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1.
Medicine (Baltimore) ; 100(9): e24973, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655965

RESUMO

RATIONALE: An abdominal pseudohernia is a protrusion of the abdominal wall that there is no actual muscular disruption. This report presents a case in which abdominal muscle activities were accurately and quantitatively measured using ultrasonography (US) and surface electromyography in a patient with abdominal pseudohernia. PATIENT CONCERNS: A 62-year-old man presented with a marked protrusion on the left abdomen with increasing abdominal pressure. DIAGNOSES: First, the thickness of the abdominal muscle was measured with US while the patient constantly blew the positive expiratory pressure device. When the force was applied to the abdomen, the mean thickness of the muscle layer on the lesion site was found to be thinner. Second, the activities of the abdominal muscles were measured using surface electromyography by attaching electrodes to 8 channels at the same time. When the same pressure was applied on both sides of the abdomen, more recruitment occurred to compensate for muscle weakness at the lesion site. Through the previous 2 tests, the decrease in muscle activity in the lesion area could be quantitatively evaluated. Third, the denervation of the muscle was confirmed using US-guided needle electromyography. INTERVENTIONS: The patient in this case was wearing an abdominal binder. In addition, he had been training his abdominal muscles through McGill exercise and breathing exercises such as with a positive expiratory pressure device. OUTCOMES: The patient was able to understand his symptoms. A follow-up test will be performed to see if there is any improvement. LESSONS: By using these outstanding assessment methods, proper diagnosis and rehabilitation treatment strategies can be developed.


Assuntos
Músculos Abdominais/diagnóstico por imagem , Eletromiografia/métodos , Fraturas por Compressão/complicações , Hérnia Abdominal/diagnóstico , Vértebras Lombares/lesões , Fraturas da Coluna Vertebral/complicações , Vértebras Torácicas/lesões , Ultrassonografia/métodos , Músculos Abdominais/fisiopatologia , Fraturas por Compressão/diagnóstico , Hérnia Abdominal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas da Coluna Vertebral/diagnóstico
2.
Medicine (Baltimore) ; 100(4): e23285, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530156

RESUMO

BACKGROUND: Intensive neuromuscular stabilization exercise on highly obese patients with low back pain results in positive effects of body fat decline and prevention of complications. The purpose of this study is to investigate the effects of progressive neuromuscular stabilization exercise on unstable surface on pain, motor function, psychosocial factors, balance, and abdominal contraction with highly obese patients with lumbar instability. METHODS: This study is a double-blinded randomized controlled trial. A total of 46 highly obese patients (body mass index [BMI] ≥ 30 kg/m2) with lumbar instability were assigned randomly to experimental group (n = 23) and control group (n = 23). The control group performed the intensive progressive exercise on a stable surface and the experimental group on an unstable surface. RESULT: Significant differences were shown for BMI, QVAS, K-ODI, FABQ, and balance ability for both groups before and after the intervention (P < .05), and only the experimental group showed significant difference for transverse abdominis muscle thickness in contraction and contraction rate (P < .05). Compared to the control group, the experimental group showed significant difference (P < .05) in the amount of changes for QVAS, K-ODI, balance ability, transverse abdominis muscle thickness in contraction, and contraction rate. CONCLUSION: Progressive neuromuscular stabilization exercise program on unstable surfaces demonstrated to be an effective and clinically useful method to decrease pain level, increase motor function, balance, and transverse abdominis muscle thickness in contraction and contraction rate for highly obese patients with lumbar instability.


Assuntos
Terapia por Exercício/métodos , Instabilidade Articular/terapia , Dor Lombar/terapia , Obesidade/complicações , Doenças da Coluna Vertebral/terapia , Músculos Abdominais/fisiopatologia , Adulto , Método Duplo-Cego , Feminino , Humanos , Instabilidade Articular/etiologia , Dor Lombar/etiologia , Vértebras Lombares/fisiopatologia , Região Lombossacral/fisiopatologia , Masculino , Contração Muscular , Obesidade/fisiopatologia , Medição da Dor , Equilíbrio Postural , Doenças da Coluna Vertebral/etiologia , Resultado do Tratamento
3.
Sci Rep ; 10(1): 21883, 2020 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-33318516

RESUMO

Exercise is the most common conservative intervention for chronic low back pain (CLBP). We have developed an innovative exercise device for the abdominal trunk muscles that also measures muscle strength in a sitting position. The device, which is easy for patients with CLBP to use, allows for lumbar stabilization exercise under pressure. This study aimed to examine the efficacy of abdominal trunk muscle strengthening using the device in improving CLBP. We conducted a two-group non-randomized controlled clinical trial. CLBP patients were allocated into two groups. The strengthening group underwent a 12-week exercise program that included abdominal trunk muscle strengthening using our device and stretching exercises, while the control group received a 12-week stretching exercise program. The outcome measures included the improvement of the abdominal trunk muscle strength measured by the device, pain intensity of CLBP, physical function, and quality of life (QOL). A total of 40 participants (20 in each group) were analyzed. The strengthening group showed better improvement in the abdominal trunk muscle strength, CLBP, physical function, and QOL than in the control group. In conclusion, the strengthening exercise using the device with easy stretching was effective in improving the strength of the abdominal trunk muscles, pain intensity of CLBP, physical function, and QOL.


