention and at 3 months follow-up. In both groups pain and functional disability were significantly reduced following treatment (p0.05). All measurements were improved in both groups (p<0.01) although patients in the experimental group showed greater improvement in PFM strength and endurance (p<0.01). It seems that the PFM exercise combined with routine treatment was not superior to routine treatment alone in patients with chronic LBP.

  7. Individuals with chronic low back pain demonstrate delayed onset of the back muscle activity during prone hip extension.

    Science.gov (United States)

    Suehiro, Tadanobu; Mizutani, Masatoshi; Ishida, Hiroshi; Kobara, Kenichi; Osaka, Hiroshi; Watanabe, Susumu

    2015-08-01

    Prone hip extension (PHE) is commonly used in the evaluation of the stability of the lumbopelvic region. There is little evidence of difference in muscle activity onset timing between healthy individuals and individuals with chronic low back pain (CLBP) during PHE. The purpose of this study was to determine if individuals with and without CLBP differ in the onset time of the trunk and hip extensor muscles activity during PHE. The participants were 20 patients with CLBP and 20 healthy individuals. Electromyography data of the erector spinae, multifidus, gluteus maximus, and semitendinosus were collected during PHE using a surface electromyograph. Relative differences in the onset times between each muscle and the prime mover (i.e., the semitendinosus) were calculated. The onsets of the bilateral multifidus and contralateral erector spinae were significantly delayed in the CLBP group compared with the healthy group (pleg movement not being significantly different between the groups. The onset times of the gluteus maximus and ipsilateral erector spinae showed no significant differences between the groups. These results suggest that individuals with CLBP use an altered, and possibly inadequate, trunk muscle recruitment pattern.

  8. The anatomy and ontogeny of the head, neck, pectoral, and upper limb muscles of Lemur catta and Propithecus coquereli (primates): discussion on the parallelism between ontogeny and phylogeny and implications for evolutionary and developmental biology.

    Science.gov (United States)

    Diogo, Rui; Molnar, Julia L; Smith, Timothy D

    2014-08-01

    Most anatomical studies of primates focus on skeletal tissues, but muscular anatomy can provide valuable information about phylogeny, functional specializations, and evolution. Herein, we present the first detailed description of the head, neck, pectoral, and upper limb muscles of the fetal lemuriforms Lemur catta (Lemuridae) and Propithecus coquereli (Indriidae). These two species belong to the suborder Strepsirrhini, which is often presumed to possess some plesiomorphic anatomical features within primates. We compare the muscular anatomy of the fetuses with that of infants and adults and discuss the evolutionary and developmental implications. The fetal anatomy reflects a phylogenetically more plesiomorphic condition in nine of the muscles we studied and a more derived condition in only two, supporting a parallel between ontogeny and phylogeny. The derived exceptions concern muscles with additional insertions in the fetus which are lost in adults of the same species, that is, flexor carpi radialis inserts on metacarpal III and levator claviculae inserts on the clavicle. Interestingly, these two muscles are involved in movements of the pectoral girdle and upper limb, which are mainly important for activities in later stages of life, such as locomotion and prey capture, rather than activities in fetal life. Accordingly, our findings suggest that some exceptions to the "ontogeny parallels phylogeny" rule are probably driven more by ontogenetic constraints than by adaptive plasticity.

  9. Muscle Water and Electrolyte Balance During Chronic Exposure and Work in the Heat,

    Science.gov (United States)

    1985-05-31

    lack of substrate for the flux generating step of glycogenolysis . It is interesting to note that muscle glycogen approached this level (46.6 mmol/kg...E.A., N.B. Ruderman, H. Gavras, E. Belur, and H. Galbo. Muscle glycogenolysis during exercise: Dual e. control by epinepherine and contractions. Am

  10. [Effect of methylphenidatum on inspiratory muscles function in patients with chronic obstructive pulmonary disease and its mechanism].

    Science.gov (United States)

    Wang, Y; Luo, Y; Chen, W; Yuan, Y; He, T; Zeng, J

    1997-03-01

    To have a better understanding of the effect of methylphenidatum on inspiratory muscles function, we studied the respiratory force parameters of 70 patients with chronic obstructive pulmonary disease by intravenous infusion methylphenidatum in a randomized controlled clinical trial. The indices of respiratory force parameter included maximal inspiratory mouth pressure (MIP), maximal midinspiratory flow (MMIF), forced inspiratory capacity (FIC), maximal works of inspiration (Wimax) and airway occlusion pressure (P0.1), etc. Aminophylline and Nikethamidi were chosen as controls. The results showed that MIP, MMIF, FIC, Wimax, P0.1 and minute ventilation (Vr) were significantly increased after administration of methylphenidatum and aminophylline. There were no significant differences in MIP, MMIF, FIC and Wimax after administration of Nikethamidi, but P0.1 was significantly increased and the increase was higher than that after administration of methylphenidatum and aminophylline groups. We conclude that methylphenidatum can significantly improve the function of inspiratory muscles as aminophylline can do.

  11. Maximal oxygen uptake is proportional to muscle fiber oxidative capacity, from chronic heart failure patients to professional cyclists.

    Science.gov (United States)

    van der Zwaard, Stephan; de Ruiter, C Jo; Noordhof, Dionne A; Sterrenburg, Renske; Bloemers, Frank W; de Koning, Jos J; Jaspers, Richard T; van der Laarse, Willem J

    2016-09-01

    V̇o2 max during whole body exercise is presumably constrained by oxygen delivery to mitochondria rather than by mitochondria's ability to consume oxygen. Humans and animals have been reported to exploit only 60-80% of their mitochondrial oxidative capacity at maximal oxygen uptake (V̇o2 max). However, ex vivo quantification of mitochondrial overcapacity is complicated by isolation or permeabilization procedures. An alternative method for estimating mitochondrial oxidative capacity is via enzyme histochemical quantification of succinate dehydrogenase (SDH) activity. We determined to what extent V̇o2 max attained during cycling exercise differs from mitochondrial oxidative capacity predicted from SDH activity of vastus lateralis muscle in chronic heart failure patients, healthy controls, and cyclists. V̇o2 max was assessed in 20 healthy subjects and 28 cyclists, and SDH activity was determined from biopsy cryosections of vastus lateralis using quantitative histochemistry. Similar data from our laboratory of 14 chronic heart failure patients and 6 controls were included. Mitochondrial oxidative capacity was predicted from SDH activity using estimated skeletal muscle mass and the relationship between ex vivo fiber V̇o2 max and SDH activity of isolated single muscle fibers and myocardial trabecula under hyperoxic conditions. Mitochondrial oxidative capacity predicted from SDH activity was related (r(2) = 0.89, P < 0.001) to V̇o2 max measured during cycling in subjects with V̇o2 max ranging from 9.8 to 79.0 ml·kg(-1)·min(-1) V̇o2 max measured during cycling was on average 90 ± 14% of mitochondrial oxidative capacity. We conclude that human V̇o2 max is related to mitochondrial oxidative capacity predicted from skeletal muscle SDH activity. Mitochondrial oxidative capacity is likely marginally limited by oxygen supply to mitochondria.

