Biomedical subjects

H Alaranta

Publications and source records attributed to H Alaranta.

At least 19 recordsLinked to original sources

PubMed1998

One-footed and externally disturbed two-footed postural control in patients with chronic low back pain and healthy control subjects. A controlled study with follow-up.

STUDY DESIGN: A study of postural control during one-footed and externally disturbed two-footed stance among healthy control subjects and patients with chronic low back pain at the beginning of a functional back restoration program and 6 months later at follow-up examination. OBJECTIVES: To study postural control cross-sectionally among control subjects and patients with low back pain, and to evaluate the effects of functional restoration on the postural control parameters in a follow-up examination. SUMMARY OF BACKGROUND DATA: Deficits of motor skills and coordination have been reported in association with musculoskeletal disorders. It has been found that patients with chronic low back pain have impaired psychomotor control, but the impairment is reversible with successful low back rehabilitation. It is insufficiently known how functional activation and intensive physical training affect postural control. METHODS: Sixty-one healthy volunteers (32 men, 29 women) and altogether 99 patients with low back pain participated in the study. Sixty-eight patients (33 men, 35 women) had moderate and 31 (18 men, 13 women) had severe low back pain. Postural stability was measured with a force platform. In two-footed stance, vibration stimulation on calf and back muscles was used to disturb the balance. Center point of force-velocity (cm/sec), average position shift in anteroposterior direction (cm), and maximal position shift in lateral direction (cm) were used as the parameters. RESULTS: Reliability of all tests was acceptable. Center point of force-velocity was the most sensitive parameter and the one-footed measurement the most sensitivetest for evaluating postural stability. At the beginning, the patients with severe low back pain had poorer one-footed postural control compared with the control subjects (P = 0.0003). The subgroup of patients with moderate low back pain participated in the restoration program. The outcome of the restoration program was considered good if the disability because of low back pain (Oswestry index) decreased during the restoration program and poor if the disability increased or did not change. The one-footed postural stability remained primarily at the same level as the initial results in the control and good outcome groups, but became significantly poorer in the poor outcome group. The difference between poor outcome and control groups was statistically significant (P = 0.04). CONCLUSIONS: Impaired postural stability seems to be one factor in multidimensional symptomatology of patients with chronic low back trouble. Postural stability is easily disturbed in case of impairment in strength, coordination, or effective coupling of muscles in the lumbar and pelvic area. Patients with chronic low back pain seem to experience impairment in these functions, which should be taken into consideration when back rehabilitation programs are planned.

Adult↗

PubMed1998

Comparison of health-related quality of life in three subgroups of spinal cord injury patients.

Health-related quality of life (HRQL) was evaluated in three subgroups of spinal cord injury (SCI) patients: (1) persons who had sustained a pediatric SCI (mean time from injury 20 years, age at injury 11.3 years, n = 36), (2) newly injured patients at the beginning of acute rehabilitation (mean age 35.3 years, n = 31), and (3) patients with a chronic SCI (mean time from injury 4.8 years, mean age at injury 35.2 years, n = 34). All the patients were clinically examined and structurally interviewed with a list of questions dealing with details of anamnestic information about injury, its treatment, possible complications and persons past and present psycho-social condition. HRQL was assessed by a generic fifteen-dimensional self-administered instrument (15D). The relative importance of the 15D dimensions and an overall judgement of health status were measured by a 0-100 visual analogue scale. Average importance weights of the dimensions of moving and working differed significantly in the three subgroups. Patients with pediatric SCI assigned the lowest importance for moving. The newly injured patients highly valued working capability. The HRQL scores of the patients who had sustained their injury in childhood were significantly higher than those of the newly injured patients or chronic patients. The tetraplegic patients estimated their HRQL significantly lower than patients with incomplete paraplegia. Of the three subgroups studied, those with pediatric SCI were well adjusted on the basis of anamnestic information and scored high on HRQL when compared with the other two subgroups. Patients injured in adulthood rated their overall HRQL lower and were often unable to return to work. Patients injured in childhood expressed better performance in physical functions than patients who had sustained their injury in adulthood. The subgroups did not differ in psychological functions.

