scholarly journals Hypertrophy in the cervical muscles and thoracic discs in bed rest?

2013 ◽  
Vol 115 (5) ◽  
pp. 586-596 ◽  
Author(s):  
Daniel L. Belavý ◽  
Tanja Miokovic ◽  
Gabriele Armbrecht ◽  
Dieter Felsenberg
Keyword(s):  
Thoracic Spine ◽  
Bed Rest ◽  
Exercise Group ◽  
Magnetic Resonance Images ◽  
Disc Height ◽  
Whole Body ◽  
Resistive Exercise ◽  
Upper Thoracic ◽  
Thoracic Disc ◽  
The Impact

The impact of prolonged bed rest on the cervical and upper thoracic spine is unknown. In the 2nd Berlin BedRest Study (BBR2-2), 24 male subjects underwent 60-day bed rest and performed either no exercise, resistive exercise, or resistive exercise with whole body vibration. Subjects were followed for 2 yr after bed rest. On axial cervical magnetic resonance images from the skull to T3, the volumes of the semispinalis capitis, splenius capitis, spinalis cervicis, longus capitis, longus colli, levator scapulae, sternocleidomastoid, middle and posterior scalenes, and anterior scalenes were measured. Disc height, anteroposterior width, and volume were measured from C2/3 to T6/7 on sagittal images. The volume of all muscles, with the exception of semispinalis capitis, increased during bed rest ( P < 0.025). There were no significant differences between the groups for changes in the muscles. Increased upper and midthoracic spine disc height and volume ( P < 0.001) was seen during bed rest, and disc height increases persisted at least 6 mo after bed rest. Increases in thoracic disc height were greater ( P = 0.003) in the resistive vibration exercise group than in control. On radiological review, two subjects showed new injuries to the mid-lower thoracic spine. One of these subjects reported a midthoracic pain incident during maximal strength testing before bed rest and the other after countermeasure exercise on day 3 of bed rest. We conclude that bed rest is associated with increased disc size in the thoracic region and increases in muscle volume at the neck. The exercise device needs to be modified to ensure that load is distributed in a more physiological fashion.

Countermeasures against lumbar spine deconditioning in prolonged bed rest: resistive exercise with and without whole body vibration

2010 ◽  
Vol 109 (6) ◽  
pp. 1801-1811 ◽  
Author(s):  
Daniel L. Belavý ◽  
Gabriele Armbrecht ◽  
Ulf Gast ◽  
Carolyn A. Richardson ◽  
Julie A. Hides ◽  
...  
Keyword(s):  
Whole Body Vibration ◽  
Bed Rest ◽  
Magnetic Resonance Images ◽  
Erector Spinae ◽  
Whole Body ◽  
Resistive Exercise ◽  
Body Vibration ◽  
Vibration Exercise ◽  
Quadratus Lumborum ◽  
Lumbar Muscle

To evaluate the effect of short-duration, high-load resistive exercise, with and without whole body vibration on lumbar muscle size, intervertebral disk and spinal morphology changes, and low back pain (LBP) incidence during prolonged bed rest, 24 subjects underwent 60 days of head-down tilt bed rest and performed either resistive vibration exercise ( n = 7), resistive exercise only ( n = 8), or no exercise ( n = 9; 2nd Berlin Bed-Rest Study). Discal and spinal shape was measured from sagittal plane magnetic resonance images. Cross-sectional areas (CSAs) of the multifidus, erector spinae, quadratus lumborum, and psoas were measured on para-axial magnetic resonance images. LBP incidence was assessed with questionnaires at regular intervals. The countermeasures reduced CSA loss in the multifidus, lumbar erector spinae and quadratus lumborum muscles, with greater increases in psoas muscle CSA seen in the countermeasure groups ( P ≤ 0.004). There was little statistical evidence for an additional effect of whole body vibration above resistive exercise alone on these muscle changes. Exercise subjects reported LBP more frequently in the first week of bed rest, but this was only significant in resistive exercise only ( P = 0.011 vs. control, resistive vibration exercise vs. control: P = 0.56). No effect of the countermeasures on changes in spinal morphology was seen ( P ≥ 0.22). The results suggest that high-load resistive exercise, with or without whole body vibration, performed 3 days/wk can reduce lumbar muscle atrophy, but further countermeasure optimization is required.

scholarly journals Effects of Six-Week Resistance Training with or without Vibration on Metabolic Markers of Bone Metabolism

