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At least 595 records · Page 33Linked to original sources
PubMed2005

Neck strength and myoelectric fatigue in fighter and helicopter pilots with a history of neck pain.

INTRODUCTION: Flight-induced neck pain at high Gz loads or during sustained rotary-wing missions may be caused by limitations in neck muscle function. A better understanding of the contributing factors of excessive external load and internal neck-stabilizing mechanisms would improve the ability to prevent and treat such pain. The aim of this single-blinded cross-sectional study was to evaluate neck neuromuscular function in fighter and helicopter pilots who suffered from frequent neck pain. METHODS: Subjects with pain were 16 fighter pilots (FP-P) and 15 helicopter pilots (HP-P) with frequent neck pain episodes who were compared with pain-free controls (FP-C and HP-C). In all groups, neck extensor and flexor muscles were studied by measuring 1) the strength of maximum voluntary contraction (MVC), and 2) fatigue due to a submaximal isometric contraction. The decline (slope) of the electromyogram (EMG) median frequency power spectra was used as an index of fatigue, while initial median frequency (fi) was taken from the intercept of the regression line. RESULTS: Two-way analysis of variance (ANOVA) revealed interaction effects for extensor MVC. Post hoc testing showed that FP-P had significantly lower extensor MVC (p = 0.03) than FP-C, while there was no such difference for the HP-P vs. HP-C or between the two control groups. There were no significant effects for MVC-balance (flexors/extensors); nor were there any fi or extensor EMG-slope effects. However, there were interaction effects for flexor EMG-slopes: HP-P showed lower slopes than did HP-C (p = 0.02). CONCLUSIONS: To protect and stabilize the head and neck in high Gz environments, higher neck muscle strength is needed; less muscle strength in FP-P may cause further pain and perhaps reduced mission effectiveness. Less localized steep slopes for HP-P might reflect impaired muscle functioning. Specific preventive and clinical attention may be warranted for different types of pilot.

Adult↗
PubMed1988

Degeneration of the primary snout sensory afferents in the cervical spinal cords following the infraorbital nerve transection in some mammals.

To obtain the neuroanatomical information on the role of the snout sensory input in mastication, the present study was conducted on young and adult mice, young Wistar rats and adult Japanese shrew-moles. The animals were subjected to unilateral and bilateral infraorbital nerve transection. Transganglionic degeneration was studied by the Nauta method and electron microscopy including HRP application to the neck muscles. Transganglionic degeneration was found in every experimental case. 1. Transganglionic degeneration of the fibers was found not only in the main sensory nucleus and spinal tract nucleus of the trigeminal nerve but throughout the cervical and the upper part of the thoracic spinal cord. 2. These transganglionically degenerated fibers descended bilaterally through the cuneate nucleus and then caudally through the posterior funiculus at the obex level. They then entered the dorsal and ventral horns to make a synaptic contact with the degenerated synapses on the dorsal horn cells and with the multipolar cells in the ventral horns. This neuroanatomical information suggests: 1) that the trigemino-neck muscle reflex will be generated monosynaptically by the primary neurons arising from the snout sensory organs and 2) that these primary neurons may play a large role as a neuronal bridge in connecting the masticatory reflex system and the cranio-neck reflex system.

Animals↗
PubMed1985

Role of the cat substantia nigra pars reticulata in eye and head movements. II. Effects of local pharmacological injections.

Guided and reflex eye movements were studied in cats trained to make orienting saccades toward visual and auditory targets. Injections of a GABA-agonist (Muscimol) or GABA-antagonists (Bicuculline and Picrotoxin) were made in the Substantia Nigra pars reticulata (SNpr). Bicuculline and Picrotoxin, whether unilaterally or bilaterally injected had no effect on the posture nor the oculomotor performance of the animals. Neck muscle activity remained symmetrical. Unilateral injections of Muscimol produced oro-facial akinesia, reduction of the number of eye movements, contralateral head turning, visual neglect mostly (but not only) for ipsilateral visual space. Balance between the gains of the vestibulo-ocular reflex (VOR) in the two directions of movement was changed. Gain was decreased for the ipsilateral rotation. The optokinetic nystagmus (OKN) was not affected. Contralateral neck muscles were hypertonic. After bilateral injections of Muscimol, the cats did not orient. The VOR was normal when the injections induced no postural asymmetry. Hypertony was bilateral. Implications of these results for the role of the basal ganglia in motor control are discussed. We suggest that in Parkinson's disease the fixed inhibitory drive of the SNpr on the tectum and on the thalamus is disrupted.

