Extensor Endurance Research Articles

Trunk Muscle Function and Core Stability in Women Who Had Muscle-Sparing Pedicled Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction.

The long-term effects of the unilateral muscle-sparing pedicled transverse rectus abdominis myocutaneous (TRAMmsp) flap procedure on trunk muscle performances and core stability were investigated in women with breast cancer. Forty women (mean age = 42.6years) who had received breast reconstruction with the unilateral TRAMmsp flap procedure no less than 6months earlier (mean = 10.3 [standard deviation, SD = 4.9] months) (TRAM group) participated, and 30 women who were healthy and matched for age (mean age = 41.2years) served as controls (control group). Their abdominal and back muscle strength was assessed using the curl-up and prone extension tests, respectively, and their static abdominal muscle endurance and back extensor endurance were assessed using the sit-up endurance test in the crook-lying position and the Biering-Sørensen test, respectively. Core stability strength was assessed using a 4-level limb-lowering test (abdominal muscle test), and core stability endurance was assessed while lying supine with both flexed legs 1 inch off the mat while keeping the pelvis in a neutral position with a pressure biofeedback unit. Compared with the control group, trunk muscles of the TRAM group were weaker, showing less endurance, as were their core stability strength and endurance. Static trunk muscle endurances and trunk flexion strength were associated with core stability in both groups. Women exhibit trunk flexor and extensor weakness along with poor endurance and impaired core stability even after an average of 10months from receiving the TRAMmsp flap procedure. Immobilization after surgery, with possible systemic inflammatory effects from surgery and chemotherapy, might have further contributed to the generalized weakness subsequent to the partial harvesting of the rectus abdominis. Women after breast reconstruction with the TRAMmsp flap procedure show long-lasting deficits of strength and endurance in abdominal muscles, back extensors, and core stability. Proactive measures including early detection and evaluation of impairments as well as timely intervention targeting these clients are important to minimize the dysfunction and support their return to community participation.

P478 Fatigue, physical fitness, and physical activity in patients with inflammatory bowel disease

Abstract Background Fatigue is a common and debilitating symptom in patients with Inflammatory Bowel Disease (IBD) with a great impact on quality of life and work productivity. A better comprehension of the contributing factors to fatigue could potentially pave the way for more targeted and effective strategies for managing fatigue in IBD. Fatigue may be associated with lower levels of physical activity and reduced physical fitness. Yet, the interaction between these factors in IBD, measured with validated tests, is not fully understood. Therefore, this study aimed to investigate the association between fatigue and physical fitness and physical activity in patients with IBD. Methods Adult patients with IBD in remission or with mild-to-moderate clinical disease activity with an ASA Physical Status <III were eligible for inclusion. Fatigue was defined as a Checklist Individual Strength-fatigue subscale score ≥35. Patient and clinical characteristics were collected, including age, sex, body mass index, comorbidities, disease duration, disease location and behavior, clinical and biochemical disease activity, smoking status, previous intestinal resection, and medication use. Cardiorespiratory fitness was measured using cardiopulmonary exercise testing to assess the oxygen uptake at peak exercise (VO2peak). Muscular strength (peak torque at 60°/s) and endurance (fatigue rate as percentage decline in peak torque over 30 repetitions at 180°/s) of the knee extensor and flexor muscles were assessed using an isokinetic dynamometer. Objective physical activity data were collected continuously for seven consecutive days utilizing the MOX accelerometer, with activities categorized into sedentary, standing, light (LPA), moderate (MPA), and vigorous physical activity (VPA) levels. Results In total, 50 patients were included, with 17 being classified as fatigued. Fatigued patients had significantly higher BMIs, a higher frequency of clinical disease activity, and a higher prevalence of smoking (Table 1). They also exhibited significantly lower VO2peak (mean [±SD] 28.1 [±7.9] vs. 36.0 [±9.8] mL·kg-1·min-1, p=0.007) and higher knee extensor fatigue rate (mean [±SD] 39.0% [±8.8] vs. 31.1% [±10.4], p=0.010) compared to non-fatigued patients. There was no statistical significant difference in physical activity between fatigued and non-fatigued patients. Conclusion Although physical activity did not differ between patients with and without fatigue, fatigued patients exhibited lower cardiorespiratory fitness and knee extensor muscular endurance. A larger population is needed to further investigate the influence of patient and disease characteristics on this relationship to work towards more targeted and effective strategies for managing fatigue in patients with IBD.