2021 ◽  
Vol 18 (18) ◽  
pp. 9860
Author(s):  
Patrick Lau ◽  
Åsa Beijer ◽  
André Rosenberger ◽  
Eckhard Schoenau ◽  
Christoph Stephan Clemen ◽  
...  
Keyword(s):  
Bone Metabolism ◽  
Type I Collagen ◽  
Bed Rest ◽  
Whole Body ◽  
Type I ◽  
Metabolic Markers ◽  
Resistive Exercise ◽  
Procollagen Type ◽  
Amino Terminal ◽  
First Session

Acute and protracted effects of resistive exercise (RE) and resistive exercise with whole-body vibration (RVE) on metabolic markers of bone metabolism were investigated. Twenty-six men participated in a randomized training program including RE (n = 13; age = 23.4 ± 1.4 years) or RVE (n = 13; age = 24.3 ± 3.3 years). During the first session, acute C-terminal telopeptide of type I collagen (CTX) responses decreased by 12.9% (standard deviation, SD 13.7%) after 2 min, followed by a 15.5% (SD 36.0%) increase at 75 min after exercise (both p < 0.001). Procollagen type I amino terminal propeptide (P1NP) increased by 12.9% (SD 9.1%) at 2 min (p < 0.001) but no change occurred at 75 min. Sclerostin showed prolonged responses from 2 to 75 min post-exercise in the first session (p < 0.001). Acute responses at the first session were comparable between groups for CTX and P1NP, acute sclerostin responses were substantially greater in RE than in RVE (p = 0.003). No significant differences were noted in the resting baseline levels of CTX, P1NP, or sclerostin from the beginning to the end of the six-week progressive training. The present study therefore did not demonstrate any sizeable enhancement of bone turnover that could match the effects that have been repeatably made in response to countermeasure exercise during bed rest.

Global coronal decompensation and adult spinal deformity surgery: comparison of upper-thoracic versus lower-thoracic proximal fixation for long fusions

2021 ◽  
pp. 1-13
Author(s):  
Thomas J. Buell ◽  
Christopher I. Shaffrey ◽  
Han Jo Kim ◽  
Eric O. Klineberg ◽  
Virginie Lafage ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Spinal Deformity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Adult Spinal Deformity ◽  
Leg Pain ◽  
Sagittal Vertical Axis ◽  
Upper Thoracic ◽  
The Impact

OBJECTIVE Deterioration of global coronal alignment (GCA) may be associated with worse outcomes after adult spinal deformity (ASD) surgery. The impact of fusion length and upper instrumented vertebra (UIV) selection on patients with this complication is unclear. The authors’ objective was to compare outcomes between long sacropelvic fusion with upper-thoracic (UT) UIV and those with lower-thoracic (LT) UIV in patients with worsening GCA ≥ 1 cm. METHODS This was a retrospective analysis of a prospective multicenter database of consecutive ASD patients. Index operations involved instrumented fusion from sacropelvis to thoracic spine. Global coronal deterioration was defined as worsening GCA ≥ 1 cm from preoperation to 2-year follow-up. RESULTS Of 875 potentially eligible patients, 560 (64%) had complete 2-year follow-up data, of which 144 (25.7%) demonstrated worse GCA at 2-year postoperative follow-up (35.4% of UT patients vs 64.6% of LT patients). At baseline, UT patients were younger (61.6 ± 9.9 vs 64.5 ± 8.6 years, p = 0.008), a greater percentage of UT patients had osteoporosis (35.3% vs 16.1%, p = 0.009), and UT patients had worse scoliosis (51.9° ± 22.5° vs 32.5° ± 16.3°, p < 0.001). Index operations were comparable, except UT patients had longer fusions (16.4 ± 0.9 vs 9.7 ± 1.2 levels, p < 0.001) and operative duration (8.6 ± 3.2 vs 7.6 ± 3.0 hours, p = 0.023). At 2-year follow-up, global coronal deterioration averaged 2.7 ± 1.4 cm (1.9 to 4.6 cm, p < 0.001), scoliosis improved (39.3° ± 20.8° to 18.0° ± 14.8°, p < 0.001), and sagittal spinopelvic alignment improved significantly in all patients. UT patients maintained smaller positive C7 sagittal vertical axis (2.7 ± 5.7 vs 4.7 ± 5.7 cm, p = 0.014). Postoperative 2-year health-related quality of life (HRQL) significantly improved from baseline for all patients. HRQL comparisons demonstrated that UT patients had worse Scoliosis Research Society–22r (SRS-22r) Activity (3.2 ± 1.0 vs 3.6 ± 0.8, p = 0.040) and SRS-22r Satisfaction (3.9 ± 1.1 vs 4.3 ± 0.8, p = 0.021) scores. Also, fewer UT patients improved by ≥ 1 minimal clinically important difference in numerical rating scale scores for leg pain (41.3% vs 62.7%, p = 0.020). Comparable percentages of UT and LT patients had complications (208 total, including 53 reoperations, 77 major complications, and 78 minor complications), but the percentage of reoperated patients was higher among UT patients (35.3% vs 18.3%, p = 0.023). UT patients had higher reoperation rates of rod fracture (13.7% vs 2.2%, p = 0.006) and pseudarthrosis (7.8% vs 1.1%, p = 0.006) but not proximal junctional kyphosis (9.8% vs 8.6%, p = 0.810). CONCLUSIONS In ASD patients with worse 2-year GCA after long sacropelvic fusion, UT UIV was associated with worse 2-year HRQL compared with LT UIV. This may suggest that residual global coronal malalignment is clinically less tolerated in ASD patients with longer fusion to the proximal thoracic spine. These results may inform operative planning and improve patient counseling.