Adult↗

PubMed1998

Bone mineral status after pediatric spinal cord injury.

The impact of spinal cord injury (SCI) on later bone mineral status was studied in 35 adults who had sustained their injury in childhood. The median age of the patients was 31 years, the median age at injury 12.9 years and the median time period from injury was 19 years. The methods used in the study were clinical interview and examination, measurement of bone mineral density (BMD) of the lumbar spine and the proximal femur with dual energy X-ray absorptiometry (DEXA) and estimation of bone turnover with biochemical markers. The densitometric examination revealed that the BMD at the lumbar spine was within the normal range but grossly decreased in the femoral region. Moreover, there was a significant difference in BMD between patients with high (C2-T6) and low (below T6) lesions in the lumbar spine as well as in the femoral region. Patients with lower lesions had higher BMD values. The markers of bone turnover which were studied were serum and urinary calcium and phosphate serum alkaline phosphatase and its isoenzymes, osteocalcin, carboxyterminal propeptide of human type I procollagen (PICP), carboxyterminal telopeptide of type I collagen (ICTP) and urinary deoxypyridinoline. These markers of bone metabolism showed no signs of ongoing accelerated bone formation or resorption. The present study suggests that caution should be observed in weight bearing training or mobilisation of patients with pediatric SCI or perhaps with long standing SCI because of increased fracture risk. The prevention of dissociated osteoporosis should be investigated further in order to avoid fractures of weakened bones. The modes of prevention might be found in the use of modern pharmacotherapy of osteoporosis and from correctly dosage physical training.

Absorptiometry, Photon↗

PubMed1998

Ten-year survival of Finnish lower limb amputees.

Data on mortality for the ten years following lower limb amputation were obtained from all the 16 surgical units in Southern Finland and the National Social Insurance Institution. In Southern Finland during the period 1984-1985, amputations of the lower limb were performed on 705 patients, of whom 382 (54%) were women and 323 (46%) men. The majority of the amputations, 47% were performed for vascular diseases and 41% were performed for diabetes mellitus. The overall survival was 62% at one year after amputation, 49% at two years, 27% at five years and 15% at ten years. The median survival after amputation was 1 yr 5 mth for the women and 2 yr 8 mth for the men. Of the arteriosclerotics, 43% died within one postoperative year while 43% lived longer than two years and 23% longer than five years. The median survival of arteriosclerotics was 1 yr 6 mth. The corresponding figure for patients with diabetes was 1 yr 11 mth. Of the diabetics, 38% died within one postoperative year while 47% lived longer than two years and 20% longer than five years. Of the trauma patients, 86% lived longer than five years and 71% longer than ten years. Of the trans-femoral amputees, 54% lived longer than one year, 36% over two years, 18% over five years and 8% over ten years. The corresponding figures for trans-tibial amputees were 70%, 53%, 21% and 4%. Many elderly vascular and diabetic patients undergoing amputation have a reduced physiological reserve and high mortality. The more proximal the amputation, the greater the risk that the patient will never be able to walk or that the duration of use of the prosthesis will be short. If a prosthesis seems to be a reasonable option for the elderly amputee, any delays in prosthetic fitting should be avoided in older age groups.

Adolescent↗

PubMed1998

Lumbar spinal stenosis: assessment of long-term outcome 12 years after operative and conservative treatment.

