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Biomedical subjects

Olavi Airaksinen

Publications and source records attributed to Olavi Airaksinen.

At least 19 recordsLinked to original sources
PubMed2006

Preoperative predictors for postoperative clinical outcome in lumbar spinal stenosis: systematic review.

STUDY DESIGN: Systematic review. OBJECTIVE: To define preoperative factors predicting clinical outcome after lumbar spinal stenosis (LSS) surgery. SUMMARY OF BACKGROUND DATA: LSS is the most common reason requiring lumbar spine surgery in adults older than 65 years. There are no published systematic reviews on this topic. METHODS: A literature search was done until April 30, 2005. Included were randomized controlled or controlled trials or prospective studies dealing with operated LSS. The preoperative predictors had to be presented. Included articles were assessed as high-quality (HQ) and low-quality studies. The predictors in HQ studies were considered as the main results. RESULTS: A total of 21 articles were included. Depression and walking capacity were predictors according to 2 HQ studies. Predictors reported in 1 HQ study were cardiovascular/overall comorbidity, disorder influencing walking ability, self-rated health, income, severity of central stenosis, and scoliosis. CONCLUSION: Depression, cardiovascular comorbidity, disorder influencing walking ability, and scoliosis predicted poorer subjective outcome. Better walking ability, self-rated health, higher income, less overall comorbidity, and pronounced central stenosis predicted better subjective outcome. Male gender and younger age predicted better postoperative walking ability. The predictive value may be outcome specific; thus, the use of all relevant outcome measures is recommended when studying predictors of LSS.

Databases, Factual↗
PubMed2006

Depression and associated factors in patients with lumbar spinal stenosis.

PURPOSE: To investigate the prevalence of depression and associated factors in patients (n = 100) with lumbar spinal stenosis selected for surgical treatment. METHOD: Depression was assessed with the 21-item Beck Depression Inventory. Psychological well-being was assessed with Life Satisfaction Scale, Toronto Alexithymia Scale and Sense of Coherence Scale. Physical functioning and pain were assessed with the Oswestry disability index, the questionnaire devised by Stucki and the Visual Analogue Scale. All questionnaires were administered before surgical treatment of lumbar spinal stenosis. RESULTS: Twenty percent of the patients with LSS were found to have clinically important depression. In univariate analyses, subjective disability measured with the Oswestry disability index, low sense of coherence and poor life satisfaction were common in depressed patients. In the multiple logistic regression analyses, being dissatisfied with life was associated with depression. When sense of coherence score was included in the model, then only low sense of coherence was independently associated with depression. Neither socio-demographic nor pain-related factors associated with depression. CONCLUSIONS: Clinically important depression is rather common among preoperative patients with lumbar spinal stenosis. The factors associated with depression are subjective disability of everyday living and decreased life satisfaction. A low sense of coherence is an important correlate of depression. The results underline the importance of assessing depression in clinical practice dealing with these patients.

Depression↗
PubMed2006

Somatic comorbidity and younger age are associated with life dissatisfaction among patients with lumbar spinal stenosis before surgical treatment.

The objective of the study was to examine self-reported life satisfaction and associated factors in patients (n=100) with lumbar spinal stenosis (LSS) in secondary care level, selected for surgical treatment. Life satisfaction was assessed with the four-item Life Satisfaction scale. Depression was assessed with a 21-item Beck Depression Inventory (BDI). Psychological well-being was assessed with Toronto Alexithymia Scale and Sense of Coherence Scale. LSS related physical functioning and pain were assessed with Oswestry disability index, Stucki questionnaire, Visual Analogue Scale and pain drawings. All questionnaires were administered before surgical treatment of LSS. Results showed that 25% of the patients with LSS were found to be dissatisfied with life. In a univariate analysis, smoking, elevated subjective disability scores and extensive markings in the pain drawings were more common in the dissatisfied patients. The dissatisfied patients also showed lower coping resources, elevated alexithymia and depression scores, and were more often depressed. In multiple logistic regression analyses, only younger age and somatic comorbidity were associated with life dissatisfaction. This association remained significant even when the BDI score was added into the model. No other significant associations emerged. In conclusion, life dissatisfaction was rather common among preoperative LSS patients. Pain and constraints on everyday functioning were important correlates of life dissatisfaction. However, only younger age and somatic comorbidity were independently associated with life dissatisfaction. These results emphasize the importance of recognizing and assessing the effect of coexisting medical conditions and they need to be addressed in any treatment program.

