Long-term effects of supervised physical training in secondary prevention of low back pain.

BACKGROUND AND OBJECTIVES: In the last few years, several studies have focused on short-term treatment effects of exercise therapy. However, there is a lack of knowledge concerning the long-term treatment effects recorded after several years. Hence, this study was performed to investigate the short- and long-term effects of supervised physical training on functional ability, self-rated pain and disability in secondary prevention of low back pain. METHODS: One hundred and eighty-three hospital employees with chronic low back pain were randomly assigned either to back school (comparison group), or three-months supervised physical training including a back school (exercise group). Various measurements of functional ability were performed and subjects completed questionnaires on self-rated pain, disability, and general well-being before treatment, immediately after intervention, and at six-months follow-up. At one-year and at ten-years follow-up participants evaluated treatment effectiveness. RESULTS: Out of 183 employees, 148 completed the program. Participation at follow-ups ranged from 66 to 96%. Supervised physical training significantly improved muscular endurance and isokinetic strength during a six-months follow-up, and effectively decreased self-rated pain and disability during a one-year follow-up. At ten-years follow-up the subjects' assessment of the effectiveness of treatment was significantly better in the exercise group. CONCLUSIONS: Supervised physical training effectively improved functional capacity and decreased LBP and disability up to one-year follow-up. The subjects' positive evaluation of the treatment effect at ten-years follow-up suggests a long-term benefit of training.

Trapezius muscle motor unit activity in symptomatic participants during finger tapping using properly and improperly adjusted desks.

Work-related musculoskeletal disorders in the neck-shoulder area and upper extremities are common among computer users, especially women. We compared temporal changes of motor unit (MU) activation in the trapezius muscle during finger tapping using both appropriate and inappropriate ergonomic desk adjustments. Sixteen intensive and nonintensive computer users with either moderate or severe musculoskeletal disorders participated in the study. Six-channel intramuscular electromyographic (EMG) signals and 2-channel surface EMG were recorded from 2 positions of the trapezius muscle. A statistically significant increase in activity was observed with a desk adjusted 5 cm higher than appropriate and was attributable mainly to increased duration of MU activity. Participants with severe symptoms activated more MUs, and these were also active longer. In women, on average, MUs were active nearly twice as long as in men during the same tapping task. This study demonstrates that it is possible to evaluate ergonomic topics on the MU level and that incorrectly adjusted office equipment, in addition to motor demands imposed by the work task, results in prolonged activity of MUs. A potential application of this research is an increased awareness that certain individuals who work with incorrectly adjusted office equipment may be at greater risk of developing work-related musculoskeletal disorders.

Motor unit identification in two neighboring recording positions of the human trapezius muscle during prolonged computer work.

Work-related shoulder-neck pain is a major health risk in computer operators. To understand the physiological mechanisms behind the development of these disorders, EMG recordings of some minutes up to several hours must be accurately decomposed. For this reason we developed EMG-LODEC, an automatic decomposition software program, especially designed for multi-channel long-term recordings of signals detected during slight muscle movements. The subjects executed a 30-min computer task to simulate real work conditions while working at an ergonomically designed workstation. Six-channel intramuscular EMG signals were recorded from two positions of the upper trapezius muscle. The EMG signals were decomposed into individual motor unit action potential trains using EMG-LODEC. The study design enabled us first to study the dependence of intramuscular analysis on the insertion points and second to test the accuracy of the decomposition technique under laboratory conditions during a real experiment. The two positions yielded 887 motor units--452 located in position 1 and 435 in position 2. Although the numbers of detected action potentials were strongly correlated between the two insertion positions, different motor units were mostly recorded. In particular, the detection of continuously active motor units is specific for the selected insertion points and may not be representative of a muscle, not even for parts with common functions. The approach for the quantitative evaluation of the decomposition technique was to independently decompose two signals that were simultaneously detected by separate sets of wire electrodes placed close to each other in the muscle. Common trains discovered in each signal were compared for consistency. A cross-correlation analysis was performed to find corresponding motor unit pairs that were concurrently active. Concurrently active motor units were found in six subjects. For these motor units the extent of simultaneous occurrence of motor unit action potentials between the two positions ranged from 23% to 78% depending on the distinction of the single motor units and the number of superimposed motor unit action potentials. High concordance was seen in 3 out of the 15 motor unit pairs. Based on the results, EMG-LODEC is capable of providing reliable decompositions with satisfying accuracy and reasonable processing time. EMG-LODEC is suitable for the study of motor unit discharge patterns and recruitment order in subjects with and without musculoskeletal pain during long-term measurements to study work-related musculoskeletal disorders.

Performance in a complex task and breathing under odor exposure.

We investigated the influences of odor exposure on performance and on breathing measures. The task was composed of tracking, short-term memory, and peripheral reaction parts. During rest or while performing the task, 12 participants were exposed to 4 different odors in 2 intensities. The higher intensity of the malodors induced a short-term decrement in mean inspiration flow (Vi/Ti) after stimulus onset and impaired performance in the short-term memory task, as compared with control trials; no effect was found for the positively judged odors. The study suggests that a distractor as simple as a bad smell may pull a person off task, however briefly, and may result in a detriment to performance. Actual or potential applications of this research involve designing or securing tasks in such a way that a brief withdrawal of attention does not have fatal consequences.

Project NEMESIS: perception of a 50 Hz electric and magnetic field at low intensities (laboratory experiment).

The Electrical Hypersensitivity Syndrome (EHS) is a condition where people suffer from various nonspecific health symptoms attributed to an assumed adverse effect of electric and magnetic fields (EMF). Many EHS patients report the ability to consciously perceive EMF at very low intensities. The existence of a direct EMF perception could be the key to explain at least partially the aetiology of EHS through stress mechanisms and allow the comparison with well known environmental stressors such as noise or odor. The double blind laboratory experiment tested the hypothesis that there are subjects with the ability to perceive 50 Hz EMF at 100 V/m and 6 microT (EMF sensitive) and to investigate the prevalence of EMF sensitivity in a group consisting of subjects with or without self-reported EHS. A total of 63 volunteers, 49 with EHS and 14 controls, took part in the EMF perception experiment, where 10 sham and 10 exposed 2 min blocks had to be judged in randomized sequence (field on/field off). Seven out of 63 subjects reached a statistically significant result which points to the existence of a small EMF sensitive subgroup within the study group. There was no relevant difference between the subjects with self reported EHS and those without in terms of the success rate in the field perception experiment, as well as the number and types of symptoms encountered during the test. The results of the EMF perception experiment suggest that EHS is not a prerequisite for the ability to consciously perceive weak EMF and vice versa.