Biomedical subjects

M C Battié

Publications and source records attributed to M C Battié.

At least 19 recordsLinked to original sources

PubMed2006

Material handling performance of patients with chronic low back pain during functional capacity evaluation: a comparison between three countries.

PURPOSE: Functional Capacity Evaluations (FCEs) are batteries of tests designed to measure patients' ability to perform work-related activities. Although FCEs are used worldwide, it is unknown how patients' performances compare between countries or settings. This study was performed to explore similarities and differences in FCE performance of patients with chronic low back pain (CLBP) between three international settings that utilize the same FCE protocol. METHODS: Standardized FCEs were performed on three cohorts of patients with CLBP: A sample from an outpatient rehabilitation context in The Netherlands (n = 121), a Canadian sample in a Worker's Compensation context (n = 273), and a Swiss sample in an inpatient rehabilitation context (n = 170). Patients were undergoing FCE as part of their usual clinical care. Means and standard deviations of maximum performance on the FCE material handling items were calculated and differences compared using ANOVA. Multivariable linear regression was used to determine the relationship between country of origin and FCE performance while controlling for potential confounders including, age, sex, duration of back pain problems, and self-reported pain and disability ratings. RESULTS: Compared to the Dutch sample, the mean performance of patients in the Canadian and Swiss samples was consistently lower on all FCE items. This association remained statistically significant after controlling for potential confounders. CONCLUSIONS: Considerable differences were observed between settings in maximum weight handled on the various FCE items. Future FCE research should examine the effects of a number of potentially influential factors, including variability in evaluator judgements across settings, the evaluator-patient interaction and patients' expectations of the influence of FCE results on disability compensation.

Alberta↗

PubMed2006

Does functional capacity evaluation predict recovery in workers' compensation claimants with upper extremity disorders?

OBJECTIVES: Functional capacity evaluations (FCEs) are commonly used to determine return-to-work readiness and guide decision making following work related injury, yet little is known of their validity. The authors examined performance on the Isernhagen Work Systems' FCE as a predictor of timely and sustained recovery in workers' compensation claimants with upper extremity disorders. A secondary objective was to determine whether FCE is more predictive in claimants with specific injuries (that is, fracture) as compared to less specific, pain mediated disorders (that is, myofascial pain). METHODS: The authors performed a longitudinal study of 336 claimants with upper extremity disorders undergoing FCE. FCE indicators were maximum performance during handgrip and lift testing, and the number of tasks where performance was rated below required job demands. Outcomes investigated were days receiving time-loss benefits (a surrogate of return to work or work readiness) in the year following FCE, days until claim closure, and future recurrence defined as whether benefits restarted, the claim reopened, or a new upper extremity claim was filed. Cox and logistic regression were used to determine the prognostic effect of FCE crudely and after controlling for potential confounders. Analysis was performed separately on claimants with specific and pain mediated disorders. RESULTS: Most subjects (95%) experienced time-loss benefit suspension within one year following FCE. The one year recurrence rate was 39%. Higher lifting performance was associated with faster benefit suspension and claim closure, but explained little variation in these outcomes (r2 = 1.2-11%). No FCE indicators were associated with future recurrence after controlling for confounders. Results were similar between specific injury and less specific groups. CONCLUSIONS: Better FCE performance was a weak predictor of faster benefit suspension, and was unrelated to sustained recovery. FCE was no more predictive in claimants with specific pathology and injury than in those with more ambiguous, pain mediated conditions.

Accidents, Occupational↗

PubMed2006

The predictive role of bone turnover markers for BMD in middle-aged men.

