Paravertebral Muscle Mechanical Properties in Patients with Axial Spondyloarthritis or Low Back Pain: A Case-Control Study

Different musculoskeletal disorders are a source of pain in the spinal region; most of them can be divided into mechanical, such as low back pain (LBP), or inflammatory origins, as is the case of axial spondyloarthritis (axSpA). Nevertheless, insufficient information is available about the muscle negative consequences of these conditions. Thus, the objective of this study was to identify whether mechanical muscle properties (MMPs) of cervical and lumbar muscles are different between patients with axSpA, subacute LBP (sLBP), and healthy controls. Furthermore, we aimed identify whether MMPs were related to sociodemographic and clinical variables in various study groups. The MMPs, sociodemographic, and clinical variables were obtained in 43 patients with axSpA, 43 subjects with sLBP, and 43 healthy controls. One-way ANOVAs and ROC curves were applied to identify whether the MMPs could differentiate between the study groups. Intra-group Pearson r coefficients to test the associations between MMPs and the rest of the variables were calculated. The results showed that axSpA subjects have a higher tone and stiffness and a lower relaxation and creep than sLBP and healthy ones (p < 0.05). All lumbar and cervical MMPs, except for decrement, could correctly classify axSpA and healthy subjects and axSpA and sLBP patients (in both cases, Area Under the Curve > 0.8). However, no MMP could differentiate between sLBP and healthy subjects. Each group had a different pattern of bivariate correlations between MMPs and sociodemographic and clinical data, with a worse state and progression of the axSpA group associated with a higher tone and stiffness in both spinal regions. This study supports that MMPs are different and show different patterns of correlations depending on the type of spinal pain.

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THU0380 LUMBOPELVIC RHYTHM IN PATIENTSWITH AXIAL SPONDYLOARTHRITIS COMPARED WITH LOW BACK PAIN AND HEALTHY SUBJECTS

10.1136/annrheumdis-2019-eular.1053 ◽

2019 ◽

Author(s):

Juan L. Garrido-Castro ◽

Inmaculada Concepcion Aranda-Valera ◽

Sandra Alcaraz-Clariana ◽

Lourdes García-Luque ◽

Daiana Rodriguez-de-Souza ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Healthy Subjects ◽

Axial Spondyloarthritis ◽

Low Back

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Differences in myoelectric activity of the lumbar muscles between recurrent and chronic low back pain: a cross-sectional study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04623-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Balasch-Bernat Mercè ◽

Willems Tine ◽

Danneels Lieven ◽

Meeus Mira ◽

Goubert Dorien

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Muscle Activity ◽

Healthy Subjects ◽

Erector Spinae ◽

Emg Activity ◽

Myoelectric Activity ◽

Healthy Controls ◽

Low Back ◽

Trunk Extension

Abstract Background Altered lower back muscle activity is proposed as a contributing factor to the reoccurrence and chronicity of low back pain (LBP). This study compared lumbar muscle activity during trunk extension in patients with continuous chronic LBP (CLBP), non-continuous CLBP, recurrent LBP (RLBP) and healthy subjects. Methods In 75 subjects (16 continuous CLBP, 15 non-continuous CLBP, 23 RLBP, 21 healthy controls), surface electromyographic (EMG) activity of the lumbar erector spinae (ES), multifidus (MF), latissimus dorsi (LD) and gluteus maximus (GM) was recorded during the concentric, holding and eccentric phase of a modified Biering Sorenson exercise. Results Continuous CLBP patients showed higher EMG activity in the ES and MF muscles compared to healthy controls in the concentric (p = 0.011; p = 0.009 respectively) and the holding phase (p = 0.015; p = 0.013). Higher EMG activity was observed in continuous CLBP compared to RLBP in the ES and MF muscles in the holding phase (p = 0.035; p = 0.037), and in the MF in the concentric phase (p = 0.046), but not in the ES (p = 0.062). No differences in muscle activity were established in either the concentric, holding, and eccentric phase for the LD and GM muscles. No differences were found between non-continuous CLBP and the other groups. Conclusions An enhanced muscle activity of the lumbar muscles during the concentric and holding phase was observed during trunk extension in patients with continuous CLBP compared to patients with RLBP and healthy subjects. No differences between groups are present in the GM and LD muscles during concentric and holding phases and for any muscle in the eccentric phase.