Low-magnitude whole body vibration with resistive exercise as a countermeasure against cardiovascular deconditioning after 60 days of head-down bed rest

2011 ◽  
Vol 301 (6) ◽  
pp. R1748-R1754 ◽  
Author(s):  
Mickael Coupé ◽  
Ming Yuan ◽  
Claire Demiot ◽  
Yanqiang Q. Bai ◽  
Shizhong Z. Jiang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Baroreflex Sensitivity ◽  
Whole Body Vibration ◽  
Bed Rest ◽  
Whole Body ◽  
Resistive Exercise ◽  
Body Vibration ◽  
Cardiovascular Deconditioning ◽  
Low Magnitude

Whole body vibration with resistive exercise is a promising countermeasure against some weightlessness-induced dysfunctions. Our objective was to study whether the combination of low-magnitude whole body vibration with a resistive exercise can prevent the cardiovascular deconditioning induced by a nonstrict 60-day head-down bed rest (Earth Star International Bed Rest Experiment Project). Fourteen healthy men participated in this study. We recorded electrocardiograms and blood pressure waves by means of a noninvasive beat-by-beat measurement system (Cardiospace, integrated by Centre National d'Etudes Spatiales and Astronaut Center of China) during an orthostatic test (20 min of 75-degree head-up tilt test) before and immediately after bed rest. We estimated heart rate, blood pressure, cardiac output, stroke volume, total peripheral resistance, baroreflex sensitivity, and heart rate variability. Low-magnitude whole body vibration with resistive exercise prevented an increase of the sympathetic index (reflecting the sympathovagal balance of cardiac autonomic control) and limited the decrease of the spontaneous baroreflex sensitivity induced by 60 days of head-down bed rest. However, this countermeasure had very little effect on cardiac hemodynamics and did not improve the orthostatic tolerance. This combined countermeasure did not efficiently prevent orthostatic intolerance but prevents changes in the autonomic nervous system associated with cardiovascular deconditioning. The underlying mechanisms remain hypothetical but might involve cutaneous and muscular mechanoreceptors.

scholarly journals UPPER THORACIC SPINE FRACTURE ASSOCIATED WITH FRACTURE OF THE STERNUM

2017 ◽  
Vol 16 (1) ◽  
pp. 60-63
Author(s):  
JOAQUÍN VALERO ◽  
NICOLÁS MAXIMILIANO CICCIOLI ◽  
PEDRO LUIS BAZÁN ◽  
ALVARO ENRIQUE BORRI
Keyword(s):  
Thoracic Spine ◽  
Spinal Injury ◽  
High Energy ◽  
High Energy Trauma ◽  
Upper Thoracic Spine ◽  
Direct Trauma ◽  
Thoracic Spine Fracture ◽  
Upper Thoracic ◽  
Car Accident ◽  
The Impact