The Improvement of Trunk Muscle Endurance in Adolescents with Idiopathic Scoliosis Treated with ScoliBrace® and the ScoliBalance® Exercise Approach

The impact of scoliosis bracing combined with physiotherapeutic scoliosis-specific exercises (PSSE) on trunk muscle endurance in adolescents with idiopathic scoliosis is unknown. ScoliBrace®, a rigid, three-dimensional, over-corrective thoraco-lumbar-sacral orthosis (TLSO), and ScoliBalance®, a PSSE program, were used to treat adolescent idiopathic scoliosis (AIS) patients. A retrospective study of the trunk muscle endurance of 33 AIS patients who received ScoliBrace® and ScoliBalance® was conducted. The patients were treated with ScoliBrace® and an individualized ScoliBalance® program. Trunk extensor muscle endurance (TE) and abdominal muscle endurance (AE) tests were performed at initial assessment and then at averages of 6.6 and 24.4 weeks of treatment. The data were analyzed using the Wilcoxon signed-rank test, Stata version 15.1. The participants were aged 13.24 years (SD = 1.64) with a mean Cobb angle of 38.97° (SD = 9.49°). TE improved significantly (p < 0.001) at both short- and medium-term intervals using ScoliBalance® and ScoliBrace® in the AIS patients. AE also showed significant improvement between baseline and short-term follow-up, with non-significant improvement at medium-term follow-up. Overall, trunk muscle endurance showed improvement in the AIS patients using ScoliBrace® and ScoliBalance®. Future research is required to determine the individual and combined effects of each treatment. However, it seems likely that trunk muscle endurance will not deteriorate in AIS patients with this combined treatment.

Reliability and Validity of the Star Excursion Balance Test for Evaluating Dynamic Balance of Upper Extremities.

Upper extremity (UE) dynamic balance is a significant physical fitness ability, which includes high-level neuromuscular proprioception, joint mobility, force, and coordination. The evaluation methods of UE dynamic balance are insufficient and lack experimental support. The Star Excursion Balance Test (SEBT) is a reliable assessment of dynamic balance and injury risk of the lower extremity. The UE-SEBT is a reliable and reproducible approach for evaluating dynamic balance of UEs. Observational study. Level 4. This cross-sectional study recruited 65 healthy adults. All participants were required to complete UE-SEBT, UE Y-balance test (UE-YBT), maximal voluntary isometric contraction (MVIC) of UE, closed kinetic chain UE stability test (CKCUEST), trunk flexor endurance test (TFET), trunk extensor endurance test (TEET), and lateral trunk endurance test (LTET). Intra- and inter-rater reliability and the correlation of UE-SEBT with other outcomes were measured. Among the participants, the intra- and interoperator reliability of UE-SEBT in all directions and composite score achieved a moderate-to-excellent (intraclass correlation coefficients [ICC], 0.729-0.946) reliability. For validity, the UE-SEBT had a moderate to very strong correlation with UE-YBT (r = 0.315-0.755, P < 0.01) and a strong correlation with CKCUEST (r = 0.4-0.67, P < 0.01). Furthermore, the UE-SEBT performance showed weak-to-strong correlations with MVIC (r = 0.26-0.43, P < 0.05). UE-SEBT was also correlated with LTET, TEET, and TFET to varying degrees. UE-SEBT has good reliability and validity to assess UE dynamic balance compared with other tests. UE-SEBT can be used as a clinical assessment method to evaluate UE dynamic balance and injury prevention.

Low back pain frequency and the related risk factors in nurses and caregivers.

The objective of this study is to investigate the frequency of low back pain and the relationship between low back pain and personal and occupational risk factors in hospital employees. The study sample consisted of 270 nurses and 189 caregivers working in a university hospital. Demographic characteristics, low back pain history, and low back pain risk factors were queried by self-report questionnaires. The Biering-Sorensen Test was used to evaluate the endurance of trunk extensor muscles. Also, the Oswestry Disability Index (ODI) and Hospital Anxiety and Depression Scale (HADS) were used. Of the hospital employees included in the study, 56.5% had low back pain in the last month, and 81.9% had a his-tory of low back pain. The frequency of low back pain was significantly higher among those who work in a stressful working environment, stand for extended periods, lift patients or heavy subjects without using a lifting device, and transfer patients alone. In addition, it was determined that those who exercise regularly and are satisfied with their job had significantly less low back pain (p<0.05). The mean Biering-Sorensen test difference between the two groups was statistically significant (p<0.001). There was a significant difference between the groups with and without low back pain in terms of HADS-Anxiety and HADS-Depression subscale scores. The study findings indicated that being a hospital worker is a risk factor for low back pain, and the decrease in the strength and endurance of the lower back muscles increases the risk of low back pain.