Assuntos
Músculos Abdominais/fisiopatologia , Terapia por Exercício/instrumentação , Dor Lombar , Força Muscular , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Terapia por Exercício/métodos , Feminino , Humanos , Dor Lombar/fisiopatologia , Dor Lombar/terapia , Masculino , Medição da Dor
5.
Metabolism ; 111: 154321, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32712219

RESUMO

BACKGROUND: Lean muscle plays critical roles in physical functioning and metabolism. However, little is known regarding associations between muscle and mortality in adults. OBJECTIVE: The purpose was to evaluate associations between abdominal muscle quantity (area) and quality (density) with risk of all-cause mortality in a diverse cohort free of cardiovascular disease. DESIGN: Data were taken from the Abdominal Body Composition, Inflammation, and Cardiovascular Disease ancillary study of the Multi-Ethnic Study of Atherosclerosis prospective cohort study. Participants were adults (45-85 years) free of extant cardiovascular disease, and of Hispanic, African American, Chinese, or Caucasian descent. Of the original 6814 MESA participants, a random, representative sample (n = 1974) participated in the ancillary body composition study. Abdominal muscle area and density were measured from computed tomography scans spanning L2-L4. Muscle density was measured as attenuation in Hounsfield units, and area was quantified as cm2. Gender-stratified cox proportional hazard models assessed the risk of all-cause mortality across gender-specific quartiles of muscle area and density adjusting for confounders, with area and density entered simultaneously. RESULTS: At baseline, the mean age for men (n = 946) and women (n = 955) was 61.5 and 62.5 years and median follow-up time was 10.6 and 10.9 years, respectively. Muscle density was inversely associated with mortality, with the highest quartile of density showing a 73% reduction in risk for men (HR = 0.27, 95% CI = 0.14-0.51; p-trend<0.001) and 57% reduction for women (HR = 0.43, 95% CI = 0.18-1.01; p-trend = 0.04) compared to the lowest quartile when adjusting for mortality risk factors, lifestyle, BMI and visceral fat. There was no association between muscle area and all-cause mortality for men (p-trend = 0.58) or women (p-trend = 0.47). CONCLUSIONS: Greater abdominal muscle density, but not muscle area, is associated with markedly lower risk of all-cause mortality across a decade of follow up. Muscle quality may be a powerful predictor of mortality in community dwelling adults.


Assuntos
Músculos Abdominais/fisiopatologia , Aterosclerose/mortalidade , Aterosclerose/fisiopatologia , Composição Corporal/fisiologia , Grupos Étnicos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
6.
Med Sci Monit ; 26: e921295, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32182226

RESUMO

BACKGROUND This study examined the effects of abdominal draw-in lumbar stabilization exercises (ADIM) with respiratory resistance on women ages 40-49 years with low back pain. MATERIAL AND METHODS Forty-four women ages 40-49 years were screened for participation and were randomly assigned to either a respiratory with resistance exercise group (n=22) or a control group (n=22). Abdominal draw-in lumbar stabilization exercises were administered to both groups, but only the respiratory with resistance exercise group received the respiratory resistance training. The exercise training lasted 50 min per session, 3 sessions per week for 4 weeks. The assessment methods used were the quadruple visual analogue scale (QVAS), Oswestry disability index-Korean version (ODI-K), diaphragm thickness and contraction rate, and lung capacity test. RESULTS Both groups showed significant differences in the QVAS, ODI-K, maximum voluntary ventilation (MVV), and diaphragm thickness and contraction rate before and after the intervention (p<0.05). In the respiratory resistance exercise group, the ODI-K, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), MVV, and diaphragm thickness and contraction rate showed significantly better improvement than the control group (p<0.05). CONCLUSIONS A lumbar stabilization exercise program consisting of ADIM and respiratory resistance resulted in decreased pain, reduced dysfunctions, and increased muscle thickness in contraction, contraction rate, and pulmonary function. Strong contraction of the diaphragm and deep abdominal muscles through breathing resistance increased the pressure in the abdominal cavity. Therefore, this may be an effective clinical exercise method for patients with lumbar instability.