Measurement of bone turnover markers has been proposed as a potentially valuable clinical laboratory aid in osteoporosis risk assessment. These markers may allow quantitative evaluation of rates of bone loss, and thereby identify persons at risk for osteoporosis at an earlier stage. As far as we know, this is the longest longitudinal study on bone turnover markers conducted in adult men. The objectives of this study were to determine whether markers of bone formation (type I procollagen amino-terminal propeptide, PINP, and carboxy-terminal propeptide, PICP), and of bone resorption (type I collagen carboxy-terminal telopeptide, ICTP), are predictive of changes in lumbar spine and femoral neck BMD over a 5-year period, and to determine the ability of the bone resorption marker urine amino-terminal telopeptide (NTx) to explain the variance in BMD change over the past 5 years in a group of men 35-69 years old. In this group, NTx was the only marker to correlate significantly with BMD changes at the femoral neck (r = -0.21), but not at the spine. The use of the biochemical markers studied to predict change in bone density in adult men in middle-aged years is of very limited value.

Biomarkers↗

PubMed2003

Factors associated with exercise lifestyle--a study of monozygotic twins.

Regular exercise is widely advocated for a broad range of health issues. Yet, the association of familial factors (i. e. both genetic and childhood environmental factors) and specific environmental factors (not shared by family members) as well as health behavior with lifelong exercise participation is currently poorly understood. A total of 117 monozygotic male twin pairs aged 35 - 69 y (mean age 49 y), recruited from the population-based Finnish Twin Cohort, were studied. A summary outcome exercise variable was created by calculating the mean hours of exercise per week from 18 y of age to present from data provided from a structured interview. Suspected factors associated with exercise were analyzed with linear regression, while pairwise relationships were analysed using polychoric correlations and structural equation modeling. There was substantial familial aggregation in adulthood exercise, accounting for 43 % of all variation in exercise using the LISREL model. Factors associated with enhanced adherence to exercise in adulthood were participation in exercise and competitive sports in adolescence (from age 12 to 18). Education, age, number of chronic diseases, smoking, alcohol use, marital status, number of children and number of changes in residence were not associated with exercise adherence in adulthood. Our results suggest that early childhood environmental factors strongly influence exercise level throughout the lifespan. Therefore, interventions aimed at enhancing lifelong exercise participation may achieve more beneficial long-term results by targeting families and other childhood and adolescent environments.

Adult↗

PubMed2001

The relative roles of intragenic polymorphisms of the vitamin d receptor gene in lumbar spine degeneration and bone density.

STUDY DESIGN: A retrospective cohort study. OBJECTIVES: To compare the magnitudes of the associations of TaqI polymorphisms of the vitamin D receptor gene with bone density and lumbar spine degeneration in the same sample. SUMMARY OF BACKGROUND DATA: Vitamin D receptor gene variations are associated with osteoporosis, osteoarthritis, and disc degeneration. Their role in these conditions remains poorly understood. METHODS: Bone density of the spine and femur were determined through DEXA, and lumbar disc degeneration was determined from magnetic resonance imaging assessments of signal intensity, disc narrowing, bulging, anular tears, herniations, and osteophytes. Associations between these measures and TaqI polymorphisms of the coding region of the Vitamin D receptor locus were examined in a population-based sample of 142 men. RESULTS: The strongest associations were with signal intensity and anular tears, which were worse for the subjects with tt genotypes than for those with TT genotypes in the L4-S1 spine discs. Conversely, the prevalences of disc bulges and osteophytes were lowest for the tt genotype. Bone density, disc height, and herniations did not differ significantly by genotype. CONCLUSIONS: The strongest association of Vitamin D receptor TaqI polymorphisms with degeneration in nonmineralized connective tissues suggests that the underlying mechanism of TaqI polymorphisms is not specific to bone. This study demonstrated for the first time that those with the tt genotype had more anular tears than those with the TT genotype, a finding that should stimulate further analyses of this gene in conditions that result in back pain. The apparent discrepancies of the associations of the tt genotype with lower signal intensity and more anular tears, but less bulges and osteophytes, could be explained if bulging and osteophytes primarily represented remodeling related to lifetime physical loading.

Adult↗

PubMed2001

Repeatability of lifetime exercise reporting.

