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At least 757 records · Page 42Linked to original sources

PubMed1996

Isolated lumbar strengthening in the rehabilitation of chronic low back pain.

OBJECTIVE: To discuss the effects of an active care protocol that includes isolated lumbar spine strengthening on a chronic low back pain patient. CLINICAL FEATURES: A 20-yr-old female college basketball player suffered from a 7-month history of debilitating low back and left leg pain. Four previous independent physicians expressed diagnostic and therapeutic uncertainty. Bone scan, MRI, nerve conduction study, electromyography, CT, discogram and laboratory evaluation had all failed to identify the etiology of the problem. The patient was forced to discontinue basketball and drop out of college as a result of her spinal problem. Treatment by her prior physicians consisted of analgesics and prolonged bedrest. INTERVENTION AND OUTCOMES: The patient underwent a functional restoration program consisting of isolated lumbar extensor progressive resistance exercise (PRE) on a MedX lumbar instrument, PRE to ancillary musculature, progressive aerobic exercise, static stretching and proprioceptive exercises. She showed a 368% increase in average lumbar isometric strength, 41% increase in isolated lumbar sagittal plane range of motion and decrease in pain. The patient returned to school after 8 wk of care; at 18-month check-up, she remained asymptomatic. CONCLUSION: Functional restoration, even with uncertain diagnosis, can be effective in the resolution of chronic low back pain.

Adult↗

PubMed1992

The use of eccentric training and stretching in the treatment and prevention of tendon injuries.

Tendon injuries are a common consequence of either sports or daily routine activity. Most people will suffer at least one tendon injury in his or her lifetime. It is therefore prudent to understand the different ways to load tendon and the ways in which the muscle-tendon-bone unit responds to these stresses. By maximizing tendon training and rehabilitation, one can maximize the stresses (eccentric) a tendon will withstand. This article provides an explanation of these principles.

Achilles Tendon↗

PubMed1984

The nonsurgical treatment of microstomia in scleroderma: a pilot study.

A 6-month clinical trial with nine scleroderma patients compared two exercise programs for the nonsurgical treatment of the decreased oral opening ( microstomia ). The experimental group employed three mouth-stretching exercises and a new oral augmentation exercise, using tongue depressors , to obtain a 5.6 mm mean increased vertical oral opening. The controls used six currently recommended "facial grimacing " exercises for a 3.0 mm mean increase. When the controls used the experimental treatment, their mean improvement increased to 5.7 mm. Although surgical correction of microstomia may be warranted, some reversal of this condition may be achieved with the aid of this new nonsurgical exercise program.

Double-Blind Method↗

PubMedDate not supplied

Traffic accident induced thoracic outlet syndrome: decompression without rib resection, correction of associated recurrent thoracic aneurysm.

Traffic accident injuries accounted for the sum of 72 billion in the United States last year. These injuries included Thoracic Outlet Syndrome and its associated Thoracic Aortic Aneurysms. Typically, the injured person has stopped for a red traffic light when another vehicle of higher speed and weight hits the stopped vehicle from behind. The force exerted hyperextends the neck and stretches the scalenus muscles. The muscles stretch, bleed, hypertrophy, and shorten. This process further narrows the already crowded triangular tunnel through which the neurovascular bundle passes. Sixty-five severely symptomatic Thoracic Outlet patients were operated on no sooner than two months after the accident to allow the non-surgical measures to take effect. The median age for these patients was 33.8 years. The female to male preponderance was 40/25. All patients had MRI of the cervical spine to rule out radiculopathy. MRI of the thorax was also requested when a Thoracic Aneurysm was suspected. Nerve conduction tests of the upper extremities were also taken to support the diagnosis. The most valuable clinical test was Elevated Arm Stress Exercising which was positive in all cases. At operation, the Brachial Plexus was compressed mostly by the hypertrophied, adherent, and fibrous scalenus medius from behind. The approach was anterior and supraclavicular in all cases including the recurrent one. Both scalenus medius and anticus were largely resected to enlarge the Thoracic Outlet triangular tunnel. The first rib was not resected in any of these patients, but all costo-cervical ligaments and bands and/or cervical ribs were resected.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Traffic↗

PubMed1979

The control of blood flow through human forearm muscles following brief isometric contractions.

