RESUMEN
Trunk control involves integration of sensorimotor information in the brain. Individuals with chronic low back pain (cLBP) have impaired trunk control and show differences in brain structure and function in sensorimotor areas compared with healthy controls (HC). However, the relationship between brain structure and trunk control in this group is not well understood. This cross-sectional study aimed to compare seated trunk control and sensorimotor white matter (WM) structure in people with cLBP and HC and explore relationships between WM properties and trunk control in each group. Thirty-two people with cLBP and 35 HC were tested sitting on an unstable chair to isolate trunk control; performance was measured using the 95% confidence ellipse area (CEA95) of center-of-pressure tracing. A WM network between cortical sensorimotor regions of interest was derived using probabilistic tractography. WM microstructure and anatomical connectivity between cortical sensorimotor regions were assessed. A mixed-model ANOVA showed that people with cLBP had worse trunk control than HC (F = 12.96; p < .001; ηp2 = .091). There were no differences in WM microstructure or anatomical connectivity between groups (p = 0.564 to 0.940). In the cLBP group, WM microstructure was moderately correlated (|r| = .456 to .565; p ≤ .009) with trunk control. Additionally, the cLBP group demonstrated stronger relationships between anatomical connectivity and trunk control (|r| = .377 to .618 p < .034) compared to the HC group. Unique to the cLBP group, WM connectivity between right somatosensory and left motor areas highlights the importance of interhemispheric information exchange for trunk control. Parietal areas associated with attention and spatial reference frames were also relevant to trunk control. These findings suggest that people with cLBP adopt a more cortically driven sensorimotor integration strategy for trunk control. Future research should replicate these findings and identify interventions to effectively modulate this strategy.
Asunto(s)
Dolor de la Región Lumbar , Corteza Sensoriomotora , Sustancia Blanca , Humanos , Dolor de la Región Lumbar/fisiopatología , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/fisiopatología , Sustancia Blanca/patología , Masculino , Femenino , Adulto , Corteza Sensoriomotora/fisiopatología , Corteza Sensoriomotora/diagnóstico por imagen , Estudios Transversales , Persona de Mediana Edad , Torso/fisiopatología , Dolor Crónico/fisiopatología , Dolor Crónico/diagnóstico por imagen , Dolor Crónico/patología , Sedestación , Estudios de Casos y Controles , Imagen por Resonancia MagnéticaRESUMEN
BACKGROUND: Motor control exercise is commonly applied in people with chronic low back pain (CLBP), but possibly not all people with CLBP have motor control impairments. We suggest movement precision as measure to identify motor control impairments. Movement precision has been operationalized as trunk movement variability (TMV) and as trunk tracking error(s) (TTE). OBJECTIVES: To compare the known-group validity and the responsiveness of TMV and TTE. DESIGN: We used a case-control comparison (Healthy controls (n = 30) vs CLBP (n = 60)) to assess the known-group validity. A cohort study, (measurements in week 3 and week 12 of treatment), was used to assess responsiveness. METHODS: TMV (temporal (CyclSD) and spatial (MeanSD)) was analyzed during standing, repetitive flexion and rotation tasks (35x). TTE was measured during movement target tracking tasks, again in flexion and rotation. Participants with CLBP followed a multidisciplinary intervention and both measures were assessed in week 3 and week 12 of treatment. 2-way MANOVA and 2-way ANOVA were used to assess the effect of Group (CLBP vs healthy controls) and direction (flexion vs rotation) on TMV and TTE. For responsiveness, 2-way MANOVA and 2-way ANOVA were used to assess the effect of treatment and direction on both measures. FINDINGS: At baseline, TMV was not different between groups, while TTE was higher in the people with CLBP (p = 0.005, np2 = 0.09). Treatment strongly decreased temporal TMV (p = 0.025, np2 = 0.33) and TTE (p < 0.001, np2 = 0.844). CONCLUSIONS: These results demonstrate that TTE is more sensitive to CLBP and more responsive to treatment than TMV.
