scholarly journals Sacroiliac joint motion in patients with degenerative lumbar spine disorders

2015 ◽  
Vol 23 (2) ◽  
pp. 209-216 ◽  
Author(s):  
Yukitaka Nagamoto ◽  
Motoki Iwasaki ◽  
Hironobu Sakaura ◽  
Tsuyoshi Sugiura ◽  
Takahito Fujimori ◽  
...  

OBJECT Usually additional anchors into the ilium are necessary in long fusion to the sacrum for degenerative lumbar spine disorders (DLSDs), especially for adult spine deformity. Although the use of anchors is becoming quite common, surgeons must always keep in mind that the sacroiliac (SI) joint is mobile and they should be aware of the kinematic properties of the SI joint in patients with DLSDs, including adult spinal deformity. No previous study has clarified in vivo kinematic changes in the SI joint with respect to patient age, sex, or parturition status or the presence of DLSDs. The authors conducted a study to clarify the mobility and kinematic characteristics of the SI joint in patients with DLSDs in comparison with healthy volunteers by using in vivo 3D motion analysis with voxel-based registration, a highly accurate, noninvasive method. METHODS Thirteen healthy volunteers (the control group) and 20 patients with DLSDs (the DLSD group) underwent low-dose 3D CT of the lumbar spine and pelvis in 3 positions (neutral, maximal trunk flexion, and maximal trunk extension). SI joint motion was calculated by computer processing of the CT images (voxel-based registration). 3D motion of the SI joint was expressed as both 6 df by Euler angles and translations on the coordinate system and a helical axis of rotation. The correlation between joint motion and the cross-sectional area of the trunk muscles was also investigated. RESULTS SI joint motion during trunk flexion-extension was minute in healthy volunteers. The mean rotation angles during trunk flexion were 0.07° around the x axis, −0.02° around the y axis, and 0.16° around the z axis. The mean rotation angles during trunk extension were 0.38° around the x axis, −0.08° around the y axis, and 0.08° around the z axis. During trunk flexion-extension, the largest amount of motion occurred around the x axis. In patients with DLSDs, the mean rotation angles during trunk flexion were 0.57° around the x axis, 0.01° around the y axis, and 0.19° around the z axis. The mean rotation angles during trunk extension were 0.68° around the x axis, −0.11° around the y axis, and 0.05° around the z axis. Joint motion in patients with DLSDs was significantly greater, with greater individual difference, than in healthy volunteers. Among patients with DLSDs, women had significantly more motion than men did during trunk extension. SI joint motion was significantly negatively correlated with the cross-sectional area of the trunk muscles during both flexion and extension of the trunk. CONCLUSIONS The authors elucidated the mobility and kinematic characteristics of the SI joint in patients with DLSDs compared with healthy volunteers for the first time. This information is useful for spine surgeons because of the recent increase in spinopelvic fusion for the treatment of DLSDs.

2016 ◽  
Vol 17 (2) ◽  
pp. 138-141
Author(s):  
Samira Sharmin ◽  
Mabubul Haque ◽  
Syedur Rahman Miah ◽  
Md Mahbub Ur Rahman ◽  
Jasmine Ara Haque ◽  
...  