Age Factors↗
PubMed2005

Wireless on-line electromyography in recording neck muscle function: a pilot study.

AIM: The surface electromyography (SEMG) records muscle activity without causing pain and therefore it can be used in the on-line kinetic evaluation of rehabilitation methods. The cables are a problem in the clinical work. The aim of this pilot study was to introduce a wireless on-line SEMG method in the measurements of neck muscle activity and preliminarily evaluate its usability in dynamic exercises in a healthy and a neck pain subject. METHOD: The bilateral wireless on-line SEMG measurements were performed at the level C4-C5 of the cervical spine. The subjects (one healthy 32-year-old female and one neck pain patient, 35-year-old female) were performing slow cervical flexions with eyes open. The angle of the flexion was measured with inclinometer. RESULTS: In healthy subjects, the SEMG curve demonstrated clear flexion-relaxation rhythm whereas in the patient the rhythm was blurred. The SEMG signal quality was, however, good in both cases. CONCLUSION: Wireless on-line SEMG method seems promising in daily clinical work for the measurements of neck muscle activity.

Journal Article↗
PubMed2005

Back and neck extensor loading and back pain provocation in urban bus drivers with and without low back pain.

This study assessed low back and trapezius muscle activity in bus drivers, with or without recurrent low back pain (LBP), during the long term driving. In addition, low back and neck-shoulder pain intensities and fatigue were measured and the effect of low back support was observed. Also the possible source of LBP was attempted to assess by vibration pain provocation test and lumbar MRI. Forty bus drivers (recurrent LBP n = 25) participated in this study. Low back and neck-shoulder pain and subjective fatigue intensity was assessed by visual analogue scales (VAS) before and after driving. Lumbar paraspinal and trapezius muscle activation during driving was measured by surface EMG. Vibration pain provocation test was applied for all subjects. Average paraspinal myoelectric activity during driving was approximately 1% of MVC in both groups. Average trapezius myoelectric activity during driving was from 2 to 4% of MVC. Trapezius muscle activity was higher in back healthy drivers than in those with LBP. The low back support had no effect either on paraspinal or trapezius EMG activity. Low back and neck-shoulder fatigue increased during driving in both groups especially in those subjects with positive vibration pain provocation. The neck-shoulder pain and fatigue were more severe in drivers suffering from LBP. Low back support had no effect on low back and neck-shoulder subjective fatigue and neck-shoulder pain but tended to limit the LBP increase during driving. Paraspinal muscle loading in urban bus drivers was very limited and either LBP or ergonomic low back support had no effect on it. Trapezius muscle seemed to be less active in drivers suffering from recurrent LBP. Internal disc disruptions may expose to pain and fatigability during driving.

Journal Article↗
PubMed2005

Effect of passive stretch on reproducibility of hip range of motion measurements.