The purpose of the study was to determine the reliability of lifetime exercise data obtained through a structured interview. Interviews were conducted in 1992-1993 and repeated in 1997 in 150 monozygotic male twins, aged 35-69 years, from the population-based Finnish Twin Cohort. Exercise mode, frequency, duration, intensity and period of participation were solicited for each regularly performed exercise from 12 years of age to the present. Questions related to the most common exercise mode reported in the initial interview were repeated in all subjects and the entire exercise interview was repeated in a subgroup of 38 subjects. The repeatability was highest for exercise years and mean hours/ week by mode for the most commonly performed exercise (Mean ICC=0.63-0.90), and for the sum of all lifetime exercises reported (Mean ICC = 0.69-0.73). The lowest repeatability was found for exercise intensity (Mean Kappa = 0.33-0.48). Similarly poor reliability was found for whether or not exercise was performed at a competitive level (Mean Kappa = 0.25-0.63). Overall, the structured interview of lifetime exercise was most repeatable for years of exercise and mean hours/week. Thus, these exposure variables should be considered in retrospective studies of exercise effects.

Adult↗

PubMed2000

Disc degeneration and bone density in monozygotic twins discordant for insulin-dependent diabetes mellitus.

The effects of insulin-dependent diabetes mellitus on bone density and connective tissue degeneration have theoretical interest and practical relevance. Several experimental studies in animals have demonstrated the harmful effects of insulin deficiency on connective tissues. However, clinical studies in humans have produced somewhat contradictory results, most likely due to difficulties controlling for general degeneration and factors associated with diabetes. In nine pairs of monozygotic twins discordant for insulin-dependent diabetes mellitus, we compared femoral and lumbar bone mineral density (assessed by dual-energy x-ray absorptiometry) and spinal degeneration (assessed by magnetic resonance imaging). The bone densities were, on average, 0.1-0.3% lower (p = 0.87-0.96) in diabetic patients. However, after controlling for smoking, we found that the bone density in the femoral neck was 2.5% (0.025 g/cm2) lower in diabetic individuals than in their twins (p = 0.09). The five magnetic resonance imaging parameters used to evaluate disc degeneration did not differ between diabetic patients and their twins. In conclusion, our results provide no evidence that insulin-dependent diabetes mellitus has any major effect on bone density or disc degeneration.

Absorptiometry, Photon↗

PubMed1999

The influence of occupation on lumbar degeneration.

In many countries, back problems have been defined as occupational injuries. The belief underlying this injury model is that back symptoms are caused primarily by work-related mechanical factors that damage the structures of the spine, either through a single incident or repeated loading. Although the etiopathogenesis of degenerative findings in the disc and their relation to pain are poorly understood, changes in the disc are suspected of underlying many back symptoms. The focus of this article is on examining the relation between occupational factors and disc degeneration. Occupational factors suspected of accelerating spinal degeneration include accident-related trauma; heavy physical loading and materials handling, including lifting, bending, and twisting; prolonged sitting; and sustained nonneutral work postures and vehicular driving. There is evidence to suggest that occupational exposures have an effect on disc degeneration. However, these factors explain little of the variability in degeneration found in the adult population. Furthermore, the lack of a clear dose-response relation between time spent in various occupational loading conditions and degenerative findings adds to doubts about a strong causal link. The contribution of suspected occupational risk factors appears to be particularly modest when compared with familial influences, which reflect the combined effects of genes and early childhood environment. These findings challenge the dominant role assumed for occupational loading in disc degeneration and associated back problems, and suggest a more complex etiology.

Humans↗

PubMed1998

Intragenic polymorphisms of the vitamin D receptor gene associated with intervertebral disc degeneration.