Asunto(s)
Dolor de la Región Lumbar , Movimiento , Torso , Humanos , Dolor de la Región Lumbar/terapia , Dolor de la Región Lumbar/fisiopatología , Masculino , Femenino , Estudios de Casos y Controles , Adulto , Persona de Mediana Edad , Movimiento/fisiología , Torso/fisiopatología , Estudios de Cohortes , Dolor Crónico/terapia , Dolor Crónico/fisiopatología , Rango del Movimiento Articular/fisiología , Terapia por Ejercicio/métodosRESUMEN
PURPOSE: To determine whether the application of continuous lateral trunk support forces during walking would improve trunk postural control and improve gait performance in children with CP. MATERIALS AND METHODS: Nineteen children with spastic CP participated in this study (8 boys; mean age 10.6 ± 3.4 years old). Fourteen of them were tested in the following sessions: 1) walking on a treadmill without force for 1-min (baseline), 2) with lateral trunk support force for 7-min (adaptation), and 3) without force for 1-min (post-adaptation). Overground walking pre/post treadmill walking. Five of them were tested using a similar protocol but without trunk support force (i.e., control). RESULTS: Participants from the experimental group showed enhancement in gait phase dependent muscle activation of rectus abdominis in late adaptation period compared to baseline (P = 0.005), which was retained during the post-adaptation period (P = 0.036), reduced variability of the peak trunk oblique angle during the late post-adaptation period (P = 0.023), and increased overground walking speed after treadmill walking (P = 0.032). Participants from the control group showed modest changes in kinematics and EMG during treadmill and overground walking performance. These results suggest that applying continuous lateral trunk support during walking is likely to induce learning of improved trunk postural control in children with CP, which may partially transfer to overground walking, although we do not have a firm conclusion due to the small sample size in the control group.
Asunto(s)
Parálisis Cerebral , Electromiografía , Equilibrio Postural , Torso , Caminata , Humanos , Masculino , Niño , Parálisis Cerebral/fisiopatología , Proyectos Piloto , Femenino , Caminata/fisiología , Equilibrio Postural/fisiología , Fenómenos Biomecánicos/fisiología , Torso/fisiopatología , Torso/fisiología , Adolescente , Adaptación Fisiológica/fisiología , Marcha/fisiología , Postura/fisiología , Prueba de Esfuerzo , Músculo Esquelético/fisiopatologíaRESUMEN
Background and Objectives: Compared to other subjects, obese people have inferior trunk muscle endurance and balance. A modern method of neuro-muscular training called whole body vibration (WBV) may improve trunk muscle endurance and balance. This study evaluates the impact of a 4-week WBV program on trunk endurance and balance in obese female students. Materials and Methods: Sixty participants from 18 to 25 years of age and with BMI values ≥ 30 were randomly distributed into two equal groups: Group A (WBV group), who received 4 min of WBV, and Group B (sham WBV group), who received WBV with a turn-off device. The training was conducted two days/week for six weeks. Trunk endurance was evaluated using the Sorensen Test (ST) and Trunk Flexor Endurance Test (TFET). The Single-Leg Test (SLT) was used to assess static balance, while the Biodex Stability System measured dynamic balance. Results: The current study demonstrated no significant differences (p > 0.05) in pre-treatment variables between Groups A and B. Post-treatment, Group A showed a significantly higher duration of the Sorensen test, TFET and SLS than Group B (p < 0.001). Moreover, Group A showed significantly lower dynamic balance (p < 0.001) than Group B. Conclusions: WBV has a short-term effect on trunk endurance and balance in obese female students. WBV can be added to the rehabilitation program for obese subjects with deficits in trunk endurance and balance.
Asunto(s)
Obesidad , Resistencia Física , Equilibrio Postural , Vibración , Humanos , Femenino , Vibración/uso terapéutico , Equilibrio Postural/fisiología , Obesidad/fisiopatología , Obesidad/terapia , Adulto , Adolescente , Resistencia Física/fisiología , Adulto Joven , Estudiantes/estadística & datos numéricos , Torso/fisiología , Torso/fisiopatologíaRESUMEN
We aimed to assess high-density surface electromyography (HDsEMG)-torque relationships in the presence of delayed onset trunk muscle soreness (DOMS) and the effect of these relationships on torque steadiness (TS) and lumbar movement during concentric/eccentric submaximal trunk extension contractions. Twenty healthy individuals attended three laboratory sessions (24 h apart). HDsEMG signals were recorded unilaterally from the thoracolumbar erector spinae with two 64-electrode grids. HDsEMG-torque signal relationships were explored via coherence (0-5 Hz) and cross-correlation analyses. Principal component analysis was used for HDsEMG-data dimensionality reduction and improvement of HDsEMG-torque-based estimations. DOMS did not reduce either concentric or eccentric trunk extensor muscle strength. However, in the presence of DOMS, improved TS, alongside an altered HDsEMG-torque relationship and kinematic changes were observed, in a contraction-dependent manner. For eccentric trunk extension, improved TS was observed, with greater lumbar flexion movement and a reduction in δ-band HDsEMG-torque coherence and cross-correlation. For concentric trunk extensions, TS improvements were observed alongside reduced thoracolumbar sagittal movement. DOMS does not seem to impair the ability to control trunk muscle force, however, perceived soreness induced changes in lumbar movement and muscle recruitment strategies, which could alter motor performance if the exposure to pain is maintained in the long term.