OBJECTIVE: To examine the intra- and intertester and intra- and interday reliability of hip passive range of motion (PROM) measurements and the effect of passive stretch on the reproducibility of PROM measurements. DESIGN: Reliability study. SETTING: Rehabilitation clinic at university hospital. PARTICIPANTS: Twenty volunteers (12 women, 8 men; age range, 18-45 y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Two physical therapists made 2 PROM measurements on the first day and repeated them once after 2 days. The PROM in hip flexion, extension, and inner rotation and knee flexion were determined. The measurements of the hip flexion and inner rotation involved either 1 or 8 short-term passive stretches. The reproducibility was expressed as the intraclass correlation coefficient (ICC) and the coefficient of variation (CV) (in percent). RESULTS: The passive stretch increased significantly ( P <.05 to P <.001) the PROM of the hip joint. The reproducibility of the PROM measurement did not increase after repetitive passive stretch. The intra- and interday intra- and intertester ICC and CV of the PROM of the hip flexion and hip inner rotation ranged from .655 to .988 and 2.1% to 12.6%, respectively. The intra- and intertester intra- and interday ICC of the PROM of the hip extension ranged from .740 to .961, and the CV ranged from -85.5% to 242.6%. The intra- and intertester intra- and interday ICC of the PROM of the knee flexion ranged from .497 to .913, and the CV ranged from 2.5% to 9.9%. CONCLUSIONS: Repetitive stretching increased significantly the PROM in hip flexion and inner rotation, but the reproducibility of the PROM measurement did not improve. The hip flexion and the hip inner rotation PROM measurements had moderate to very high intra- and interday intra- and intertester reliabilities. The reliability of the PROM in hip extension and knee flexion was poor.

Adult↗
PubMed2005

Effect of long-term neck muscle training on pressure pain threshold: a randomized controlled trial.

Muscle tenderness has been measured in several studies to evaluate effectiveness of treatment methods, but only short-term results have been reported so far. The aim of the present study was to evaluate the long-term effects of two different muscle training methods on the pressure pain threshold of neck muscles in women with neck pain. Altogether 180 woman with chronic, non-specific neck pain were randomized into three groups: neck muscle endurance training, neck muscle strength training and control groups. The main outcome measures included pressure pain threshold measurement at six muscle sites and on the sternum. Neck pain was assessed by a visual analogue scale (VAS). At the 12-month follow-up statistically significantly higher pressure pain threshold values were obtained in both training groups at all muscle sites compared to the baseline, while no significant change occurred in the controls. Significantly higher changes in pressure pain threshold were detected at all six sites in the strength training group and at four out of six sites in the endurance training group compared to the control group. This is the first study to show an increase in pressure pain thresholds as a result of long-term muscle training. A decrease in neck pain was associated with reduced pressure pain sensitivity in neck muscles, showing that the pressure pain threshold may be a useful outcome measure of the effectiveness of neck muscle rehabilitation.

Adult↗
PubMed2005

Back extensor muscle oxygenation and fatigability in healthy subjects and low back pain patients during dynamic back extension exertion.

The purpose of this study was to assess if chronic low back pain patients have impaired paraspinal muscle O2 turnover and endurance capacity as compared to healthy control subjects during dynamic exercise. Middle-aged healthy male subjects (n = 12, control) and male patients with chronic low back pain (n = 17, CLBP) participated in the study. L4–L5 level paraspinal muscle fatigue was objectively assessed during earlier validated 90 s dynamic back endurance test (spectral EMG, MPFslope). Also EMG amplitude (EMGamplitude) and initial MPF (MPFinitial) were assessed from the initial 5 s of the endurance contraction. Simultaneously near infrared spectroscopy (NIRS) was used for quantitative measurement of local L4–L5 paraspinal muscle O2 consumption. Subcutaneous tissue thickness (ATT) was measured from the EMG and NIRS recording sites. The results indicated that control and CLBP groups were compatible as regarding anthropometric variables, paraspinal muscle activation levels (EMGamplitude), initial MPF (MPFinitial) and ATT. When the ATT was used as a covariate in the ANOVA analysis, CLBP group did not show significantly greater paraspinal muscle fatigability (right MPFslope – 12.2 ± 10.7%/min, left right MPFslope – 12.6 ± 13.3%/min) or O2 consumption (right NIRSslope – 52.8 ± 79.6 μM/l/s) as compared to healthy controls (right MPFslope – 11.9 ± 7.6%/min, left MPFslope – 12.7 ± 8.6%/min, right NIRSslope – 53.7 ± 95.2 μM/l/s). As a conclusion, these CLBP male patients did not show any impaired rate of paraspinal muscle oxygen consumption or excessive paraspinal muscle fatigability during dynamic exercise as compared with healthy controls. Subcutaneous tissue thickness has a strong influence on the NIRS and EMG amplitude measurements and, if unchecked, it could result in the false interpretation of the results.

