Evaluation of functional outcomes in individuals 10 years after posterior lumbar interbody fusion with corundum implants and decompression: a comparison of 2 surgical techniques.

BACKGROUND: The purpose of this study was to evaluate lumbar spine-related functional disability in individuals 10 years after lumbar decompression and lumbar decompression with posterior lumbar interbody fusion (PLIF) with corundum implants surgery for degenerative stenosis and to compare the long-term outcome of these 2 surgical techniques. MATERIAL/METHODS: From 1998 to 2002, 100 patients with single-level lumbar stenosis were surgically treated. The patients were randomly divided into 2 groups that did not differ in terms of clinical or neurological symptoms. Group A consisted of 50 patients who were treated with PLIF and the use of porous ceramic corundum implants; the mean age was 57.74 and BMI was 27.34. Group B consisted of 50 patients treated with decompression by fenestration; mean age was 51.28 and the mean BMI was 28.84. RESULTS: There was no statistical significance regarding age, BMI, and sex. Both treatments revealed significant improvements. In group A, ODI decreased from 41.01% to 14.3% at 1 year and 16.3 at 10 years. In group B, ODI decreased from 63.8% to 18.36% at 1 year and 22.36% at 10 years. The difference between groups was statistically significant. There were no differences between the groups regarding the Rolland-Morris disability questionnaire and VAS at 1 and 10 years after surgery. CONCLUSIONS: Long-term results evaluated according to the ODI, the Rolland-Morris disability questionnaire, and the VAS showed that the both methods significantly reduce patient disability, and this was maintained during next 10 years. The less invasive fenestration procedure was only slightly less favorable than surgical treatment of stenosis by both PLIF with corundum implants and decompression.

The effect of spinal curvature on the photogrammetric assessment on static balance in elderly women.

BACKGROUND: Involutional changes to the body in elderly patients affect the shape of the spine and the activity of postural muscles. The purpose of this study was to assess the influence of age-related changes in spinal curvature on postural balance in elderly women. METHODS: The study population consisted of 90 women, with a mean age of 70 ± 8.01 years. Static balance assessments were conducted on a tensometric platform, and posturographic assessments of body posture were performed using a photogrammetric method based on the Projection Moiré method. RESULTS: The results obtained were analysed using the Spearman's rank correlation coefficient test. We found a statistically significant correlation between body posture and the quality of the balance system response based on the corrective function of the visual system. The shape of the spinal curvature influenced postural stability, as measured by static posturography. Improvement in the quality of the balance system response depended on corrective information from the visual system and proprioceptive information from the paraspinal muscles. CONCLUSIONS: The sensitivity of the balance system to the change of centre of pressure location was influenced by the direction of the change in rotation of the shoulder girdle and spine. Development of spinal curvature in the sagittal plane and maintenance of symmetry in the coronal and transverse planes are essential for correct balance control, which in turn is essential for the development of a properly proportioned locomotor system.

Rehabilitation protocol for patellar tendinopathy applied among 16- to 19-year old volleyball players.

The aim of the study was to investigate the efficacy of rehabilitation protocol applied during competitive period for the treatment of patellar tendinopathy. A total of 28 male volleyball players were divided into two groups. Fifteen from experimental group (E) and 13 from control group (C) fulfilled the same tests 3 times: before the training program started (first measurement), after 12 weeks (second measurement) and after 24 weeks (third measurement). The above-mentioned protocol included the following: USG imagining with color Doppler function, clinical testing, pain intensity evaluation with VISA-P questionnaire, leg muscle strength and power and jumping ability measurements. The key element of the rehabilitation program was eccentric squat on decline board with additional unstable surface. The essential factor of the protocol was a set of preventive functional exercises, with focus on eccentric exercises of hamstrings. Patellar tendinopathy was observed in 18% of the tested young volleyball players. Implementation of the presented rehabilitation protocol with eccentric squat on decline board applied during sports season lowered the pain level of the young volleyball players. Presented rehabilitation protocol applied without interrupting the competitive period among young volleyball players together with functional exercises could be an effective method for the treatment of patellar tendinopathy.

A comparative analysis of static balance between patients with lumbar spinal canal stenosis and asymptomatic participants.