What keeps mobile in ageing? A comparison of balance, physical activity and social integration between 60- to 80-year-old healthy people who regularly dance, do sports or are active in everyday life – a cross-sectional study / Was hält im Alter mobil? Gleichgewicht, körperliche Aktivität und soziale Integration im Vergleich zwischen 60- bis 80-jährigen gesunden Personen, die regelmäßig tanzen, Sport betreiben

Abstract Background Physical and social activity can influence positively the effects of ageing. This study examined differences in balance, physical activity and social integration between everyday active, sportive or dancing 60- to 80-year-old people in Lower Austria. Materials and methods We recruited 50 seniors with a mean age of 66.8 ± 4.2 years for this cross-sectional study. 13 people were active everyday, 21 were sportive on a weekly basis and 16 were “Seniorentanz” dancers. We blindly assessed balance (MiniBESTest), mobility (Timed Up and Go), and muscular endurance of knee extensors, hip abductors, and plantar flexors. Questionnaires identified physical activity (IPAQ-SF) and social integration (LSNS-6). The analysis of group differences was carried out descriptively and via ANOVA or the Kruskal-Wallis H test. Results People who were regularly active in senior dance showed 5.5 points significantly higher balance ability in the MiniBESTest than those who were otherwise sportive (p = .002), and 7.5 points significantly higher balance than people who were active in everyday life (p = .006). According to the IPAQ-SF, athletes were by 4515 MET-min/week significantly more physically active than people who are only active in everyday life (p = .003). Social integration or other parameters did not differ between groups. Conclusion The small sample, the heterogeneity of the participants and differences in the contextual conditions of the measurements limit the validity of the results of this study. The results of this Lower Austrian sample could indicate differences in balance and physical activity between everyday active, sportive or dancing ageing people.

Lumbar extension peak-torque, muscle endurance and motor imagery in junior-elite basketballers with and without a history of low back pain: a pilot study.

Low back pain (LBP) is common in elite athletes. Several peripheral and central factors have been identified to be altered in non-athletic LBP populations, however whether these alterations also exist in elite athletes with LBP is unknown. The aim of this study was to determine whether elite basketballers with a history of persistent LBP perform worse than those without LBP at a lumbar muscle endurance task, a lumbar extension peak-torque task, and a lumbar motor imagery task. An observational pilot study. Twenty junior elite-level male basketballers with (n=11) and without (n=9) a history of persistent LBP were recruited. Athletes completed a lumbar extensor muscle endurance (Biering-Sorensen) task, two lumbar extensor peak-torque (modified Biering-Sorensen) tasks and two motor imagery (left/right lumbar and hand judgement) tasks across two sessions (48 hours apart). Performance in these tasks were compared between the groups with and without a history of LBP. Young athletes with a history of LBP had reduced lumbar extensor muscle endurance (p<0.001), reduced lumbar extension peak-torque (p<0.001), and were less accurate at the left/right lumbar judgement task (p=0.02) but no less accurate at a left/right hand judgement task (p=0.59), than athletes without a history of LBP. Response times for both left/right judgement tasks did not differ between groups (lumbar p=0.24; hand p=0.58). Junior elite male basketballers with a history of LBP demonstrate reduced lumbar extensor muscle endurance and lumbar extension peak-torque and are less accurate at a left/right lumbar rotation judgement task, than those without LBP.

Youth Female Field Hockey Players Physical Condition

Introduction: lower limb injuries and low back pain are common injuries in field hockey that have different risk factors. The aim of this study was to characterize youth field hockey players’ physical condition to determine their possible injury risk factors. Methods: youth field hockey players of the Club Deportivo Universidad Católica of Chile were assessed during April and May of the 2022 season. The test used were: Ely’s, Thomas, Ober and AKE for flexibility, Biering Sorensen, Plank Test, Sport Specific Endurance Plank Test, Single Leg Bridge Test, Lunge Test, Hop Test (single, triple and croo-over) and Y Balance Test. Statistical analyses were performed using R Statistical Software (2023.09.0+463; R Core Team 2023). Results: 87 youth field hockey players from the under 14, 16 and 19 were assess (age 15.1 ± 1.5). Poor core and back extensor endurance was found, along with poor hamstring strength and unipodal balance. Significant difference was found between categories in the plank test and sport specific endurance plank test (p&lt;0.001). Conclusion: several impairments were found in chilean youth field hockey players that could pose a risk of injury, however, further research is needed in order to determine if these impairments really are risk factors in this sport and population.