1. The blood flow through the forearm was measured 2 sec after single, brief isometric hand-grip contractions. The tension and duration of those contractions varied from 10 to 100% of the maximal voluntary contraction (m.v.c.) and from 2 to 12 sec, respectively. 2. The blood flow increased linearly with tension up to about 60% m.v.c. but further increases in tension, up to 100% m.v.c., did not elicit higher blood flows than were found at 60% m.v.c. The same relationship between tension and the resultant blood flow held for all durations of contractions, from 2 to 12 sec. The blood flow immediately after (2 sec) contractions at a given tension increased linearly with the duration of the contraction, from 2 to 12 sec. Maximal exercise blood flow was approached only in response to the longest contractions (12 sec) at tensions of 60% m.v.c. or higher. 3. Brief alterations (2--5 sec) of transmural pressure across blood vessels did not result in a significant change of blood flow, either in the resting forearm or when the vessels were dilated by brief, isometric contractions. When the tension was applied or released either rapidly or gradually ('ramp' contractions) there was no correlation between the rate of change of stretch on arterial vessels and the resultant blood flow. However, there was a direct relationship between a force--time integral (duration of contraction x peak tension) and blood flow. All these results make it clear that changes in blood flow in the forearm elicited by brief isometric contractions are not the result of a myogenic reflex but are metabolically induced. 4. Successive contractions exerted at 60% m.v.c. for 4 sec induced a blood flow of 21.2 +/- 1.6 ml.min-1.100 ml.-1 when a rest interval of 8 sec was allowed between the contractions. Blood flows remained constant at this submaximal level, even when muscular fatigue was induced, and when there was an accompanying large increase in blood pressure. 5. Isometric muscular activity by the contralateral arm which resulted in fatigue, associated with a large increase in mean blood pressure, did not alter the level of vasodilation that was induced by brief, isometric contractions in the 'test' arm. 6. It is suggested that the vasodilatation in response to intermittent isometric contractions is the result of metabolic vasodilatation of distal segments and continued sympathetic vasoconstriction of the proximal segments of the forearm vascular bed.

Blood Pressure↗

PubMed2005

Augmented mechanical response of muscle thin-fiber sensory receptors recorded from rat muscle-nerve preparations in vitro after eccentric contraction.

Unaccustomed strenuous exercise, especially that from eccentric muscular work, often causes muscle tenderness, which is a kind of mechanical hyperalgesia. We developed an animal model of delayed-onset muscle soreness (DOMS) from eccentric muscular contraction (ECC) in rats and demonstrated the existence of muscle tenderness by means of behavioral pain tests and c-Fos protein expression in the spinal dorsal horn. The purpose of the present study was to examine whether the sensitivities of muscle thin-fiber sensory receptors to mechanical, chemical, and thermal stimuli were altered after repetitive ECC in a rat model of DOMS. ECC was caused in the animals by electrical stimulation of the common peroneal nerve innervating the extensor digitorum longus muscle (EDL) while the muscle was being stretched. Activities of single thin-fiber receptors (sensitive to pressure but insensitive to stretch, with conduction velocity slower than 2.0 m/s) were recorded from muscle (EDL)-nerve preparations in vitro 2 days after ECC when mechanical hyperalgesia was at its peak. The mechanical threshold of thin-fiber receptors was found to be very much lower in the ECC preparations than in the nontreated control (CTR) [median 65.4 mN (interquartile range [IQR]; 46.6-122.0 mN) in the CTR preparation vs. 38.2 mN (IQR; 26.8-55.8 mN) in the ECC, P < 0.001]. In addition, the total number of evoked discharges during a ramp mechanical stimulus, taken as an index of the magnitude of the mechanical response, nearly doubled in the ECC preparations compared with the CTR [24.7 spikes (IQR; 14.2-37.1 spikes) in the CTR preparation vs. 54.2 spikes (IQR; 24.3-89.0 spikes) in the ECC, P < 0.001]. In contrast, the numbers of discharges induced by chemical (pH 5.5, lactic acid, adenosine triphosphate, and bradykinin) and thermal (cold and heat) stimuli were not different between the two preparations. These results suggest that augmentation of the mechanical response in muscle thin-fiber sensory receptors might be related to the muscle tenderness in DOMS after ECC.