The present study focuses on the long-term prognosis of radiographically verified stenosis of the lower lumbar spine. The purpose here was to describe the outcome 12 years after radiographic diagnosis of spinal stenosis and to identify factors predicting disability after operative or conservative treatment. Data were compiled on 75 patients (43 men and 32 women) with changes in functional myelography diagnostic for spinal stenosis. Their mean age at the interview 12 years later was 61 years. The sagittal diameter of the dural sac was measured from baseline myelographs at all intervertebral levels and was corrected for magnification. In the interview, subjective outcome assessment was obtained with a structured questionnaire, and the low-back disorder was scored using the Oswestry disability index. The sagittal diameter of the dural sac was severely stenotic (<7.0 mm) in 32 patients (26 operated), and moderately stenotic (7.0-10.5 mm) in 43 patients (31 operated). The severity of the stenosis significantly predicted disability, even when the effects of age, sex, therapy regimen, and body mass index were adjusted for. For moderate and severe stenosis, the adjusted mean Oswestry indices were 28.4 and 39.1, respectively (p = 0.01). Therapy as such (operative versus nonoperative) did not significantly correlate with later disability. The radiographic severity of lumbar spinal stenosis predicts disability independently of therapy regimen. Randomized clinical trials are needed to establish the indications for surgical and conservative treatment. Radiographic severity of the stenosis should be considered as an effect-modifying or confounding factor in clinical trials and other studies focusing on the outcome of lumbar spinal stenosis.

Aged↗

PubMed1997

Arm motion speed and risk of neck pain. A preliminary communication.

STUDY DESIGN: A sample of 486 Helsinki City Council workers, 35 to 54 years of age, was examined twice at a 1-year interval. OBJECTIVES: To investigate the speed of repetitive arm motion for its ability to predict neck pain. SUMMARY OF BACKGROUND DATA: Psychomotor factors have been suggested to play a role in the etiology of spinal disorders. It was hypothesized that motor skills, as reflected by arm motion speed, could provide protection against neck pain. METHODS: Both the baseline and follow-up examinations consisted of a questionnaire on the history of neck pain and of a number of tests, including arm motion speed and static and dynamic strength of the upper extremities. RESULTS: Of the 124 men and women who reported not having had neck pain during the 1 year before the baseline examination, 23 (19%) reported neck pain on reexamination. The incidence of neck pain was significantly higher both in the least and most rapid quintiles of arm motion speed than in the medium quintiles. This association was not confounded by age, sex, smoking, physical activity at work or at leisure, psychological distress score, or strength measures of the upper extremities, although these factors were significant covariates of the arm motion speed at baseline. When adjusted for these factors, the odds ratios of neck pain in the most and least rapid quintiles of arm motion speed were 8.68 (95% confidence interval 1.85-40.75) and 9.57 (95% confidence interval 2.21-41.52) respectively, compared with the medium quintiles. CONCLUSIONS: These results suggest that people with either very slow or very rapid arm motion speed may have an increased risk of neck pain. The etiology of neck pain is probably different on these two occasions.

Adult↗

PubMed1997

Instrumented measurement of anterior-posterior translation in knees with chronic anterior cruciate ligament tear.

Anteroposterior translation of the knee joint was measured with a Knee Signature System device on 12 women and 14 men with a unilateral, chronic, isolated, anterior cruciate ligament (ACL) tear. A control group with stable knees consisted of 10 women and 10 men. Anterior translation at 178 N load of the uninjured knees was 8.0 mm (+/-2.2 mm) and in knees with an ACL tear, 14.2 mm (+/-4.2 mm). Corresponding values for anteroposterior translation were 12.1 mm (+/-2.5 mm) and 19.3 mm (+/-4.9 mm), respectively. A difference of 3 mm or more in anteroposterior translation at 178 N load between injured and uninjured knees indicated an ACL tear with 85% specificity and 88% sensitivity.

Adult↗

PubMed1997

Abdominal wall competence after free transverse rectus abdominis musculocutaneous flap harvest: a prospective study.