Animals↗
PubMed1994

Quantitative EMG in botulinum toxin treatment of cervical dystonia. A double-blind, placebo-controlled study.

We used turns-amplitude analysis of the EMG as a guidance for botulinum toxin (BT) treatment in 19 patients with cervical dystonia. At the first examination, muscles showing abnormal activity (> 100 turns/sec at rest) were given BT 75 units (10 patients) or placebo (9 patients). At subsequent examinations, about 6, 12 and 18 weeks after the start, BT 75 units were given to all hyperactive muscles. Six weeks after the first BT treatment the sternocleidomastoid muscle contralateral to the involuntary head rotation and the ipsilateral and contralateral posterior neck muscles (PNM) showed a reduction of involuntary activity, as indicated by reduced turns/sec and mean amplitude at rest. Similar changes were seen when comparing BT treatment with placebo. The reduction was greater in the contralateral sternocleidomastoid muscle than in PNM, suggesting that PNM need higher doses of BT. At maximal voluntary contraction, BT treated muscles showed unchanged turns/sec (5/6 tests), decreased mean amplitude and increased ratio (turns/amplitude). This may reflect a functional random loss of muscle fibres, combined with inability to activate all motor units. A high (89%) clinical success rate with BT therapy was obtained, and it is concluded that quantitative EMG is a useful tool for the precise identification of hyperactive muscles, for optimal placing of the injection cannula and for unbiased monitoring of the treatment effect.

Adult↗
PubMed2004

Craniovertebral instability with spinal cord compression in a 17-month-old boy with Sly syndrome (mucopolysaccharidosis type VII): a surgical dilemma.

STUDY DESIGN: A case study with review of surgical technique in craniovertebral stabilization for young children with mucopolysaccharidosis. OBJECTIVES: To describe an interesting patient with a rare metabolic disorder and review surgical technique for craniovertebral instability in this rare patient population. SUMMARY OF BACKGROUND DATA: Craniovertebral instability has been reported in patients with mucopolysaccharidosis and poses a problem for spinal surgery because of the inherent metabolic disorder and age at presentation. We present the first case of craniovertebral instability and spinal cord compression occurring in Sly syndrome (mucopolysaccharidosis type VII) who is the youngest patient afflicted with this metabolic disorder to undergo craniovertebral stabilization. METHODS: A 17-month-old boy presented with inability to support his head, decreasing muscle strength in all extremities, distended abdomen, and shortness of breath. The patient was found to have a dilated cardiomyopathy, hepatosplenomegaly, abnormal hepatobiliary function, corneal clouding, and a questionable tracheal anomaly. Genetic testing provided a diagnosis of Sly syndrome, mucopolysaccharidosis type VII. Magnetic resonance imaging revealed focal stenosis with significant spinal cord compression at the craniovertebral junction. Neurologic examination revealed normal muscle volume with strength 3/5 in all extremities and significant weakness in the neck muscles with instability at the craniovertebral junction. RESULTS: On a concerted preoperative medical clearance by pediatric intensive care, pediatric neuroanesthesia, pediatric cardiology, pediatric gastroenterology, and pediatric neurosurgery, the patient underwent occipital to C3 decompression and fusion with autogenous rib grafts. The patient was placed in a prefitted halo-vest after surgery and was neurologically intact. CONCLUSIONS: This case demonstrates the heterogeneity of cervical spine deformities among the mucopolysaccharidosis syndromes and confirms the propensity for deposition of glycosaminoglycans at the craniovertebral junction. Further studies should investigate the etiology for this propensity of glycosaminoglycan deposition at the craniovertebral junction. We think that this case demonstrates that, with appropriate preoperative planning, these patients can undergo successful posterior cervical arthrodesis despite their age or metabolic defects.

Atlanto-Occipital Joint↗
PubMed1988

Activity levels during isometric test contractions of neck and shoulder muscles.