Objectives: Low bone mass is a common disorder in elderly population which predisposes to fracture with minimal trauma. This study was performed to find out the association between the Body Mass Index (BMI) and Bone Mineral Density (BMD) in postmenopausal women.Materials and Methods: This cross sectional study was carried out at Institute of Nuclear Medicine and Allied Sciences Comilla and Mitford, Dhaka over a period of 12 months from January 2013 to December 2013. A total 93 postmenopausal women were enrolled for this study. All postmenopausal women underwent a BMD scan of femoral neck and lumbar vertebrae using a Dual Energy X-ray Absorptiometry (DEXA). Participants were categorized into three groups according to their age and BMI. BMD were expressed base on T-score according to WHO criteria. The relation among BMI, age and BMD were assessed.Results: The results of this study showed that the mean age of the study group was 57.13±7.49 years with range of 46 to 75 years. The most postmenopausal women were in age group 55-65years. The mean BMI of the study subjects were 24.18±5.08 kg/m2 with a range of 15.62 to 36.20 kg/m2. Among 93 subjects osteopenia was greater at lumbar spine (45.2%) with T-score mean±SD-1.83±0.33 and osteoporosis at femoral neck (51.6%) with T-score mean ±SD-3.36±-0.67. Pearson’s correlation coefficient test showed inverse relationship between age and BMD both lumbar spine (r = -0.301, p = 0.003) and femoral neck (r = -0.303, p=0.003) whereas the positive relation between BMI and BMD both at lumbar spine (r=0.338, p=0.001) and femoral neck (r =0.343, p=0.001). These showed that with advancing age, BMD decreases and the risk of osteoporosis increases and with increasing BMI, BMD increases and risk of osteoporosis decreases.Conclusion: The findings of this study portrait that aging and low BMI are risk factors associated with bone loss. So preventive measure should be taken for high risk post menopausal women.Bangladesh J. Nuclear Med. 17(2): 138-141, July 2014


2020 ◽  
pp. 1-10
Author(s):  
Frederico Ribeiro Neto ◽  
Rodrigo Rodrigues Gomes Costa ◽  
Ricardo Antônio Tanhoffer ◽  
Josevan Cerqueira Leal ◽  
Martim Bottaro ◽  
...  

BACKGROUND: The neuromuscular efficiency index (NME) is defined as the individual ability to generate force in relation to the muscle activation level and might be useful to the assessment of individuals with spinal cord injury (SCI) and might elucidate the modifications in strength after an SCI compared to non-disabled subjects (CG). OBJECTIVE: Verify if the NME of fully and partially preserved muscles discriminate men with low and high levels of SCI and a matched non-disabled CG. METHODS: Fifty-four men with SCI were stratified into the high (HP), and low (LP) paraplegia groups and twenty-seven non-disabled individuals were selected (CG). All subjects performed maximum strength tests in the isokinetic dynamometer for shoulder abduction/adduction (isokinetic) and trunk flexion/extension (isometric). Surface electromyography was measured to calculate the NME, and discriminant analysis was carried out to identify which NME variables would be able to discriminate HP, LP, and CG. RESULTS: There were no NME significant differences between groups for the primary muscles of the shoulder abduction/adduction. All NME data failed at discriminant tolerance test to compare HP from LP. The latissimus dorsi NME during trunk extension discriminated CG from HP and LP. CONCLUSIONS: The latissimus dorsi NME during trunk extension might be used as an assessment tool to compare SCI individuals and the non-disabled-matched controls. The authors recommend using the NME index for the analysis or comparisons between the same SCI levels.


2021 ◽  
Author(s):  
Krunal Patel

The purpose of this study is to present a forward kinematics model of the human lumbar spine and to compare the internal loads and trunk flexion extension with existing literature. The forward kinematics model of lumbar spine with 30 DOF was designed using Solidworks and used Matlab to simulate the results for different postures. The forward kinematics model predicted similar trend for trunk flexion extension, compression force, shear forces and moment as described in literature for in vivo studies. The comparison between the proposed model and in vivo measurement showed a pressure difference of less than 15% on the disc L4-L5 for all activities whereas the compression force and moment differed by ~17% on the disc L5-S1. The modeling methodology presented in this thesis provides a more accurate representation of compression forces and moments of the human lumbar spine since the model makes no assumptions regarding muscle force and does not rely on any other software for kinematics data.


2019 ◽  
Vol 67 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Amira Ben Moussa Zouita ◽  
Sghaier Zouita ◽  
Catherine Dziri ◽  
Matt Brughelli ◽  
David G. Behm ◽  
...  