Asunto(s)
Electromiografía , Ejercicio Físico , Mialgia , Humanos , Masculino , Mialgia/fisiopatología , Mialgia/etiología , Adulto , Femenino , Ejercicio Físico/fisiología , Fenómenos Biomecánicos , Torque , Adulto Joven , Contracción Muscular/fisiología , Músculo Esquelético/fisiopatología , Músculo Esquelético/fisiología , Región Lumbosacra/fisiopatología , Torso/fisiopatología , Vértebras Lumbares/fisiopatologíaRESUMEN
This paper presents an analysis of trunk movement in women with postnatal low back pain using machine learning techniques. The study aims to identify the most important features related to low back pain and to develop accurate models for predicting low back pain. Machine learning approaches showed promise for analyzing biomechanical factors related to postnatal low back pain (LBP). This study applied regression and classification algorithms to the trunk movement proposed dataset from 100 postpartum women, 50 with LBP and 50 without. The Optimized optuna Regressor achieved the best regression performance with a mean squared error (MSE) of 0.000273, mean absolute error (MAE) of 0.0039, and R2 score of 0.9968. In classification, the Basic CNN and Random Forest Classifier both attained near-perfect accuracy of 1.0, the area under the receiver operating characteristic curve (AUC) of 1.0, precision of 1.0, recall of 1.0, and F1-score of 1.0, outperforming other models. Key predictive features included pain (correlation of -0.732 with flexion range of motion), range of motion measures (flexion and extension correlation of 0.662), and average movements (correlation of 0.957 with flexion). Feature selection consistently identified pain, flexion, extension, lateral flexion, and average movement as influential across methods. While limited to this initial dataset and constrained by generalizability, machine learning offered quantitative insight. Models accurately regressed (MSE < 0.01, R2 > 0.95) and classified (accuracy > 0.94) trunk biomechanics distinguishing LBP. Incorporating additional demographic, clinical, and patient-reported factors may enhance individualized risk prediction and treatment personalization. This preliminary application of advanced analytics supported machine learning's potential utility for both LBP risk determination and outcome improvement. This study provides valuable insights into the use of machine learning techniques for analyzing trunk movement in women with postnatal low back pain and can potentially inform the development of more effective treatments.Trial registration: The trial was designed as an observational and cross-section study. The study was approved by the Ethical Committee in Deraya University, Faculty of Pharmacy, (No: 10/2023). According to the ethical standards of the Declaration of Helsinki. This study complies with the principles of human research. Each patient signed a written consent form after being given a thorough description of the trial. The study was conducted at the outpatient clinic from February 2023 till June 30, 2023.
Asunto(s)
Dolor de la Región Lumbar , Aprendizaje Automático , Movimiento , Torso , Humanos , Dolor de la Región Lumbar/fisiopatología , Dolor de la Región Lumbar/diagnóstico , Femenino , Adulto , Torso/fisiopatología , Movimiento/fisiología , Periodo Posparto/fisiología , Rango del Movimiento Articular/fisiología , Fenómenos Biomecánicos , Algoritmos , Curva ROCRESUMEN
BACKGROUND: Sitting ability is an important prognostic factor for patients with acute stroke. However, the characteristics of trunk muscle activity and weight-bearing during sitting are unclear. RESEARCH QUESTION: Are trunk muscle activity and weight-bearing during static sitting associated with sitting ability in patients with acute stroke? METHODS: Trunk electromyography and sitting posturography were performed during static sitting in 20 patients with acute stroke. The electromyography measured the bilateral external oblique and erector spinae muscles. The symmetry of muscle activity between the paralyzed and non-paralyzed side was calculated using the Symmetry Index (SI) raw value and absolute value. The activity of each muscle during static sitting was calculated as the percent reference voluntary contraction (%RVC) normalized by the maximum contraction in the sitting position. Sitting posturography was used to calculate the weight-bearing pressure (%) on the paralyzed and non-paralyzed side, and the raw and absolute values of weight-bearing SI were calculated as a representative value. The trunk impairment scale (TIS) for sitting ability and the Berg balance scale (BBS) for basic balance ability were used as primary outcomes. RESULTS: None of the SI of electromyography for each trunk muscle correlated significantly with clinical performance tests. The %RVC of paralyzed and non-paralyzed external oblique muscle negatively correlated with TIS. The absolute SI of weight-bearing was negatively correlated with BBS. SIGNIFICANCE: This study showed that the amount, but not the symmetry, of external oblique muscle activity during sitting was associated with sitting ability. We also found that the symmetry of the weight-bearing was associated with sitting ability, not the direction, but the absolute amount of deviation. This suggests that it is important to focus on the amount of external oblique muscle activity and weight-bearing deviation during sitting as a measure of sitting ability in patients with acute stroke.