STUDY DESIGN: A study in genetic epidemiology of disc degeneration, based on lifetime exposure data, findings on magnetic resonance imaging, and genotyping of intragenic markers. OBJECTIVES: To pursue the potential correlation between common allelic variations in the vitamin D receptor locus and degeneration of the intervertebral disc. SUMMARY OF BACKGROUND DATA: Familial aggregation has been observed in intervertebral disc degeneration, but the relative significance of the genetic component and shared environmental influences is unknown. The identification of relevant candidate genes associated with disc degeneration would specify a genetic component and increase our understanding of the etiopathogenesis of disc degeneration. METHODS: From the population-based Finnish Twin cohort, 85 pairs of male monozygotic twins were selected based on exposure to suspected risk factors for disc degeneration. Interview data were gathered on relevant lifetime exposures, and thoracic and lumbar disc degeneration was determined through quantitative and qualitative assessments of signal intensity on magnetic resonance imaging, and qualitative assessments of disc bulging and disc height narrowing. Possible associations were examined between disc degeneration measures and two polymorphisms of the coding region of the vitamin D receptor locus. RESULTS: Two intragenic polymorphisms of the vitamin D receptor gene revealed an association with disc degeneration. Quantitatively assessed signal intensities of thoracic and lumbar (T6-S1) discs were 12.9% worse in men with the Taql tt genotype and 4.5% worse in men with the Tt genotype, compared with signal intensity in men with the TT genotype (age adjusted P = 0.003). A similar pattern was found between disc signal intensity and Fokl genotypes; men with the ff and Ff genotypes had mean signal intensities that were 9.3% and 4.3% lower, respectively, than those in men with FF genotypes (age-adjusted P = 0.006). The summary scores of qualitatively assessed signal intensity, bulging, and disc height were 4.0% and 6.9% worse in men with Ff and ff genotypes, respectively, when compared with those in men with the FF genotype (age-adjusted P = 0.029). CONCLUSION: Specific vitamin D receptor alleles were associated with intervertebral disc degeneration as measured by T2-weighted signal intensity, demonstrating for the first time, the existence of genetic susceptibility to this progressive, age-related degenerative process.

Adult↗

PubMed1998

Determinants of psychomotor speed among 61 pairs of adult male monozygotic twins.

BACKGROUND: Declining psychomotor speed is an indicator of the aging process, and it is influenced by genetics and environmental factors. The present study examined the relative effects of familial aggregation (reflecting a combination of genetics and early environmental influences), and occupational, lifestyle, and health factors on psychomotor speed. METHODS: Hand and foot psychomotor speed was studied with 61 pairs of monozygotic male twins aged 35-67 years from the population-based Finnish Twin Cohort. The determinants of visual simple and choice reaction times were analyzed with multiple regression analysis. RESULTS: Familial aggregation, reflecting genetic influences and shared environmental effects, explained in mean 47% of decision times, 31% of movement times, and 37% of response times (decision time and movement time combined). Age, cardiovascular morbidity, lifetime vigorous and frequent exercise participation, and mean lifetime daily hours sitting at work explained 0-19% of hand psychomotor speed and 0-10% of foot speed, depending on the outcome. The predicted increase in decision times due to the presence of cardiovascular morbidity was 11-35 ms. The predicted increase for hand and contralateral foot response times between ages 45 and 55 was 18-41 ms. Smaller effects were noted for each year of strenuous exercise and each hour/day of average lifetime sitting at work. CONCLUSIONS: Results indicate that cardiovascular status, age, strenuous exercise, and work play a role in psychomotor speed, but a rather minor one. In contrast, genetic and shared early environmental influences as revealed from familial aggregation were relatively strong, yet a major proportion of the variability in psychomotor speed remained unexplained.

Activities of Daily Living↗

PubMed1998

Determinants of paraspinal muscle cross-sectional area in male monozygotic twins.

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the general magnitude and relative contributions of anthropometric, lifestyle, and medical history factors and familial aggregation (combined effects of genes and early environment) as determinants of paraspinal muscle cross-sectional area (CSA). SUBJECTS: The subjects were 65 pair of male monozygotic twins aged 35 to 65 years (mean = 49, SD = 8). METHODS: Study methods included magnetic resonance imaging, percentage body fat determination, and a detailed interview. RESULTS: Most of the anthropometric factors were associated with the CSAs. Familial aggregation was the strongest determinant, however, explaining 66% to 73% of the variance in the outcomes beyond what age alone predicted. Levels of occupational, sport, and leisure-time physical activities reported by the subjects had negligible effects. CONCLUSION AND DISCUSSION: The CSAs of the paraspinal muscles were influenced more by some combination of genes and early environmental factors than by anthropometric factors and lifestyle choices in adulthood.