OBJECTIVE: The aim of this study was to assess static balance in patients with lumbar spinal canal stenosis who qualified for surgical decompression of associated neural structures and compare them with asymptomatic participants. METHODS: This case-controlled study evaluated a sample of 50 patients with spinal canal stenosis (stenosis group) and 48 participants with no history of clinical symptoms of back pain. Static balance was assessed by conducting quantitative analysis of balance reaction parameters in quiet standing with the eyes closed. RESULTS: Higher values were observed in total length of center of pressure (COP) path, length of COP path in the anterior-posterior plane, mean amplitude of COP projection in the anterior-posterior plane, maximal amplitude between the 2 most distant points in the anterior-posterior plane, mean COP velocity, and sway area marked by the moving COP in the stenosis group compared with the asymptomatic group. CONCLUSIONS: This study showed statistically significant differences in static balance parameters between patients with spinal canal stenosis compared with the asymptomatic group.

Correction: Muscle strength, muscle power and body composition in college-aged young women and men with Generalized Joint Hypermobility.

[This corrects the article DOI: 10.1371/journal.pone.0236266.].

The effect of a short-term combined conditioning training for the development of leg strength and power.

The aim of the study was to compare the effect of combined weight and pendulum training exercises with those isolated ones on muscle strength and vertical jump performance. A total of 38 young active men were divided into 4 groups performing different combinations of strength and power training and measured directly and 2 weeks after the training program. Weight training and pendulum swing exercises, involving lower body during dynamic bounces, were used. Results of 1 repetition maximum (1RM) in full squat and squat jump with the barbell, maximal force measured during countermovement jump (CMJ), and hip and knee flexor and extensor isometric strength were analyzed. Significant differences (p

Muscle strength, muscle power and body composition in college-aged young women and men with Generalized Joint Hypermobility.

The aim of this study was an evaluation of the musculoskeletal system in women and men with Generalized Joint Hypermobility (GJH). The study included 87 participants- 40 with Generalized Joint Hypermobility (aged 21.2 ±1.8 years) and 47 (aged 21.0 ±1.3 years) in the control group (CG). The study included the Beighton score, the measurements of body composition, muscle flexibility (Straight Leg Raise test, Popliteal Angle test, Modified Thomas Test), and the measurements of muscle strength and muscle power. T-test and Mann-Whitney U Test were applied to assess the differences between independent groups. The study showed that there were no significant differences (p>.05) in the assessed body composition and the muscle flexibility between both women and men with GJH and the participants in the CG. Under isokinetic conditions for the non-dominant lower extremity, men from the CG received significantly higher (p = .02) flexion peak torque at 180°/s angular velocity. Women from the CG received a statistically significantly lower (p = .04) F/E ratio at 180°/s velocity. Under isometric conditions for both women and men with GJH, there were no statistically significant differences (p>.05) in the maximum torques in knee extension and flexion compared to the CG. For women and men with GJH, the maximum power in the lower extremities and jumping ability were not significantly different (p>.05) compared to the CG participants. The body composition, muscle flexibility, muscle strength, and muscle power of adults with Generalized Joint Hypermobility did not differ compared to healthy participants. The fact that there are no differences does not exclude the efficacy of strength training in increasing levels of muscle strength and its impact on body posture and proprioception or coordination.

Assessment of postural stability in patients with lumbar spine chronic disc disease.

PURPOSE: The pain, motor and sensory deficits are common symptoms of the lumbar disc disorder, and they can significantly affect human postural control. The aim of this study was to assess postural stability in patients with severe symptoms of lumbar spine disc disease qualifying them for surgical treatment and to compare them with a control group. METHODS: The study involved 103 subjects: 54 patients and 49 healthy subjects. Patient's mean age was 46.4 ± 11.3 years, mean body height 172.2 ± 10.3 cm, mean body mass 83.1 ± 18.9 kg, and mean body mass index (BMI) was 27.9 ± 5.2 kg m-2. The mean time of their recent pain episode was 9.7 ± 8.5 months. RESULTS: We found statistically significant differences between postural stability in patients with lumbar spine disc disease and the control group. The measurements taken with eyes closed, as compared with the clinical control group, revealed higher and statistically significant values of the mean amplitude of COP, mean amplitude of COP on sagittal plane, and maximal sway in sagittal plane parameters. The analysis of pressure value differences between the right and left lower limbs in both groups revealed statistical significance. In the study population the difference was significantly greater in comparison to the control group. The patients had significantly greater asymmetry of lower limb load. CONCLUSIONS: 1. Patients with lumbar spine discogenic pain had decreased postural control. 2. The patients had significant asymmetry in foot pressure resulting from pain radiating to a lower limb.