Understanding the Biering-Sørensen test: Contributors to extensor endurance in young adults with and without a history of low back pain

The Biering-Sørensen test is commonly used to assess paraspinal muscle endurance. Research using a single repetition of the test has provided conflicting evidence for the contribution of impaired paraspinal muscle endurance to low back pain (LBP). This study investigated how Sørensen test duration, muscle activation, and muscle fatigability are affected by multiple repetitions of the test and determined predictors of Sørensen test duration in young adults with and without a history of LBP. Sixty-four young individuals performed three repetitions of the Sørensen test. Amplitude of activation and median frequency slope (fatigability) were calculated for the lumbar and thoracic paraspinals and hamstrings. Duration of the test was significantly less for the 3rd repetition in individuals with LBP. In individuals without LBP, test duration was predicted by fatigability of the lumbar paraspinals. In individuals with LBP, Sørensen test duration was predicted by fatigability of the hamstrings and amplitude of activation of the thoracic and lumbar paraspinals. Our findings demonstrate that it is necessary to amplify the difficulty of the Sørensen test to reveal impairments in young, active adults with LBP. Training programs aiming to improve lumbar paraspinal performance should monitor performance of other synergist muscles during endurance exercise.

Effect of aerobic exercises on patients with chronic mechanical low back pain: A randomized controlled clinical trial

BackgroundChronic mechanical low back pain (CMLBP) is one of the most prevalent and costly disorders. Determining its most effective treatment approach is a priority for researchers. PurposeTo examine the effects of including aerobic exercise within a conventional therapy regimen for young adults with CMLBP. MethodsFifty CMLBP patients (22 males and 28 females) were randomly and equally assigned to one of two groups to receive the prescribed treatment for 8 weeks. The control group received the traditional program only (infrared, ultrasound, burst TENS, and exercises); for the experimental group, an aerobic training program using a stationary bicycle was added. Back pain intensity was the primary outcome. Secondary outcomes included the Oswestry disability index, back extensor endurance measured by the Sorensen test, and physical performance indicated by the back performance scale and the 6-min walk test. A Two-way MANOVA was used for data analysis. ResultsMultivariate tests revealed statistically significant effects of group (p = 0.002, partial η2 = 0.182), time (p < 0.001, partial η2 = 0.928), and group-by-time interaction (p = 0.01, partial η2 = 0.149). Univariate group-by-time interactions were significant for back disability (p = 0.043), extensor endurance (p = 0.023) and results of the 6-min walk test (p = 0.023) showing greater improvement in the experimental group. However, back pain intensity and the back performance scale revealed no significant group-by-time interactions. Within-group comparisons were significant for all measured variables in both groups (p < 0.001). ConclusionAlthough a traditional program of infrared, ultrasound, TENS, and exercises is beneficial for CMLBP treatment, adding aerobic exercises to the program leads to more beneficial outcomes.

A comparison of core muscle endurance of females with fibromyalgia versus healthy females: An observational study

IntroductionDespite the numerous benefits of core muscle strengthening in improving symptoms of fibromyalgia (FM), limited studies have quantified core muscle function in FM patients. ObjectiveTo compare the core muscle endurance of FM females with age-matched healthy females and determine whether a correlation exists between core muscle endurance and FM severity. Materials and methodsPre-diagnosed female FM patients (n=7) and age-matched healthy females (n=19) were assessed using McGill's core endurance tests in four positions – flexion, extension, and bilateral side-bridge. The longest contraction holding time (in seconds) in each position was noted and compared in both groups. Additionally, patient-reported Fibromyalgia Impact Questionnaire (FIQ) scores were obtained to determine disease severity. ResultsThe mean holding time for trunk extensors (26.14±7.7s), right lateral flexors (20.14±8.3s), and left lateral flexors (20.86±5.3s) was significantly lower in the FM females than the healthy females (trunk extensors=55.21±17.1s; right lateral flexors=36.05±13.2s; left lateral flexors=35.11±13.8s). The endurance of trunk flexors was statistically similar in both groups (FM females=52.14±27.9s; healthy females=74.37±37.7s). Lastly, core muscle endurance was not correlated with the FIQ scores in FM patients (p>0.05). ConclusionThe results of this preliminary study revealed that core extensor and lateral flexor endurance in FM females was lower than their healthy female counterparts. Larger sample studies are needed to further substantiate our findings.