  12. Protocol for Shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mortensen Ole S

    2011-01-01

    Full Text Available Abstract Background Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Such musculoskeletal pain - which is often associated with restricted range of motion and loss of muscle strength - is one of the most common conditions treated by physical therapists. The exact mechanism of neck pain is rarely revealed by clinical examination and the treatment has varied from passive rest to active treatments. Active treatments have often been divided into either training of the painful area or the surrounding musculature avoiding direct training of the painful area. Our study investigates the effect of the latter approach. Methods/Design A randomized controlled trial of 10 weeks duration is currently being conducted. Employed office workers with severe neck-shoulder pain are randomized to 3 × 20 min shoulder function training with training supervision or to a reference group receiving advice to stay physically active. Shoulder function training primarily focuses on the serratus anterior and lower trapezius muscle with only minimal activation the upper trapezius. An announcement was sent to the administrative section of the university including jobs characterized by intensive computer work. The first 100 positive replies entered the study. Among these inclusion criteria were pain intensity in the neck/shoulder of at least 3 on a 0-9 scale. Exclusion criteria were cardiovascular disease, trauma, hypertension, or serious chronic disease. Before and after the intervention period the participants replied to a questionnaire about musculoskeletal disorders and work disability, and underwent a standardized clinical examination of the neck and shoulder girdle. Further, on a weekly basis the participants log pain intensity of the neck and shoulder during the previous week. The primary outcome measure is pain in the neck and shoulders at week 10 based on the weekly pain registration and results

  13. Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: from sarcopenic obesity to cachexia.

    Science.gov (United States)

    Biolo, Gianni; Cederholm, Tommy; Muscaritoli, Maurizio

    2014-10-01

    Skeletal muscle is the most abundant body tissue accounting for many physiological functions. However, muscle mass and functions are not routinely assessed. Sarcopenia is defined as skeletal muscle loss and dysfunction in aging and chronic diseases. Inactivity, inflammation, age-related factors, anorexia and unbalanced nutrition affect changes in skeletal muscle. Mechanisms are difficult to distinguish in individual subjects due to the multifactorial character of the condition. Sarcopenia includes both muscle loss and dysfunction which induce contractile impairment and metabolic and endocrine abnormalities, affecting whole-body metabolism and immune/inflammatory response. There are different metabolic trajectories for muscle loss versus fat changes in aging and chronic diseases. Appetite regulation and physical activity affect energy balance and changes in body fat mass. Appetite regulation by inflammatory mediators is poorly understood. In some patients, inflammation induces anorexia and fat loss in combination with sarcopenia. In others, appetite is maintained, despite activation of systemic inflammation, leading to sarcopenia with normal or increased BMI. Inactivity contributes to sarcopenia and increased fat tissue in aging and diseases. At the end of the metabolic trajectories, cachexia and sarcopenic obesity are paradigms of the two patient categories. Pre-cachexia and cachexia are observed in patients with cancer, chronic heart failure or liver cirrhosis. Sarcopenic obesity and sarcopenia with normal/increased BMI are observed in rheumatoid arthritis, breast cancer patients with adjuvant chemotherapy and in most of patients with COPD or chronic kidney disease. In these conditions, sarcopenia is a powerful prognostic factor for morbidity and mortality, independent of BMI.

  14. [Spinal accessory nerve and lymphatic neck dissection].

    Science.gov (United States)

    Pinsolle, V; Michelet, V; Majoufre, C; Caix, P; Siberchicot, F; Pinsolle, J

    1997-09-01

    Radical neck dissection was the golden standard of treatment for cervical nodes in head and neck tumors. From the seventies, the preservation of the spinal accessory nerve has become increasingly popular in order to improve the functional result of the neck dissections. The aim of this study was to assess the degree of functional disability associated with each type of neck dissection and the value of anatomical references for dissection of the spinal accessory nerve. One hundred twenty seven patients were evaluated 1 month and 1 year after radical, functional or supraomohyoid neck dissection with a questionnaire and a physical examination. Anatomical measurements of the spinal accessory nerve were performed in 20 patients. We found considerable or severe shoulder dysfunction in 7%, 34% and 51% respectively of patients in whom supraomohyoid, functional and radical neck dissections were performed. Furthermore 49% of patients having undergone a radical neck dissection had little or no symptoms. Sacrifice of the spinal accessory nerve in radical neck dissection may lead to shoulder dysfunction. A functional disability may also be associated, although in a less extent, with any neck dissection in which the spinal accessory nerve is dissected and placed in traction. There is a large variation in the degree of functional disability and pain in patients with similar neck dissections. The course of the spinal accessory nerve in the neck makes it particularly vulnerable to injury during the dissection near the sternocleidomastoid muscle and in the posterior cervical triangle.

  15. 肌肉疲劳与慢性腰痛研究进展%Research Progress of Muscle Fatigue and Chronic Low Back Pain

    Institute of Scientific and Technical Information of China (English)

    唐能章; 陈少清; 林建平; 王诗忠

    2015-01-01

    慢性腰痛是骨科及康复学科常见的肌肉骨骼疾病,有关肌肉疲劳的研究有助于认识慢性腰痛的发病机制.腰部肌肉长期处于疲劳状态可导致慢性损伤,易疲劳性增加,肌肉耐力下降,最终可能导致腰痛.目前多采用表面肌电图研究慢性腰痛患者腰部肌肉功能的改变及慢性腰痛与肌肉疲劳之间的关系.%Chronic low back pain is a kind of common musculoskeletal disease in orthopedics department and rehabilitation subject, related study of muscle fatigue is helpful to understand pathogenesis of chronic low back pain. The long-term fatigue of waist muscles can lead to chronic injury, in-creasing fatigue and decreasing muscle endurance, which may eventually bring about low back pain. Surface electromyography is used to study the waist muscle function changes of patients with chronic low back pain and the relationship between chronic low back pain and muscle fatigue at pres-ent.

  16. Skeletal muscle contractility, self-reported pain and tissue sensitivity in females with neck/shoulder pain and upper Trapezius myofascial trigger points - a randomized intervention study

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Hartvigsen, Jan; Aagaard, Per

    2012-01-01

    ABSTRACT: BACKGROUND: In relation to Myofascial Triggerpoints (MFTrPs) of the upper Trapezius, this study explored muscle contractility characteristics, the occurrence of post-intervention muscle soreness and the effect of dry needling on muscle contractile characteristics and clinical outcomes......-intervention and 48 hours post-intervention. Symptomatic and asymptomatic participant groups were each randomized into two treatment sub-groups (superficial (SDN) and deep dry needling (DDN)) after baseline testing. At 48 hours post-intervention participants were asked whether delayed onset muscle soreness (DOMS) and....../or post-needling soreness had developed. RESULTS: Muscle contractile characteristics did not differ between groups at baseline. Forty-six individuals developed muscle soreness (39 from mechanical testing and seven from needling). No inter-group differences were observed post-intervention for Fmax or RFD...

  17. Essential Amino Acids and Exercise Tolerance in Elderly Muscle-Depleted Subjects with Chronic Diseases: A Rehabilitation without Rehabilitation?