Journal Article↗
PubMed2004

Whiplash injuries in Finland--the possibility of some sociodemographic and psychosocial factors to predict the outcome after one year.

PURPOSE: The aim of our study was to evaluate if there was any relation between the change experienced in the condition of health or the length of the reported sick leaves after one year of whiplash injury and different sociodemographic and psychosocial factors. METHOD: Our study design is a prospective 1-year-follow-up study. The material was collected in the year 1998 from neck injuries that had been caused by traffic accidents. The insurance companies sent a notice of the accident with medical certificate to the research team. After this we sent questionnaires to the injured and after one year of the accident a new inquiry was done. One hundred and eighty-two persons returned the 1-year-follow-up questionnaire which formed the material of this study. RESULTS: The persons who had the lowest basic education and people over 60 years of age had more health problems after one year of the accident. The other sociodemographic and psychosocial factors had only limited prognostic value when we evaluated the experienced change of health one year after the whiplash injury. Only 71 persons reported that they had been on sick leave because of the whiplash injury and of them only 21 reported sick leave over 1 month. CONCLUSIONS: Several sociodemographic and psychosocial factors can have relation to the deterioration of health experienced after whiplash injury but in this prospective study they proved to have only limited prognostic value in the long term symptoms with the exception of the education.

Accidents, Traffic↗
PubMed2004

Factors related to postmenopausal muscle performance: a cross-sectional population-based study.

The aim of the present study was to investigate cross-sectionally the association of postmenopausal muscle strength with simple performance tests. A random sample of 1,166 naturally postmenopausal women (born 1932-1941) was selected from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study cohort. Grip and quadriceps strength were measured with strain gauge dynamometers and reported in both absolute values (KPa and kg) and per kilogram of body mass (N cm(-2) kg(-1) and N kg(-1)). In addition, two performance tests, 'ability to stand on one foot' and 'ability to squat down to touch the floor' were carried out. A five-category self-assessment of overall health ('very good', 'good', 'moderate', 'bad', and 'very bad') was obtained by postal questionnaire. The women that were able to stand on one foot and able to squat down to touch the floor had greater grip and quadriceps strength than their counterparts ( P<0.001 and P<0.03 in ANOVA, respectively). In addition, self-assessed health had a strong positive association with muscle strength in the grip and leg extensor muscles in ANOVA ( P<0.001 between 'very good' and 'moderate' or poorer state of health) and regression model ( P<0.001). Adjustment for age, duration of menopause, body mass, height, physical activity level, use of HRT, and number of diseases and medications did not change any of the main effects. Also, there were no differences in results between absolute measurement values and values reported per kilogram of body mass. According to the present study, a simple performance test may be useful in the prediction of postmenopausal muscle strength. Furthermore, self-assessed state of health is strongly associated with muscle strength in postmenopausal women.

Body Constitution↗
PubMed2004

Whiplash injuries in Finland: the situation 3 years later.

The aim of this study was to define the influence of whiplash injuries on the perceived condition of health 3 years after injury. We evaluated remaining symptoms and the use of health services. Insurance companies provided reports and medical certificates from traffic accidents in Finland in 1998, for those injured who had agreed to take part in the study. Participants in the 1-year follow-up study answered a self-report questionnaire. Three years after the whiplash-causing accident, 11.8% of participants reported that injury symptoms had caused their health to deteriorate significantly as compared with before the accident. Neck pain was the most common single symptom, reported by 14.6% of respondents. The severity of the initial symptoms according to the WAD classification is reflected in the subject's self-perception of health after 3 years. A remarkable 10-17% of respondents still used health services regularly because of the symptoms. Although some of the injured had improved in the long term, some reported that their health condition was worse after 3 years than at the 1-year follow-up. The percentage of respondents reporting a significant health deterioration remains unchanged 3 years after the whiplash injury. These findings illuminate the importance of early recognition of risk factors for long-term disability and the primary treatment and rehabilitation procedures.

