Correction and prevention of lumbosacral osteochondrosis in elderly women based on the use of exercise complexes in water

The study is devoted to identifying the effectiveness of exercise complexes in water for the correction and prevention of lumbosacral osteochondrosis in elderly women, which was proven and expressed in a significant improvement in systolic blood pressure, the Stange and Gencha test, spinal mobility in the Tomayer test and the Schober test, lateral flexion of the spine to the left and right, maintaining stability of balance in the Romberg test, quality of life. Keywords: elderly age, osteochondrosis, exercises in water.

Evaluation of 3D vertebral and pelvic position by surface topography in asymptomatic females: presentation of normative reference data

Background Deviations from a conventional physiologic posture are often a cause of complaint. According to current literature, the upright physiological spine posture exhibits inclinations in the sagittal plane but not in the coronal and transverse planes, but individual vertebral body positions of asymptomatic adults have rarely been described using surface topography. Therefore, this work aims to form a normative reference dataset for the thoracic and lumbar vertebral bodies and for the pelvis in all three planes in asymptomatic women. Methods In a prospective, cross-sectional, monocentric study, 100 pain-free asymptomatic women, aged 20–64 years were enrolled. Habitual standing positions of the trunk were measured using surface topography. Data were analyzed in all three planes. Age sub-analysis was: 1) ages ≤ 40 years and 2) ages ≥ 41 years. Two-sample t-tests were used for age comparisons of the vertebral bodies, vertebra prominence (VP)–L4, and global parameters. One-sample t-tests were used to test deviations from symmetrical zero positions of VP–L4. Results Coronal plane: on average, the vertebral bodies were tilted to the right between the VP and T4 (maximum: T2 − 1.8° ± 3.2), while between T6 and T11 they were tilted to the left (maximum: T7 1.1° ± 1.9). T5 and L2 were in a neutral position, overall depicting a mean right-sided lateral flexion from T2 to T7 (apex at T5). Sagittal plane: the kyphotic apex resided at T8 with − 0.5° ± 3.6 and the lumbar lordotic apex at L3 with − 2.1° ± 7.4. Transverse plane: participants had a mean vertebral body rotation to the right ranging from T6 to L4 (maximum: T11 − 2.2° ± 3.5). Age-specific differences were seen in the sagittal plane and had little effect on overall posture. Conclusions Asymptomatic female volunteers standing in a habitual posture displayed an average vertebral rotation and lateral flexion to the right in vertebral segments T2–T7. The physiological asymmetrical posture of women could be considered in spinal therapies. With regard to spinal surgery, it should be clarified whether an approximation to an absolutely symmetrical posture is desirable from a biomechanical point of view? This data set can also be used as a reference in clinical practice. Trial registration: This study was registered with WHO (INT: DRKS00010834) and approved by the responsible ethics committee at the Rhineland–Palatinate Medical Association (837.194.16).

Kinematics of the head and associated vertebral artery length changes during high-velocity, low-amplitude cervical spine manipulation

Background Cervical spine manipulation (CSM) is a frequently used treatment for neck pain. Despite its demonstrated efficacy, concerns regarding CSM safety remain. The purpose of this study was to quantify the angular displacements of the head relative to the sternum and the associated vertebral artery (VA) length changes during the thrust phase of CSM. Methods Bilateral rotation and lateral flexion CSM procedures were delivered from C1 to C7 to three male cadaveric donors. For each CSM the force-time profile was recorded using a thin, flexible pressure pad (100-200Hz), to determine the timing of the thrust. Three dimensional displacements of the head relative to the sternum were recorded using an eight-camera motion analysis system (120-240Hz) and angular displacements of the head relative to the sternum were computed in Matlab. Positive kinematic values indicate flexion, left lateral flexion, and left rotation. Ipsilateral refers to the same side as the clinician's contact and contralateral, the opposite. Length changes of the VA were recorded using eight piezoelectric ultrasound crystals, inserted along the entire vessel. VA length changes were calculated as D=(L1-L0)/L0, where L0= length of the whole VA (sum of segmental lengths) or the V3 segment at CSM thrust onset; L1= whole VA or V3 length at peak force during the CSM thrust. Results VA length changes during the thrust phase were greatest with ipsilateral rotation CSM (producing contralateral head rotation): [mean ± SD (range)] whole artery [1.3 ± 1.0 (-0.4 to 3.3%)]; and V3 segment [2.6 ± 3.6 (-0.4 to 11.6%)]. For ipsilateral rotation CSM, head angular displacements relative to the sternum during the thrust were: flexion/extension [1.2 ± 3.4 (-6.6 to 7.6º)]; rotation [-10.2 ± 3.5 (-16.1 to -3.7º)]; and lateral flexion [8.8 ± 3.0 (2.5 to 14.1º)]. Conclusion Mean head angular displacements and VA length changes were small during CSM thrusts. Of the four different CSM measured, mean VA length changes were largest during rotation procedures. This suggests that if clinicians wish to limit VA length changes, consideration should be given to the type of CSM used.