    Directory of Open Access Journals (Sweden)

    Roberto Aquilani

    2014-01-01

    Full Text Available Exercise intolerance remains problematic in subjects with chronic heart failure (CHF and/or chronic obstructive pulmonary disease (COPD. Recent studies show that supplemented essential amino acids (EAAs may exert beneficial effects on CHF/COPD physical capacity. The results from 3 investigations (2 conducted on CHF and 1 on COPD subjects served as the basis for this paper. The 3 studies consistently showed that elderly CHF and COPD improved exercise intolerance after 1–3 months of EAA supplementation (8 g/d. In CHF exercise capacity increased 18.7% to 23% (watts; bicycle test, and 12% to 22% (meters in 6 min walking test. Moreover, patients reduced their resting plasma lactate levels (by 25% and improved tissue insulin sensitivity by 16% (HOMA index. COPD subjects enjoyed similar benefits as CHF ones. They increased physical autonomy by 78.6% steps/day and decreased resting plasma lactate concentrations by 23%. EAA mechanisms explaining improved exercise intolerance could be increases in muscle aerobic metabolism, mass and function, and improvement of tissue insulin sensitivity (the latter only for the CHF population. These mechanisms could be accounted for by EAA’s intrinsic physiological activity which increases myofibrils and mitochondria genesis in skeletal muscle and myocardium and glucose control. Supplemented EAAs can improve the physical autonomy of subjects with CHF/COPD.

  18. Essential Amino Acids and Exercise Tolerance in Elderly Muscle-Depleted Subjects with Chronic Diseases: A Rehabilitation without Rehabilitation?

    Science.gov (United States)

    Aquilani, Roberto; D'Antona, Giuseppe; Baiardi, Paola; Iadarola, Paolo; Pasini, Evasio; Barbieri, Annalisa

    2014-01-01

    Exercise intolerance remains problematic in subjects with chronic heart failure (CHF) and/or chronic obstructive pulmonary disease (COPD). Recent studies show that supplemented essential amino acids (EAAs) may exert beneficial effects on CHF/COPD physical capacity. The results from 3 investigations (2 conducted on CHF and 1 on COPD subjects) served as the basis for this paper. The 3 studies consistently showed that elderly CHF and COPD improved exercise intolerance after 1–3 months of EAA supplementation (8 g/d). In CHF exercise capacity increased 18.7% to 23% (watts; bicycle test), and 12% to 22% (meters) in 6 min walking test. Moreover, patients reduced their resting plasma lactate levels (by 25%) and improved tissue insulin sensitivity by 16% (HOMA index). COPD subjects enjoyed similar benefits as CHF ones. They increased physical autonomy by 78.6% steps/day and decreased resting plasma lactate concentrations by 23%. EAA mechanisms explaining improved exercise intolerance could be increases in muscle aerobic metabolism, mass and function, and improvement of tissue insulin sensitivity (the latter only for the CHF population). These mechanisms could be accounted for by EAA's intrinsic physiological activity which increases myofibrils and mitochondria genesis in skeletal muscle and myocardium and glucose control. Supplemented EAAs can improve the physical autonomy of subjects with CHF/COPD. PMID:25009815

  19. Non-muscle myosin as target antigen for human autoantibodies in patients with hepatitis C virus-associated chronic liver diseases.

    Science.gov (United States)

    von Mühlen, C A; Chan, E K; Peebles, C L; Imai, H; Kiyosawa, K; Tan, E M

    1995-04-01

    Three patients with hepatitis C virus (HCV)-related chronic liver disease were shown to have autoantibodies strongly reacting with cytoskeletal fibres of non-muscle cells. The heavy chain of non-muscle myosin microfilament was the main target for those autoantibodies, as determined by (i) cell and tissue immunofluorescence studies showing colocalization with an anti-myosin antibody prototype; (ii) primary reactivity in immunoblotting with a 200-kD protein, using either MOLT-4 cells, human platelets, or affinity-purified non-muscle myosin as antigen extract; and (iii) immunoblotting of similar immunoreactive fragments in papain-digested MOLT-4 cell extracts, by using those human sera and antibody prototype. Autoantibodies to non-muscle myosin heavy chain were not previously reported in patients with chronic liver diseases, especially in those associated with HCV infection.

  20. Acute cold- and chronic heat-exposure upregulate hepatic leptin and muscle uncoupling protein (UCP) gene expression in broiler chickens.

    Science.gov (United States)

    Dridi, Sami; Temim, Soraya; Derouet, Michel; Tesseraud, Sophie; Taouis, Mohammed

    2008-08-01

    Emerging evidence showed that variations in environmental temperature affect both leptin and uncoupling protein (UCP) gene expression in mammals, whereas a little is known about such interactions in birds. Thus, we conducted the present study to investigate the influence of acute (2 hours) cold (4 degrees C) and chronic (10 days) heat (32 degrees C) exposure on hepatic leptin and muscle UCP gene expression in 5-wk-old broiler chickens. Both cold- and heat-exposure significantly (P < 0.05 to P < 0.001) upregulated hepatic leptin (by 35 and 46%, respectively) and muscle UCP mRNA levels (by 71 and 71%, respectively) compared to the thermoneutrality (22 degrees C). This result suggests that leptin and UCP may be involved in the thermoregulation response of chickens to extreme climate (cold and hot temperatures). The upregulation of hepatic leptin gene expression was accompanied by an increase in plasma leptin levels, indicating that leptin may be regulated at transcriptional level. The increase of leptin and UCP mRNA abundance, and leptinemia we report here were not related to plasma glucose or insulin levels. In conclusion, the exposure of broiler chickens to extreme ambient temperatures (cold and heat) increases hepatic leptin and muscle UCP gene expression.

  1. Electrical stimulation of skeletal muscles. An alternative to aerobic exercise training in patients with chronic heart failure?

    Science.gov (United States)

    Dobsák, Petr; Nováková, Marie; Fiser, Bohumil; Siegelová, Jarmila; Balcárková, Pavla; Spinarová, Lenka; Vítovec, Jirí; Minami, Naoyoshi; Nagasaka, Makoto; Kohzuki, Masahiro; Yambe, Tomoyuki; Imachi, Kou; Nitta, Shin-ichi; Eicher, Jean-Christophe; Wolf, Jean-Eric

    2006-05-01

    The aim of this study was to investigate whether electrical stimulation of skeletal muscles could represent a rehabilitation alternative for patients with chronic heart failure (CHF). Thirty patients with CHF and NYHA class II-III were randomly assigned to a rehabilitation program using either electrical stimulation of skeletal muscles or bicycle training. Patients in the first group (n = 15) had 8 weeks of home-based low-frequency electrical stimulation (LFES) applied simultaneously to the quadriceps and calf muscles of both legs (1 h/day for 7 days/week); patients in the second group (n = 15) underwent 8 weeks of 40 minute aerobic exercise (3 times a week). After the 8-week period significant increases in several functional parameters were observed in both groups: maximal VO2 uptake (LFES group: from 17.5 +/- 4.4 mL/kg/min to 18.3 +/- 4.2 mL/kg/min, P bicycle group: from 18.1 +/- 3.9 mL/kg/min to 19.3 +/- 4.1 mL/kg/min, P bicycle group: from 91.2 +/- 13.4 W to 112.9 +/- 10.8 W, P bicycle group: from 425 +/- 118 m to 483 +/- 120 m, P bicycle group: from 510 +/- 90 seconds to 611 +/- 112 seconds, P electrical stimulation. LFES should be considered as a valuable alternative to classical exercise training in patients with CHF.