A prospective study was designed to evaluate the possible changes in abdominal wall strength following free transverse rectus abdominis musculocutaneous (TRAM) flap surgery for breast reconstruction. Twenty-two patients were examined 1 day before surgery, and at 3, 6, and 12 months postoperatively. Trunk muscle strength was measured by the same physiotherapist using an isokinetic dynamometer (Lido Multi Joint II, Loredan Biomedical Inc., Davies, CA). The peak torque and average torque for both flexion and extension at 60 degrees per second angular velocity were recorded from the curves obtained. There was a significant reduction in trunk flexion strength at 3 months postoperatively (peak torque mean, 92% of the preoperative value; p = 0.04), but this was corrected by 6 months (mean, 96%), and improved to 98% by 12 months. The patient's ability to do curled trunk sit-ups was evaluated by the same physiotherapist and graded on a scale from 1 to 6. In 9 of 19 patients the operation had no effect on sit-up performance during follow-up. In 10 of 19 patients there was a reduction of one or two grades at 3 months that did not improve by 12 months. Magnetic resonance imaging of the abdominal wall was performed on 9 patients. The mean area of the upper third of both rectus muscles was measured on the axial images. At 3 months postoperatively the mean area of the upper third of the donor muscle was significantly larger than the contralateral (p = 0.03). There was no difference in size at 6 months, and by 12 months the donor side was smaller. This prospective study shows that harvesting of a free TRAM flap can cause a subclinical reduction in abdominal strength, although this was not noticed by the patients themselves.

Abdominal Muscles↗

PubMed1997

Postural stability, neck proprioception and tension neck.

We examined whether tension neck (TN) may due to inadequate proprioceptive and vestibular activation of the cervico-collic reflex (CCR). CCR and vestibulospinal responses (VSRs) were recorded from 106 forest workers by stimulating the neck, lumbar or calf proprioceptors by vibration. The VSRs were recorded with posturography. TN occurred in 27 out of 106 subjects. The subjects with TN (48.5 years) were older than those without TN (43.1). The mean body sway during quiet stance was the same in both groups during the neck stimulation. In subjects with tension neck stimulation of neck or lumbar proprioceptors caused excessive, unpredictable body excursion in the lateral and anteroposterior direction that continued after stimulation. Results from stimulation of lower limb proprioceptors did not significantly differ between the 2 groups. In logistic regression analysis a model to predict TN consisting of perstimulatory postural stability (odds ratio 1.4) and poststimulatory postural stability (odds ratio 1.8) turned out to be statistically significant. The anatomical findings of CCR in the medulla oblongata suggest that neck muscle afferents control the posture and muscle activity of the neck. The erroneus facilitation of proprioception in TN subjects indicate that TN may be raised by inadequate facilitation of CCR.

Adult↗

PubMed1997

Comparison of trunk strength measurements between two different isokinetic devices used at clinical settings.

Intradevice reliability of isokinetic trunk strength measurements has been studied frequently, but no evidence is available on interdevice reliability. This motivated the present study, in which two isokinetic devices, the Ariel 5000 and Lido Multi-Joint II, were compared in a sample of 41 subjects (20 healthy and 21 low back pain subjects). The measurements were made in a random order with both machines. The results showed that the two isokinetic machines gave quite different results in trunk flexion-extension strength measurements. A statistically significant difference was present in the average peak torques between the two devices, with the exception of flexion at low angular velocity (60 degrees/s), and the correlations between the two measurements were low. The results were assumed to be more of a reflection of the interdevice variations (hardware and software, attachment of the subject) than of learning effects or other phenomena. We conclude that isokinetic trunk-muscle strength test results with the Ariel and Lido are device specific, and one cannot automatically compare results obtained from different devices with each other.

Adult↗

PubMed1996

Psychomotor speed and postural control in chronic low back pain patients A controlled follow-up study.