Adult↗
PubMed2004

The possibility to use simple validated questionnaires to predict long-term health problems after whiplash injury.

STUDY DESIGN: A prospective follow-up study. OBJECTIVES: To evaluate the relation of the state of health before the accident and the significance of the symptoms reported soon after the injury to the situation 3 years after the injury. To evaluate the possibility of using simple validated questionnaires to predict long-term health problems after the injury. SUMMARY OF BACKGROUND DATA: A whiplash injury is generally benign in its natural course. However, some of the patients have diverse and prolonged symptoms. Although several prognostic factors have been suggested for the poor recovery, in most cases the factors leading to prolonged disability remain unclear. METHODS: In collaboration with traffic insurance companies, we gathered information of neck injuries that occurred in traffic accidents in Finland in 1998. After the insurance company received a notification of a neck injury and consent from the injured party to participate in the study, they sent the information to the research team. The first inquiry was sent to the patients as soon as possible. One- and three-year follow-up questionnaires were posted to those who responded to the first inquiry. A total of 144 persons returned the 3-year follow-up questionnaires and form the material of this study. RESULTS A poor state of health or frequent neck pain or headache before the accident did not have any significant relation to the poor outcome 3 years after the accident. The extent of neck pain and lower back pain reported soon after the accident was significantly associated to a poor outcome in the follow-up. The Neck Disability Index questionnaire was significantly related to the poor outcome after 3 years. CONCLUSIONS: The subjective experience of a notably decreased level of activity because of the neck pain when supplemented by the enhanced score of Neck Disability Index questionnaire predicts well poor outcome in long-term follow-up and can be used as a tool to identify persons who are at risk to suffer long-term health problems after whiplash injury.

Accidents, Traffic↗
PubMed2004

Activation of lumbar paraspinal and abdominal muscles during therapeutic exercises in chronic low back pain patients.

OBJECTIVES: To assess the activities of paraspinal and abdominal muscles during therapeutic exercises for the treatment of patients with nonspecific chronic low back pain (CLBP), and to study the effects of active physical rehabilitation on these activities. DESIGN: A cross-sectional study comparing muscle activities during 18 stabilization exercises, and a prospective follow-up of patients with CLBP during rehabilitation. SETTING: Rehabilitation clinic in university hospital in Finland. PARTICIPANTS: Nine volunteers (5 men, 4 women) aged 27 to 58 years. INTERVENTION: Three months of active outpatient rehabilitation (4 to 6 times in a rehabilitation clinic, supplemented with self-motivated exercise at home) supervised by a physiotherapist. MAIN OUTCOME MEASURES: Surface electromyography was recorded bilaterally from L5 level paraspinal, rectus abdominis, and obliquus externus abdominis muscles. The recorded signal was averaged and normalized to the maximal electromyographic amplitude obtained during the maximal voluntary contraction. The measurements were taken before and after the exercise treatment period. RESULTS: CLBP patients showed variable trunk muscle activity patterns during the different therapeutic exercises, similar to those that we reported earlier in healthy subjects. The maximal trunk isometric extension (pre, 147.3+/-75.9Nm; post, 170.1+/-72.3Nm) and flexion (pre, 72.0+/-37.9Nm; post, 93.5+/-42.5Nm) torques did not show a significant changes during the exercise period. However, trunk rotation-flexion torque (pre, 52.9+/-26.5Nm; post, 82.4+/-65.8Nm) increased significantly (35.8%) after the exercise period (P<.05). The corresponding maximal electromyographic amplitudes of back and abdominal muscles remained unchanged. Disability, as assessed by visual analog scale and Oswestry Disability Index, did not change. CONCLUSIONS: The CLBP patients performed therapeutic exercises with similar abdominal and back extensor muscle activities in the same way as the healthy subjects in our earlier studies. In this study, active physical rehabilitation had no effect on the abdominal and back muscle activities or on pain and functional disability indices.

Abdominal Muscles↗
PubMed2004

Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain.