ABSTRACT Objectives: The objectives of this presentation are to analyze the kinematics that causes this association, describe the impact of the injury, and evaluate the treatment performed Methods: Three cases are analyzed by quantifying the displacement and angulation of the sternum, the characteristics of the spinal injury and deformity, treatment, and complications Results: The mechanism that causes the injury is flexion-distraction, the component of the vertebral body presented is type A, and the most affected region was T5. Two patients had neurological picture E. Sternum injury was caused by direct trauma Conclusion: The association of these was observed in patients who have suffered from high-energy trauma in a car accident. There was no relationship between the angulation of the sternum and its displacement to the degree of kyphosis and displacement of the thoracic spine. It is important to carry out good radiographic studies that include the sternum when there is suspicion of this relationship.

scholarly journals Intradural Extramedullary Capillary Hemangioma in the Upper Thoracic Spine: A Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yoichiro Takata ◽  
Toshinori Sakai ◽  
Kosaku Higashino ◽  
Yuichiro Goda ◽  
Fumitake Tezuka ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Thoracic Spine ◽  
Soft Tissues ◽  
Magnetic Resonance Images ◽  
Capillary Hemangioma ◽  
Benign Tumors ◽  
Review Of The Literature ◽  
Extramedullary Tumor ◽  
Intradural Extramedullary ◽  
Upper Thoracic

Capillary hemangiomas are benign tumors found in the skin and soft tissues in younger people. They occur in the central nervous system only rarely, and intradural occurrence is extremely rare. We report here a 60-year-old man presenting with thoracic girdle pain and progressive gait disturbance. Magnetic resonance images of the thoracic spine showed a12×8×20 mm, well-defined intradural mass at the T2 level, compressing the spinal cord laterally. Relative to the spinal cord, the mass was hypo- to isointense on T1-weighted images and relatively hyperintense on T2-weighted images, with strong enhancement on contrast-enhanced T1-weighted images. The patient underwent T1-2 hemilaminectomy with resection of the intradural extramedullary tumor, which showed characteristics of a capillary hemangioma on histologic examination. The patient’s symptoms improved following the surgery and no clinical or radiological evidence of recurrence was noted at the 2-year follow-up. We present this case with a review of the literature, highlighting features for differential diagnosis.

Resistive exercise versus resistive vibration exercise to counteract vascular adaptations to bed rest

2010 ◽  
Vol 108 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Noortje T. L. van Duijnhoven ◽  
Dick H. J. Thijssen ◽  
Daniel J. Green ◽  
Dieter Felsenberg ◽  
Daniel L. Belavý ◽  
...  
Keyword(s):  
Blood Flow ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Vascular Function ◽  
Bed Rest ◽  
Flow Mediated Dilation ◽  
Resistive Exercise ◽  
Vibration Exercise ◽  
Echo Doppler Ultrasound ◽  
The Impact

Bed rest results in marked vascular adaptations, and resistive vibration exercise (RVE) has been shown to be an effective countermeasure. As vibration exercise has practical and logistical limitations, the use of resistive exercise (RES) alone has the preference under specific circumstances. However, it is unknown if RES is sufficient to prevent vascular adaptations to bed rest. Therefore, the purpose of the present study was to examine the impact of RES and RVE on the vascular function and structure of the superficial femoral artery in young men exposed to 60 days of bed rest. Eighteen healthy men (age: 31 ± 8 yr) were assigned to bed rest and randomly allocated to control, RES, or RVE groups. Exercise was applied 3 times/wk for 5–7 min/session. Resting diameter, blood flow, flow-mediated dilation (FMD), and dilator capacity of the superficial femoral artery were measured using echo-Doppler ultrasound. Bed rest decreased superficial femoral artery diameter and dilator capacity ( P < 0.001), which were significantly attenuated in the RVE group ( P < 0.01 and P < 0.05, respectively) but not in the RES group ( P = 0.202 and P = 0.696, respectively). Bed rest significantly increased FMD ( P < 0.001), an effect that was abolished by RVE ( P < 0.005) but not RES ( P = 0.078). Resting and hyperemic blood flow did not change in any of the groups. Thus, RVE abolished the marked increase in FMD and decrease in baseline diameter and dilator capacity normally associated with prolonged bed rest. However, the stimulus provided by RES alone was insufficient to counteract the vascular adaptations to bed rest.