STUDY DESIGN: Psychomotor speed (reaction time) and postural control (center point of force velocity) among healthy control volunteers and patients with chronic low back pain (LBP) were studied at the beginning of an active, functional, restoration back rehabilitation program and 5 months after the program. OBJECTIVES: To study cross-sectionally reaction times and center points of force velocity among control volunteers and patients with low back pain, and to evaluate the effects of the restoration on these measures of motor function in a follow-up examination. SUMMARY OF BACKGROUND DATA: Deficits of motor skills and of coordination have been reported in association with musculoskeletal disorders, but one can only speculate about an association between proprioceptive dysfunction and low back disorders on the basis of the currently available data. METHODS: Sixty-one healthy control volunteers and 99 patients with low back pain-68 of these patients experienced moderate pain; 31 experienced severe pain-participated in the study. Reaction times for upper and lower limbs were tested with a system based on a microcomputer. Postural stability was measured with a vertical force platform. RESULTS: A consistent trend was found in which patients with low back pain had reaction times slower than these of control volunteers. Man with severe low back pain had significantly longer hand reaction times than men in the control group (P = 0.03). Women with severe low back pain also had poorer postural control than women with moderate low back pain (P = 0.02) and women in the control group (P = 0.04). Functional restoration seemed to have an effect on reaction times. The restoration was considered successful if the condition of a patient with a disability that had resulted from low back pain improved during the follow-up examination and unsuccessful if the disability worsened. Patients who experienced these results were identified in groups called "good" and "poor," respectively. Among men, the reaction times improved in the control group and "good" groups, but they became slower in the "poor" group. The difference between "good" and "poor" groups was significant (P = 0.008). Women in the "good" group achieved the most improved reaction times, and the difference between these women and the control women almost reached significance (P = 0.076). CONCLUSION: The results indicate that patients with chronic low back pain have impaired psychomotor speed and, among women, impaired postural control. Psychomotor speed improved during an active, functional, restoration back rehabilitation program.

Adult↗

PubMed1996

Sequelae in the abdominal wall after pedicled or free TRAM flap surgery.

Twenty-seven free transverse rectus abdominis musculocutaneous (TRAM) and 16 pedicled TRAM flap breast reconstruction patients were studied for 7 to 41 months (mean, 23 months) postoperatively to compare abdominal sequelae after these two operations. The patient groups were demographically similar; mean age was 47 years in both groups. Subjective grading of the results was similar in both groups. The incidence of minor lower abdominal bulges was higher (44%, 7/16) in the pedicled group than in the free TRAM flap group (4%, 1/27). No hernias were found. Delayed healing of the abdominal scar occurred in 3 free TRAM flap and 1 pedicled TRAM flap patients. Two free TRAM flap (8%) and 7 pedicled TRAM (44%) flap patients had minor edge necrosis of the breast. Trunk strength was tested using an isokinetic device (Lido Multi Joint II), and peak torque for flexion (mean, 111 Nm +/- 25 Nm in the free TRAM flap group and 123 Nm +/- 28 Nm in the pedicled TRAM flap group) and extension (mean, 144 Nm +/- 38 Nm and 167 Nm +/- 45 Nm) were measured. No statistical differences occurred between these groups. Sit-up performance was tested and graded from 1 to 6. Both groups performed equally (4.8 and 4.8) and within normal values for this age group. Ultrasonography of the rectus muscles revealed that in the free TRAM flap group, the rectus muscle of the operated side was significantly thinner (cranial segment 6.8 mm vs. 7.8 mm, p < 0.05), thus the harvesting of a segment of muscle below the umbilicus seems to disturb the quality of the entire muscle. The mean size of the muscular defect in the free TRAM flap group was 4.3 x 6.1 cm. In this study no differences in patient satisfaction or trunk strength could be found between free and pedicled TRAM flap patients.

Abdominal Muscles↗

PubMed1996

Isokinetic performance capacity of trunk muscles. Part I: The effect of repetition on measurement of isokinetic performance capacity of trunk muscles among healthy controls and two different groups of low-back pain patients.