  2. Strength training's chronic effects on muscle architecture parameters of different arm sites.

    Science.gov (United States)

    Matta, Thiago; Simão, Roberto; de Salles, Belmiro Freitas; Spineti, Juliano; Oliveira, Liliam Fernandes

    2011-06-01

    Strength training generates alterations in muscle geometry, which can be monitored by imaging techniques as, for example, the ultrasound (US) technique. There is no consensus about the homogeneity of hypertrophy in different muscle sites. Therefore, the purpose of this study was to compare the muscle thickness (MT) and pennation angle (PA) in 3 different sites (50, 60, and 70% of arm length) of the biceps brachii and triceps brachii after 12 weeks of strength training. Forty-nine healthy untrained men were divided into 2 groups: Training Group ([TG, n = 40] 29.90 ± 1.72 years; 79.53 ± 11.84 kg; 173 ± 0.6 cm) and Control Group (n = 9 25.89 ± 3.59 years; 73.96 ± 9.86 kg; 171 ± 6 cm). The TG underwent a strength training program during 12 weeks, which included exercises such as a free-weight bench press, machine lat pull-down, triceps extension in lat pull-down, and standing free-weight biceps curl with a straight bar. A US apparatus was used to measure the PA and MT at the 3 sites. The maximal voluntary isometric contraction (MVC) test was conducted for each muscle group. After 12 weeks of training, a significant difference was observed between MT in biceps brachii, with an improvement of 12% in the proximal site, whereas the distal site increased by only 4.7% (p MVC increased significantly for both muscle groups. The results indicated that the strength training program was efficient in promoting hypertrophy in both muscles, but with dissimilar responses of the pennated and fusiform muscle architecture at different arm sites.

  3. A 66-year-old man with neck pain.

    Science.gov (United States)

    Jaynstein, Dayna

    2017-03-01

    Neck pain is a fairly common complaint among patients in the ED. The differential diagnosis is broad, from musculoskeletal causes to potentially life-threatening causes. Providers need to have a good understanding of when the complaint of neck pain requires more diagnostic investigation, even in a patient with chronic neck pain.

  4. Chronic heat exposure alters protein turnover of three different skeletal muscles in finishing broiler chickens fed 20 or 25% protein diets.

    Science.gov (United States)

    Temim, S; Chagneau, A M; Peresson, R; Tesseraud, S

    2000-04-01

    Heat-exposed chickens exhibit a lower growth rate and a depressed protein retention which may result from an alteration in protein metabolism. A high-protein diet seems to be beneficial under hot conditions because it tends to improve growth. Effects of high ambient temperature (32 vs. 22 degrees C) and dietary crude protein (25 vs. 20%) on muscle protein turnover were investigated in finishing broiler chickens. At 5-6 wk of age, protein synthesis was measured in vivo in the Pectoralis major, Sartorius and Gastrocnemius muscles (flooding dose of [(3)H]-phenylalanine). Protein breakdown was determined in the same muscles as the difference between protein synthesis and deposition. Chronic heat stress markedly reduced protein synthesis, irrespective of muscle type (P < 0.05). This was mainly related to the lower capacity for protein synthesis (muscle RNA/Protein) (P < 0.01). Chronic heat exposure also decreased protein breakdown in the P. major and Sartorius; this effect was not observed in the GASTROCNEMIUS: Protein synthesis was more affected than breakdown, leading to reduced protein deposition, at least in the P. major and Gastrocnemius muscles. Increasing dietary protein content had no significant impact on muscle protein turnover. Particularly at 32 degrees C, the high-protein diet did not significantly modify either protein synthesis, ribosomal capacity or translational efficiency. However, it favored muscle protein deposition, which was probably related to reduced proteolysis. In conclusion, we showed that chronic heat exposure decreased muscle protein deposition, mainly by reducing protein synthesis. Under these conditions, the impaired protein synthesis was not restored by a 5% higher protein intake.

  5. High-intensity strength training improves function of chronically painful muscles

    DEFF Research Database (Denmark)

    Andersen, Lars L; Andersen, Christoffer H; Skotte, Jørgen H

    2014-01-01

    randomized to 10 weeks of specific strength training (SST, n = 18), general fitness training (GFT, n = 16), or a reference group without physical training (REF, n = 8). Participants performed tests of 100 consecutive cycles of 2 s isometric maximal voluntary contractions (MVC) of shoulder elevation followed...... by 2 s relaxation at baseline and 10-week follow-up. RESULTS: In the case-control study, peak force, rate of force development, and rate of force relaxation as well as EMG amplitude were lower in MYA than CON throughout all 100 MVC. Muscle fiber capillarization was not significantly different between...... capacity during repetitive MVC of the trapezius muscle than healthy controls. High-intensity strength training effectively improves strength capacity during repetitive MVC of the painful trapezius muscle....

  6. Age-dependent Muscle Adaptation after Chronic Stretch-shortening Contractions in Rats.

    Science.gov (United States)

    Rader, Erik P; Layner, KaylaN; Triscuit, Alyssa M; Chetlin, Robert D; Ensey, James; Baker, Brent A

    2016-01-01

    Age-related differences in contraction-induced adaptation have been well characterized especially for young and old rodent models but much less so at intermediate ages. Therefore, additional research is warranted to determine to what extent alterations in adaptation are due to maturation versus aging per se. The purpose of our study was to evaluate muscles of Fisher 344XBrown Norway rats of various ages following one month of exposure to stretch-shortening contractions (SSCs). With exposure, muscles mass increased by ~10% for 27 and 30 month old rats vs. ~20% for 3 and 6 month old rats (P muscle performance in general beginning at late adulthood. Such findings motivate careful investigation to determine appropriate SSC exposures at all stages of life.

  7. Chronic hindlimb suspension unloading markedly decreases turnover rates of skeletal and cardiac muscle proteins and adipose tissue triglycerides.

    Science.gov (United States)

    Bederman, Ilya R; Lai, Nicola; Shuster, Jeffrey; Henderson, Leigh; Ewart, Steven; Cabrera, Marco E

    2015-07-01

    We previously showed that a single bolus of "doubly-labeled" water ((2)H2 (18)O) can be used to simultaneously determine energy expenditure and turnover rates (synthesis and degradation) of tissue-specific lipids and proteins by modeling labeling patterns of protein-bound alanine and triglyceride-bound glycerol (Bederman IR, Dufner DA, Alexander JC, Previs SF. Am J Physiol Endocrinol Metab 290: E1048-E1056, 2006). Using this novel method, we quantified changes in the whole body and tissue-specific energy balance in a rat model of simulated "microgravity" induced by hindlimb suspension unloading (HSU). After chronic HSU (3 wk), rats exhibited marked atrophy of skeletal and cardiac muscles and significant decrease in adipose tissue mass. For example, soleus muscle mass progressively decreased 11, 43, and 52%. We found similar energy expenditure between control (90 ± 3 kcal · kg(-1)· day(-1)) and hindlimb suspended (81 ± 6 kcal/kg day) animals. By comparing food intake (∼ 112 kcal · kg(-1) · day(-1)) and expenditure, we found that animals maintained positive calorie balance proportional to their body weight. From multicompartmental fitting of (2)H-labeling patterns, we found significantly (P triglycerides. Specifically, we found that synthesis rates of skeletal and cardiac muscle proteins were affected to a much greater degree compared with the decrease in degradation rates, resulting in large negative balance and significant tissue loss. In contrast, we found a small decrease in adipose tissue triglyceride synthesis paired with a large decrease in degradation, resulting in smaller negative energy balance and loss of fat mass. We conclude that HSU in rats differentially affects turnover of muscle proteins vs. adipose tissue triglycerides.