Sex-specific Effects of Localized Muscle Fatigue on Upper Body Kinematics During a Repetitive Pointing Task

BackgroundFemales are reported to have a higher risk of musculoskeletal disorders than males. Among risk factors for musculoskeletal disorders, the mechanism of muscle fatigue remains unclear. Especially how females and males adapt to localized fatigue is poorly understood. The purpose of the study was to examine the sex-specific effects of fatigue location on shoulder, elbow and spinal joint angles, and angular variabilities during a repetitive pointing task.MethodsSeven males and ten females performed a standing repetitive pointing task when they were non-fatigued (NF), elbow-fatigued (EF), shoulder-fatigued (SF) and trunk-fatigued (TF), while trunk and upper body tridimensional kinematic data was recorded. Joint angles and angular variabilities of shoulder, elbow, upper thorax, lower thorax, and lumbar were calculated. ResultsResults showed that shoulder angles changed the most after EF in males, but after SF in females. The similarities between sexes were that SF increased the variabilities at upper (lateral flexion: 0.15° greater than NF, rotation: 0.26° greater than all other conditions) and lower thorax (lateral flexion: 0.13° greater than NF, rotation: averagely 0.1° greater than all other condition) in both sexes. TF altered upper thorax variability (0.36° smaller than SF), lower thorax angle (lateral flexion: 3.00° greater than NF, rotation: 1.68° greater than SF), and lumbar angle (averagely 1.8° smaller than all other conditions) in both sexes. However, females had greater lower thorax angle (lateral flexion: 8.3° greater, p=0.005) as well as greater upper (rotation: 0.53° greater, p=0.006) and lower thorax (rotation: 0.5° greater, p=0.007; flexion: 0.6° greater, p=0.014) angular variabilities.ConclusionsThe overall greater lower and upper thorax angular variabilities suggested a more unstable spinal movement pattern in females. The kinematic differences between sexes highlighted a few sex differences in adapting the localized muscle fatigue.

Biomechanical Evaluation of the Transcortical and Transpedicular Trajectories for Pedicle Screw Insertion in Thoracolumbar Fracture Fixation for Ankylosing Spondylitis

Background: Ankylosing spondylitis (AS) is a chronic disorder characterized by an imbalance between bone formation and resorption. Spinal fractures often occur after minor trauma in patients with AS. For thoracolumbar fractures, transpedicular screw (TPS) fixation through the posterior approach has been suggested. The cortical bone trajectory (CBT) technique has also been used to prevent screw pull-out in patients with poor bone quality. The aim of current study was to assess the biomechanical characteristics of the TPS and CBT technique in thoracolumbar AS fracture fixation by finite element analysis.Methods: The three-dimensional finite element models of the AS spine were created. The CBT and TPS methods of screw insertion were used in AS spinal fracture models. An intact AS spine model was considered the control. An axial force and torsion in rotation, flexion/extension and lateral flexion were applied in all models in CBT, TPS, and control groups.Results: The AS spine showed similar construct stiffness after posterior fixation by CBT and TPS techniques under axial, rotational, and flexion/extension loading conditions. The TPS technique showed better intact stability under all loading conditions. Similarly, the TPS technique provided superior fracture regional stability against axial and rotational loads than did the CBT technique. The maximum von Mises stresses were 1714.4 ± 129.8 MPa and 1208.7 ± 107.3 MPa (p < 0.001), which occurred in the CBT and TPS groups under compressive loading.Conclusions: The TPS technique provides better biomechanical strength under axial, rotational, flexion/extension, and lateral flexion loading than does the CBT technique. Compared with CBT, TPS is more effective in maintaining the stability of AS thoracolumbar fractures from a finite element analysis perspective.