The aim of this investigation was to assess the reproducibility of the isokinetic trunk muscle performance measurement among patients with different degrees of low-back pain. Twenty-two healthy volunteers, 20 patients with mild and 18 patients with severe low-back pain participated in isokinetic measurements. Lidoback isokinetic dynamometer was used. The measurements were performed with the subjects standing, using velocities of 60, 90 and 120 degrees/second. Five repetitions were performed at each velocity. All subjects were tested three times with a 1-week interval between the tests. Peak torque, average peak torque, coefficient of variation, total work done and peak torque to body weight ratio were calculated for each velocity for both flexion and extension. The results showed that in every measurement peak torque, average peak torque, peak torque to body weight ratio and total work done correlated with each other very strongly both in flexion and extension (r > or = 0.9). The average peak torques increased in further measurements. The change had a strong correlation with the severity of the back problem, which was evaluated by means of the Oswestry disability index. The critical value was found to be 20% in the Oswestry index: values above this meant big changes between measurements and values below this meant small changes between measurements.

Adult↗

PubMed1996

Isokinetic performance capacity of trunk muscles. Part II: Coefficient of variation in isokinetic measurement in maximal effort and in submaximal effort.

It has been claimed that with the aid of isokinetic trunk strength measuring devices it is possible to distinguish true muscular weakness from submaximal effort in the test. This proposition is based on the presumption that in the isokinetic trunk strength test identical performances can only be reproduced by maximal effort. The purpose of this study was to investigate whether it is possible to distinguish maximal effort from submaximal with the aid of the coefficient of variation (CV) in an isokinetic trunk muscle strength test. The study group included 35 (21 male and 14 female) subjects of whom 12 were healthy, 10 had a mild low-back pain and 13 had a more severe chronic low-back pain. The subjects performed five consecutive bendings both with maximal (100%) and submaximal (50%) efforts at a speed of 90 degrees/second. In maximal effort only healthy subjects reached an average level of CV close to 10% both in extension and in flexion. In the chronic low-back pain group the average CV was close to 20%. The difference in CV was statistically significant (p < 0.05-0.02) between the healthy and the chronic low-back pain subjects. In the submaximal effort all health groups had a CV of approximately 20% or more and no significant differences were found. The group of slightly variable measurements (CV = 11-20%) was remarkably large in both the maximal and submaximal effort. The results suggest that an effort with a CV of 11-20% cannot be classified as definitely submaximal or maximal. When the CV is less than 10% the effort can be fairly certainly classified as maximal.

Back↗

PubMed1995

Effect of intensive training on the isokinetic strength and structure of lumbar muscles in patients with chronic low back pain.

STUDY DESIGN: This study investigated the effects of the intensive physical rehabilitation program on the trunk and knee extensor muscles in patients with chronic low back pain. At baseline and after 3 months, strength was measured and muscle biopsies were taken. OBJECTIVES: To evaluate the effects of strength exercises on the structure of back muscles. SUMMARY OF BACKGROUND DATA: Rehabilitation designed for chronic low back pain patients improves trunk muscle strength, mobility of the spine, and the patients' functional capacity. The effects of such programs on the structure of back muscles have not been reported previously. METHODS: Thirty patients with chronic low back pain volunteered to participate in the study. Biopsies were taken from the multifidus and vastus lateralis muscles. The sizes of Types 1 and 2 muscle fibers were measured. The peak-torques of isokinetic trunk and knee extension were determined at two different angular velocities. RESULTS: Strength increased by 19-22% (P < 0.05) in trunk extension and by 7-11% (P < 0.05) in knee extension. Type 1 fibers maintained their pre-exercise size. The size of Type 2 muscle fibers in men increased by 11% (P < 0.05) in the multifidus and by 8% (P < 0.05) in the vastus lateralis. In women, the corresponding increases were 11% (P = 0.16) and 11% (P < 0.05). The correlation between the size of Type 2 muscle fibers in the multifidus and the strength of trunk extension improved, especially in men at follow-up. CONCLUSIONS: The results of the present study suggest that training with maximal or submaximal effort may reverse the selective atrophy of Type 2 fibers in the multifidus muscles in men. Intensive training also can significantly increase the trunk extension strength in women, but women may need a longer training period than men to achieve significant structural changes in their back muscles.