Action Potentials↗

PubMed1996

Various treatment techniques on signs and symptoms of delayed onset muscle soreness.

Eccentric activities are an important component of physical conditioning and everyday activities. Delayed onset muscle soreness (DOMS) can result from strenuous eccentric tasks and can be a limiting factor in motor performance for several days after exercise. An efficacious method of treatment for DOMS would enhance athletic performance and hasten the return to activities of daily living. The purpose of this study was to identify a treatment method which could assist in the recovery of DOMS. In the selection of treatment methods, emphasis was directed toward treatments that could be rendered independently by an individual, therefore making the treatment valuable to an athletic trainer in team setting. DOMS was induced in 70 untrained volunteers via 15 sets of 15 eccentric contractions of the forearm extensor muscles on a Lido isokinetic dynamometer. All subjects performed a pilot exercise bout for a minimum of 9 weeks before data collection to assure that DOMS would be produced. Data were collected on 15 dependent variables: active and passive wrist flexion and extension, forearm girth, limb volume, visual analogue pain scale, muscle soreness index, isometric strength, concentric and eccentric wrist total work, concentric and eccentric angle of peak torque. Data were collected on six occasions: pre- and post-induced DOMS, 20 minutes after treatment, and 24, 48, and 72 hours after treatment. Subjects were randomly assigned to 1 of 7 groups (6 treatment and 1 control). Treatments included a nonsteroidal anti-inflammatory drug, high velocity concentric muscle contractions on an upper extremity ergometer, ice massage, 10-minute static stretching, topical Amica montana ointment, and sublingual A. montana pellets. A 7 x 6 ANOVA with repeated measures on time was performed on the delta values of each of the 15 dependent variables. Significant main effects (p < .05) were found for all of the dependent variables on time only. There were no significant differences between treatments. Therefore, we conclude that none of the treatments were effective in abating the signs and symptoms of DOMS. In fact, the NSAID and A. montana treatments appeared to impede recovery of muscle function.

Journal Article↗

PubMed1997

Tension neck and evaluation of a physical training course among office workers in a bank corporation.

The purpose of this study was to investigate the effects of a physical training course in a group of patients (n = 74) suffering from chronic tension neck. All participants in the course were employed by a bank corporation in Helsinki, Finland. A comparable control group (n = 77) consisted of office workers with tension neck from the same bank corporation who did not attend any training course. The outcome was analysed 6 months after the course. Pain and disability in the neck and shoulder region did not vary significantly between the group which participated in the training course and the control group. The experimental group had increased the amount of physical workout compared to the control group (83.7% vs 69.0%, P = 0.0448). Also, regarding the frequency of relaxation and stretching exercises the two groups differed significantly: the experimental group had continued to perform exercises more often (P = 0.0434). The frequency of sick leave days did not significantly differ between the groups, but the office workers in the experimental group had more periods of extended sick leave (> 10 days) and the controls had more frequent short sick leaves. The experimental group did increase their physical workout significantly compared with the controls, but no differences were detected regarding pain and disability. In order to gain more benefit more attention should be paid to the educational part of the training courses in order to enhance the patients' self-care abilities. Also, strategies to alleviate psychosocial problems and organized relaxation exercises could decrease muscle tension in the neck in office workers.

Absenteeism↗

PubMed2001

In vivo behaviour of human muscle tendon during walking.

