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Biomedical subjects

D G Simons

Publications and source records attributed to D G Simons.

14 recordsLinked to original sources
PubMed1992

The fibromyalgia and myofascial pain syndromes: a preliminary study of tender points and trigger points in persons with fibromyalgia, myofascial pain syndrome and no disease.

Four experts on myofascial pain syndrome (MFP) performed trigger point examinations and 4 experts on fibromyalgia performed tender point examinations on 3 groups of subjects (7 patients with fibromyalgia, 8 with MFP, and 8 healthy persons) while blinded as to diagnosis. Local tenderness was common in both disease groups (65-82%), but was elicited in a greater proportion of MFP experts' examinations (82%). Active trigger points were found in about 18% of examinations of patients with fibromyalgia and MFP, but latent trigger points were rare in all groups. A more liberal definition of trigger point, however, resulted in a 38 and 23% positive rate among patients with fibromyalgia and MFP, respectively. Taut muscle bands and muscle twitches were common (50 and 30%, respectively) and noted equally in all 3 diagnostic groups. Problems with reliability were identified for taut bands, muscle twitch, and active trigger points. Our data are exploratory and tentative, but suggest that attention to definition and reliability are required to advance our knowledge of these common syndromes.

Fibromyalgia↗
PubMed1988

Ulnar nerve entrapment at the elbow localized by short segment stimulation.

The purpose of the study was to evaluate the differences in the amplitudes of the compound muscle action potentials of the hypothenar muscles and the differences in conduction times. Differences in shoot segment responses were determined by stimulating the ulnar nerve at 2-cm intervals across the elbow in 20 normal adults. Thirteen ulnar nerves on the left side and 12 nerves on the right of 14 men and six women were studied for motor nerve conduction velocity. The amplitudes of the hypothenar compound muscle action potentials and the conduction times after supramaximal stimulation of the ulnar nerve were also determined. The distal-to-proximal reduction in the amplitude of the potentials was 6% on the left and 4.2% on the right. The maximum conduction time in a 2-cm segment on the right side was 0.63msec (mean +2SD = 0.43 + 0.20) and on the left, 0.60msec (mean +2SD = 0.44 + 0.16). Using the same short segment stimulation technique, ulnar nerve motor conduction was also studied in 13 patients with suspected ulnar neuropathy at the elbow in order to localize the nerve lesion. Conduction time only was abnormal in one patient, both conduction time and amplitude in nine, amplitude only in one, and conduction time and mild reduction in amplitude in two. It was concluded that short segment stimulation of the ulnar nerve at the elbow is useful in localizing the exact site of entrapment/compression of the nerve at the elbow.

Adult↗
PubMed1988

Myofascial pain syndromes: where are we? Where are we going?

In recent years, research activity related to myofascial pain syndromes due to trigger points (TrPs) has blossomed. This paper introduces and relates the presentations made in a symposium entitled "Myofascial Pain Syndromes: Where are we? Where are we going?" at the 47th Annual Assembly of the American Academy of Physical Medicine and Rehabilitation in Kansas City October 2, 1985. It summarizes a number of recent research advances and key research issues related to myofascial pain syndromes: 1. Thermography appears valuable for imaging the reflex thermal tracks of previously identified TrPs. 2. Three new devices are reported to measure reliably the pressure threshold for pain of TrPs and tender points (TePs). 3. Fibrositis/fibromyalgia and myofascial pain syndromes may or may not be separate entities. The question needs to be resolved. 4. New evidence strongly supports previous indications that a TrP is a region of increased energy consumption with an inadequate oxygen supply. 5. A foundation has been established for investigating the sensitizing agent(s) responsible for the increased sensitivity of TrPs and muscular TePs. 6. At least four mechanisms can account for the pain referred by TrPs in muscles. The convergence-projection mechanism appears to be consistently present in visceral pain pathways and to be likely in mammalian muscle nociceptive pathways.

Fibromyalgia↗
PubMed1986

Fibrositis/fibromyalgia: a form of myofascial trigger points?

The diagnostic criteria for fibrositis and primary fibromyalgia are similar to those for myofascial pain syndromes due to trigger points. Tender points in muscles are likely to be myofascial trigger points; nonmuscular tender points clearly are not myofascial trigger points, but may be areas of tenderness referred from such trigger points. Myofascial trigger points refer pain to a distance and restrict range of motion of the muscle. They are associated with a palpable taut band that exhibits a local twitch response of the muscle, and they are responsive to treatment. Persistence of myofascial trigger points is due to perpetuating factors that can usually be corrected. Although their number is unknown, it is likely that some patients who are diagnosed as having fibrositis/fibromyalgia have multiple myofascial trigger points aggravated by a powerful perpetuating factor and also have a systemic disease process independent of the myofascial trigger points. Since myofascial pain syndromes are treatable, these patients would benefit greatly by identification and relief of the myofascial component of their pain.

Diagnosis, Differential↗
PubMed1985

Stimulus artifact reduction in nerve conduction.

Techniques recommended to reduce stimulus artifact (SA) include modifications of electrodes, electrode contact, and stimulus circuitry. Twenty-two subjects were studied to evaluate two electrode positioning techniques to reduce the SA in sensory nerve conduction velocity recordings. In 16 normal subjects, rotating the stimulator anode around the cathode 70-105 degrees flattened the baseline and permitted recording a clear take-off of the sural evoked response. In the remaining six subjects, other angles were optimal. Reconfiguring location of the reference and ground electrodes to increase common mode rejection was not consistently effective in reducing the SA in the eight patients tested. Isopotential lines produced by the stimulator electric dipole are described to explain the findings. This technique is simple and effective in reducing SA.

Adult↗
PubMed1976

Microscopic features and transient contraction of palpable bands in canine muscle.

Ten pairs of biopsies were excised from gracilis and semitendinosus muscles of 4 mongrel dogs. These were compared with the histological findings reported in painful spots and muscle hardenings of human muscles. Test biopsies sampled a palpable band. Paired control biopsies sampled a portion of the same muscle where it showed no palpable hardening. Processed sections were randomized and read blind. Sections stained with aqueous toluidine blue showed no convincing metachromasia. Sections stained with trichrome showed no proliferation of endomysial connective tissue. Test sections stained with hematoxylin and eosin showed no proliferation of nuclei and no increase in the number of central nuclei in muscle fibers compared to control sections. No convincing histological difference was found. During surgery under Nembutal anesthesia, rubbing palpation of the exposed muscle elicited a transient contraction of a bundle of muscle fibers several milli-meters in diameter. This corresponded in time and position to the palpable band in the dog muscle. The band-like hardness palpated in these canine muscles appears to be caused by a circumscribed transient muscular contraction rather than histologically demonstrable structural changes.

Animals↗