Changes of the body posture parameters in the standing versus relaxed sitting and corrected sitting position.

BACKGROUND: Decrease of physiological curvatures of the spine can lead to back pain. OBJECTIVE: The aim of this study was to compare the curvatures of the spine and body posture parameters in three positions: relaxed standing, relaxed sitting, corrected sitting. METHODS: The study included 40 healthy persons aged 18-32 years (mean 24.7 ± 2.3), with body height 152-195 cm (mean 171.8 ± 9.3), weight 47-115 kg (mean 66.4 ± 13.7), BMI 17.9-32.5 kg/m2 (mean 22.3 ± 3.0). The study was performed using the photogrammetric method. RESULTS: After changing the position from relaxed standing to relaxed sitting, significant decrease of the inclination of the thoracolumbar region, the thoracic kyphosis depth and the lumbar lordosis depth were observed. Lumbar lordosis angle increased significantly. After the sitting position correction, the inclination of the upper thoracic and thoracolumbar region decreased, and the depth of thoracic kyphosis and lumbar lordosis increased. CONCLUSIONS: - In the relaxed sitting position, the lumbar lordosis was significantly smaller than in the standing position. - A change from the standing to the sitting position results in flattening of thoracic kyphosis. - The corrected sitting position does not adequately correct the spinal curvatures.

The effect of unilateral osteoarthritis of the hip on postural balance disorders.

BACKGROUND: Postural stability is of great importance because imbalances and muscle weakness are significant risk factors for falls experienced by the elderly. Hip arthrosis, which causes pain and gait disorders that affect balance control, is common in the ageing population. AIM: The aim of this study was to assess postural stability in patients with unilateral hip arthrosis before total hip arthroplasty. METHODS: The study population consisted of 52 patients with hip arthrosis (study group) and 47 subjects with no history of clinical symptoms of hip pain. The groups did not differ statistically in terms of age and BMI. Static balance was assessed by conducting a quantitative analysis of balance reaction parameters in a quiet standing position with the eyes open and closed. RESULTS: Analysis of the collected data revealed numerous statistically significant differences between patients with unilateral hip arthrosis before total hip arthoplasty and the asymptomatic group for parameters tested with eyes closed (p<0.05). We observed higher values of total length of centre of pressure (COP), sway path (SP), length of COP path in the medial-lateral plane (SPML), maximal amplitude between the 2 most distant points in the medial-lateral plane (MaxML), mean COP velocity (MV), and mean COP velocity in medial-lateral (MVML) in the study group.

Laterality versus ankle dorsi- and plantarflexion maximal torques.

PURPOSE: The aim of the study was to analyze the connections between the functional asymmetries of lower limbs, taking into account morphological feet features, and ankle dorsi- and plantarflexion maximal torques in men and women. METHODS: The study population consisted of 56 young subjects among which there were 30 women and 26 men. The assessment of upper and lower limbs' side dominance was performed on the basis of surveys, verified with simple motor tasks that resembled the actions characteristic of the upper and lower limbs. The measurements of body build, as well as foot build, were performed with the use of accepted instruments according to the anthropometry standards. The measurements of longitudinal foot arches were conducted using the pantographic method. Ankle dorsi- and plantarflexion maximal torque values were measured under static conditions. RESULTS: We found a positive correlation between the functional dominance of lower limb and greater strength only for ankle plantarflexion maximal torque values in correct laterality variants in women and in only one variant in men. No correlation was found between foot morphological asymmetry and the ankle dorsi- and plantarflexion maximal torque values, either in women or in men. CONCLUSION: Our results support the idea that the functional lower limb dominance is not equivalent to the greater muscle strength.

Laterality versus jumping performance in men and women.