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Immediate effects of myofascial release on neuromechanical characteristics in female and male patients with low back pain and healthy controls as assessed by tensiomyography. A controlled matched-pair study

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2021.105351 ◽

2021 ◽

pp. 105351

Author(s):

Christine Lohr ◽

Ivan Medina-Porqueres

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Matched Pair ◽

Healthy Controls ◽

Low Back ◽

Myofascial Release ◽

Male Patients

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Gait kinematics in Low Back Pain: A non-linear approach

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200260 ◽

2021 ◽

pp. 1-8

Author(s):

Christos Tsigkanos ◽

Theano Demestiha ◽

Chara Spiliopoulou ◽

Georgios Tsigkanos

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Healthy Subjects ◽

Infrared Camera ◽

Low Back ◽

Movement Variability ◽

Optoelectronic System ◽

Mean Values ◽

Non Linear ◽

Healthy Participants

BACKGROUND: Kinematic analysis has been a dominant tool for addressing the neuromuscular and proprioceptive alterations that occur in Low Back Pain (LBP) patients. Movement variability is a crucial component of this analysis. During the past years a promising approach appears to be the application of non-linear indices. OBJECTIVE: The aim of the study was to compare movement variability, as expressed mainly by non-linear indices, at the pelvis and lumbar between LBP patients and healthy participants during gait. METHODS: Sixteen (16) LBP patients and thirteen (13) healthy control subjects (non-athletes) participated in the study. Participants walked on a treadmill at different walking conditions while recorded by a 6-infrared camera optoelectronic system. Kinematic variability of pelvic and lumbar movement was analyzed using linear (standard deviation) and non-linear indices (Maximal Lyapunov Exponent – LyE and Approximate Entropy – ApEn). RESULTS: Healthy subjects were found to have significantly greater mean values than LBP patients at seven pelvic and lumbar components in LyE, ApEn and SD. Specifically, the calculated LyE at the pelvis during normal gait was proven to have a sensitivity of 92.3% and a specificity of 90% in the discrimination of healthy subjects from LBP patients. Female subjects presented with higher variability in gait measures than males. CONCLUSION: Healthy participants presented with higher movement variability in their kinematic behavior in comparison to LBP patients. Lower variability values may be partly explained by the attempt of LBP patients to avoid painful end of range of motion positions. In this perspective non-linear indices seem to relate to qualitive characteristics of movement that need to be taken into consideration during rehabilitation.

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Sensorimotor and body perception assessments of nonspecific chronic low back pain: a cross-sectional study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04269-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

R. Meier ◽

C. Emch ◽

C. Gross-Wolf ◽

F. Pfeiffer ◽

A. Meichtry ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Cross Sectional Study ◽

Sensorimotor System ◽

Healthy Controls ◽

Low Back ◽

Sectional Study ◽

Clinical Tests ◽

Body Perception ◽

Cross Sectional

Abstract Background Low back pain (LBP) is one of the most common musculoskeletal disorders, causing significant personal and social burden. Current research is focused on the processes of the central nervous system (particularly the sensorimotor system) and body perception, with a view to developing new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might have the ability to detect alterations in the sensorimotor system. These include back-photo assessment (BPA), two-point discrimination (TPD), and the movement control tests (MCT). The aim of this study was to determine whether the simple clinical tests of BPA, TPD or MCT are able to discriminate between nonspecific CLBP subjects with altered body perception and healthy controls. Methods A cross-sectional study was conducted. At one point in time, 30 subjects with CLBP and 30 healthy controls were investigated through using BPA, TPD and MCT on the lower back. Correlations among the main covariates and odds ratios for group differences were calculated. Results MCT showed an odds ratio for the presence of CLBP of 1.92, with a statistically significant p-value (0.049) and 95%CI. The TPD and BPA tests were unable to determine significant differences between the groups. Conclusions Of the three tests investigated, MCT was found to be the only suitable assessment to discriminate between nonspecific CLBP subjects and healthy controls. The MCT can be recommended as a simple clinical tool to detect alterations in the sensorimotor system of nonspecific CLBP subjects. This could facilitate the development of tailored management strategies for this challenging LBP subgroup. However, further research is necessary to elucidate the potential of all the tests to detect alterations in the sensorimotor system of CLBP subjects. Trial registration No trial registration was needed as the study contains no intervention. The study was approved by the Swiss Ethics Commission of Northwest and Central Switzerland (EKNZ) reference number 2015–243.