Biomechanical Evaluation of Back-Support Exoskeletons during Patient Transfers

The purpose of this study was to investigate the effects of three back-support exoskeletons (FLx ErgoSkeleton, V22 ErgoSkeleton, Laevo V2.5) and patient transfer methods (Squat pivot, stand pivot, scoot) on the musculoskeletal loading and self-reported usability measures during patient transfers between a bed and a wheelchair. In a repeated-measures laboratory study, 20 experienced caregivers (17 females and 3 males) performed a series of 24 bed-to-wheelchair transfer tasks (2 directions × 4 exoskeleton conditions × 3 patient transfer methods). The trunk flexion and lateral flexion angles, bilateral hand pull forces, and muscle activities of the erector spinae were significantly different by exoskeleton conditions and patient transfer methods (p’s < 0.01). The usability measures were significantly affected by exoskeleton designs (p’s < 0.01). There were significant two-way interaction effects on the trunk flexion and lateral flexion angles and muscle activities of the erector spinae (p’s < 0.01). For the squat pivot method, three back-support exoskeletons showed the largest reduction of erector spinae muscle activities (47.4 to 83.5% reference voluntary contractions) compared to no exoskeleton. This indicated the effects of exoskeleton conditions on the trunk postures and erector spinae muscle activities depended on the patient transfer method. More research could be needed to improve the trunk postures and usability of back-support exoskeletons suitable for patient handling.

Subjective Postural Vertical as a Prognosticator of Lateral Trunk Flexion in Patients With Parkinson's Disease.

We conducted a retrospective study to test our hypothesis that the subjective postural vertical (SPV) ratio, i.e., SPV in relation to the lateral flexion axis, is predictive of lateral trunk flexion (LTF) in patients with Parkinson's disease (PD). The study group comprised 25 patients with PD. The SPV angle, i.e., the subjective perception of a vertical position with reference to the vertical axis, and the SPV ratio, i.e., the SPV angle with reference to the axis of lateral flexion, were calculated. The SPV ratio (r = 0.698 p = 0.001) and LTF angle (r = −0.601 p = 0.001) were found to correlate with change in the LTF angle calculated at 1 year. The SPV ratio was significantly smaller in the LTF angle-improved group (n = 12) than in the non-improved group (n = 13) (0.99 ± 0.78 vs 1.66 ± 0.71, p = 0.011). The AUC under the ROC curve of the SPV ratio for discrimination of LTF improvement was 0.795 (95% confidence interval: 0.61–0.98). Our study showed that the SPV ratio is associated with change in the LTF and that the SPV ratio can conceivably be used to predict the likelihood of improvement in patients’ LTF.

ANALYSIS OF THE EFFECT OF THE DIFFERENCE BETWEEN STANDING AND SITTING POSTURES ON NECK PROPRIOCEPTION USING JOINT POSITION ERROR TEST

The proprioceptive sense is a very important function for the body, and joint position error test (JPET) is commonly used to measure it. This study was to analyze the difference of proprioception in standing and sitting postures through the JPET. A total of 60 students (M/F, 12/48) in D University in Gyeongsangbuk-do, South Korea participated in this study. A JPET was performed with the subject’s eyes closed to assess the neck proprioception. The movement of the neck was measured in flexion, extension, and lateral flexion, and separately measured when sitting and standing. The difference in repositioning errors between sitting and standing postures was analyzed using paired [Formula: see text]-test. There was a significant difference in repositioning errors between sitting and standing posture in neck extension. There was no significant difference in repositioning errors between sitting and standing posture in neck flexion and lateral flexion. In conclusion, in a sitting posture, posterior neck muscles are used more than in the standing posture, which may negatively affect the proprioceptive accuracy of the neck and may also increase the neck repositioning errors.

