1,721,217 research outputs found
Biopsy samples from the erector spinae of persons with nonspecific chronic low back pain display a decrease in glycolytic muscle fibers
No full textBackground context
Low back pain (LBP) in Western Europe was classified as having the highest disability and overall burden among 291 studied conditions. For an extensive period of time evidence has accumulated related to morphological changes (e.g. atrophy and fat infiltration) of the paraspinal muscles in persons with LBP. Despite this evidence, there is limited knowledge on muscle fiber type composition of these muscles, and their relation to LBP.
Purpose
The aim of the study is to investigate differences in muscle fiber type composition between persons with non-specific chronic low back pain (NSCLBP) and healthy controls for the lumbar erector spinae (ES) and multifidus (MF) muscle.
Study design and setting
A cross sectional study took place in the REVAL Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.
Patient sample
Twenty persons with NSCLBP (age: 44.5 ±7.42) and eighteen healthy controls (age: 39.89 ±7.90) participated in this study.
Outcome measures
The primary outcome measure was paraspinal muscle fiber type composition. Secondary outcomes consisted of physiologic measures (maximal aerobic capacity and back muscle strength) and functional measures (activity level).
Methods
Biopsy samples were taken from the lumbar ES and MF muscle at the L4 spinal level. These samples were stained using immunofluorescent antibodies against myosin heavy chains (MHC). In each sample, number and size (CSA) of type I, I/IIa, IIa, IIa/x, and IIx muscle fibers were quantified. From these data the relative cross-sectional fiber areas (RCSA) were calculated. To analyze differences in fiber type composition between healthy persons and persons with NSCLBP, a repeated measurements analysis of variance (ANOVA) was used. Secondary outcome measures were analyzed using a Student's t-test, and Wilcoxon test. This study was supported by the research fund of Hasselt University without potential conflict of interest.
Results
There were no significant differences between both groups regarding anthropometric data. There were no significant between group differences for CSA in the ES. Persons with NSCLBP displayed a non-significant (p= 0.0978) increase in the number of type I muscle fibers, and a significant decrease (p= 0.0019) in the number of type IIx muscle fibers in the ES muscle. Persons with NSCLBP also displayed a trend towards a higher (p= 0.0596) RCSA for type I fibers and a significantly lower RCSA for type IIx fibers (p= 0.0411). There were no significant between group differences within the MF. Regarding the secondary outcome measures, there was a significant between group difference in activity level (p=0.0004) and isokinetic back muscle strength (p=0.0342).
Conclusions
This is the first study to examine muscle fiber type characteristics in both the ES and MF muscle of persons with NSCLBP. Based on muscle fiber characteristics, the paraspinal muscles of persons with NSCLBP seems to display a larger oxidative potential based on an increase of the number type I fibers at the expense of type IIx glycolytic fibers.Our gratitude goes to Geert Souverijns, MD (Jessa Hospital, Department of Radiology, Belgium) who gave us the opportunity to work with a medical doctor of his department We also like to thank the Department of Pneumology (KULeuven) for their help with the immunofluorescent staining. There is no study funding sources
Extra-Articular Impingement at the Anterior Inferior Iliac Spine: A Cause of Refractory Periarticular Pain After Total Hip Arthroplasty
No full textBackground: Periarticular pain after total hip arthroplasty (THA) can significantly impair the post-operative functionality. Extra-articular impingement between the greater trochanter and the anterior inferior iliac spine is presented as a cause of refractive pain after THA. Methods: Twenty patients were treated for refractive periarticular pain and limited internal rotation between January 2014 and April 2016. All patients underwent a positive chair rise test, pelvic inclination test, and Marcainisation test. Patients were treated with bone resection of the anterior part of the greater trochanter with or without component revision. Results: At a mean follow-up of 20 months, all functional outcomes had improved significantly. All patients were willing to undergo the surgery again. Sixteen (80%) indicated the result as very good, 3 (15%) as good, and one (5%) as poor. Two patients developed a postoperative heterotopic ossification that required resection. Conclusions: Extra-articular impingement should be considered as a possible cause of refractive groin pain after THA. Bony resection through the Hueter interval provides immediate pain relief with improved functional outcomes 1 year after surgery
The effect of anti-gravity training after meniscal or chondral injury in the knee. A systematic review
No full textReduced impact loading or anti-gravity training has recently been introduced as a new tool in the rehabilitation of orthopaedic conditions that require restricted weight bearing. The purpose of this strategy is to speed up the functional rehabilitation while at the same time protect the healing structures from harmful effects associated with impact loading. Anti-gravity treadmills (AlterG ®) and harness suspension devices seem to be the two most promising techniques. It is however today unclear how effective these devices are. The purpose of our study was therefore to perform a systematic literature review on the actual technology available and its effect on impact load reduction, as well as its effectiveness in accelerating functional recovery after meniscal and chondral injury to the knee. The results from our work demonstrate that only a limited number of studies are available, usually of moderate quality. The data suggest a variable effect on cartilage regeneration, and a potential for accelerated functional recovery in gait and running dynamics both with anti-gravity treadmill as well as suspension harness systems.No benefits or funds were received in support of this study
The Role of Skeletal Muscle Mitochondria in Colorectal Cancer Related Cachexia: Friends or Foes?