In order to analyse isometric muscle test contractions in the neck and shoulder region, an electromyographic (EMG) study of ten healthy females was undertaken. A series of 13 standardized isometric contractions with manual resistance was performed in the sitting position. Rectified time-averaged EMG was recorded, using surface electrodes. All tests activated all muscles studied to some extent and at various levels, but four different patterns of activation could be identified. Maximum level of activity was obtained: 1) in the cervical erector spinae muscles during neck extension, 2) in the splenius and levator scapulae muscles during lateral flexion of the cervical spine, 3) in the trapezius, pars descendens muscle during abduction of the arm in the plane of the scapula, 4) in the thoracic erector spinae/rhomboids muscles during shoulder elevation or scapular retraction/elevation.

Adult↗
PubMed2002

Influence of vestibular activation on respiration in humans.

The purpose of this study was to determine the effects of the semicircular canals and otolith organs on respiration in humans. On the basis of animal studies, we hypothesized that vestibular activation would elicit a vestibulorespiratory reflex. To test this hypothesis, respiratory measures, arterial blood pressure, and heart rate were measured during engagement of semicircular canals and/or otolith organs. Dynamic upright pitch and roll (15 cycles/min), which activate the otolith organs and semicircular canals, increased respiratory rate (Delta2 +/- 1 and Delta3 +/- 1 breaths/min, respectively; P < 0.05). Dynamic yaw and lateral pitch (15 cycles/min), which activate the semicircular canals, increased respiration similarly (Delta3 +/- 1 and Delta2 +/- 1, respectively; P < 0.05). Dynamic chair rotation (15 cycles/min), which mimics dynamic yaw but eliminates neck muscle afferent, increased respiration (Delta3 +/- 1; P < 0.05) comparable to dynamic yaw (15 cycles/min). Increases in respiratory rate were graded as greater responses occurred during upright (Delta5 +/- 2 breaths/min) and lateral pitch (Delta4 +/- 1) and roll (Delta5 +/- 1) performed at 30 cycles/min. Increases in breathing frequency resulted in increases in minute ventilation during most interventions. Static head-down rotation, which activates otolith organs, did not alter respiratory rate (Delta1 +/- 1 breaths/min). Collectively, these data indicate that semicircular canals, but not otolith organs or neck muscle afferents, mediate increased ventilation in humans and support the concept that vestibular activation alters respiration in humans.

Adult↗
PubMed2001

Causes of persistent postoperative headache after surgery for vestibular schwannoma.

Our aim was to elucidate the aetiology of persistent postoperative headache, a common sequel for several years after vestibular schwannoma surgery through the retrosigmoid approach. Twenty-seven patients with reported major postoperative headache were tested for vestibular responses and cervico-collic reflexes. The role of local anaesthesia injected into the neck muscle insertions or around the occipital nerves was evaluated. Sixteen patients operated on for vestibular schwannoma, but without headache, and 12 healthy volunteers served as control groups. Vestibular responses and cervico-collic reflexes deteriorated equally in the patients regardless of whether or not they had a postoperative headache. Local anaesthesia did not alter the results. The posturography results were increased among both patient groups. Sumatriptan alleviated pain in nine patients and abolished it completely in one out of these nine patients. Vestibular imbalance or abnormal activation of neck muscles do not explain postoperative headache. Occipital nerve entrapment or neuralgia explains the headache in a few patients. The relatively pronounced sumatriptan effect may, however, suggest a trigeminal nerve mediated cause for postoperative headache.

Adult↗
PubMed1991

Paradoxical sleep and its chemical/structural substrates in the brain.