Assuntos
Exercícios Respiratórios/métodos , Terapia por Exercício/métodos , Dor Lombar/terapia , Músculos Abdominais/fisiopatologia , Adulto , Feminino , Humanos , Dor Lombar/fisiopatologia , Pessoa de Meia-Idade , Músculos Respiratórios/fisiopatologia , Resultado do Tratamento
7.
Neurourol Urodyn ; 39(2): 793-803, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31985114

RESUMO

AIM: To measure the neuromuscular activation of the pelvic floor and abdominal muscles concurrently with vaginal closure forces induced during a hypopressive exercise (HE) and to identify the contribution of the HEs sequences (posture and maneuver) in the muscle's activation. METHODS: A cross-sectional study design was employed. Sixty-six women who had participated in a physical therapy program focused on HEs were recruited. Pelvic floor muscle (PFM) activation was measured using surface electromyography (sEMG) in supine and in the orthostatic position, and vaginal closure force was measured through vaginal dynamometry in supine. Activation of the abdominal, gluteal, and hip adductor muscles was measured using sEMG. Maximum effort voluntary contractions (MVCs) of the PFMs and reference contractions of the abdominal and hip muscles were acquired for normalization purposes. A HE was then performed in a supine position with one leg raised, then in an orthostatic position. RESULTS: During the supine HE, the peak PFM sEMG amplitude was 74.4% to 86.5% (49.6%-109.6%) of MVC, the peak vaginal closure force was between 51.2% and 55.7% (95.5%-382.9%) of MVC, and the muscles of the lateral abdominal wall were activated between 25.4% and 35.3% of the reference contraction. During the orthostatic HE, PFM activation was 61.4% (40.1%-105.6%) of MVC, and the lateral abdominal wall muscles contracted at 22.8% of the reference activation level. CONCLUSIONS: The PFMs, abdominal, gluteal, and adductor muscles are activated during the performance of a HE. The activation level of the PFMs and abdominal muscles is likely insufficient to result in strength gains; however, they could have an endurance effect.


Assuntos
Músculos Abdominais/fisiopatologia , Distúrbios do Assoalho Pélvico/fisiopatologia , Diafragma da Pelve/fisiopatologia , Postura , Vagina/fisiopatologia , Adulto , Estudos Transversais , Eletromiografia , Terapia por Exercício , Feminino , Humanos , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Força Muscular , Músculo Esquelético/fisiologia , Modalidades de Fisioterapia
8.
J Appl Physiol (1985) ; 127(6): 1548-1561, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31670599

RESUMO

Local blood flow/oxygen partial pressure (Po2) distributions and flow-Po2 relationships are physiologically relevant. They affect the pathophysiology and treatment of conditions like hemorrhagic shock (HS), but direct noninvasive measures of flow, Po2, and their heterogeneity during prolonged HS are infrequently presented. To fill this void, we report the first quantitative evaluation of flow-Po2 relationships and heterogeneities in normovolemia and during several hours of HS using noninvasive, unbiased, automated acquisition. Anesthetized rats were subjected to tracheostomy, arterial/venous catheterizations, cremaster muscle exteriorization, hemorrhage (40% total blood volume), and laparotomy. Control animals equally instrumented were not subjected to hemorrhage/laparotomy. Every 0.5 h for 4.5 h, noninvasive laser speckle contrast imaging and phosphorescence quenching were employed for nearly 7,000 flow/Po2 measurements in muscles from eight animals, using an automated system. Precise alignment of 16 muscle areas allowed overlapping between flow and oxygenation measurements to evaluate spatial heterogeneity, and repeated measurements were used to estimate temporal heterogeneity. Systemic physiological parameters and blood chemistry were simultaneously assessed by blood samplings replaced with crystalloids. Hemodilution was associated with local hypoxia, but increased flow prevented major oxygen delivery decline. Adding laparotomy and prolonged HS resulted in hypoxia, ischemia, decreased tissue oxygen delivery, and logarithmic flow/Po2 relationships in most regions. Flow and Po2 spatial heterogeneities were higher than their respective temporal heterogeneities, although this did not change significantly over the studied period. This quantitative framework establishes a basis for evaluating therapies aimed at restoring muscle homeostasis, positively impacting outcomes of civilian and military trauma/HS victims.NEW & NOTEWORTHY This is the first study on flow-Po2 relationships during normovolemia, hemodilution, and prolonged hemorrhagic shock using noninvasive methods in multiple skeletal muscle areas of monitored animals. Automated flow/Po2 measurements revealed temporal/spatial heterogeneities, hypoxia, ischemia, and decreased tissue oxygen delivery after trauma/severe hemorrhage. Hemodilution was associated with local hypoxia, but hyperemia prevented a major decline in oxygen delivery. This framework provides a quantitative basis for testing therapeutics that positively impacts muscle homeostasis and outcomes of trauma/hemorrhagic shock victims.