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Isokinetic Trunk Strength in Acute Low Back Pain Patients Compared to Healthy Subjects: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052576 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2576

Author(s):

Waleska Reyes-Ferrada ◽

Luis Chirosa-Rios ◽

Angela Rodriguez-Perea ◽

Daniel Jerez-Mayorga ◽

Ignacio Chirosa-Rios

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Reference Values ◽

Healthy Subjects ◽

Isokinetic Strength ◽

Low Back ◽

Acute Low Back Pain ◽

Trunk Strength

Background: The purpose of this systematic review was to: (I) determine the quality of evidence from studies assessing trunk isokinetic strength in subjects with acute low back pain (ALBP) compared to healthy subjects and (II) establish reference values of isokinetic trunk strength in subjects with ALBP. Methodology: Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statements were followed using keywords associated with trunk, strength and low back pain. Four databases were used: PubMed, Web of Science, Scopus and SPORTDiscus. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Results: A total of 1604 articles were retrieved, four included in this review. All were evaluated as high risk of bias (Rob). Due to the high Rob and the diversity of protocols, instruments and variables used, it was not possible to determine reference values for subjects with ALBP, we can only establish a range of flexion peak torque (PT) between 175.1 and 89.7 Nm at 60°/s and between 185 and 81.5 Nm at 120°/s, and for extension PT between 240.0 and 91.5 Nm at 60°/s and between 217.5 and 69.2 Nm at 120°/s in subjects with ALBP. Conclusions: Due to the low quality of the evidence and the diversity of protocols used when measuring trunk isokinetic strength, it is necessary to carry out new high-quality research to establish reference values of trunk strength in subjects with ALBP.

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Peripheral Autonomic Potentials in Primary Headache and Drug-Induced Headache

Cephalalgia ◽

10.1046/j.1468-2982.1998.1804216.x ◽

1998 ◽

Vol 18 (4) ◽

pp. 216-221 ◽

Cited By ~ 12

Author(s):

S Evers ◽

H Voss ◽

B Bauer ◽

P Sörös ◽

I-W Husstedt

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Drug Abuse ◽

Healthy Subjects ◽

Primary Headache ◽

Tension Type Headache ◽

Low Back ◽

Drug Induced ◽

Type Headache ◽

Drug Induced Headache

Autonomic functions of different primary headache types have been investigated in several studies, most of them analyzing cardiovascular reflex mechanisms or biochemical changes. The results are contradictory; only in tension-type headache and in cluster headache has a sympathetic hypofunction been shown in a preponderance of studies. We analyzed the peripheral autonomous potentials (PAPs) in different primary headache types and in drug-induced headache and compared the results with those of healthy subjects and of patients with low back pain. Latencies of PAPs were significantly increased in all headache types but not in low back pain; amplitudes of PAPs did not show significant differences compared to healthy subjects. Patients with a long duration of drug abuse had increased PAP latencies, whereas patients with a high number of migraine attacks per year had decreased latencies. Our data suggest that sympathetic hypo-function as measured by PAP latencies is a general phenomenon in headache but not in all pain syndromes. Drug abuse leads to an increase of this hypofunction. While measuring PAPs is not an appropriate method by which to differentiate between headache disorders, it allows assessment of autonomic disturbances in primary and drug-induced headache.

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POS1290 CYTOKINE BIOMARKERS IN COMMON LOW BACK PAIN

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4205 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 926.3-926

Author(s):

R. Dhahri ◽

A. Dghaies ◽

M. Slouma ◽

L. Metoui ◽

I. Gharsallah ◽

...