In the present study we investigated in vivo length changes in the fascicles and tendon of the human gastrocnemius medialis (GM) muscle during walking. The experimental protocol involved real-time ultrasound scanning of the GM muscle, recording of the electrical activity of the muscle, measurement of knee- and ankle-joint rotations, and measurement of ground reaction forces in six men during walking at 3 km h(-1) on a treadmill. Fascicular lengths were measured from the sonographs recorded. Musculotendon complex length changes were estimated from anatomical and joint kinematic data. Tendon length changes were obtained combining the musculotendon complex and fascicular length-change data. The fascicles followed a different length-change pattern from those of the musculotendon complex and tendon throughout the step cycle. Two important features emerged: (i) the muscle contracted near-isometrically in the stance phase, with the fascicles operating at ca. 50 mm; and (ii) the tendon stretched by ca. 7 mm during single support, and recoiled in push-off. The behaviour of the muscle in our experiment indicates consumption of minimal metabolic energy for eliciting the contractile forces required to support and displace the body. On the other hand, the spring-like behaviour of the tendon indicates storage and release of elastic-strain energy. Either of the two mechanisms would favour locomotor economy

Adult↗

PubMed2003

Rapid muscle-specific gene expression changes after a single bout of eccentric contractions in the mouse.

Eccentric contractions (ECs), in which a muscle is forced to lengthen while activated, result in muscle injury and, eventually, muscle strengthening and prevention of further injury. Although the mechanical basis of EC-induced injury has been studied in detail, the biological response of muscle is less well characterized. This study presents the development of a minimally invasive model of EC injury in the mouse, follows the time course of torque recovery after an injurious bout of ECs, and uses Affymetrix microarrays to compare the gene expression profile 48 h after ECs to both isometrically stimulated muscles and contralateral muscles. Torque dropped by approximately 55% immediately after the exercise bout and recovered to initial levels 7 days later. Thirty-six known genes were upregulated after ECs compared with contralateral and isometrically stimulated muscles, including five muscle-specific genes: muscle LIM protein (MLP), muscle ankyrin repeat proteins (MARP1 and -2; also known as cardiac ankyrin repeat protein and Arpp/Ankrd2, respectively), Xin, and myosin binding protein H. The time courses of MLP and MARP expression after the injury bout (determined by quantitative real-time polymerase chain reaction) indicate that these genes are rapidly induced, reaching a peak expression level of 6-11 times contralateral values 12-24 h after the EC bout and returning to baseline within 72 h. Very little gene induction was seen after either isometric activation or passive stretch, indicating that the MLP and MARP genes may play an important and specific role in the biological response of muscle to EC-induced injury.

Animals↗

PubMed1992

High-school football injuries: effects of a post-halftime warm-up and stretching routine.

There are 300,000 to 1,215,000 high-school football injuries each year in the United States. These injuries have an important effect on player participation and health care costs. This study investigates what portion of injuries occur during the third quarter of a game, and if completing a warm-up and stretching routine after halftime reduces the incidence of third-quarter injuries. Intervention-group teams participated in a prescribed three-minute warm-up and stretching routine following the halftime break. The control group received no warm-up and stretching intervention. Fifty-five games with 108 total injuries were examined. Overall, ligament sprains and muscle strains were the most common type of injury (38%). In the nonintervention group, injuries occurred most often in the third quarter. Intervention teams sustained significantly fewer third-quarter sprains and strains per game (p less than 0.05), although no significant difference in total third-quarter injuries was noted. These findings suggest an association between post-halftime warm-up and stretching and reduced third-quarter sprain and strain injuries. We suggest a larger-scale, randomized confirmatory study.

Adolescent↗

PubMed1996

Intrathecal blockade of both NMDA and non-NMDA receptors attenuates the exercise pressor reflex in cats.