Assuntos
Músculos Abdominais/fisiopatologia , Consumo de Oxigênio/fisiologia , Roedores/fisiologia , Choque Hemorrágico/fisiopatologia , Músculos Abdominais/metabolismo , Animais , Hemodiluição/métodos , Hipóxia/metabolismo , Hipóxia/fisiopatologia , Pulmão/metabolismo , Pulmão/fisiopatologia , Masculino , Microcirculação/fisiologia , Músculo Esquelético/metabolismo , Músculo Esquelético/fisiopatologia , Oxigênio/metabolismo , Pressão Parcial , Perfusão/métodos , Ratos , Ratos Sprague-Dawley , Fluxo Sanguíneo Regional/fisiologia , Fenômenos Fisiológicos Respiratórios , Roedores/metabolismo , Choque Hemorrágico/metabolismo
9.
BMC Musculoskelet Disord ; 20(1): 459, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31638957

RESUMO

BACKGROUND: Trunk muscle dysfunction is often regarded as a key feature of non-specific chronic low back pain (NSCLBP) despite being poorly understood and variable with increases, decreases and no change in muscle activity reported. Differences in thoraco-lumbar kinematics have been observed in motor control impairment NSCLBP subgroups (Flexion Pattern, Active Extension Pattern) during static postures and dynamic activities. However, potential differences in muscle activity during functional tasks has not been established in these subgroups to date. METHODS: A case-control study design recruited 50 NSCLBP subjects (27 Flexion Pattern, 23 Active Extension Pattern) and 28 healthy individuals. Surface electromyography determined muscle activity during functional tasks: reaching upwards, step-down, step-up, lifting and replacing a box, stand-to-sit, sit-to-stand, bending to retrieve (and returning from retrieving) a pen from the floor. Normalised (% sub-maximal voluntary contraction) mean amplitude electromyography of bilateral musculature (transversus abdominis/internal oblique, external oblique, superficial lumbar multifidus and longissimus thoracis) was analysed using Kruskal-Wallis and post-hoc Mann-Whitney U tests. RESULTS: Transversus abdominis/internal oblique activity was significantly increased in the Flexion Pattern group compared to controls during stand-to-sit (p = 0.009) on the left side only. External oblique activity was significantly greater in the Active Extension Pattern group compared to controls during box lift (p = 0.016) on the right side only. Significantly greater activity was identified in the right Superficial lumbar multifidus during step up (p = 0.029), reach up (p = 0.013) and box replace (p = 0.007) in the Active Extension Pattern group compared to controls. However left-sided superficial lumbar multifidus activity was significantly greater in the Flexion Pattern group (compared to controls) only during stand-to-sit (p = 0.009). No significant differences were observed in longissimus thoracis activity bilaterally during any task. No significant differences between NSCLBP subgroups were observed. CONCLUSIONS: Muscle activity in these NSCLBP subgroups appears to be highly variable during functional tasks with no clear pattern of activity identified. The findings reflect inconsistencies and variability in trunk muscle activity previously observed in these NSCLBP subgroups. Further work evaluating ratios of muscle activity and changes in muscle activity throughout task duration is warranted.


Assuntos
Músculos Abdominais/fisiopatologia , Músculos do Dorso/fisiopatologia , Dor Crônica/fisiopatologia , Dor Lombar/fisiopatologia , Adulto , Estudos de Casos e Controles , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Artigo em Inglês | MEDLINE | ID: mdl-31498333

RESUMO

Background: Belly dancer syndrome (BDS) and parkinsonian features are rarely described in association as a drug-induced movement disorder. Phenomenology shown: A 62-year-old woman with paranoid schizophrenia presented with bradykinesia, rigidity, rest, and postural tremor, as well as dyskinetic abdominal movements. Educational value: Our case highlights that drug-induced parkinsonism can be associated with other rare movement disorders, such as BDS, with subsequent greater morbidity.