PURPOSE: The aim of this study was to investigate relationships between functional asymmetry of lower limbs, taking into account morphological features of the feet, and jumping ability in men and women. METHODS: The study population consisted of 56 subjects, 30 women (age: 20.29 ± 0.59 years; body mass: 58.13 ± 4.58 kg, body height: 165.60 ± 5.03 cm) and 26 men (age: 20.41 ± 0.78 years, body mass: 78.39 ± 8.42 kg, body height: 181.15 ± 6.52 cm). The measurements of longitudinal arches were performed with the plan- tographic method on the basis of Clarke's angle mapped on a computer foot print. The measurements of jumping performance during bilateral (two legs) and unilateral (single-leg) counter movement jump (CMJ) were done on force plate. All subjects jumped three times each type of jump (total 9 jumps): three right leg, three left leg and three two legs. We put the test results through a detailed statistical analysis with the Statistica 8.0. The t-test for dependent variables and the Wilcoxon signed-rank test for divergent variances of the fea- tures compared. The analysis of relationships between the chosen podometric and plantographic features and jumping performance was conducted on the basis of the Pearson product-moment correlation coefficient (for the features which presented normal distribution, according to the Shapiro-Wilk test). RESULTS: The correlations between values of height of single-leg jumps (right and left) and bilateral jumps, and foot indices were found in few cases only in men who had greater values of jump height with the non-dominant limb. We did not find a significant difference in jumping ability between the dominant limb and the non-dominant limb in women. We found bilateral deficits in jumping ability in the study groups, though we did not find significant differences (P ≤ 0.05) between the values for women (a mean of 6.5%) and for men (a mean of 8.4%). CONCLUSION: We found significant gender differences of the correlations between the values of height of jumps (single-leg and bilateral jumps) and foot indices.

Static balance after surgical decompression of lumbar spinal canal stenosis.

BACKGROUND AND OBJECTIVES: Spinal canal stenosis is the most common reason for spinal surgeries in patients over 65 years of age. The aim of the study was to assess static balance in patients prior to and after surgical decompression of lumbar spinal canal stenosis. MATERIAL AND METHODS: The study population consisted of 30 patients suffering from spinal canal stenosis. Their static balance was measured, i.e. quantitative analysis of balance reaction parameters in quiet standing was performed. RESULTS: The analysis of the collected data did not reveal any statistically significant differences between parameters measured prior to and after the surgery (for p< 0.05). A tendency for a decrease of measured parameters was observed. The regularity of changes was determined; in addition, for this analysis, the Spearman's rank correlation coefficient was used. CONCLUSIONS: The analysis of the collected data did not reveal any statistically significant improvement of balance reactions after spinal canal stenosis surgery. In spite of pain reduction, there was no improvement in balance reactions, as behavioural patterns for balance reactions had been fossilised before surgery.

Postural stability disorders in patients with osteoarthritis of the hip.

The osteoarthritis of the hip dominant symptom is pain that leads to disability and to postural and gait disorders. The aim of this study was to analyze postural stability and its impact on disability and pain. The study population consisted of 60 patients and control group of 30. Group 1 (n=30) included patients with unilateral coxarthrosis, aged 56.2 (±12.3) years, BMI 25.17 (±2.87) kg/m2. There were 16 men (53.3%). The mean age of patients in group 2 (n=30) with bilateral coxarthrosis was 62.3 (±12.1) years; the mean BMI was 24.87 (±2.06) kg/m2. There were 15 men in this group (50%). The patients were evaluated using the WOMAC, the Harris Hip Score, VAS and the Biodex Balance System. Both study groups had stability index results different than the control group. There was a significant correlation between the stability indexes and BMI. VAS correlated with the M-L plane variance. In group 2, there were significant differences related to disability for the disability scales for all measured parameters. Balance disorder is a basic parameter found in coxathrosis. There is a statistically significant correlation between balance disorders and BMI, VAS and functional scales.

The foot deformity versus postural control in females aged over 65 years.

PURPOSE: Correct foot structure is important due to locomotion and postural stability. The aim of this study was to determine the relationships between morphological foot structure and balance indices in a quiet standing position in women over 65 years of age. METHODS: The study included 116 women aged 65-90 years. The mean age was 70.6 ± 8.4 years and BMI 29.1 ± 3.4 m/kg2. The measured indices included postural control while standing on both feet and photogrammetric foot evaluation. An analysis was performed of the selected foot and balance indices. RESULTS: There were no significant differences observed in the feet structure. Certain correlations between some foot indices and the indices of postural control were noted. The increased differences in the width indices between the right and the left foot lead to balance deterioration. Larger angles of valgity and varus deformity of toes and indices describing the longitudinal arch and transverse front arch of the foot have the greatest impact on the deterioration of balance in the medio-lateral axis. CONCLUSIONS: The differences between the indices and morphological indices for the right and the left foot are not significant, which indicates the proportionate formation of feet in the individual life. The increased differences in the width indices between the right and the left foot lead to balance deterioration. Larger angles of valgity and varus deformity of toes and indices describing the longitudinal arch and transverse front arch of the foot have the greatest impact on the deterioration of balance in the medio-lateral axis.