  8. Effects of exercise training on atrophy gene expression in skeletal muscle of mice with chronic allergic lung inflammation

    Directory of Open Access Journals (Sweden)

    J.L.Q. Durigan

    2009-04-01

    Full Text Available We evaluated the effects of chronic allergic airway inflammation and of treadmill training (12 weeks of low and moderate intensity on muscle fiber cross-sectional area and mRNA levels of atrogin-1 and MuRF1 in the mouse tibialis anterior muscle. Six 4-month-old male BALB/c mice (28.5 ± 0.8 g per group were examined: 1 control, non-sensitized and non-trained (C; 2 ovalbumin sensitized (OA, 20 µg per mouse; 3 non-sensitized and trained at 50% maximum speed _ low intensity (PT50%; 4 non-sensitized and trained at 75% maximum speed _ moderate intensity (PT75%; 5 OA-sensitized and trained at 50% (OA+PT50%, 6 OA-sensitized and trained at 75% (OA+PT75%. There was no difference in muscle fiber cross-sectional area among groups and no difference in atrogin-1 and MuRF1 expression between C and OA groups. All exercised groups showed significantly decreased expression of atrogin-1 compared to C (1.01 ± 0.2-fold: PT50% = 0.71 ± 0.12-fold; OA+PT50% = 0.74 ± 0.03-fold; PT75% = 0.71 ± 0.09-fold; OA+PT75% = 0.74 ± 0.09-fold. Similarly significant results were obtained regarding MuRF1 gene expression compared to C (1.01 ± 0.23-fold: PT50% = 0.53 ± 0.20-fold; OA+PT50% = 0.55 ± 0.11-fold; PT75% = 0.35 ± 0.15-fold; OA+PT75% = 0.37 ± 0.08-fold. A short period of OA did not induce skeletal muscle atrophy in the mouse tibialis anterior muscle and aerobic training at low and moderate intensity negatively regulates the atrophy pathway in skeletal muscle of healthy mice or mice with allergic lung inflammation.

  9. The role of exercise-induced myokines in muscle homeostasis and the defense against chronic diseases

    DEFF Research Database (Denmark)

    Brandt, Claus; Pedersen, Bente K

    2010-01-01

    Chronic inflammation is involved in the pathogenesis of insulin resistance, atherosclerosis, neurodegeneration, and tumour growth. Regular exercise offers protection against type 2 diabetes, cardiovascular diseases, colon cancer, breast cancer, and dementia. Evidence suggests that the protective...

  10. Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

    OpenAIRE

    2016-01-01

    Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report...

  11. The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain - a randomised controlled pilot study

    OpenAIRE

    2011-01-01

    Abstract Background In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated. Methods Fifty patients (50.5 ± 11.9 years) were randomised to a treatment group (TG) or a waiting-list control group (WL). Patients in the TG received a series of 5 cupping treatments ...

  12. [Myofascial pain syndrome--fascial muscle pain].

    Science.gov (United States)

    Partanen, Juhani; Ojala, Tuula; Arokoski, Jari P A

    2010-01-01

    Symptoms of myofascial pain syndrome, i.e. fascial muscle pain may occur in several areas of the body, particularly in the neck-shoulder region. The muscle pain symptom in the neck-shoulder region is commonly termed tension neck pain or nonspecific neck pain, but myofascial pain syndrome can also be distinguished into its own diagnosis. This review deals with the clinical picture of myofascial pain syndrome along with pathophysiological hypotheses and treatment options.

  13. Connective tissue cells expressing fibro/adipogenic progenitor markers increase under chronic damage: relevance in fibroblast-myofibroblast differentiation and skeletal muscle fibrosis.

    Science.gov (United States)

    Contreras, Osvaldo; Rebolledo, Daniela L; Oyarzún, Juan Esteban; Olguín, Hugo C; Brandan, Enrique

    2016-06-01

    Fibrosis occurs in skeletal muscle under various pathophysiological conditions such as Duchenne muscular dystrophy (DMD), a devastating disease characterized by fiber degeneration that results in progressive loss of muscle mass, weakness and increased extracellular matrix (ECM) accumulation. Fibrosis is also observed after skeletal muscle denervation and repeated cycles of damage followed by regeneration. The ECM is synthesized largely by fibroblasts in the muscle connective tissue under normal conditions. Myofibroblasts, cells that express α-smooth muscle actin (α-SMA), play a role in many tissues affected by fibrosis. In skeletal muscle, fibro/adipogenic progenitors (FAPs) that express cell-surface platelet-derived growth factor receptor-α (PDGFR-α) and the transcription factor Tcf4 seem to be responsible for connective tissue synthesis and are good candidates for the origin of myofibroblasts. We show that cells positive for Tcf4 and PDGFR-α are expressed in skeletal muscle under normal conditions and are increased in various skeletal muscles of mdx mice, a murine model for DMD, wild type muscle after sciatic denervation and muscle subjected to chronic damage. These cells co-label with the myofibroblast marker α-SMA in dystrophic muscle but not in normal tissue. The Tcf4-positive cells lie near macrophages mainly concentrated in dystrophic necrotic-regenerating foci. The close proximity of Tcf4-positive cells to inflammatory cells and their previously described role in muscle regeneration might reflect an active interaction between these cell types and growth factors, possibly resulting in a muscular regenerative or fibrotic condition.

  14. Inter-vertebral flexibility of the ostrich neck: implications for estimating sauropod neck flexibility.

    Directory of Open Access Journals (Sweden)

    Matthew J Cobley

    Full Text Available The flexibility and posture of the neck in sauropod dinosaurs has long been contentious. Improved constraints on sauropod neck function will have major implications for what we know of their foraging strategies, ecology and overall biology. Several hypotheses have been proposed, based primarily on osteological data, suggesting different degrees of neck flexibility. This study attempts to assess the effects of reconstructed soft tissues on sauropod neck flexibility through systematic removal of muscle groups and measures of flexibility of the neck in a living analogue, the ostrich (Struthio camelus. The possible effect of cartilage on flexibility is also examined, as this was previously overlooked in osteological estimates of sauropod neck function. These comparisons show that soft tissues are likely to have limited the flexibility of the neck beyond the limits suggested by osteology alone. In addition, the inferred presence of cartilage, and varying the inter-vertebral spacing within the synovial capsule, also affect neck flexibility. One hypothesis proposed that flexibility is constrained by requiring a minimum overlap between successive zygapophyses equivalent to 50% of zygapophyseal articular surface length (ONP50. This assumption is tested by comparing the maximum flexibility of the articulated cervical column in ONP50 and the flexibility of the complete neck with all tissues intact. It is found that this model does not adequately convey the pattern of flexibility in the ostrich neck, suggesting that the ONP50 model may not be useful in determining neck function if considered in isolation from myological and other soft tissue data.