Asunto(s)
Electromiografía , Equilibrio Postural , Sedestación , Accidente Cerebrovascular , Soporte de Peso , Humanos , Masculino , Estudios Transversales , Femenino , Persona de Mediana Edad , Accidente Cerebrovascular/fisiopatología , Anciano , Equilibrio Postural/fisiología , Soporte de Peso/fisiología , Músculo Esquelético/fisiopatología , Músculo Esquelético/fisiología , Torso/fisiopatología , Torso/fisiología , Rehabilitación de Accidente CerebrovascularRESUMEN
This study aimed to observe the effects of acupuncture combined with trunk strengthening training on balance and gait abilities in stroke hemiplegic patients. Sixty stroke hemiplegic patients were selected and randomly divided into a treatment group and a control group, with 30 patients in each group. The control group received conventional rehabilitation training and trunk strengthening exercises, while the treatment group received acupuncture in addition to the same interventions. Before and after 8 weeks of treatment, patients were assessed using the Holden Functional Ambulation Categories and Berg Balance Scale, and measurements were taken for step length, step width, and gait speed. Prior to treatment, there were no significant differences in Holden scores, Berg scores, step length, step width, or gait speed between the 2 groups (Pâ >â .05). After 8 weeks of treatment, significant improvements were observed in the aforementioned parameters in both groups (Pâ <â .05), with the acupuncture group showing significantly greater improvement compared to the control group (Pâ <â .05). Acupuncture combined with trunk strengthening training can significantly improve balance and gait impairments in stroke hemiplegic patients.
Asunto(s)
Terapia por Acupuntura , Marcha , Hemiplejía , Equilibrio Postural , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Masculino , Persona de Mediana Edad , Equilibrio Postural/fisiología , Femenino , Terapia por Acupuntura/métodos , Hemiplejía/rehabilitación , Hemiplejía/terapia , Hemiplejía/etiología , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatología , Anciano , Marcha/fisiología , Torso/fisiopatología , Terapia por Ejercicio/métodos , Resultado del Tratamiento , Entrenamiento de Fuerza/métodos , Terapia CombinadaRESUMEN
The flexion-relaxation phenomenon (FRP) is frequently absent among non-specific chronic low back pain (NSCLBP) patients. However, it is unknown whether this absence is intrinsic to their pathology or merely a consequence of reduced trunk flexion. Immersive virtual reality (IVR) can create a patient avatar whose range of motion can be modulated to differ from the real movement. The present study enrolled 15 NSCLBP patients and 15 asymptomatic participants with similar characteristics to disentangle the relationship between range of motion and the FRP in NSCLBP using IVR. Trunk kinematics and lumbar muscle electromyography were assessed. The IVR environment was combined with a motion capture system to create avatars that moved like each participant. The IVR display showed a closed room and a mirror reflecting the subject's avatar with a target line to be reached by trunk flexion. The avatar's trunk movements were modulated from reality, leading the participants to flex their trunk more than their voluntary maximum trunk flexion. Under IVR conditions, NSCLBP patients significantly increased their trunk flexion angle, which was coupled with a significant improvement in the FRP. The absence of the FRP among the NSCLBP population appeared to be primarily related to reduced trunk flexion.
Asunto(s)
Electromiografía , Dolor de la Región Lumbar , Rango del Movimiento Articular , Realidad Virtual , Humanos , Dolor de la Región Lumbar/fisiopatología , Femenino , Masculino , Adulto , Rango del Movimiento Articular/fisiología , Fenómenos Biomecánicos , Persona de Mediana Edad , Dolor Crónico/fisiopatología , Torso/fisiopatología , Torso/fisiología , Movimiento/fisiologíaRESUMEN
BACKGROUND: Adjusting trunk inclination from a semi-recumbent position to a supine-flat position or vice versa in patients with respiratory failure significantly affects numerous aspects of respiratory physiology including respiratory mechanics, oxygenation, end-expiratory lung volume, and ventilatory efficiency. Despite these observed effects, the current clinical evidence regarding this positioning manoeuvre is limited. This study undertakes a scoping review of patients with respiratory failure undergoing mechanical ventilation to assess the effect of trunk inclination on physiological lung parameters. METHODS: The PubMed, Cochrane, and Scopus databases were systematically searched from 2003 to 2023. INTERVENTIONS: Changes in trunk inclination. MEASUREMENTS: Four domains were evaluated in this study: 1) respiratory mechanics, 2) ventilation distribution, 3) oxygenation, and 4) ventilatory efficiency. RESULTS: After searching the three databases and removing duplicates, 220 studies were screened. Of these, 37 were assessed in detail, and 13 were included in the final analysis, comprising 274 patients. All selected studies were experimental, and assessed respiratory mechanics, ventilation distribution, oxygenation, and ventilatory efficiency, primarily within 60 min post postural change. CONCLUSION: In patients with acute respiratory failure, transitioning from a supine to a semi-recumbent position leads to decreased respiratory system compliance and increased airway driving pressure. Additionally, C-ARDS patients experienced an improvement in ventilatory efficiency, which resulted in lower PaCO2 levels. Improvements in oxygenation were observed in a few patients and only in those who exhibited an increase in EELV upon moving to a semi-recumbent position. Therefore, the trunk inclination angle must be accurately reported in patients with respiratory failure under mechanical ventilation.