Adult↗

PubMed1995

Severe sciatica: a 13-year follow-up of 342 patients.

This study involved 342 patients hospitalized because of severe, persistent sciatica suggestive of a lumbar intervertebral disc herniation. After standard clinical evaluation, EMG and myelography, 220 patients underwent lumbar discectomy. The remaining 122 patients were treated conservatively. Follow-up examinations were arranged after 1, 5 and 13 years. The study focused on the rehabilitation outcome in general and differences in outcome between the two treatment groups. Several indicators showed a rather poor outcome for sciatica patients during the 13-year follow-up period. In the operated group 16% had been re-operated because of lumbar disc herniation. True recurrence of herniation (same level and side) occurred in 8%. In the conservatively treated group 14% had undergone spinal surgery. Nearly 70% of the patients still reported sciatica. Self-assessed levels of low back pain were "no change/worse" for 19% in the operated group and for 44% in the conservatively treated group. In both the study groups, nearly 40% of the subjects had retired on disability pensions.

Activities of Daily Living↗

PubMed1995

Good muscle performance does not compensate instability symptoms in chronic anterior cruciate ligament deficiency.

A total of 167 patients with documented anterior cruciate ligament deficiency was examined preoperatively with laxity and isokinetic muscle strength measurements. Functional evaluation with Lysholm knee and Tegner activity level scores were done. Antero-posterior (AP) knee laxity correlated negatively with Tegner activity level (NS), and insignificantly with Lysholm knee score. A marginal correlation was found between the Lysholm score and muscle strength. Patients were divided into four groups depending on whether their AP laxity was greater or less than 20 mm and whether their quadriceps strength was greater or less than 85% of their control knee. No difference in the Lysholm or Tegner scores between the groups was observed. As a conclusion it seems that even a relatively good muscle performance does not compensate severe instability symptoms.

Adolescent↗

PubMed1995

Cardiovascular functional disorder and stress among patients having neck-shoulder symptoms.

OBJECTIVES: To investigate if autonomic nervous system function, reflected in cardiovascular variables, among patients with neck-shoulder symptoms (tension neck group (T)) differed from that in a symptom free control group (C), and to establish its relation with pain and psychological stress. METHODS: Twelve women with tension neck and nine controls in secretarial jobs were studied. They underwent an orthostatic test, deep breathing test, Valsalva manoeuvre, isometric handgrip test, and muscular endurance test. Pain was measured using visual analogue scales, and psychological stress by the Modified Somatic Perception Questionnaire (MSPQ). Plasma endothelin-1 (ET-1) was measured using high pressure liquid chromatography and radioimmunoassay. RESULTS: Signs of psychological stress were significantly (p < 0.001) more common in group T than in group C. Mean resting heart rate in group T (77.8 (SE 2.9) beats/min; range 64-100) was significantly greater than that in group C (63.8 (3.1) beats/min; range 52-80) (p < 0.01). In the orthostatic test, the overall changes in R-R intervals during the first 40 heart beats after standing up and during seven minutes of testing differed significantly between the groups (p < 0.001, < 0.05, respectively). The increase in diastolic blood pressure in the three minute isometric handgrip test was significantly less in group T (19.4 (3.5) mm Hg; range -5 to 35) than in group C (30 (3.4) mm Hg; range 15-50) (p < 0.05). The MSPQ score in the study group (n = 21) correlated positively with resting heart rate (r = 0.462, p < 0.05) and negatively with increase in diastolic blood pressure (r = -0.514, p < 0.05). Plasma concentrations of ET-1 did not differ between the groups. CONCLUSION: Increased sympathetic activity was found among patients having neck-shoulder symptoms. Local mechanisms may have influenced the cardiovascular changes observed during isometric testing in these patients.

Adult↗