AbstractInvestigations of trunk strength with high-level athletes are limited. The purpose of this study was to compare maximal concentric isokinetic trunk extension and flexion torque, power, and strength ratios between high-level weightlifters (n = 20), wrestlers (n = 20) and a control (n = 25) population. Isokinetic dynamometry was used to evaluate peak torque, power and strength ratios during seated trunk extension/flexion actions at 60°/s and 180°/s. There were no significant anthropometric differences between groups. Overall, trunk isokinetic force variables as a function of the increase in angular velocity, showed a decrease in peak torque, but an increase in power (athletes and controls). Compared to the control group, athletes demonstrated significantly higher trunk extension torque (+67.05 N·m, ES = 0.81) and power (+49.28 N·m, ES = 0.82) at 60°/s and 180°/s, respectively. Athletes produced significantly greater trunk flexion-extension ratios at 60°/s and 180°/s (ES = 0.80-0.47) than controls. Weightlifters and wrestlers exhibited significantly higher extensor than flexor torque at all angular velocities. Weightlifters demonstrated greater torque (ES = 0.79) than wrestlers at 60°/s. The wrestlers’ average power was significantly higher (ES = 0.43) than weightlifters at 180°/s. There were no significant ratio differences between wrestlers (66.23%) and weightlifters (72.06%). Weightlifters had stronger extensor muscles at 60°/s, whereas wrestlers had higher power at 180°/s for extensor muscles. It was postulated that the extensor muscles were stronger than the flexors to ensure trunk stabilisation, and for prevention of injuries. These differences seem to be associated to the movements that occur in each sport in terms of both muscle actions and contractile forces.


Motricidade ◽  
2017 ◽  
Vol 13 (2) ◽  
pp. 49
Author(s):  
Rafaella Stradiotto Bernardelli ◽  
Auristela Duarte de Lima Moser ◽  
Gerson Linck Bichinho

The spine has a direct influence on postural alignment and movement of the whole body. Lumbar muscles constitute a critical element in trunk performance while weakness of these muscles has been associated with low back pain. Hence, strength profiling of trunk muscles is clinically significant. The objective of this research was to determine, by means of isokinetic dynamometry, peak moment (PM) values during isokinetic concentric and eccentric efforts of trunk flexion and extension in sedentary asymptomatic individuals. The sample consisted of 100 asymptomatic sedentary volunteers, fifty from each sex, aging 22.2 ± 3.3 years old. The sample underwent concentric and eccentric isokinetic assessment of the trunk flexor and extensor muscles at an angular velocity of 60 degrees/sec for each mode of contraction. The mean concentric PM for trunk flexion and extension were 139.5 and 166.6 Nm, respectively, while the respective values for the eccentric efforts were 188.8 and 221.2 Nm. The PM flexion/extension ratio was 0.87 and 0.89 for the concentric and eccentric efforts, respectively. These values of concentric and eccentric PM and PM ratio will serve as comparison parameters for future research, as well as for the assessment of symptomatic patients, and to help in the creation of the trunk muscle rebalance protocols.


2020 ◽  
pp. 1-7
Author(s):  
Reza Heydari Armaki ◽  
Keramatollah Abbasnia ◽  
Alireza Motealleh

Objective: Patellofemoral pain (PFP) is the most commonly reported musculoskeletal overuse injury in active individuals, such as athletes, and is a multifactorial problem with no definite cause identified to date. Some studies have shown a relationship between impaired core and trunk sensorimotor control and knee disorders, especially PFP. The aim of this study was to evaluate trunk flexion proprioception by comparing the repositioning error between healthy athletes and athletes with PFP. Design: Cross-sectional case–control study. Setting: Rehabilitation sciences research center. Participants: Twenty healthy athletes and 20 athletes with PFP. Main Outcome Measures: To examine proprioception of trunk flexors, the absolute active and passive repositioning error at 30° and 60° trunk flexion were evaluated with isokinetic dynamometry. The results were compared between the two groups. Results: In the PFP group, the active trunk repositioning error at 30° flexion was significantly greater than in the healthy individuals (P < .001). The mean absolute active repositioning error at 30° flexion was 3.04° (1.37°) in the PFP group and 1.50° (0.70°) in the control group. There was no significant difference between groups in the active trunk repositioning error at 60° flexion (P = .066). The mean absolute active repositioning error at 60° flexion was 2.96° (1.26°) in the PFP group and 2.18° (0.99°) in the control group. The passive trunk repositioning error at 30° and 60° flexion was significantly greater in the PFP group (P = .013 and P = .004, respectively). The mean absolute passive repositioning error at 30° and 60° flexion in the PFP group was 2.94° (0.80°) and 3.13° (1.19°), respectively, and was 2.08° (1.08°) and 1.96° (0.71°), respectively, in the control group. The calculated eta-squared value showed that joint repositioning errors had large effect sizes (0.15–0.32). Conclusion: Trunk proprioception in the flexion direction may be impaired in patients with PFP. This finding suggests that trunk proprioception training may be important in rehabilitation for athletes with PFP.