Asunto(s)
Insuficiencia Respiratoria , Humanos , Insuficiencia Respiratoria/fisiopatología , Insuficiencia Respiratoria/terapia , Respiración Artificial/métodos , Mecánica Respiratoria/fisiología , Postura/fisiología , Posicionamiento del Paciente/métodos , Torso/fisiopatología , Torso/fisiologíaRESUMEN
Exercise is a front-line intervention to increase functional capacity and reduce pain and disability in people with low strength levels or disorders. However, there is a lack of validated field-based tests to check the initial status and, more importantly, to control the process and make tailored adjustments in load, intensity, and recovery. We aimed to determine the test-retest reliability of a submaximal, resistance-band test to evaluate the strength of the trunk stability muscles using a portable force sensor in middle-aged adults (48 ± 13 years) with medically diagnosed chronic low back pain and healthy peers (n = 35). Participants completed two submaximal progressive tests of two resistance-band exercises (unilateral row and Pallof press), consisting of 5 s maintained contraction, progressively increasing the load. The test stopped when deviation from the initial position by compensation movements occurred. Trunk muscle strength (CORE muscles) was monitored in real time using a portable force sensor (strain gauge). Results revealed that both tests were highly reliable (intra-class correlation [ICC] > 0.901) and presented low errors and coefficients of variation (CV) in both groups. In particular, people with low back pain had errors of 14-19 N (CV = 9-12%) in the unilateral row test and 13-19 N (CV = 8-12%) in the Pallof press. No discomfort or pain was reported during or after the tests. These two easy-to-use and technology-based tests result in a reliable and objective screening tool to evaluate the strength and trunk stability in middle-aged adults with chronic low back pain, considering an error of measurement < 20 N. This contribution may have an impact on improving the individualization and control of rehabilitation or physical training in people with lumbar injuries or disorders.
Asunto(s)
Dolor de la Región Lumbar , Fuerza Muscular , Humanos , Dolor de la Región Lumbar/fisiopatología , Fuerza Muscular/fisiología , Persona de Mediana Edad , Masculino , Femenino , Adulto , Reproducibilidad de los Resultados , Torso/fisiopatología , Torso/fisiología , Entrenamiento de Fuerza/métodos , Dolor Crónico/fisiopatología , Dolor Crónico/diagnóstico , Músculo Esquelético/fisiopatología , Músculo Esquelético/fisiologíaRESUMEN
INTRODUCTION: Parkinson's disease (PD) causes gait abnormalities that may be associated with an arm swing reduction. Medication and freezing of gait (FoG) may influence gait characteristics. However, these comparisons do not consider differences in gait speed and clinical characteristics in individuals with PD. OBJECTIVE: This study aims to analyze the effect of FoG and medication on the biomechanics of the trunk and upper limbs during gait in PD, controlling for gait speed and clinical differences between groups. METHODS: Twenty-two people with a clinical diagnosis of idiopathic PD in ON and OFF medication (11 FoG), and 35 healthy participants (control) were selected from two open data sets. All participants walked on the floor on a 10-m-long walkway. The joint and linear kinematic variables of gait were compared: (1) Freezers and nonfreezers in the ON condition and control; (2) Freezers and nonfreezers in the OFF condition and control; (3) Group (freezers and nonfreezers) and medication. RESULTS: The disease affects the upper limbs more strongly but not the trunk. The medication does not significantly influence the joint characteristics but rather the linear wrist displacement. The FoG does not affect trunk movement and partially influences the upper limbs. The interaction between medications and FoG suggests that the medication causes more substantial improvement in freezers than in nonfreezers. CONCLUSION: The study shows differences in the biomechanics of the upper limbs of people with PD, FoG, and the absence of medication. The future rehabilitation protocol should consider this aspect.