As originally named for the ostensibly contradictory appearance of rapid eye movements and low voltage fast cortical activity during behavioral sleep, paradoxical sleep or rapid eye movement sleep, represents a distinct third state, in addition to waking and slow wave sleep, in mammals and birds. It is an internally generated state of intense tonic and phasic central activation that is contemporaneous with the inhibition of sensory input and motor output. In early studies, it was established that the state of paradoxical sleep was generated within the brainstem, and particularly within the pons. Pharmacological studies indicated an important role for acetylcholine as a neurotransmitter in the generation of this state. Local injections of cholinergic agonists into the pontine tegmentum triggered a state of paradoxical sleep marked by phasic ponto-geniculo-occipital spikes in association with cortical activation and neck muscle atonia. Following the immunohistochemical identification of choline acetyl transferase-containing neurons and their localization to the dorsolateral ponto-mesencephalic tegmentum, neurotoxic lesions of this major cholinergic cell group could be performed to assess its importance in paradoxical sleep. Destruction of the majority of the cholinergic cells, which are concentrated within the laterodorsal tegmental and pedunculopontine tegmental nuclei but extend also into the locus coeruleus and parabrachial nuclei in the cat, resulted in a loss or diminishment of the state of paradoxical sleep, ponto-geniculo-occipital spiking and neck muscle atonia. These deficits were correlated with the loss of choline acetyltransferase-immunoreactive neurons in the region, so as to corroborate results of pharmacological studies and single unit recording studies indicating an active role of these cholinergic cells in the generation of paradoxical sleep and its components. These cells provide a cholinergic innervation to the entire brainstem reticular formation that may be critical in the generation of the state which involves recruitment of massive populations of reticular neurons. Major ascending projections into the thalamus, including the lateral geniculate, may provide the means by which phasic (including ponto-geniculo-occipital spikes) and tonic activation is communicated in part to the cerebral cortex. Descending projections through the caudal dorsolateral pontine tegmentum and into the medial medullary reticular formation may be involved in the initiation of sensorimotor inhibition. Although it appears that the pontomesencephalic cholinergic neurons play an important, active role in the generation of paradoxical sleep, this role may be conditional upon the simultaneous inactivity of noradrenaline and serotonin neurons, evidence for which derives from both pharmacological and recording studies.(ABSTRACT TRUNCATED AT 400 WORDS)

Acetylcholine↗
PubMed2001

Microdialysis perfusion of 5-HT into hypoglossal motor nucleus differentially modulates genioglossus activity across natural sleep-wake states in rats.

1. Serotonin (5-hydroxytryptamine, 5-HT) excites hypoglossal (XII) motoneurons in reduced preparations, and it has been suggested that withdrawal of 5-HT may underlie reduced genioglossus (GG) muscle activity in sleep. However, systemic administration of 5-HT agents in humans has limited effects on GG activity. Whether 5-HT applied directly to the XII motor nucleus increases GG activity in an intact preparation either awake or asleep has not been tested. 2. The aim of this study was to develop a novel freely behaving animal model for in vivo microdialysis of the XII motor nucleus across sleep-wake states, and test the hypothesis that 5-HT application will increase GG activity. 3. Eighteen rats were implanted with electroencephalogram and neck muscle electrodes to record sleep-wake states, and GG and diaphragm electrodes for respiratory muscle recording. Microdialysis probes were implanted into the XII motor nucleus and perfused with artificial cerebrospinal fluid (ACSF) or 10 mM 5-HT. 4. Normal decreases in GG activity occurred from wakefulness to non-rapid eye movement (non-REM) and REM sleep with ACSF (P < 0.01). Compared to ACSF, 5-HT caused marked GG activation across all sleep-wake states (increases of 91-251 %, P < 0.015). Importantly, 5-HT increased sleeping GG activity to normal waking levels for as long as 5-HT was applied (3-5 h). Despite tonic stimulation by 5-HT, periods of phasic GG suppression and excitation occurred in REM sleep compared with non-REM. 5. The results show that sleep-wake states differentially modulate GG responses to 5-HT at the XII motor nucleus. This animal model using in vivo microdialysis of the caudal medulla will enable the determination of neural mechanisms underlying pharyngeal motor control in natural sleep.

Animals↗
PubMed1979

Thermogenic control during exercise in a cold environment.

To determine whether the voluntary contractions of exercise interfere with involuntary shivering contractions, four male subjects were each exposed to a 10 degrees C environment for 60 min of rest followed by either another rest period or 30 min of cycleergometer exercise. On different days exercise was performed at zero load, light load, and moderate load. Each experiment was performed twice, resulting in a minimum of eight experiments for each subject. Esophageal temperature (Tes), eight skin temperatures (Tsk), oxygen uptake (VO2), and the integrated electrical activity from a neck muscle (EMG) were continuously monitored. Pedaling flushed cold blood into the body core, causing Tes to fall. The rate and absolute magnitude of the decrease in Tes was proportional to the intensity of exercise. Thermoregulatory VO2 (attributable to shivering) and EMG were inversely related both to Tsk during rest, prior to any changes in Tes, and to Tes during exercise, when Tsk was constant, once shivering thresholds were surpassed. The slope of the thermoregulatory VO2-to-Tes relation was significantly suppressed by increasing exercise intensity. The slope of the EMG-to-Tes relation was similarly suppressed; since the neck muscles are not involved in the additional acitivity of exercise, we concluded that the graded inhibition of shivering during exercise was of central origin rather than from the rhythmic contractions required to sustain exercise.