In decerebrate unanesthetized cats we tested the hypothesis that glutamatergic-receptor blockade in the lumbosacral spinal cord attenuated the reflex increases in mean arterial pressure, inspired minute ventilation, and renal sympathetic nerve activity (RSNA) evoked by static contraction of the triceps surae muscles. Blockade of N-methyl-D-aspartate (NMDA) receptors by intrathecal injection of DL-2-amino-5-phosphonovaleric acid had no effect on the initial phase of the pressor, ventilatory, and RSNA responses to contraction but did attenuate the secondary phase of these responses. Subsequent blockade of non-NMDA receptors in the lumbosacral spinal cord by intrathecal injection of 6-cyano-7-nitroquinoxaline-2,3-dione attenuated both the initial phase of the pressor, RSNA, and ventilatory responses to contraction and the secondary phase of these responses. In addition, NMDA-receptor blockade had no effect on the pressor or RSNA responses to tendon stretch, whereas non-NMDA-receptor blockade abolished these responses. We confirmed that our results were not related to the order of the antagonists injected by performing a series of experiments in which a non-NMDA-receptor antagonist was injected first. Our findings suggest that non-NMDA receptors mediate the spinal transmission of the initial and secondary phases of the pressor, RSNA, and ventilatory responses to contraction and tendon stretch. Therefore, non-NMDA receptors in the dorsal horn appear to be involved in the spinal processing of input from mechanoreceptors and metaboreceptors. Our findings also suggest that NMDA receptors mediate the spinal transmission of the secondary phase of the pressor, RSNA, and ventilatory responses to contraction but do not mediate the spinal transmission of the responses to tendon stretch. Therefore, NMDA receptors in the dorsal horn appear to be involved in the spinal processing of input from metaboreceptors.

2-Amino-5-phosphonovalerate↗

PubMed2000

Measurement of fatigue in knee flexor and extensor muscles.

In order to examine fatigue of the knee flexor and extensor muscles and to investigate the characteristics of muscular fatigue in different sports, a Cybex machine was used to measure muscle fatigue and recovery during isokinetic knee flexion and extension. Eighteen baseball players, 12 soccer players and 13 marathon runners were studied. Each subject was tested in the sitting position and made to perform 50 consecutive right knee bends and stretches at maximum strength. This was done 3 times with an interval of 10 min between each series. The peak torque to body weight ratio and the fatigue rate were determined in each case. In all subjects, the peak torque to body weight ratio was higher for extensors than flexors. Over the 3 trials, the fatigue rate of extensors showed little change, while that of flexors had a tendency to increase. In each subject, knee extensors showed a high fatigue rate but a quick recovery, while knee flexors showed a low fatigue rate but a slow recovery. As the marathon runners had the smallest fatigue rates for both flexors and extensors, we concluded that marathon runners had more stamina than baseball players and soccer players.

Adolescent↗

PubMed1998

Comparison of muscle and tendon stiffness, jumping ability, muscle strength and fatigue in the plantar flexors.

An isokinetic dynamometer was used to measure plantar flexion muscle strength at 60 degrees/s and 200 degrees/s in 10 healthy young men (mean age 25 years). Muscle and tendon stiffnesses were determined on the dynamometer by the use of electrical stimulation and passive stretch (200 degrees/s). Differences in jumping heights between squat and counter-movement jumps were calculated from flight times. The number of heel-rises performed until exhaustion, standing on one leg, were counted. Stepwise regression analysis showed that differences in jumping height increased with lower muscle strength and with higher muscle and tendon stiffnesses, indicating that elastic components may be of more importance in persons with lower muscle strength. The number of heel-rises was negatively dependant on tendon stiffness, indicating that increased stiffness may enhance the development of fatigue.

Adult↗

PubMed1980

Effects of an occlusal splint on integrated electromyography of masseter muscle in experimental tooth clenching in man.

Six male subjects exercised maximal voluntary tooth clenching until fatigue appeared in the masseter muscle and until pains and exhaustion of this muscle could no longer be endured; that is, the fatigue threshold and the pain tolerance of the muscle were determined in seconds. An occlusal splint was inserted and the clenching exercises were repeated. During these exercises, and also during 10s of clenching, the electrical activity in the masseter muscle was recorded by bipolar surface electrodes and linearly integrated. Use of the splint did not result in significant changes in the subjective sensations of onset of fatigue and endurance of pain. As the periods of clenching increased, after insertion of the splint, the electrical activity decreased consistently, and use of the splint caused a significant decrease in the electrical activity of the pain tolerance test. As induced by the splint, there was no orderly pattern in changes of the fatigue thresholds and pain tolerances in relation to changes in the electrical activities of these parameters. The mode of action of the splint, in reducing the muscle activity, might have been that of stretching the elevator jaw muscles beyond their resting length.