Asunto(s)
Trastornos Neurológicos de la Marcha , Marcha , Enfermedad de Parkinson , Torso , Extremidad Superior , Humanos , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/tratamiento farmacológico , Fenómenos Biomecánicos , Masculino , Femenino , Anciano , Extremidad Superior/fisiopatología , Persona de Mediana Edad , Torso/fisiopatología , Trastornos Neurológicos de la Marcha/fisiopatología , Trastornos Neurológicos de la Marcha/tratamiento farmacológico , Marcha/fisiología , Dopaminérgicos , Antiparkinsonianos/uso terapéuticoRESUMEN
BACKGROUND & AIMS: Skeletal muscles are essential for postural retention and balance function. However, the relationship between trunk muscle mass (TMM) and balance function has not yet been clarified. This study aimed to examine the impact of TMM on the change in balance function in patients with stroke from admission to a rehabilitation hospital to discharge. METHODS: This retrospective observational study included patients aged ≥65 years with cerebral infarction admitted to our rehabilitation hospital from May 2018 to July 2022. The trunk muscle mass index (TMI) was calculated at admission and discharge using bioelectrical impedance analysis. Patients were divided into low and high TMI groups according to the median TMI at admission. The primary outcome was the change in the Berg Balance Scale (BBS) score (BBS score at discharge - BBS score at admission). RESULTS: A total of 315 patients (mean age, 78.9 ± 8.0 years; 172 men and 143 women) were included. The median TMI was 7.31 kg/m2 in men and 6.30 kg/m2 in women. Among male patients, the high TMI group had higher BBS scores at admission (31.2 ± 18.2 vs. 23.4 ± 17.7, P = 0.005) and discharge (43.0 ± 15.3 vs. 33.4 ± 19.0, P < 0.001) than those in the low TMI group. After adjusting for confounding factors, TMI at admission was independently associated with the change in BBS score (ß = 0.587, P = 0.002). CONCLUSIONS: Reduced TMM negatively influences balance function recovery in patients after stroke. A strategy aimed at increasing TMM could have beneficial effects on balance function.
Asunto(s)
Músculo Esquelético , Equilibrio Postural , Recuperación de la Función , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Masculino , Femenino , Anciano , Estudios Retrospectivos , Músculo Esquelético/fisiopatología , Accidente Cerebrovascular/fisiopatología , Anciano de 80 o más Años , Torso/fisiopatologíaRESUMEN
The aim of this study was to investigate the effect of trunk position and experimental lumbar pain location on lumbar extensor muscle recruitment strategies. Nineteen healthy participants (10 men and 9 women), aged 25.3 ± 4.7 yr, performed isometric back extension contractions in three positions (neutral, 45°, and 90° trunk flexion) and under three conditions (no pain, caudal pain, and cranial pain). Lumbar muscle activation strategies were recorded using high-density surface electromyography. The effect of position and pain condition on muscle activity amplitude and spatial redistributions was assessed. Muscle activity amplitude was 43% higher in 45° trunk flexion than in neutral position on both sides (P < 0.05). In the 90° trunk flexion, participants showed a more lateral spatial distribution than in the 45° trunk flexion on the left side (P < 0.01, 5.4 mm difference) and the neutral position on both sides (P < 0.05, 8.2 mm difference). In the 45° trunk flexion, participants exhibited a more lateral spatial distribution compared with the neutral position on the right side (P < 0.05, 3.7 mm difference). A lateral spatial redistribution of muscle activity was observed in the caudal pain condition compared with the no pain condition on the right side (P < 0.05, 3.0 mm difference). Individual responses to pain varied across all variables. Different trunk positions result in different distributions of activation within the lumbar extensor muscles, possibly based on regional mechanical advantage. No clear indication of location-specific pain adaptation and no effect of task-dependent pain adaptation were found, whereas individual-specific adaptations were observed.NEW & NOTEWORTHY Changes in muscle activity amplitude and spatial redistribution of lumbar extensor muscles were observed in different trunk positions, potentially due to changes in their mechanical advantage. The results complement the current pain-adaptation theory by illustrating individual spatial redistributions of activation within lumbar extensor muscles during pain. The study found no clear indication of location-specific pain adaptation and no effect of task-dependent pain adaptation.
Asunto(s)
Electromiografía , Región Lumbosacra , Músculo Esquelético , Postura , Torso , Humanos , Masculino , Femenino , Adulto , Electromiografía/métodos , Postura/fisiología , Región Lumbosacra/fisiopatología , Músculo Esquelético/fisiopatología , Músculo Esquelético/fisiología , Torso/fisiopatología , Torso/fisiología , Adulto Joven , Reclutamiento Neurofisiológico/fisiología , Contracción Isométrica/fisiología , Dolor de la Región Lumbar/fisiopatologíaRESUMEN
Overhead sports overload the shoulder complex due to movement repetition and the great amount of force created during the athletic motion, which may cause adaptations in the shoulder and lead to shoulder pain. However, overhead movements include the kinetic chain, and alterations in some of the structures throughout the kinetic chain may increase stress on the shoulder complex and be associated with shoulder pain. PURPOSE: To compare kinetic chain components in overhead athletes with and without shoulder pain. METHODS: Forty-one volleyball and handball athletes (21 with and 20 without shoulder pain) were included and assessed for hip internal (IR) and external rotation (ER) range of motion (ROM), hip and trunk isometric strength, trunk endurance and neuromuscular control of the lower and upper limbs (Y balance test). RESULTS: Athletes with shoulder pain showed smaller IR ROM in both hips, lower endurance time for trunk extensors and flexors, decreased reach distance in the anterior and posteromedial direction, as well as a smaller composite score in the Y balance test (p < 0.05). CONCLUSION: Volleyball and handball athletes with shoulder pain showed changes in ROM throughout the kinetic chain in addition to lower core endurance, and decreased neuromuscular control of lower limbs.