Adult↗
PubMed1992

Botulinum toxin treatment of spasmodic torticollis.

We reviewed the efficacy and adverse effects of repeated botulinum toxin injections into hyperactive neck muscles of 107 successive patients with spasmodic torticollis. They received 510 injection treatments over a median period of 15 months (range 3-42 months). One patient failed to benefit at all, but 101 (95%) patients reported considerable (moderate or excellent) benefit from at least one treatment. On a global subjective response rating, 93% of 429 treatments resulted in some improvement and 76% in moderate or excellent improvement. Pain reduction followed 89% of 190 treatments with moderate or excellent reduction after 66%. Median duration of benefit was 9 weeks. All torticollis types responded equally well and injections into two (or more) involved neck muscles were more effective than injection into a single muscle. The most frequent adverse effect was dysphagia, occurring after 44% of all treatments, but this was severe after only 2%. Antibodies to botulinum toxin were detected in the serum of three out of the five patients in whom loss of treatment efficacy occurred. We conclude that botulinum toxin treatment is the most effective available therapy for spasmodic torticollis and practical advice is provided for anyone wishing to set up the technique.

Adult↗
PubMed2006

The prevalence and risk factors for occupational voice disorders in teachers.

OBJECTIVE: Occupational voice disorders in Poland account for over 25% of all occupational diseases. The aim of the study was to assess the prevalence of voice problems in the general population of Polish teachers, and identify risk factors for developing voice pathology. PATIENTS AND METHODS: The study group comprised 425 female full-time teachers (most of them primary and secondary school, age ranging from 23 to 61 years) and 83 non-teacher women (control) whose jobs did not involve vocal effort, matched for age to the study group. All participants were subjected to a survey using an extensive questionnaire, and to laryngological, phoniatric and videostroboscopic examinations. RESULTS: The overall lifetime vocal symptoms were more frequent in the teachers than in the non-teachers (69 vs. 36%), and in particular it related to permanent and recurrent hoarseness, and dryness in the throat. Mean number of the voice symptoms was 3.21 in teachers and 1.98 in controls (p < 0.001). Abnormal (non-euphonic) voice, neck muscle hypertension during phonation and incorrect resonator function were also significantly more frequent in the teachers. Mean maximum phonation time was shorter in teachers than in the controls (14.3 vs. 15.9 s, p < 0.01). Occupational voice disorders and hyperfunctional dysphonia (that is thought to predispose to such pathology) were found in 32.7% of teachers and 9.6% of control subjects. The probability of developing incomplete glottal closure (odds ratio 13.2x; 95% CI: 1.8-96.8) and hyperfunctional dysphonia (odds ratio 2.7; 95% CI: 1.14-6.44) were significantly higher in the teacher group versus non-teachers. A significant positive relationship was found in teachers between the prevalence of hyperfunctional dysphonia and strained phonation, neck muscle hypertension, instability of voice, self-assessed hyper-arousal, and lifetime vocal effort index (years of employment as a teacher x hours of professional activity/week). The prevalence of vocal nodules and incomplete glottal closure were correlated with incorrect phonation technique parameters, but not with psychological factors. No correlation was found with environmental variables, such as classroom temperature, humidity, airborne dust. CONCLUSION: The prevalence of self-reported symptoms and clinical signs of voice disorders is around 2-3 times more frequent in Polish female teachers than in non-teachers. Lifetime vocal effort, incorrect technique of phonation and psychological predisposition seem to constitute major risk factors for developing occupational voice disorders.

Adult↗
PubMed2003

Trigeminocervical reflex in fibromyalgia patients.