Several studies have reported lower neck muscle strength in patients with chronic neck pain compared to healthy controls. The aim of the present study was to evaluate the association between the severity of neck pain and disability with neck strength and range of movement in women suffering from chronic neck pain. One hundred and seventy-nine female office workers with chronic neck pain were selected to the study. The outcome was assessed by the self-rating questionnaires on neck pain (visual analogue scale, Vernon's disability index, Neck pain and disability index) and by measures of the passive range of movement (ROM) and maximal isometric neck muscle strength. No statistically significant correlation was found between perceived neck pain and the disability indices and the maximal isometric neck strength and ROM measures. However, the pain values reported during the strength tests were inversely correlated with the results of strength tests (r=-0.24 to -0.46), showing that pain was associated with decreased force production. About two-thirds of the patients felt pain during test efforts. Pain may prevent full effort during strength tests and hence the production of maximal force. Thus in patients with chronic neck pain the results do not always describe true maximal strength, but rather the patients' ability to bear strain, which may be considerably influenced by their painful condition. The results of the present study suggest that rehabilitation in cases of chronic neck pain should aim at raising tolerance to mechanical strain.

Adult↗
PubMed2004

The effect of home biofeedback training on stress incontinence.

BACKGROUND: To compare the effectiveness of pelvic floor training (PFT) with the aid of a home biofeedback device to PFT alone for urodynamic stress urinary incontinence (SUI) in women after a 1-year follow-up. METHODS: A randomized study comparing two conservative interventions was conducted in an outpatient clinic of a university hospital. Thirty-five consecutive women were randomized to either the PFT with home biofeedback group or the PFT alone group. The intensive training period lasted 12 weeks. After 1 year, 33 women could be evaluated according to the protocol. At the 1-year visit pelvic floor muscle activity was measured and the need for surgical intervention was evaluated. Logistic multivariate analysis was used to predict response to the PFT. RESULTS: In the home biofeedback training group 11/16 (68.8%) avoided surgery vs. 10/19 (52.6%) in the PFT alone group. The difference was not statistically significant. In the nonoperated home biofeedback group the increase in pelvic floor muscle activity (p = 0.005 in supine, p = 0.005 in standing) and the decrease in leakage index (p = 0.05) was significant after 12 weeks and pelvic floor activity remained constant. By contrast, in the nonoperated PFT group the increase in pelvic floor muscle activity after 12 weeks predicted a good result for conservative treatment. CONCLUSIONS: This randomized controlled trial suggests that the home biofeedback method in PFT has a good success rate of 68.8%. The change achieved in leakage index after 12 weeks of training predicted an effective outcome for conservative treatment.

Adult↗
PubMed2003

Does the outcome 2 months after lumbar disc surgery predict the outcome 12 months later?

PURPOSE: To assess the prognostic value of some preoperative and early post-operative indicators in the prediction of disability 14 months after lumbar disc surgery. METHODS: Of 173 patients, who had participated in baseline measurements, 145 (84%) attended the 14-month follow-up. Before surgery the duration and intensity of pain was assessed. Follow-up questionnaires were completed during check-ups and included items on pain (VAS), Oswestry and Million disability indices, depression (BDS) and work status. RESULTS: Two months after surgery average back pain was 67% lower and leg pain 70% lower than pre-operatively. The median Oswestry and Million disability indices were 14 and 15 at 2-months and remained low also at 14-months check-up. Further, the post-operative Oswestry and Million disability indices and BDS were highly associated with 14-month back and leg pain. Although the outcome of the patients was mostly good, 5% and 8% of them, respectively, reported severe pain at 2- and 14-month check-ups. CONCLUSIONS: As recovery following lumbar disc surgery occurred to a great extent during the first 2 months, the early post-operative outcome appears to be quite a reliable indicator of the postoperative outcome in 1-year follow-up. The strong association between pain and the disability indices allows us to conclude that both the Million and Oswestry indices are clinically useful instruments in the evaluation of outcome in these cases.

Adult↗