  15. Chronic impairment of leg muscle blood flow following cardiac catheterization in childhood. [/sup 133/Xe clearance measurements

    Energy Technology Data Exchange (ETDEWEB)

    Skovranek, J.; Samanek, M.

    1979-01-01

    In 99 patients with congenital heart defects or chronic respiratory disease without clinical symptoms of disturbances in peripheral circulation, resting and maximal blood flow in the anterior tibial muscle of both extremities were investigated 2.7 yrs (average) after cardiac catheterization. The method used involved /sup 133/Xe clearance. Resting blood flow was normal and no difference could be demonstrated between the extremity originally used for catheterization and the contralateral control extremity. No disturbance in maximal blood flow could be proved in the extremity used for catheterization by the venous route only. Maximal blood flow was significantly lower in that extremity where the femoral artery had been catheterized or cannulated for pressure measurement and blood sampling. The disturbance in maximal flow was shown regardless of whether the arterial catheterization involved the Seldinger percutaneous technique, arteriotomy, or mere cannulation of the femoral artery. The values in the involved extremity did not differ significantly from the values in a healthy population.

  16. Atrophy of sacrospinal muscle groups in patients with chronic, diffusely radiating lumbar back pain

    Energy Technology Data Exchange (ETDEWEB)

    Laasonen, E.M.

    1984-01-01

    After surgery necessitated by lumbar back pain syndromes, radiolucency verified by CT may appear in the sacrospinal muscle group on the operate side. This radiolucency represents muscular atrophy and is in its most severe form a result of the replacement of muscle tissue with adipose tissue. Such muscular atrophy appeared in the present series in 31 out of all 156 patients (19.9%) and in 29 out of 94 patients operated on because of radiating lumbar back pain (30.9%). The radiological appearance, extent, and HU values of this muscular atrophy are presented in detail. Only weak correlations with the multitude of clinical symptoms and signs were found in this retrospective study. The effects of irreversible muscular atrophy on the indications for surgery and physiotherapy are discussed.

  17. Mechanisms underlying enhancements in muscle force and power output during maximal cycle ergometer exercise induced by chronic β2-adrenergic stimulation in men

    DEFF Research Database (Denmark)

    Hostrup, Morten; Kalsen, Anders; Onslev, Johan;

    2015-01-01

    The study was a randomized placebo-controlled trial investigating mechanisms by which chronic β2-adrenergic stimulation enhances muscle force and power output during maximal cycle ergometer exercise in young men. Eighteen trained men were assigned to an experimental group [oral terbutaline 5 mg/3...... that muscle hypertrophy is the primary mechanism underlying enhancements in muscle force and peak power during maximal cycling induced by chronic β2-adrenergic stimulation in humans.......The study was a randomized placebo-controlled trial investigating mechanisms by which chronic β2-adrenergic stimulation enhances muscle force and power output during maximal cycle ergometer exercise in young men. Eighteen trained men were assigned to an experimental group [oral terbutaline 5 mg/30...... kg body weight (bw) twice daily (TER); n = 9] or a control group [placebo (PLA); n = 9] for a 4-wk intervention. No changes were observed with the intervention in PLA. Isometric muscle force of the quadriceps increased (P ≤ 0.01) by 97 ± 29 N (means ± SE) with the intervention in TER compared...

  18. Reduced neck-shoulder muscle strength and aerobic power together with increased pericranial tenderness are associated with tension-type headache in girls

    DEFF Research Database (Denmark)

    Tornoe, Birte; Andersen, Lars L; Skotte, Jørgen H

    2013-01-01

    and pericranial tenderness in girls with TTH compared with healthy controls. METHODS: A blinded case-control study comprising 41 girls with TTH and 41 age-matched healthy controls. Standardised testing of isometric maximal voluntary contraction (MVC) and force steadiness of neck flexion and extension, as well...... as MVC and rate-of-force development of dominant shoulder, was conducted. VO2 max was recorded by a submaximal ergometer test and pericranial tenderness by standardised manual palpation. Logistic regression analyses were applied. RESULTS: Girls with TTH demonstrated significantly higher pericranial...

  19. Differential effects of chronic overload-induced muscle hypertrophy on mTOR and MAPK signaling pathways in adult and aged rats

    Science.gov (United States)

    We examined activation of the mammalian target of rapamycin (mTOR) and mitogen-activated protein kinase (MAPK) signaling pathways in adult (Y; 6 mo old; n = 16) and aged (O; 30 mo old; n = 16) male rats (Fischer 344 x Brown Norway) subjected to chronic overload-induced muscle hypertrophy of the plan...

  20. Effects of chronic renal failure rat serum on histone acetyltransferase p300 and activation of activating transcription factor 4 of arterial smooth muscle cells cultured in vitro

    Institute of Scientific and Technical Information of China (English)

    张耀全

    2014-01-01

    Objective To investigate the effects of the rat serum with chronic renal failure(CRF)on ubiquitin-proteasome pathway,histone acetyltransferase p300 and activation of activating transcription factor 4(ATF4)of rat arterial vascular smooth muscle cells(VSMCs)cultured in vitro,and explore the possible mechanism.Methods Objective To establish the rat model of

  1. Functional evaluation of paratubal muscles using electromyography in patients with chronic unilateral tubal dysfunction.

    Science.gov (United States)

    Chang, Ki-Hong; Jun, Beom-Cho; Jeon, Eun-Ju; Park, Yong-Soo

    2013-03-01

    Eustachian tube dysfunction is closely related to the development of otitis media and result from several factors including inflammation within the nasal cavity and nasopharynx, adenoid hypertrophy, cleft palate and nasopharyngeal carcinoma. To some extent, eustachian tube dysfunction may be related to weakness of the paratubal muscles, such as the tensor veli palatini and levator veli palatini muscles. The aim of the study is to find out myogenic factors in eustachian tube dysfunction using electromyography (EMG), and to evaluate the clinical feasibility of EMG. Ten patients with unilateral eustachian tube dysfunction were included in this study. The healthy side of each patient was used as a control. EMG tests on paratubal muscles were conducted under the view of a 30° endoscope or fiberoptic laryngoscope. EMG on the tensor veli palatini showed decreased amplitudes on the affected side in one patient during phonation. EMG on the levator veli palatini showed decreased amplitudes on the affected side in two patients during both deglutition and phonation, one patient during phonation only, and two patients during deglutition only. The only patient who had decreased amplitude on EMG of the tensor veli palatini also had decreased amplitude on EMG of the levator veli palatini. In conclusion, although it is generally accepted that the tensor veli palatini plays a major role in opening the eustachian tube, reduced activity of the levator veli palatini may be related to eustachian tube dysfunction. When assessing eustachian tube function, EMG is useful for evaluating myogenic factors.