Asunto(s)
Fuerza Muscular , Rango del Movimiento Articular , Dolor de Hombro , Voleibol , Humanos , Rango del Movimiento Articular/fisiología , Masculino , Voleibol/fisiología , Adulto Joven , Femenino , Dolor de Hombro/fisiopatología , Fuerza Muscular/fisiología , Adulto , Fenómenos Biomecánicos/fisiología , Rotación , Atletas , Adolescente , Torso/fisiopatología , Torso/fisiologíaRESUMEN
BACKGROUND: Limited knowledge exists about the effectiveness of dry needling (DN) concerning the torso kinematics in patients with non-specific low back pain (NS-LBP). Acute effects of DN in NS-LBP patients from a functional perspective were investigated. METHODS: Sixteen NS-LBP patients and 11 healthy individuals (HG) were examined. NS-LBP patients received a single session of DN at the lumbar region. Baseline and immediate post-treatment measurements during flexion-extension and lateral bending of the trunk were conducted for the NS-LBP patients. HG were measured only at baseline to be used as a reference of NS-LBP patients' initial condition. Algometry was applied in NS-LBP patients. Centre of pressure, range of motion of the trunk and its' derivatives were obtained. FINDINGS: HG performed significantly faster, smoother and with greater mobility in the performed tasks compared to the pre intervention measurements of the NS-LBP patients. For the NS-LBP patients, significant greater angular velocity in frontal plane and significant lower jerk in the sagittal plane were demonstrated post intervention. DN alleviated pain tolerance significantly at the L5 level. Regarding the effectiveness of the DN upon spine kinematics, their derivatives were more sensitive. INTERPRETATION: It appeared that the pathological type of torso movement was acutely affected by DN. NS-LBP patients showcased smoother movement immediately after the intervention and better control as imprinted in the higher derivative of motion although range of motion did not improve. This quantitative variable may not be subjected to acute effects of DN but rather need additional time and training to be improved.
Asunto(s)
Punción Seca , Dolor de la Región Lumbar , Rango del Movimiento Articular , Torso , Humanos , Dolor de la Región Lumbar/terapia , Dolor de la Región Lumbar/fisiopatología , Fenómenos Biomecánicos , Masculino , Femenino , Adulto , Torso/fisiología , Torso/fisiopatología , Rango del Movimiento Articular/fisiología , Punción Seca/métodos , Equilibrio Postural/fisiología , Persona de Mediana EdadRESUMEN
BACKGROUND: Trunk control is the basic component of postural control, and achieving trunk control is a complex process that can be achieved by dynamically building and maintaining neuromuscular function. Lateropulsion, which is also defined as the body falling to one side, is considered an important condition that is frequently encountered after stroke and affects trunk control. It is known that there are differences in the regulation of postural control and trunk control according to hemispheric localization. We had a very specific group of patients and tried to find out the outcomes prospectively in this study. METHODS: The patients were divided into 2 groups those with right hemisphere lesions (Group 1) and those with left hemisphere lesions (Group 2). Comorbidity and cognitive function were evaluated using the Charlson Comorbidity Index (CMI) and Standardized Mini-Mental State Test (SMMSE). Activities of daily living were evaluated using the Turkish version of the Modified Barthel Index (MBI). The Stroke Rehabilitation Assessment of Movement Instrument (STREAM) test was used to assess trunk control and the Brunnstrom (BS) test was used to assess motor functions. RESULTS: There was a significant difference between Groups 1 and 2 in terms of STREAM in lower extremity scores were higher in Group 2 (Pâ <â .05). The number of patients in BS lower extremity Stages IV-VI was higher in Group 1 and Group 2 (Pâ <â .05). It was determined that upper extremity, lower extremity and Total STREAM scores and BS Hand stage in Group 2 were significantly higher than Group 1 in patients with total middle cerebral artery (MCA) affected(Pâ <â .05). CONCLUSION: It was determined that trunk control was more affected in patients with right hemispheric lesions. Additionally, trunk control is significantly affected in patients with total MCA lesions.