1999 ◽  
Author(s):  
Maruti R. Gudavalli ◽  
Jerrilyn A. Backman ◽  
Steven J. Kirstukas ◽  
Anant V. Kadiyala ◽  
Avinash G. Patwardhan ◽  
...  

Abstract The objective of this study was to determine the electromyographic (EMG) activity of the superficial muscles during the treatment of low back patients during a conservative procedure known as the Cox flexion-distraction procedure. A total of 33 low back pain patients were recruited for this study from chiropractic and allopathic orthopedic clinics. EMG signals were collected while the patient was in a prone relaxed position, during the treatment using the flexion-distraction procedure, and during maximum voluntary exertions in the three planes (flexion, extension, left and right lateral bending, and left and right twisting). The mean values of the Root Mean Square (RMS) values of EMG ratios during treatment versus resting indicate that the muscles are active during the treatment. This activity is more than the activity at rest. However the mean values of the RMS EMG ratios (during treatment versus maximum voluntary contraction) are small indicating that the muscle activity during treatment may not influence the treatment loads. The left and right muscles in all muscle groups were similarly active. During the treatment, erector spinae muscles were the most active, followed by the external oblique, and the rectus abdominus muscles. The results from this study provide quantitative data for the muscle activity during the flexion-distraction treatment. This information can be incorporated into computer models to estimate the loads generated during the flexion-distraction treatment due to the muscle activity compared to the loads generated by the chiropractic physician.


Spine ◽  
2004 ◽  
Vol 29 (15) ◽  
pp. 1636-1641 ◽  
Author(s):  
Kris W.N. Wong ◽  
John C.Y. Leong ◽  
Man-kwong Chan ◽  
K D.K. Luk ◽  
W W. Lu

2020 ◽  
Author(s):  
Nguyen Ngoc Anh ◽  
Le Dinh Tung ◽  
Ngo Xuan Khoa ◽  
Le Manh Cuong ◽  
Nguyen Xuan Hung ◽  
...  

Abstract Background This study aims to identify normal HRAM values and related factors in healthy Vietnamese adults. Methods This cross-sectional study was conducted at Viet Duc hospital, Hanoi, Vietnam, during April and May, 2019. Healthy volunteers were recruited to participate in the study. Anorectal measurement values including pressure and an electromyographical signal from the digestive tract were recorded. Differences between groups were analyzed using paired t-tests, and linear regression models was used to compare anorectal values between men and women. Results A total of the 76 healthy volunteers was recruited. The mean functional anal canal length was 4.2 ± 0.5 cm while the mean anal high-pressure zone (HPZ) length was 3.4 ± 0.5 cm. The mean defecation index was 1.4 ± 0.8, with values ranging from 0.3 to 5.0. The mean threshold volume to elicit RAIR was 18.1 mL. Mean rectal sensation values were 32.4 mL, 81.6 mL, and 159 mL at the first sensation, the desire to defecate, and the urge to defecate, respectively. Dyssynergic patterns occurred in approximately 50% of study participants and included mainly types I (27.6%) and III (14.6%). There were significant differences between males and females in maximum anal squeeze pressure, maximum anal cough pressure, maximum anal strain pressure, maximum rectal cough pressure, and maximum rectal strain pressure (all p < 0.01). Conclusions This study establishes normal HRAM values in healthy Vietnamese adults, particularly with regards to normal values of anorectal pressure and rectal sensation. Further studies that include larger sample sizes should be conducted in order to further confirm the constants and their relationships.


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