  2. Chronic eccentric cycling improves quadriceps muscle structure and maximum cycling power.

    Science.gov (United States)

    Leong, C H; McDermott, W J; Elmer, S J; Martin, J C

    2014-06-01

    An interesting finding from eccentric exercise training interventions is the presence of muscle hypertrophy without changes in maximum concentric strength and/or power. The lack of improvements in concentric strength and/or power could be due to long lasting suppressive effects on muscle force production following eccentric training. Thus, improvements in concentric strength and/or power might not be detected until muscle tissue has recovered (e. g., several weeks post-training). We evaluated alterations in muscular structure (rectus-femoris, RF, and vastus lateralis, VL, thickness and pennation angles) and maximum concentric cycling power (Pmax) 1-week following 8-weeks of eccentric cycling training (2×/week; 5-10.5 min; 20-55% of Pmax). Pmax was assessed again at 8-weeks post-training. At 1 week post-training, RF and VL thickness increased by 24±4% and 13±2%, respectively, and RF and VL pennation angles increased by 31±4% and 13±1%, respectively (all Peccentric cycling can be a time-effective intervention for improving muscular structure and function in the lower body of healthy individuals. The larger Pmax increase detected at 8-weeks post-training implies that sufficient recovery might be necessary to fully detect changes in muscular power after eccentric cycling training.

  3. Glucose Metabolic Changes in the Brain and Muscles of Patients with Nonspecific Neck Pain Treated by Spinal Manipulation Therapy: A [18F]FDG PET Study

    Directory of Open Access Journals (Sweden)

    Akie Inami

    2017-01-01

    Full Text Available Objective. The aim of this study was to investigate changes in brain and muscle glucose metabolism that are not yet known, using positron emission tomography with [18F]fluorodeoxyglucose ([18F]FDG PET. Methods. Twenty-one male volunteers were recruited for the present study. [18F]FDG PET scanning was performed twice on each subject: once after the spinal manipulation therapy (SMT intervention (treatment condition and once after resting (control condition. We performed the SMT intervention using an adjustment device. Glucose metabolism of the brain and skeletal muscles was measured and compared between the two conditions. In addition, we measured salivary amylase level as an index of autonomic nervous system (ANS activity, as well as muscle tension and subjective pain intensity in each subject. Results. Changes in brain activity after SMT included activation of the dorsal anterior cingulate cortex, cerebellar vermis, and somatosensory association cortex and deactivation of the prefrontal cortex and temporal sites. Glucose uptake in skeletal muscles showed a trend toward decreased metabolism after SMT, although the difference was not significant. Other measurements indicated relaxation of cervical muscle tension, decrease in salivary amylase level (suppression of sympathetic nerve activity, and pain relief after SMT. Conclusion. Brain processing after SMT may lead to physiological relaxation via a decrease in sympathetic nerve activity.

  4. Utrophin A is essential in mediating the functional adaptations of mdx mouse muscle following chronic AMPK activation.

    Science.gov (United States)

    Al-Rewashdy, Hasanen; Ljubicic, Vladimir; Lin, Wei; Renaud, Jean-Marc; Jasmin, Bernard J

    2015-03-01

    Duchenne muscular dystrophy (DMD) is caused by the absence of dystrophin along muscle fibers. An attractive therapeutic avenue for DMD consists in the upregulation of utrophin A, a protein with high sequence identity and functional redundancy with dystrophin. Recent work has shown that pharmacological interventions that induce a muscle fiber shift toward a slower, more oxidative phenotype with increased expression of utrophin A confer morphological and functional improvements in mdx mice. Whether such improvements result from the increased expression of utrophin A per se or are linked to other beneficial adaptations associated with the slow, oxidative phenotype remain to be established. To address this central issue, we capitalized on the use of double knockout (dKO) mice, which are mdx mice also deficient in utrophin. We first compared expression of signaling molecules and markers of the slow, oxidative phenotype in muscles of mdx versus dKO mice and found that both strains exhibit similar phenotypes. Chronic activation of 5' adenosine monophosphate-activated protein kinase with 5-amino-4-imidazolecarboxamide riboside (AICAR) resulted in expression of a slower, more oxidative phenotype in both mdx and dKO mice. In mdx mice, this fiber type shift was accompanied by clear functional improvements that included reductions in central nucleation, IgM sarcoplasmic penetration and sarcolemmal damage resulting from eccentric contractions, as well as in increased grip strength. These important morphological and functional adaptations were not seen in AICAR-treated dKO mice. Our findings show the central role of utrophin A in mediating the functional benefits associated with expression of a slower, more oxidative phenotype in dystrophic animals.

  5. Role of Adipose Tissue in Determining Muscle Mass in Patients with Chronic Kidney Disease

    Science.gov (United States)

    OBJECTIVE: Malnutrition is a powerful predictor of mortality in chronic kidney disease (CKD). However, its etiology is unclear. We hypothesized that the adipocyte-derived proteins leptin and adiponectin, inflammation (as measured by C-reactive protein, CRP), and insulin resistance (as measured by ho...

  6. Impaired Bronchoprotection Is Not Induced by Increased Smooth Muscle Mass in Chronic Treatment In Vivo with Formoterol in Asthmatic Mouse Model

    Directory of Open Access Journals (Sweden)

    W Luo

    2014-09-01

    Full Text Available Objective: Inhaling β2-adrenoceptor agonist is first-line asthma treatment, which is used for both acute relief and prevention of bronchoconstriction. However, chronic use of β-agonists results in impaired bronchoprotection and increasing occurrences of severe asthma exacerbation, even death in clinical practice. The mechanism of β-adrenoceptor hyposensitivity has not been thoroughly elucidated thus far. Bronchial smooth muscle contraction induces airway narrowing and also mediates airway inflammation. Moreover, bronchial smooth muscle mass significantly increases in asthmatics. We aimed to establish an asthmatic model that demonstrated that formoterol induced impaired bronchoprotection and to see whether increased smooth muscle mass played a role in it. Methods: We combined routine allergen challenging (seven weeks with repeated application of formoterol, formoterol plus budesonide or physiological saline in allergen-sensitized BALB/c mouse. The bronchoprotection mediated by β-agonist was measured in five consecutive weeks. Smooth muscle mass was shown by morphometric analysis, and α-actin expression was detected by western blot. Results: The trend of bronchoprotection was wavy in drug interventional groups, which initially increased and then decreased. Chronic treatment with formoterol significantly impaired bronchoprotection. According to the morphometric analysis and α-actin expression, no significant difference was detected in smooth muscle mass in all groups. Conclusion: This experiment successfully established that a chronic asthmatic mouse model, which manifested typical features of asthmatic patients, with chronic use of formoterol, results in a loss of bronchoprotection. No significant difference was detected in smooth muscle mass in all groups, which implied some subcellular signalling changes may be the key points.