Asunto(s)
Equilibrio Postural , Torso , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Torso/fisiopatología , Equilibrio Postural/fisiología , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/complicaciones , Estudios Prospectivos , Actividades Cotidianas , Rehabilitación de Accidente Cerebrovascular/métodosRESUMEN
Staircases are a frequently encountered obstacle in daily life, requiring individuals to navigate ascending and descending movements that place additional demands on the trunk and lower limbs compared to walking on level surfaces. Therefore, it is crucial to examine the biomechanical characteristics of the trunk and lower limbs in individuals with scoliosis during stair activity. The aim of this study was to investigate the biomechanical differences in trunk and lower limbs during daily stair activities between patients with scoliosis and a healthy population. Additionally, the study aimed to explore the relationship between trunk abnormalities and lower limb biomechanics, providing a clinical and objective assessment basis for scoliosis. The Qualisys system, based in Gothenburg, Sweden, was employed for data collection in this study, with a sampling frequency of 150 Hz. It captured the kinematics of the trunk and lower limbs, as well as the kinetics of the lower limbs during stair ascent and descent for both the 28 individuals with scoliosis and the 28 control participants. The results indicate that scoliosis patients demonstrated significantly higher asymmetry compared to the control group in various measures during ascent and decent. These include different parts of kinematics and kinetics. Scoliosis patients demonstrate noticeable variations in their movement patterns compared to the healthy population when engaging in stair activities. Specifically, during stair ascent, scoliosis patients exhibit a seemingly more rigid movement pattern, whereas descent is characterized by an unstable pattern.
Asunto(s)
Extremidad Inferior , Escoliosis , Torso , Humanos , Escoliosis/fisiopatología , Fenómenos Biomecánicos , Femenino , Extremidad Inferior/fisiopatología , Masculino , Torso/fisiopatología , Adolescente , Subida de Escaleras/fisiología , Adulto , Niño , Adulto JovenRESUMEN
PURPOSE: The purpose of the present study was to investigate the association between quantitatively assessed trunk extensor strength and gait-induced back pain (GIBP) in patients with adult spinal deformity (ASD). METHODS: Ninety-five patients with ASD aged ≥ 50 years who were admitted to our hospital between April 2018 and March 2023 were included in the study. GIBP was evaluated through a 6-minute walking test (6MWT), with GIBP being defined as the occurrence of back pain during the evaluation and inability to complete the test. The patients were divided into three groups: difficulty completing the 6MWT (Group 1), ability to complete the 6MWT with breaks (Group 2), and ability to complete the 6MWT without taking a break (Group 3). The main independent variable was trunk extensor strength, which was measured using a hand-held dynamometer. Ordered logistic regression analysis was conducted to assess the association between GIBP and trunk extensor strength while adjusting for basic characteristics and radiographic parameters as covariates. RESULTS: The numbers of patients with ASD included in each group were; 27 in Group 1 (28.4%), 31 in Group 2 (32.6%), and 37 in Group 3 (39.0%). An ordered logistic regression analysis adjusted for basic characteristics and radiographic parameters, trunk extensor strength was significantly associated with GIBP (odds ratios, 1.128; 95% confidence intervals, 1.025-1.242). CONCLUSIONS: The results of the present study strongly indicate that trunk extensor strength is a valuable factor associated with GIBP in patients with ASD.
Asunto(s)
Dolor de Espalda , Marcha , Fuerza Muscular , Humanos , Masculino , Femenino , Anciano , Estudios Transversales , Persona de Mediana Edad , Fuerza Muscular/fisiología , Dolor de Espalda/fisiopatología , Dolor de Espalda/etiología , Marcha/fisiología , Torso/fisiopatología , Curvaturas de la Columna Vertebral/fisiopatología , Anciano de 80 o más AñosRESUMEN
BACKGROUND: Poor postural control has been reported in people with Parkinson's disease, which could be explained by the changes in muscular activation patterns related to antigravitational muscles. This study aims to measure the muscle activation of antigravitational muscles during balance tasks in individuals, with and without Parkinson's. METHODS: Sixteen (16) participants (9 with Parkinson's), aged ≥65 yrs., performed 2 × 30-s trials of 4 balance tasks (bipodal and semi-tandem opened eyes and closed eyes) on a force platform (center of pressure measurement); while surface electromyography measurements were obtained bilaterally on the multifidus at L5, biceps femoris and medialis gastrocnemius. Electromyography amplitude analysis was processed by the Root Mean Square (250 ms window epochs) and normalized by the peak of activation during the balance task, to determine each muscle's activity level. FINDINGS: The Parkinson's group reported lower muscle activation than control across tasks (in mean for multifidus = 8%, biceps femoris = 16%, gastrocnemius = 7%), although not statistically significant. Parkinson's reported significantly poorer postural control than control, mainly for the center of pressure sway ellipse area (p = 0.016) from challenge balance tasks such as semi-tandem. INTERPRETATION: Poor postural control was confirmed in the Parkinson's group, but not significantly associated by the changes from muscle activation of trunk and lower limbs, during balance performance.