Keyword(s):

Neuropathic Pain ◽

Low Back Pain ◽

Back Pain ◽

Inflammatory Cytokines ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Controls ◽

Low Back ◽

Tnf Α ◽

Functional Scores ◽

The Mean

Background:Common low back pain (LBP) is a common health problem affecting 50 to 80% of working age adults. It is one of the common and costly health problems in Tunisia. Actually, the role of the immune response and inflammatory cytokines in the pathogenesis of chronic pain has been of growing interest.Objectives:The aim of this study was to assess whether pro and anti-inflammatory cytokines could be detected in serum in patients with LBP compared with healthy subjects and whether they could be related to pain severity and to clinical findings.Methods:It was a an analytical cross-sectional study including 50 patients with at least three months of LBP, in the department of rheumatology, orthopedics and immunology at the Military Hospital of Tunis between January 1st and March 31, 2020. All patients had a standardized clinical assessment.Levels of serum cytokines IL-6, IL-8, IL-1β and TNF- α, were measured using the chimiluminescence technique. Serum concentration of IL-10 was assayed by the enzyme-linked immunosorbent assay technique (ELISA). The normal levels of cytokines were determined in 50 healthy controls.Results:The mean age of the patients was 41.9 ± 8.4 years and the sex ratio was 4.5. LBP duration was 66.4 months. The mean lumbar visual analog scale (VAS) was 4.5 ± 1.9, and the root VAS was 2.6 ± 2.5. Neuropathic pain was found in 26% of patients. The average BMI was 27 ± 3.7 kg/m2. Only serum level of IL-8 was significantly higher in subjects with LBP compared to healthy controls (p <10-3). IL-1β was indetectable in both patients and controls. Positive correlations were found between IL-8 levels and anxiety/functional scores (r = 0.3; p = 0.02/ r = 0.3; p = 0.04). IL-6 was positively correlated with BMI, and negatively correlated with the Schober test. No correlations were found between serum levels of IL-6, IL-8, IL-10, TNF-α and pain intensity (VAS), neuropathic pain (DN4), fibromyalgia (FIRST), depression (HAD) and various radiological data.Conclusion:Interleukin-8 is a biomarker of common low back pain and correlate with anxiety and functional disability. These results suggest that IL-8 may be a therapeutic target to reduce chronic back pain and reduce the social and profession impact.Disclosure of Interests:None declared

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Discriminatory Aspects of Pre-employment Screening: Low-Back X-ray Examinations in the Railroad Industry

American Journal of Law & Medicine ◽

10.1017/s0098858800004950 ◽

1979 ◽

Vol 5 (3) ◽

pp. 197-214

Author(s):

Paul H. Rockey ◽

Jane Fantel ◽

Gilbert S. Omenn

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Screening Program ◽

Job Applicants ◽

Radiation Hazard ◽

Low Back ◽

Negative Consequences ◽

X Ray ◽

Work Related ◽

Increased Risk

AbstractIn screening the majority of job applicants, most of this nation's railroads administer a low-back X-ray examination in an attempt to ascertain the likelihood that the applicant will sustain future work-related low-back pain or injury. Many applicants are rejected for employment on the basis of the X-ray findings. The railroads apparently perceive this screening program as a cost-effective means (1) of decreasing the incidence of compensation claims for work-related injuries, brought against the rail-roads under the Federal Employers' Liability Act (FELA), (2) of reducing the number of lost workdays resulting from low-back pain or injury, and (3) of protecting particularly susceptible workers from job-related hazards.The authors of this Article submit that low-back X-ray examinations are poor predictors of future low-back pain or injury. They assert that the railroads' use of such examinations misclassifies a substantial number of job applicants as being at increased risk for such pain or injury, and, in consequence, unfairly denies them employment. Furthermore, the authors claim, the screening program has other negative consequences. For example, applicants rejected for railroad employment on the basis of X-ray findings may as a result have difficulty finding jobs in other industries. In addition, they state, there is a potential radiation hazard to examinees. Moreover, both the railroads and those applicants accepted for employment may inappropriately be reassured by normal findings.On balance, the authors conclude, the screening program has a negative social value. The authors suggest that the program, in effect, erroneously labels many applicants as handicapped, and then denies them employment. Such persons might have legal recourse under federal and state statutes prohibiting employment discrimination against the handicapped.

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