Assuntos
Músculos Abdominais/fisiopatologia , Antagonistas de Dopamina/efeitos adversos , Discinesia Induzida por Medicamentos/fisiopatologia , Doença de Parkinson Secundária/induzido quimicamente , Doença de Parkinson Secundária/fisiopatologia , Esquizofrenia Paranoide/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Gravação em Vídeo
11.
PLoS One ; 14(8): e0221207, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31449525

RESUMO

BACKGROUND: Children and young people with neuromuscular disorders (NMD), such as Duchenne Muscular Dystrophy (DMD), develop progressive respiratory muscles weakness and pulmonary restriction. Pulmonary function monitoring of the decline in lung function allows for timely intervention with cough assist techniques and nocturnal non-invasive ventilation (NIV). NMD may find the measurement of lung function difficult using current techniques. Structured Light Plethysmography (SLP) has been proposed as a novel, non-contact, self-calibrating, non-invasive method of assessing lung function. The overarching aim of this study was to investigate the use of SLP as a novel method for monitoring respiratory function in children with neuromuscular disease. METHODS: SLP thoraco-abdominal (TA) displacement was correlated with forced vital capacity measurements recorded by spirometry and the repeatability of the measurements with both methods examined. SLP tidal breathing parameters were investigated to assess the range and repeatability of regional right and left side TA displacement and rib cage and abdominal wall displacement. RESULTS: The comparison of the FVC measured with SLP and with spirometry, while having good correlation (R = 0.78) had poor measurement agreement (95% limits of agreement: -1.2 to 1.2L) The mean relative contribution of right and left TA displacement in healthy controls was 50:50 with a narrow range. Repeatability of this measure with SLP was found to be good in healthy controls and moderate in NMD children with/without scoliosis but with a wider range. The majority of the control group displayed a predominant rib cage displacement during tidal breathing and those who displayed predominant abdominal wall displacement showed displacement of both regions close to 50:50 with similar results for the rib cage and abdomen. In comparison, children with NMD have a more variable contribution for all of these parameters. In addition, SLP was able to detect a reduction in abdominal contribution to TA displacement with age in the DMD group and detect paradoxical breathing in children with NMD. Using SLP tracings during tidal breathing we were able to identify three specific patterns of breathing amongst healthy individuals and in children with NMD. CONCLUSIONS: SLP is a novel method for measuring lung function that requires limited patient cooperation and may be especially useful in children with neuromuscular disorders. Measuring the relative contributions of the right and left chest wall and chest versus abdominal movements allows a more detailed assessment.


Assuntos
Tosse/fisiopatologia , Pulmão/fisiopatologia , Distrofia Muscular de Duchenne/diagnóstico por imagem , Pletismografia , Músculos Abdominais/diagnóstico por imagem , Músculos Abdominais/fisiopatologia , Adolescente , Adulto , Criança , Tosse/diagnóstico por imagem , Feminino , Humanos , Pulmão/diagnóstico por imagem , Masculino , Distrofia Muscular de Duchenne/fisiopatologia , Ventilação não Invasiva , Respiração , Insuficiência Respiratória/diagnóstico por imagem , Insuficiência Respiratória/fisiopatologia , Fenômenos Fisiológicos Respiratórios , Costelas/diagnóstico por imagem , Costelas/fisiopatologia , Espirometria , Adulto Jovem
12.
NeuroRehabilitation ; 44(4): 599-608, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31256087

RESUMO

BACKGROUND: Postural instability in Amyotrophic Lateral Sclerosis (ALS) occurs at an early stage of the disease and often results in falls. As ALS is considered a multisystem neurodegenerative disorder, postural instability may result from motor, sensory and central processing deficits. OBJECTIVE AND METHODS: We analysed postural control of 12 ALS patients and 12 healthy age-matched control subjects. Postural control was characterised by spontaneous sway measures and measures of postural reactions to pseudorandom anterior-posterior platform tilts, which were then correlated with clinical test scores. RESULTS: Spontaneous sway amplitudes and velocities were significantly larger and sway frequencies higher in ALS patients than in control subjects. ALS patients' body excursions following platform tilts were smaller, with relatively higher upper body excursions. We found high correlations between abnormal postural reactions and clinical tests representing motor or balance deficits. CONCLUSIONS: We conclude that ALS patients' postural abnormalities are mainly determined by an abnormal axial control and abnormally small body excursions as a function of support surface tilts, seemingly indicating better postural stabilization than control subjects. The latter contradicts the hypothesis that muscle weakness is the main source for this deficit. Instead, we suggest an altered central control strategy.