Evidence for an additional effect of whole-body vibration above resistive exercise alone in preventing bone loss during prolonged bed rest

2010 ◽  
Vol 22 (5) ◽  
pp. 1581-1591 ◽  
Author(s):  
D. L. Belavý ◽  
G. Beller ◽  
G. Armbrecht ◽  
F. H. Perschel ◽  
R. Fitzner ◽  
...  
Keyword(s):  
Bone Loss ◽  
Whole Body Vibration ◽  
Bed Rest ◽  
Whole Body ◽  
Resistive Exercise ◽  
Body Vibration

PATTERNS OF THORACIC DISC DEGENERATION FROM MRI: AGE, GENDER AND SPINAL LEVEL INFLUENCES

2001 ◽  
Vol 05 (04) ◽  
pp. 269-278
Author(s):  
CELIA I. C. TAN ◽  
SWITHIN SONG ◽  
STEPHEN J. EDMONDSTON ◽  
KEVIN P. SINGER
Keyword(s):  
Disc Degeneration ◽  
Thoracic Spine ◽  
Magnetic Resonance Images ◽  
Thoracic Region ◽  
Point Scale ◽  
Spinal Level ◽  
End Plate ◽  
Age Related ◽  
Spine Pathology ◽  
Thoracic Disc

The present retrospective study reviewed and examined the prevalence of thoracic disc degeneration, end-plate lesions and osteophytes in the thoracic spine using T2-weighted sagittal magnetic resonance images (MRI). The sample comprised 216 thoracic spine cases (101 males and 115 females), aged from 1 to 85 years (mean age = 42±19.7 years). Nuclear and anular degeneration, end-plate lesions and osteophytes were graded using a 3-point scale. The prevalence of degeneration was highest in the nucleus (86%) and lowest in the end-plates (63%). Males had a higher prevalence of degeneration in the nucleus, anulus and end-plates, and a lower prevalence of osteophytes compared to females. Increasing cranio-caudal trends in the prevalence of degeneration in the nucleus, anulus and end-plates were observed, and these trends were statistically significant (p<0.01). Vertebral body osteophytes were most prevalent in the mid thoracic region. Osteophytes and degenerative changes in the nucleus and anulus increased significantly with age (p<0.05). These regional and age-related degenerative trends may influence the interpretation of thoracic spine pathology from MRI investigations.

Upper Thoracic Spine Fractures Outcomes and Complications in King Abdul-Aziz Medical City, Riyadh

2021 ◽  
pp. 16
Author(s):  
Faisal Konbaz
Keyword(s):  
Thoracic Spine ◽  
Sagittal Alignment ◽  
High Energy ◽  
Spine Fractures ◽  
Associated Injuries ◽  
Upper Thoracic Spine ◽  
Thoracic Spine Fractures ◽  
The Mean ◽  
Upper Thoracic ◽  
The Impact

Introduction: Upper thoracic spine fractures (T1-T6) are not uncommon. They are often high-energy injuries complicated by multiple life-threatening comorbidities. There is a controversial discussion in the literature regarding the treatment choices. Thoracic pedicle screw fixation has replaced all other fixation techniques for its success rate and safety. Despite the number of studies discussing upper thoracic spine fractures, data on literature reporting postoperative complications are deficient. The aim of the study was to assess, in a series of patients, the impact of traumatic upper thoracic fractures on sagittal alignment, the incidence of possible complications, and the effect of associated injuries. Methodology: This retrospective chart review study included all adult cases diagnosed as traumatic upper thoracic spine fractures in KAMC in Riyadh. Data were obtained from the computerized database. The information reviewed included fracture characteristics, associated injuries, pre- and postoperative neurological status and sagittal alignment, follow-up duration, and the presence of complications. Result: A total of 19 patients were included in the study. Of them, 17 (89.5%) were injured secondary to a motor vehicle accident. There were three patients with a fixation level crossing the CT junction, more blood loss and procedure time was noticed with these cases. There was a notable improvement in upper thoracic kyphosis by 9º when measuring pre- and postop fracture Cobb's angle. The mean preop angle was 28.98 and the mean postop was 20.76. Of all the 19 cases involved in the study, 3 patients had developed surgical site infection as a complication. No other complication was reviewed. Conclusion: It is well-known in the literature that the correction of kyphosis and the absence of residual deformity postoperatively are indicators of the success and safety of the procedure used. Our findings correspond to the literature discussion that the current practice in managing traumatic upper thoracic spine fracture in KAMC in Riyadh is relatively safe and effective. Yet, further studies are needed to elaborate more on the relationship between the presence of other injuries and patients’ factors and postoperative outcomes.

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