OBJECTIVE: To describe the properties of trigeminocervical reflex in normal subjects and in patients with primary fibromyalgia syndrome (PFS) having neck pain. DESIGN: Prospective testing of trigeminocervical reflex. SETTING: University hospital electromyography laboratory in Turkey. PARTICIPANTS: Patients with PFS (n=16) and healthy volunteers (n=20). INTERVENTIONS: Trigeminocervical reflex is a brainstem reflex that is evoked by stimulating the sensory branches of the trigeminal nerve and can be recorded from the neck muscles. Electric stimulation of the supraorbital nerve evokes a reflex response (C3) and early reflex response (C1). The mean latencies of C1 and C3 of patients with PFS were compared with normal values. MAIN OUTCOME MEASURE: The C1 and C3 latencies of trigeminocervical reflex. RESULTS: In healthy volunteers, C3 latency +/- standard deviation was 54.17+/-6.00ms ipsilaterally and 51.25+/-9.26ms contralaterally. The difference was not significant (P=.26). The C1 latency was 17.46+/-4.89ms. In patients with PFS, C1 latency was 13.83+/-4.48ms and the C3 latency was 62.70+/-18.22ms. The difference was not significant between the patients (P=.08) and healthy volunteers (P=.17). CONCLUSION: In patients with PFS having neck pain, trigeminocervical connections were not influenced and some other mechanisms may be responsible for pain in these patients.

Adolescent↗
PubMed1979

Suboesophageal neurons involved in head movements and feeding in locusts.

The projections of nerves 6 and 7 of the locust suboesophageal ganglion (SOG) were stained by axonal filling with cobalt chloride. Nerve 6 contains two motoneurons which innervate neck muscles 50 and 51. Sensory neurons innervating hairs on the dorso-occipital region of the head also enter the ganglion through nerve 6 and terminate in a small bilateral plexus. The projections of the head hairs in nerve 6 do not overlap the arborizations of the motoneurons or the neurons of nerve 7, but lie in the same area as descending sensory neurons from wind-sensitive hairs of the front of the head. One branch of nerve 7 (7B) contains two fibres which innervate the salivary gland. These 'salivary' neurons (labelled SN1 and SN2) have their cell bodies in the ganglion. The second branch, 7A, contains sensory neurons from the submentum of the labium, which form four sensory plexuses, two dorsal and two ventral. The sensory plexuses from the submentum have specific regions of overlap with the salivary neurons and with the neck muscle motoneurons. We interpret these as indicating a flow of information from labial receptors signalling head and mouthpart movement to neurons involved in salivation and head movement. We further postulate that the anatomical separation of the various sensory plexuses is indicative of functional localization within the ganglion.

Animals↗
PubMed2001

The nurse's workload in care situations.

AIM: The aim of this study was to describe the nurse's workload in care situations and on different work shifts on surgical and medical wards. Changes in heart rate, shoulder-neck muscle tension and perceived exertion were measured in these care situations. DESIGN: Nurses' physical fitness was tested using a clinical exercise test. RESULTS: Transportation of a patient to the operating theatre was the most strenuous care situation on morning and evening shifts. Primary care, and situations related to practical nursing procedures were the second most strenuous situations regardless of the shift. Workload in primary care situations and in transporting the patient can be classified as medium heavy based on heart rate and relative workload, whereas in other situations it can be classified on average as moderate or light. The nurse's good physical fitness was reflected in relative workload in care situations so that in primary care and practical nursing procedures there was a statistically significant difference between those who scored high on a fitness test and those who scored low. Transferring tasks and practical nursing procedures involved more shoulder-neck muscle tension than other care situations.

Adaptation, Psychological↗
PubMed1998

Neck training and +Gz-related neck pain: a preliminary study.

This study compared the effects of two neck training methods on workdays lost or flying under +Gz restrictions because of +Gz-related neck pain, and on neck muscle strength and the passive cervical range of motion among fighter pilots. One group (n = 10) participated in dynamic neck and shoulder muscle training, and another (n = 10) participated in helmet training with additional weights. The measurements were done at 0, 3, 6, and 12 months. The loss of workdays or restrictions in +Gz flights were recorded during the 1-year training period and the year preceding it. Neck muscle strength increased similarly in both groups. Nevertheless, during the training year, the pilots doing dynamic exercises had fewer sick leaves and +Gz restrictions than the pilots doing helmet exercises. Because the number of subjects was small and the study included no control group, firm conclusions on the effects of the training methods cannot be drawn.

Absenteeism↗