Assuntos
Esclerose Amiotrófica Lateral/diagnóstico , Esclerose Amiotrófica Lateral/fisiopatologia , Equilíbrio Postural/fisiologia , Tronco/fisiopatologia , Músculos Abdominais/fisiopatologia , Acidentes por Quedas/prevenção & controle , Idoso , Músculos do Dorso/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
Am J Phys Med Rehabil ; 98(12): 1110-1117, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31274514

RESUMO

OBJECTIVE: The aim of the study was to investigate trunk function during seated upper limb tasks in patients with spinal muscular atrophy types 2 and 3. DESIGN: Seventeen persons with spinal muscular atrophy and 15 healthy controls performed several tasks when sitting unsupported, such as reaching (and placing) forward and sideward. Joint torque and muscle activity were measured during maximum voluntary isometric contractions. Three-dimensional kinematics and normalized muscle activity were analyzed when performing tasks. RESULTS: Trunk joint torques were significantly decreased, approximately 45%, in patients with spinal muscular atrophy compared with healthy controls. Active range of trunk motion was also significantly decreased in all directions. When performing tasks, the average back muscle activity was 27% and 56% of maximum voluntary isometric contractions for healthy controls and spinal muscular atrophy and for abdominal muscles 10% and 44% of maximum voluntary isometric contractions, respectively. Trunk range of motion did not differ when performing daily tasks. CONCLUSIONS: The trunk of patients with spinal muscular atrophy is weaker compared with healthy controls, reflected by reduced trunk torques and decreased active range of motion. In addition, patients with spinal muscular atrophy use high percentages of their trunk muscle capacity to perform tasks. Clinicians should take this into account for intervention development, because using high percentages of the maximum muscle capacity results in fatigue and muscle overloading.


Assuntos
Músculo Esquelético/fisiopatologia , Atrofia Muscular Espinal/fisiopatologia , Postura Sentada , Análise e Desempenho de Tarefas , Músculos Abdominais/fisiopatologia , Adulto , Fenômenos Biomecânicos/fisiologia , Estudos de Casos e Controles , Feminino , Humanos , Contração Isométrica/fisiologia , Masculino , Postura , Amplitude de Movimento Articular
14.
Rheumatol Int ; 39(8): 1389-1396, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31190088

RESUMO

The main purpose of this study was to compare core stability and balance between ankylosing spondylitis (AS) patients and healthy controls. AS patients diagnosed according to the Modified New York criteria and healthy age- and sex-matched controls were included in the study. Clinical status of AS patients was assessed using Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Spinal Mobility Index (BASMI). For evaluation of core stability, static and dynamic core endurance and hip strength were assessed. Trunk flexor and extensor endurance, lateral side bridge tests for static core endurance; modified sit-up test for dynamic core endurance were used. Hip strength was measured with a hand-held dynamometer. Biodex Balance System was used to assess static and dynamic balance. Bilateral standing static and dynamic postural stability, single leg standing postural stability and limits of stability test results were recorded. 64 AS patients (40 male, 24 female) and 64 healthy controls (39 male, 25 female) were assessed. Static and dynamic core endurance test results, hip abductor strength were significantly higher in control group than AS group (p < 0.05). Static postural stability and left leg postural stability test results were significantly better in control group than AS group (p < 0.05). Overall, forward, backward, and right, limits of stability test results were significantly higher in control group (p < 0.05). The results of our study demonstrate that AS has negative effects on core stability and balance. It would be beneficial to add core stability and balance training to AS patients' rehabilitation program.


Assuntos
Músculos Abdominais/fisiopatologia , Músculos do Dorso/fisiopatologia , Quadril/fisiopatologia , Equilíbrio Postural , Coluna Vertebral/fisiopatologia , Espondilite Anquilosante/fisiopatologia , Adulto , Estudos de Casos e Controles , Estudos Transversais , Terapia por Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Resistência Física , Índice de Gravidade de Doença , Espondilite Anquilosante/diagnóstico , Espondilite Anquilosante/reabilitação
15.
BMC Musculoskelet Disord ; 20(1): 273, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159812

RESUMO

BACKGROUND: Previous studies have indicated that trunk muscle strength decreases with chronic low back pain, and is associated with poor balance, poor functional performance, and falls in older adults. Strengthening exercises for chronic low back pain are considered the most effective intervention to improve functional outcomes. We developed an innovative exercise device for abdominal trunk muscles that also measures muscle strength. The correlation between muscle weakness, as measured by our device, the presence of chronic low back pain, and decreased physical ability associated with a risk of falling were evaluated in older women. METHODS: Thirty-eight elderly women, who could walk without support during daily activities and attended our outpatient clinic for treatment of chronic low back pain, knee or hip arthritis, or osteoporosis, were included in this study. Anthropometric measurements were performed. Grip power and one-leg standing time with eyes open were measured, and abdominal trunk muscle strength was measured using our device. History of falling in the previous 12 months was noted. Subjects with chronic low back pain (visual analog scale score ≥ 20 mm) for over 3 months were assigned to the low back pain group (n = 21). The remaining subjects formed the non-low back pain group (n = 17). RESULTS: Abdominal muscle strength of subjects in the low back pain group, and with history of falling, was significantly lower compared with that of subjects in the non-low back pain group, and in subjects without a history of falling, respectively. There was a moderate positive correlation between abdominal trunk muscle strength and one-leg standing time with eyes open. CONCLUSION: We measured abdominal muscle strength in older women with chronic low back pain using our device, and it was significantly lower than that of those without chronic low back pain. Muscle weakness was associated with a history and risk of falling.


