Relationship between Muscle Tone of the Erector Spinae and the Concave and Convex Sides of Spinal Curvature in Low-Grade Scoliosis among Children

The objective of the present research was to assess the relationship between muscle tone of the erector spinae and the concave and convex sides of spinal curvature in low-grade scoliosis found among children. The study included 251 children, aged 7–8. Examination of the spine and body posture was carried out using the Diers Formetric III 4D optoelectronic method. Surface electromyography (sEMG) was used to assess erector spinae muscle tone. The trial was carried out using the 14-channel Noraxon TeleMyo DTS apparatus. The highest generalised tone (sEMG amplitude) of the erector spinae occurred in the case of scoliosis. The higher the angle of curvature, the greater the erector spinae muscle tone. Regardless of the position adopted during examination of the thoracic spine, greater erector spinae tone (sEMG amplitude) was exhibited on the convex side of the spinal curvature. However, in the area of the lumbar spine, greater tone (sEMG amplitude) of the erector spinae occurred on the curvature’s concave side. The exception was the test performed in a standing position, during which greater muscle tone was noted on the side of the convex curvature. In therapeutic practice, within the thoracic section, too tense erector spinae muscles should be stretched on the convex side of the scoliosis, while in the lumbar region, this should be performed on the concave side. However, each case of scoliosis requires individually tailored treatment. The current research has applicative value and does fill a research gap with regard to erector spinae muscle tone in young children experiencing low-grade scoliosis. The development of scoliosis is associated with asymmetry and an increase in erector spinae tone. The uneven distribution of its tone, occurring on both sides of the spine and in its various segments, causes destabilisation and its abnormal progression.

A Case Report of Chronic Expanding Hematoma of the Left Erector Spinae Muscle After Stereotactic Body Radiotherapy for Renal Cell Carcinoma

Background: Hematomas that slowly increase in size for over a period of more than one month after the initial hemorrhage are referred to as chronic expanding hematoma (CEH). We report a case of CEH of left erector spinae muscle after stereotactic body radiotherapy (SBRT) for renal cell carcinoma (RCC). Case presentation: A 74-year-old Japanese male complained of back pain. There was no history of surgery or trauma of his back. He received SBRT for RCC of left kidney of seven years ago. Computed tomography (CT) revealed the left erector spinae muscle was swollen compared to the contralateral side at the third lumbar level. Ultrasonography showed a tumor of 30 mm in size without blood flow in left paraspinal muscle. Positron emission tomography-CT revealed uptake in the left paraspinal muscle. Pathological examination showed radiation-induced CEH. We performed conservative therapy with medication alone because the tumor had been gradually growing. One year after starting observation, the patient died due to subdural hemorrhage after a fall and progression of renal failure. Discussion and conclusions: Because this study was a case study, it is difficult to definite the CEH after SBRT. Since SBRT has recently been increasing, SBRT-induced CEH is considered to be an important complication.

Relationship between Foot Position and Lumbar Loads while Turning Patients on a Bed: An Investigation via Computational Simulation and Electromyography

Caregivers have lower back pain (LBP) since they must reposition patients in bed frequently. Thus, the low lumbar load posture for turning patients should be explored. In this study, we focused on foot position because it can be easily adjusted to reduce back pain. The hypothesis was that short anteroposterior foot distance could reduce lumbar loads because closer position to patient made smaller moments. Therefore, this study aimed to investigate the relationship between foot position and lumbar loads while turning patients on beds. Furthermore, we compared compression stresses of L4–L5 via computational simulation and erector spinae muscle activities obtained from electromyography (EMG) in nine foot positions. The results showed that short anteroposterior foot distance reduced lumbar loads while turning a patient on a bed.

MRI-Determined Psoas Muscle Fat Infiltration Correlates with Severity of Weight Loss during Cancer Cachexia

Purpose: To evaluate the suitability of psoas and erector spinae muscle proton density fat fraction (PDFF) and fat volume as biomarkers for monitoring cachexia severity in an oncological cohort, and to evaluate regional variances in muscle parameters over time. Methods: In this prospective study, 58 oncological patients were examined by a 3 T MRI receiving between one and five scans. Muscle volume and PDFF were measured, segmentation masks were divided into proximal, middle and distal muscle section. Results: A regional variation of fat distribution in erector spinae muscle at baseline was found (p < 0.01). During follow-ups significant relative change of muscle parameters was observed. Relative maximum change of erector spinae muscle showed a significant regional variation. Correlation testing with age as a covariate revealed significant correlations for baseline psoas fat volume (r = −0.55, p < 0.01) and baseline psoas PDFF (r = −0.52, p = 0.02) with maximum BMI change during the course of the disease. Conclusion: In erector spinae muscles, a regional variation of fat distribution at baseline and relative maximum change of muscle parameters was observed. Our results indicate that psoas muscle PDFF and fat volume could serve as MRI-determined biomarkers for early risk stratification and disease monitoring regarding progression and severity of weight loss in cancer cachexia.

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.

Comparison among low intensity bridge exercises using suspension devices based on muscle activity and subjective difficulty

BACKGROUND: Recent clinical studies have revealed the advantages of using suspension devices. Although the supine, lateral, and forward leaning bridge exercises are low-intensity exercises with suspension devices, there is a lack of studies directly comparing exercise progression by measuring muscular activity and subjective difficulty. OBJECTIVE: To identify how the variations in the bridge exercise affects trunk muscle activity, the present study investigated changes in neuromuscular activation during low-intensity bridge exercises. We furthermore explored whether the height of the suspension point affects muscle activation and subjective difficulty. METHODS: Nineteen asymptomatic male participants were included. Three bridge exercise positions, supine bridge (SB), lateral bridge (LB), forward leaning (FL), and two exercise angles (15 and 30 degrees) were administered, thereby comparing six bridge exercise conditions with suspension devices. Surface electromyography and subjective difficulty data were collected. RESULTS: The rectus abdominis activity was significantly higher with the LB and FL exercises compared with the SB exercise (p< 0.05). The erector spinae muscle activity was significantly higher with the SB and LB exercises, compared with the FL exercise (p< 0.05). The LB exercise significantly increased the internal oblique muscle activity, compared with other exercise variations (p< 0.05). The inclination angle of the exercise only affected the internal oblique muscle and subjective difficulty, which were significantly higher at 30 degrees compared with 15 degrees (p< 0.05). CONCLUSIONS: Relatively higher inclination angle was not effective in overall activation of the trunk muscles; however, different bridge-type exercises could selectively activate the trunk muscles. The LB and SB exercises could be good options for stimulating the internal oblique abdominis, and the erector spinae muscle, while the FL exercise could minimize the erector spinae activity and activate the abdominal muscles.