No full textUp to 60% of colorectal cancer (CRC) patients develop cachexia. The presence of CRC related cachexia is associated with more adverse events during systemic therapy, leading to a high mortality rate. The main manifestation in CRC related cachexia is the loss of skeletal muscle mass, resulting from an imbalance between skeletal muscle protein synthesis and protein degradation. In CRC related cachexia, systemic inflammation, oxidative stress, and proteolytic systems lead to mitochondrial dysfunction, resulting in an imbalanced skeletal muscle metabolism. Mitochondria fulfill an important function in muscle maintenance. Thus, preservation of the skeletal muscle mitochondrial homeostasis may contribute to prevent the loss of muscle mass. However, it remains elusive whether mitochondria play a benign or malignant role in the development of cancer cachexia. This review summarizes current (mostly preclinical) evidence about the role of skeletal muscle mitochondria in the development of CRC related cachexia. Future human research is necessary to determine the physiological role of skeletal muscle mitochondria in the development of human CRC related cachexia.This research received no external funding
The effect of anti-gravity training after meniscal or chondral injury in the knee. A systematic review
No full textReduced impact loading or anti-gravity training has recently been introduced as a new tool in the rehabilitation of orthopaedic conditions that require restricted weight bearing. The purpose of this strategy is to speed up the functional rehabilitation while at the same time protect the healing structures from harmful effects associated with impact loading. Anti-gravity treadmills (AlterG ®) and harness suspension devices seem to be the two most promising techniques. It is however today unclear how effective these devices are. The purpose of our study was therefore to perform a systematic literature review on the actual technology available and its effect on impact load reduction, as well as its effectiveness in accelerating functional recovery after meniscal and chondral injury to the knee. The results from our work demonstrate that only a limited number of studies are available, usually of moderate quality. The data suggest a variable effect on cartilage regeneration, and a potential for accelerated functional recovery in gait and running dynamics both with anti-gravity treadmill as well as suspension harness systems.No benefits or funds were received in support of this study
Unilateral changes of the multifidus in persons with lumbar disc herniation: a systematic review and meta-analysis
No full textBACKGROUND: Lumbar disc herniation (LDH) is one of the most often diagnosed degenerative pathologies within the lumbar spine. Paraspinal muscle involvement could be a possible mediator in the pathophysiology of disc herniation and influences the course of pain and disability after both surgical or nonsurgical treatment. To potentially improve treatment, it may be important to assess multifidus muscle morphology in patients diagnosed with a LDH. OBJECTIVE: A systematic literature review and meta-analysis regarding the multifidus morphology in patients diagnosed with a LDH was conducted to assess the differences in multifidus muscle morphology between persons with LDH and healthy controls, and between the involved and the uninvolved side within subjects experiencing unilateral LDH. METHODS: A systematic search was conducted of articles published up to and including November 2019 using the Pubmed, Web of Science, EMBASE, and MEDLINE Ovid search engines. The articles obtained from this search were screened based on title and abstract using the predetermined eligibility criteria. Included full text articles were assessed for their methodologic quality using the modified Downs and Black checklist. Heterogeneous data regarding multifidus muscle morphology was included in the descriptive analysis; data that was homogenous was included in the meta-analysis. RESULTS: We identified 3,176 articles. Based on the screening for inclusion/exclusion criteria, 18 articles were included. Studies were either cross sectional or case-control studies assessing side-toside differences or comparing patients diagnosed with a LDH to a healthy control group. Nine studies investigated whole muscle atrophy, six looked at muscle fat infiltration, seven studies assessed microscopic muscle properties including muscle fiber size, distribution, and muscle fibrosis. From the 18 articles, 10 were included in the meta-analysis. In the meta-analysis, a comparison was made between side-to-side differences for muscle fiber size, distribution, and whole muscle size. Descriptive analysis showed increased fat infiltration and atrophy (muscle and individual fiber) of the multifidus muscle when comparing side-to-side differences or comparing cases to controls. Meta-analysis showed a significant decrease in type I and II muscle fiber size (p=.002, .01, respectively) combined with a significant increase in the number of type I muscle fibers (p=.008) at the side of LDH. Regarding whole muscle size, no significant differences were found. CONCLUSIONS: This study shows the presence of ipsilateral multifidus muscle changes in persons with unilateral LDH. (C) 2020 Elsevier Inc. All rights reserved.This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors. None of the authors state to have professional
and financial affiliations that may be perceived to have biased the presentation.Stevens, S (corresponding author), Hasselt Univ, Fac Rehabil Sci, Rehabil Res Ctr, Agoralaan Bldg A, B-3590 Diepenbeek, Belgium.