Adipose Tissue↗

PubMed1998

The effect of lifelong exercise on psychomotor reaction time: a study of 38 pairs of male monozygotic twins.

PURPOSE: The aim was to study the effect of lifetime physical activity on psychomotor speed. METHODS: Foot and dominant hand visual simple and choice psychomotor reaction times were studied among monozygotic twins (38 pairs) aged 35-69, discordant for lifetime exercise histories. RESULTS: There was a trend that some components of psychomotor reaction time were faster for frequent than for occasional exercisers, but the findings were not consistent for the hand and feet. After controlling for occupational physical activity, only choice decision time for the hand (26 ms, P < 0.01) and choice reaction time for the contralateral foot (51 ms, P < 0.05) both remained 7% faster. There was no trend for systematic differences in reaction times between twins engaged in regular exercise versus their siblings exercising infrequently. CONCLUSIONS: Results suggest a somewhat smaller effect of exercise than reported in previous studies. Reaction time may be significantly affected only by vigorous, frequent exercise. Thus, health promotion through exercise may be unlikely to have notable effects on reaction time.

Adult↗

PubMed1997

Determinants of isokinetic and psychophysical lifting strength and static back muscle endurance: a study of male monozygotic twins.

STUDY DESIGN: Retrospective cohort. OBJECTIVES: To determine the relative contributions of anthropometric factors, physical activity, back and neck pain, overall health, and familial aggregation (the combined effects of genetics and childhood environment) to different measurements of adult back muscle function. SUMMARY OF BACKGROUND DATA: Many methods of muscle testing are employed in the attempt to predict, prevent, treat, and rehabilitate low back pain. Poor correlations between the test results suggest that they are measuring different attributes and have different determinants. METHODS: Muscle function tests, magnetic resonance images, and a detailed interview were obtained in 65 pairs of monozygotic male twins. RESULTS: Familial aggregation was the strongest determinant of isokinetic and psychophysical lifting and static back endurance, explaining 56%, 32%, and 15% of the variances, respectively, beyond that which age alone predicted. Back pain and physical loading in work and leisure explained 2%, 0%, and 23% of the variances. CONCLUSIONS: The combined effects of genetics and childhood environment play a dominant role in determining adult back muscle function. Physical loading at work and leisure, back and neck pain history, overall health, and anthropometric factors had a comparatively minor role, suggesting that the potential of interventions to increase and sustain back muscle function in healthy adults, measured through these tests, may be limited. The relative contributions of constitutional, behavioral, and environmental factors differ substantially in the three tests, and provide insights into what these commonly used tests actually reflect or measure. This knowledge can be used to guide more appropriate selection and interpretation of results of back muscle function tests.

Adult↗

PubMed1997

Differences in hand and foot psychomotor speed among 18 pairs of monozygotic twins discordant for lifelong vehicular driving.

The purpose of this study was to examine driving as a determinant of hand and foot psychomotor reaction times. Visual simple and choice hand and foot psychomotor reaction times were measured. The occupational driving contrast was determined by an interview reviewing every job held during each subject's lifetime. Comparison was made of psychomotor speed among 18 pairs of 39- to 62-year-old monozygotic male twins discordant for lifelong occupational driving. The mean discordance was the equivalent of 16 years of full-time driving. The twins who drove more tended to have slower hand simple and choice reaction times, although only the difference in hand-choice decision time was statistically significant (32 ms, P < 0.05). The drivers also had slower ipsilateral foot-choice decision times (21 ms, P < 0.01), but on average they had faster reaction times in 8 of the 12 ipsilateral and contralateral foot measurements. The slightly longer decision times could be related to some general harmful effects of driving, possibly whole-body vibration. Faster foot movement times of drivers may be affected by practice effects of rapid lower-extremity movements in driving.

Adult↗

PubMed1997

Lifetime exercise and disk degeneration: an MRI study of monozygotic twins.