Assuntos
Músculos Abdominais/fisiopatologia , Acidentes por Quedas/estatística & dados numéricos , Dor Lombar/complicações , Debilidade Muscular/diagnóstico , Acidentes por Quedas/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Terapia por Exercício/instrumentação , Terapia por Exercício/métodos , Feminino , Humanos , Dor Lombar/fisiopatologia , Dor Lombar/terapia , Força Muscular/fisiologia , Debilidade Muscular/etiologia , Debilidade Muscular/fisiopatologia
16.
Epileptic Disord ; 21(3): 302-306, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31225805

RESUMO

Epilepsia partialis continua (EPC) of abdominal muscles is a rare entity with variable clinical localization and aetiology. A 25-year-old man presented with sudden onset of intermittent focal myoclonic movements involving the abdominal muscles on the right side exclusively, lasting from 20 minutes to an hour. Brain MRI revealed a ring-enhancing lesion, suggestive of cysticercal granuloma over the left precentral gyrus. The patient fulfilled the revised diagnostic criteria for definitive diagnosis of neurocysticercosis. EEG did not show focal abnormalities during the events. Episodes of EPC were controlled with difficulty using 600 mg oxcarbazepine, 200 mg lacosamide, and 2,000 mg levetiracetam. The patient received antiparasitic therapy with albendazole (15 mg/kg for two weeks) and oral dexamethasone (0.1 mg/kg) for two weeks which was then tapered. The involvement of the primary motor cortex during ictal propagation may account for this curious phenomenon. This is the first report of abdominal EPC in a patient with inflammatory granuloma as a result of neurocysticercosis.


Assuntos
Abdome/fisiopatologia , Músculos Abdominais/fisiopatologia , Epilepsia Parcial Contínua/complicações , Neurocisticercose/complicações , Músculos Abdominais/efeitos dos fármacos , Adulto , Eletroencefalografia/métodos , Epilepsia Parcial Contínua/diagnóstico , Epilepsia Parcial Contínua/tratamento farmacológico , Humanos , Levetiracetam/uso terapêutico , Imagem por Ressonância Magnética/métodos , Masculino , Córtex Motor/fisiopatologia , Neurocisticercose/diagnóstico , Neurocisticercose/fisiopatologia
17.
Physiotherapy ; 105(4): 442-445, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31204031

RESUMO

OBJECTIVE: The primary objective of this study was to compare the long-term (1-year follow-up) effects of the McKenzie method and motor control exercises on trunk muscle thickness in people with chronic low back pain (LBP) and a directional preference. DESIGN: Randomized controlled trial. SETTING: A secondary public health facility in Sydney, Australia. PARTICIPANTS: Seventy adults with greater than 3-month history of LBP and a directional preference. INTERVENTIONS: Participants were randomized to receive 12 treatments of either the McKenzie method or motor control exercises over 8-weeks. OUTCOME MEASURES: Muscle thickness of the transversus abdominis, obliquus internus, and obliquus externus measured from ultrasound images. Secondary outcomes included function, perceived recovery, and pain. Outcomes were collected at baseline, post intervention at 8-weeks, and at 1-year follow-up by blinded assessors. The current paper focuses on the 1-year follow-up. RESULTS: Fifty-eight participants completed data collection for the primary outcome at 1-year. There were no significant between group differences for changes in trunk muscle thickness for any of the three investigated muscles: transversus abdominis [3%, 95% confidence interval (CI): -5%, 11%], obliquus internus [-4%, 95% CI: -9%, 2%] and obliquus externus [3%, 95% CI: -4%, 11%]. Similarly, there were no significant differences between groups for the secondary outcomes of function, perceived recovery and pain. CONCLUSION: Trunk muscle thickness, function, perceive recovery and pain are similar between patients receiving McKenzie method or motor control exercises at a 1-year follow-up in a population of people with chronic LBP and a directional preference. Clinical Trials Registration number CTRN12611000971932.