Immediate Effect of Strong Surged Faradic Stimulation vs Self-Stretching in Less Tensed Position on Chronic Upper Trapezius Spasm in Young Females

Faulty postural habits lead to upper trapezius spasm causing pain and affection of neck mobility. The study aimed to compare the immediate effect of Strong Surged Faradic Stimulation and self-stretching in Less Tensed Position in chronic trapezius spasm in young females. 46 female subjects with unilateral chronic trapezius spasm between the age 18-25 years were randomly allocated into Strong Surged Faradic Stimulation group and self-stretching group. Pre and post intervention Numeric Pain Rating Scale and cervical lateral flexion range of motion was measured. Both the interventions were effective in reducing pain (p < 0.0001) and improving range of motion (p <0.0001). When compared for pain, both were equally effective (p = 0.3664) but for range of motion self-stretching in Less Tensed Position was more effective (p < 0.0001). Key words: Trapezius spasm, Strong Surged Faradic Stimulation, Self-Stretching, young females.

SINGLE LEG SQUAT COMPENSATIONS ASSOCIATE WITH SOFTBALL PITCHING PATHOMECHANICS IN ADOLESCENT SOFTBALL PITCHERS

Background: Softball pitchers have an eminent propensity for injury due to the high repetition and ballistic nature of the pitch. As such, trunk pathomechanics during pitching have been associated with upper extremity pain. The single leg squat (SLS) is a simple diagnostic tool used to examine LPHC and trunk stability. Research shows a lack of LPHC stability is often associated with altered pitching mechanics consequently increasing pain and injury susceptibility. Hypothesis/Purpose: The purpose of this study was to examine the relationship between trunk compensatory kinematics during the SLS and kinematics during foot contact of the windmill pitch. The authors hypothesized there would be a relationship between SLS compensations and pitch kinematics previously associated with injury. In using a simple clinical assessment such as the SLS, athletes, coaches, parents, and clinicians can identify potential risk factors that may predispose the athlete to injurious movement patterns. Methods: Fifty-five youth and high school softball pitchers (12.6±2.2 years, 160.0±11.0 cm, 60.8±15.5 kg) were recruited to participate. Kinematic data were collected at 100Hz using an electromagnetic tracking device. Participants were asked to complete a SLS on their stride leg (contralateral to their throwing arm), then throw 3 fastballs at maximal effort. Values of trunk flexion, trunk lateral flexion, and trunk rotation at peak depth of the SLS were used as the dependent variables in three separate backward elimination regression analyses. Independent variables examined at foot contact of the pitch included: trunk flexion, trunk lateral flexion, trunk rotation, center of mass, stride length, and stride knee valgus. Results: The SLS trunk rotation regression, F(1,56) = 4.980, p = .030, revealed trunk flexion significantly predicted SLS trunk rotation (SE = .068, t = 2.232, p = .030) and explained approximately 7% of variance (Adj. R2 = .066). The SLS trunk flexion regression, F(1,56) = 5.755, p = .020, revealed stride knee valgus significantly predicted SLS trunk flexion (SE = .256, t = 2.399, p = .020) and explained approximately 8% of variance (Adj. R2 = .078). Conclusion/Significance: Additional trunk rotation and trunk flexion at peak depth of the SLS indicate increased knee valgus and trunk flexion at foot contact of the pitch, both of which suggest poor LPHC stability, may increase the potential for injury. Athletes, coaches and clinicians should acknowledge the risk of poor LPHC in softball pitching and implement exercises to improve LPHC stability in effort to decrease pitching pathomechanics and associated pain.