Adult↗

PubMed2002

The role of pelvic-floor therapy in the treatment of lower urinary tract dysfunctions in children.

The pelvic-floor is under voluntary control and plays an important role in the pathophysiology of lower urinary tract (LUT) dysfunctions in children, especially of non-neuropathic bladder sphincter dysfunction. The following therapeutic measures can be applied to try to influence the activity of the pelvic-floor during voiding: proprioceptive exercises of the pelvic-floor (manual testing), visualization of the electromyographic registration of relaxation and contraction of the pelvic-floor by a curve on a display (relaxation biofeedback), observation of the flow curve during voiding (uroflow biofeedback), learning of an adequate toilet posture in order to reach an optimal relaxation of the pelvic-floor, an individually adapted voiding and drinking schedule to teach the child to deal consciously with the bladder and its function and a number of simple rules for application at home to increase the involvement and motivation of the child. In children however with persisting idiopathic detrusor instability additional therapeutic measures may be necessary to improve present urologic symptoms (incontinence problems, frequency, urge) and to increase bladder capacity. Intravesical biofeedback has been used to stretch the bladder and seems to be useful in case of sensory urge. Recently a less invasive technique, called transcutaneous electrical nerve stimulation (TENS), has been applied on level of S3 with promising results in children with urodynamicaly proven detrusor instability, in which previous therapies have failed.

Biofeedback, Psychology↗

PubMed1994

Cardiopulmonary adaptations to pneumonectomy in dogs. III. Ventilatory power requirements and muscle structure.

Static and dynamic mechanical characteristics of the respiratory system were measured in five adult foxhounds 6-15 mo after right pneumonectomy (R-PNX) and in five matched foxhounds that underwent right thoracotomy without pneumonectomy (Sham). In R-PNX dogs, elastic recoil was lower than that in the left lung of Sham dogs. On exercise, absolute ventilatory power requirements of the lung and its components were measured, i.e., power requirements to overcome elastic and viscous resistances of the lung as well as power requirements during inspiration and expiration. All components were higher for a given minute ventilation in R-PNX dogs than in both lungs of Sham dogs. Ventilatory power requirements after R-PNX were also higher than in three adult foxhounds after left PNX studied previously by the same techniques. After R-PNX, the mass of the right costal diaphragm and total mass of inspiratory muscles were greater than in Sham dogs. There were no significant differences in ultrastructural features of the costal diaphragm. The unilateral increase in muscle mass is likely the result of chronic elevation and stretch of the right costal diaphragm after R-PNX.

Air Pressure↗

PubMed1990

Aerobic capacity of older adults: a training study.

The effects of a four month aerobic conditioning program on heart rate, blood pressure, maximal oxygen consumption (VO2max), and physical work capacity of 55-70 year old sedentary individuals were evaluated. Twenty-eight men and women participated in either 4 months of supervised fast walking or jogging at a prescribed target heart rate or stretching exercises for one hour, three days per week. Gains in VO2max (ml/kg/min) obtained during a Balke maximal treadmill test in aerobic and exercise control subjects were 27% and 9%, respectively. At posttesting subjects in both groups demonstrated improved maximal work rate, increased treadmill time, and experienced lower resting and recovery heart rates, lower resting systolic blood pressure, and fewer premature ventricular depolarizations during exercise testing. In 67 physician-supervised maximal exercise tests, only one subject did not achieve VO2max due to exercise induced arrhythmias. No events of morbidity or mortality occurred as a result of the exercise testing and training. Subjects were contacted 4 years after study participation to determine if they were adhering to an exercise program. Sixty-four percent reported exercising at least 3 days per week in large muscle activities. We conclude that four months of supervised aerobic and nonaerobic exercise training is sufficient to improve aerobic capacity and other indicators of fitness in older, sedentary men and women, and that these previously sedentary people are likely to continue exercising on an individual basis once they have experienced improved physical capacity.

Aged↗