Assuntos
Músculos Abdominais/fisiopatologia , Dor Crônica/reabilitação , Terapia por Exercício/métodos , Dor Lombar/reabilitação , Músculos Abdominais/diagnóstico por imagem , Adulto , Dor Crônica/fisiopatologia , Feminino , Humanos , Dor Lombar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Inquéritos e Questionários , Ultrassonografia
18.
Artigo em Inglês | MEDLINE | ID: mdl-31240128

RESUMO

Study Design: Single subject design with five subjects. Objectives: The objetive of this study is to compare the effectiveness and usability of alternative commercial abdominal compression garments with participants' usual medical binders. Setting: Private residences in Pierce and King Counties, WA, USA. Methods: Participants wore each garment for 5 days followed by a 2-day washout in personal binder. Week 1: Personal binder. Weeks 2 and 3: Randomly ordered test garments (tank, bodysuit). Physiologic measurements: blood pressure (SBP, DBP), blood oxygen saturation (SaO2), forced expiratory volume in one second (FEV1), and heart rate (HR). Participants completed logs twice daily for 5 days per garment regarding ease of use, comfort, respiration, and appearance. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research. Results: The use of a personal binder results in significant increases in SBP and FEV1. Personal binders support FEV1 significantly better than test garments. There is no difference in SBP between test garments and personal binders. There are no significant differences between DBP, SaO2, or HR between participants' personal binders and no binder. Participants reported that neither tank nor bodysuit felt adequately supportive or easy to use. Conclusions: Abdominal compression improves respiratory function and supports SBP in individuals with chronic SCI. Further research is needed to guide the development of an easy-to-use and physiologically supportive abdominal compression garment.


Assuntos
Músculos Abdominais/fisiopatologia , Vestuário , Bandagens Compressivas , Paralisia/etiologia , Paralisia/reabilitação , Traumatismos da Medula Espinal/complicações , Resultado do Tratamento , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
Eur Rev Med Pharmacol Sci ; 23(7): 3001-3004, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31002150

RESUMO

Epilepsia partialis continua (EPC) is a rare form of focal motor status epilepticus characterized by continuous muscular twitches or jerks involving a limited part of the body, usually facial region and distal limb. Although the cerebrovascular disease is known to be one of the most common causes of this condition, other reported cases with predominant abdominal involvement have different aetiologies, including, tumors, focal cortical dysplasia, and central nervous system infections. No cases of epilepsia partialis continua of the abdominal wall occurred after brain surgery have been previously reported. We describe the clinical, electrophysiological, and neuroimaging findings in an adult patient presenting with persistent unilateral abdominal myoclonus configuring an EPC as the evolution of a super-refractory hemibody convulsive status epilepticus, occurred after brain tumor surgery.


Assuntos
Músculos Abdominais , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Epilepsia Parcial Contínua/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Músculos Abdominais/fisiopatologia , Epilepsia Parcial Contínua/etiologia , Epilepsia Parcial Contínua/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia
20.
ESC Heart Fail ; 6(3): 526-535, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30929311

RESUMO

AIMS: We assessed preoperative muscle wasting in patients undergoing left ventricular assist device (LVAD) implantations using abdominal skeletal muscle images on computed tomography (CT) and explored the associations between the preoperative muscle wasting and clinical outcomes after LVAD implantation. METHODS AND RESULTS: We retrospectively examined the records of 111 patients who underwent continuous-flow LVAD implantations as bridge-to-transplant therapy from January 2010 to December 2016 at our institution. After 33 patients were excluded, the study cohort consisted of 78 individuals. CT images used to calculate the skeletal muscle index (SMI) at the third lumbar vertebra level were obtained before the LVAD implantation procedures. Patients were classified as having muscle wasting if their SMI fell into the lowest gender-based tertile. The median SMI for the study patients was 37.6 cm2 /m2 . The SMI cut-off values for the lowest tertiles were 36.7 cm2 /m2 for men and 28.2 cm2 /m2 for women, resulting in 26 patients (33.3%) with muscle wasting in this study. During the mean follow-up of 738 ± 379 days, there were 10 deaths (12.8% mortality). Seven of the 26 patients with muscle wasting (26.9%) died, and 3 of the 52 patients without muscle wasting (5.8%) died. The times to all-cause mortality were significantly different between patients with and without muscle wasting (P = 0.0094). Muscle wasting was found to be associated with mortality in univariate and multivariate Cox analyses (hazard ratio: 4.32; 95% CI: 1.19-20.2). CONCLUSIONS: Preoperative muscle wasting was associated with a higher mortality in patients with LVAD. Assessment of the abdominal skeletal muscle area on CT prior to LVAD implantation can help predict mortality.


Assuntos
Músculos Abdominais/fisiopatologia , Insuficiência Cardíaca/mortalidade , Coração Auxiliar , Músculos Abdominais/diagnóstico por imagem , Adulto , Proteína C-Reativa/análise , Feminino , Humanos , Japão/epidemiologia , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcopenia/mortalidade , Tomografia Computadorizada por Raios X
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