Participation in some competitive sports has been shown to increase disk degeneration; however, the long-term effects of recreational physical activities are unclear. We investigated the effects of endurance exercise and power sports on disk degeneration in monozygotic male twins with contrasting lifetime exercise histories. The effects of endurance exercise were studied in 22 discordant twin pairs (mean lifetime frequencies of 3.9 vs 1.1 times/wk), and the effects of power sports were investigated in 12 discordant pairs (2,300 vs 200 h of weightlifting). The age range of the twins was from 35 to 69 yr. No differences in MRI findings between co-twins discordant for endurance exercise were found at any of the spinal regions. Subjects with more power sport involvement had greater disk degeneration in the T6-T12 region (P < 0.03), but similar findings were not present in the lumbar spine. Controlling for recalled back injuries, occupational loading, smoking, and driving did not significantly affect the results. No signs of beneficial or harmful effects of lifetime endurance exercise on disk degeneration were seen. Increased power sport participation was associated with slightly greater disk degeneration in the lower thoracic spine, but not in the lumbar spine.

Adult↗

PubMed1997

Isokinetic and psychophysical lifting strength, static back muscle endurance, and magnetic resonance imaging of the paraspinal muscles as predictors of low back pain in men.

Magnetic resonance imaging was used to determine the cross-sectional areas and the T2-weighted and proton density-weighted signal intensities of the paraspinal muscles in a group of 128 men, aged 35-63, who had varied histories of occupational and leisure-time physical activities. These measures, and the isokinetic lifting, psychophysical lifting, and static back muscle endurance tests were examined as predictors of low back pain over 12 months of follow-up, in the 43 men who reported no low back pain in the year preceding testing. None of the imaging measures or the muscle function tests was useful as a predictor of future low back pain. Associations with the frequency of low back pain before testing were investigated in the larger group. Smaller total cross-sectional area of the paraspinal muscles and greater signal intensities had weak but significant correlations with more frequent low back pain in the previous year, possibly due to muscle atrophy.

Humans↗

PubMed1997

The association of trunk muscle cross-sectional area and magnetic resonance image parameters with isokinetic and psychophysical lifting strength and static back muscle endurance in men.

The relationship between trunk muscle morphology as measured on transverse magnetic resonance images and isokinetic lifting, psychophysical lifting, and static back muscle endurance testing was examined in 110 men, ages 35-67 years (mean, 48 years), who had been chosen based on their exposure to a wide variety of occupational and leisure-time physical activities. The computed T2-relaxation times and the T2-weighted and proton density-weighted signal intensities of the erector spinae, quadratus lumborum, and psoas major muscles had almost no association with any of the strength tests. The cross-sectional areas of the muscles had good correlations with isokinetic lifting strength (r = 0.46-0.53). They did not correlate well with psychophysical lifting and static back muscle endurance. Other characteristics or neurological or psychological factors may have more influence on those tests.

Adult↗

PubMed1996

Physical loading and performance as predictors of back pain in healthy adults. A 5-year prospective study.

We investigated muscle strength, aerobic power, and occupational and leisure-time physical loading as predictors of back pain in a 5-year follow-up study. A cohort of 456 adults aged 25, 35, 45 and 55 years, free of back pain, participated in measurements of anthropometric characteristics, aerobic power and muscle strength characteristics at baseline. The subjects' levels and types of physical activity and occupational physical loading were also determined. At 5 years after the baseline examinations 356 of these subjects (78.1%) were reached by mail, and 262 of them (73.6%) properly completed and returned a questionnaire including a detailed back pain history for the 5 years following the baseline measurements. Of this number 56 subjects (21%) who reported back pain (> 30 on a scale from 0 to 100) and functional impairment during the 5-year follow-up composed the marked back pain group. Other subjects (n = 71, 27%) noting lesser symptoms were included in the mild back pain group; 135 subjects (52%) reported having had no back pain. The subjects with marked back pain were on average taller than the subjects without back pain, while no such difference was found in body mass. Heavy occupational musculoskeletal loading (P = 0.005) and high general occupational physical demands (P = 0.036) predicted future back pain. Leisure-time physical activity, aerobic power or muscle strength characteristics were not predictive of future back pain.

Adult↗