  7. 独刺后溪穴配合颈肩运动治疗肩胛提肌劳损%Acupuncture on Houxi Combined with Neck and Shoulder Exercise therapy on Levator Scapulae Muscle Strain

    Institute of Scientific and Technical Information of China (English)

    章芬; 林立元; 郑晓彬

    2014-01-01

    目的:观察独刺后溪穴配合颈肩运动治疗肩胛提肌劳损的疗效。方法:40例肩胛提肌劳损患者随机分为独刺组和对照组各20例,独刺组针刺肩胛提肌劳损所在侧的后溪穴,并配合颈椎各方向活动和颈肩部龟缩运动,对照组穴位指压肩胛提肌走行部位的阿是穴,VAS量表评价两组治疗前后疼痛变化及疗效。结果:独刺组5次内治愈率为60%,明显高于对照组的30%(P<0.05);治疗后独刺组VAS评分显著低于对照组(P<0.05);独刺组治愈率及总有效率分别为70%及100%,显著高于对照组的35%及90%(P<0.05)。结论:独刺后溪穴配合颈肩运动能有效缓解肩胛提肌劳损的疼痛,提高治愈率,缩短治愈时间。%Objective:To observe the curative effects of acupuncture on Houxi combined with neck and shoulder exercise therapy on levator scapulae muscle strain. Methods:40 cases of levator scapulae muscle strain were randomly divided into acupuncture group and control group with each of 20 cases, acupuncture group acupunctured on Houxi of sick side and made every direction movement of cervical spine and Guisuo exercise of neck and shoulder, control group with acupressure on A’shi point of levator scapulae muscle, VAS scale was used to evaluate the efficacy and changes in pain before and after treatment of the two groups. Results:The cure rate of acupuncture group in 5 times was 60%, significantly higher than that of control group by 30%(P<0.05);after treatment, VAS score of acupuncture group was significantly lower than that of control group (P<0.05);cure rate and total effective rate of acupuncture group were 70%and 100%, significantly higher than those of control group by 35%and 90%(P<0.05). Conclu-sion:Acupuncture on Houxi combined with neck and shoulder exercise can effectively alleviate the pain of levator scapulae muscles strain, improve the cure rate and shorten the healing time.

  8. 汽车碰撞中颈部肌肉组织神经兴奋性对乘员损伤影响的研究%An Investigation into the Effects of Neck Muscle Neural Excitation on Occupant Injury During Vehicle Crash

    Institute of Scientific and Technical Information of China (English)

    金景旭; 张君媛; 周浩; 黄旭弘

    2015-01-01

    为研究汽车碰撞中神经兴奋性引起颈部肌肉力的变化对乘员损伤的影响,建立了低速正面碰撞与追尾碰撞模型,对乘员运动响应进行了仿真分析。然后使用汽车驾驶模拟器采集真实驾驶员颈部主要肌肉的肌电信号,验证了仿真结果的有效性。结果表明,在低速工况下,颈部肌肉紧张会约束头颈部的运动,头部有后倾上扬趋势,颈部受力大小有所增加。考虑颈部肌肉组织的神经兴奋性,能更真实地再现碰撞中乘员头部和颈部的运动响应,为颈部损伤评价准则的修正和乘员心理和生理变化对人体损伤影响的研究提供参考。%In order to study the influence of the change in neck muscle force caused by neural excitation on occupant injury during vehicle crash, both frontal and rear low-speed impact models are built and the kinematic re-sponse of occupant is simulated. Then a vehicle driving simulator is used to collect the EMG signals of major neck muscles, verifying the effectiveness of simulation results. The results show that in low speed condition the movement of neck is confined by muscle tension and the head tends to incline backward with a certain increase in neck muscle force. With consideration of the neural excitation of neck muscle, the kinematic response of occupant head and neck can be reproduced more truly, providing an effective reference for the amendment of neck injury evaluation criteria and the study on the effects of occupant’s psychological and physiological changes on human body injury.

  9. Intermittent and continuous high-intensity exercise training induce similar acute but different chronic muscle adaptations.

    Science.gov (United States)

    Cochran, Andrew J R; Percival, Michael E; Tricarico, Steven; Little, Jonathan P; Cermak, Naomi; Gillen, Jenna B; Tarnopolsky, Mark A; Gibala, Martin J

    2014-05-01

    High-intensity interval training (HIIT) performed in an 'all-out' manner (e.g. repeated Wingate tests) is a time-efficient strategy to induce skeletal muscle remodelling towards a more oxidative phenotype. A fundamental question that remains unclear, however, is whether the intermittent or 'pulsed' nature of the stimulus is critical to the adaptive response. In study 1, we examined whether the activation of signalling cascades linked to mitochondrial biogenesis was dependent on the manner in which an acute high-intensity exercise stimulus was applied. Subjects performed either four 30 s Wingate tests interspersed with 4 min of rest (INT) or a bout of continuous exercise (CONT) that was matched for total work (67 ± 7 kJ) and which required ∼4 min to complete as fast as possible. Both protocols elicited similar increases in markers of adenosine monophosphate-activated protein kinase (AMPK) and p38 mitogen-activated protein kinase activation, as well as Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) mRNA expression (main effects for time, P ≤ 0.05). In study 2, we determined whether 6 weeks of the CONT protocol (3 days per week) would increase skeletal muscle mitochondrial content to a similar extent to what we have previously reported after 6 weeks of INT. Despite similar acute signalling responses to the CONT and INT protocols, training with CONT did not increase the maximal activity or protein content of a range of mitochondrial markers. However, peak oxygen uptake was higher after CONT training (from 45.7 ± 5.4 to 48.3 ± 6.5 ml kg(-1) min(-1); P muscle adaptations to low-volume, all-out HIIT. Despite the lack of skeletal muscle mitochondrial adaptations, our data show that a training programme based on a brief bout of high-intensity exercise, which lasted <10 min per session including warm-up, and performed three times per week for 6 weeks, improved peak oxygen uptake in young healthy subjects.

  10. Chronic intrinsic transient tracheal occlusion elicits diaphragmatic muscle fiber remodeling in conscious rodents.

    Directory of Open Access Journals (Sweden)

    Barbara K Smith

    Full Text Available BACKGROUND: Although the prevalence of inspiratory muscle strength training has increased in clinical medicine, its effect on diaphragm fiber remodeling is not well-understood and no relevant animal respiratory muscle strength training-rehabilitation experimental models exist. We tested the postulate that intrinsic transient tracheal occlusion (ITTO conditioning in conscious animals would provide a novel experimental model of respiratory muscle strength training, and used significant increases in diaphragmatic fiber cross-sectional area (CSA as the primary outcome measure. We hypothesized that ITTO would increase costal diaphragm fiber CSA and further hypothesized a greater duration and magnitude of occlusions would amplify remodeling. METHODOLOGY/PRINCIPAL FINDINGS: Sprague-Dawley rats underwent surgical placement of a tracheal cuff and were randomly assigned to receive daily either 10-minute sessions of ITTO, extended-duration, 20-minute ITTO (ITTO-20, partial obstruction with 50% of cuff inflation pressure (ITTO-PAR or observation (SHAM over two weeks. After the interventions, fiber morphology, myosin heavy chain composition and CSA were examined in the crural and ventral, medial, and dorsal costal regions. In the medial costal diaphragm, with ITTO, type IIx/b fibers were 26% larger in the medial costal diaphragm (p<0.01 and 24% larger in the crural diaphragm (p<0.05. No significant changes in fiber composition or morphology were detected. ITTO-20 sessions also yielded significant increases in medial costal fiber cross-sectional area, but the effects were not greater than those elicited by 10-minute sessions. On the other hand, ITTO-PAR resu