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General practitioners' predictions of their own patients' health literacy: a cross-sectional study in Belgium
No full textOBJECTIVES: To support patients in their disease management, providing information that is adjusted to patients' knowledge and ability to process health information (ie, health literacy) is crucial. To ensure effective health communication, general practitioners (GPs) should be able to identify people with limited health literacy. To this end, (dis)agreement between patients' health literacy and GPs' estimations thereof was examined. Also, characteristics impacting health literacy (dis)agreement were studied. DESIGN: Cross-sectional survey of general practice patients and GPs undertaken in 2016-17. SETTING: Forty-one general practices in two Dutch-speaking provinces in Belgium. PARTICIPANTS: Patients (18 years of age and older) visiting general practices. Patients were excluded when having severe impairments (physical, mental, sensory). MAIN OUTCOME MEASURES: Patients' health literacy was assessed with 16-item European Health Literacy Survey Questionnaire. GPs indicated estimations on patients' health literacy using a simple scale (inadequate; problematic; adequate). (Dis)agreement between patients' health literacy and GPs' estimations thereof (GPs' estimations being equal to/higher/lower than patients' health literacy) was measured using Kappa statistics. The impact of patient and GP characteristics, including duration of GP-patient relationships, on this (dis)agreement was examined using generalised linear logit model. RESULTS: Health literacy of patients (n=1375) was inadequate (n=201; 14.6%), problematic (n=299; 21.7%), adequate (n=875; 63.6%). GPs overestimated the proportion patients with adequate health literacy: adequate (n=1241; 90.3%), problematic (n=130; 9.5%) and inadequate (n=4; 0.3%). Overall, GPs' correct; over-/underestimations of health literacy occurred for, respectively, 60.9%; 34.2%; 4.9% patients, resulting in a slight agreement (κ=0.033). The likelihood for GPs to over-/underestimate patients' health literacy increases with decreasing educational level of patients; and decreasing number of years patients have been consulting with their GP. CONCLUSIONS: Intuitively assessing health literacy is difficult. Patients' education, the duration of GP-patient relationships and GPs' gender impact GPs' perceptions of patients' health literacy.status: Publishe
Gluteus Maximus Transfer as an Augmentation Technique for Patients With Severe Abductor Deficiency of the Hip
No full textImpaired abductor function of the hip following severe abductor deficiencies can be devastating for functionality and quality of life. Recently, gluteus maximus transfer has been proposed as a solution to these difficult problems. However, outcome results are sparse. The aim of this study was to evaluate the effects of gluteus maximus transfer on improvement of pain, disability, and quality of life in patients with severe hip abductor deficiencies. Gluteus maximus transfer was performed in 16 patients with severe disruption of the abductor muscles of the hip. Data were collected preoperatively and at 6 weeks, 3 and 6 months, and 1 to 2 years after surgery. The measurements pertained to complications, healing of the flap based on magnetic resonance imaging (MRI) findings (in 10 patients), evaluation of Trendelenburg gait and sign, and patient-reported outcome measures of pain, disability, and quality of life. Preoperatively, all patients had a positive Trendelenburg sign and reported severe pain at the level of the greater trochanter. At a mean follow-up of 20 months,the Trendelenburg sign was negative in 7 patients and the Trendelenburg gait had disappeared in 7 patients. There was an improvement in patient-reported outcome measures but not to a significant level except for the pain subscores. Two patients had a postoperative seroma that resulted in a visible bump on the lateral side. Seven of 10 repairs with MRI follow-up showed perfect ingrowth on MRI without signs of rerupture. Gluteus maximus transfer for abductor deficiency of the hip may be effective for pain relief and functional improvements.Most patients showed an improved quality of life but were not completely pain free.Corten, K (corresponding author), Hosp Zuid Oost Limburg Genk, Dept Orthoped Surg, Schiepse Bos 6, B-3600 Genk, Belgium.
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A minimally invasive percutaneous fine needle biopsy method to obtain lumbar paraspinal muscles
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