No benefit of vitamin D supplementation on muscle function and health-related quality of life in primary cardiovascular prevention patients with statin-associated muscle symptoms: A randomized controlled trial

Statins are the leading lipid-lowering drugs, reducing blood cholesterol by controlling its synthesis. Side effects are linked to the use of statins, in particular statin-associated muscle symptoms (SAMS). Some data suggest that vitamin D supplementation could reduce SAMS. The purpose of this study was to evaluate the potential benefits of vitamin D supplementation in a randomized controlled trial. Men (n = 23) and women (n = 15) (50.5 ± 7.7 years [mean ± SD]) in primary cardiovascular prevention, self-reporting or not SAMS, were recruited. Following 2 months of statin withdrawal, patients were randomized to supplementation (vitamin D or placebo). After 1 month of supplementation, statins were reintroduced. Before and 2 months after drug reintroduction, muscle damage (creatine kinase and myoglobin) was measured. Force (F), endurance (E) and power (P) of the leg extensors (ext) and flexors (fle) and handgrip strength (FHG) were also measured with isokinetic and handheld dynamometers, respectively. The Short Form 36 Health Survey (SF-36) questionnaire and a visual analog scale (VAS) were administrated to assess participants' self-reported health-related quality of life and SAMS intensity, respectively. Repeated-measures analysis was used to investigate the effects of time, supplementation, and their interaction, according to the presence of SAMS. Despite no change for objective measures, subjective measures worsened after reintroduction of statins, independent of supplementation (VAS, SF-36 mental component score, all p < 0.05). However, no interaction between time and supplementation according to the presence of SAMS was observed for any variables. Vitamin D supplementation does not appear to mitigate SAMS.

Cervical muscle parameters and allodynia in migraine and cervical pain-A controlled study.

Neck pain is common among individuals with migraine, but there is a lack of information of how this comorbidity can be associated with cervical muscle function. This controlled cross-sectional study aimed to compare cervical muscle function, activity, and sensitization in women with migraine, neck pain, both, and neither. This study included women, between 18 and 55 years old, with either episodic migraine with or without aura, without any concomitant headache diagnosis; chronic neck pain, with at least moderate intensity and mild disability; or neither headache nor neck pain. Pain pressure threshold, allodynia, muscle strength, and endurance and cervical muscles activity were evaluated. One hundred subjects, with mean age of 30.4 years old, were stratified by diagnosis (n = 25 per group) and by self-reported pain during tests. Lower endurance during flexion was observed for migraine and neck pain (34s) relative to neck pain alone (45s), migraine (40s), and controls (58s) (p = 0.04). For extensor endurance, means were 142s, 166s, 215s, and 270s, respectively (p < 0.001). Endurance times were impacted by the presence of test-induced pain decreasing about 40%-53% of the performance. Diagnostic groups did not differ significantly in strength (p > 0.05), but all pain groups presented significantly higher proportion of test-induced pain, lower muscle activity during the maximal isometric voluntary contractions, and lower pressure pain thresholds. Patients with migraine, chronic neck pain, and the association of both present altered cervical muscle function and activity. Also, test-induced pain impacts significantly on neck muscles endurance. The diagnosis of migraine and chronic neck pain is associated with altered function and activity of the cervical muscles. However, the test-induced pain had an important contribution to worse cervical muscle endurance. This suggests that the therapeutic approach should focus on de-sensitization of the trigeminal-cervical complex when dealing with the comorbidity of migraine and cervical pain.

Effects of exercise therapy using elastic bands on strength and pain in women with non-specific neck pain: A randomised controlled trial

BackgroundCervical pain has a high incidence and worldwide socio-economic effect. Its incidence is lower in men than in women. Conservative and non-pharmacological therapeutic options include strength training. Elastic bands are commonly used in physiotherapy clinics for strength work in patients. Consequently, the objective of this research was to analyse the efficacy of an exercise therapy programme using elastic bands on decreasing pain and increasing strength of the neck flexor musculature, cervical extensor, and scapular stabilizing musculature in women suffering from non-specific cervical pain. MethodsA randomised clinical trial was carried out with 35 subjects with non-specific neck pain (age = 51.7 ± 9.5 and baseline intensity of pain in Visual Analogue Scale = 52.4 ± 9.6). The experimental group (n = 18) performed the exercise programme with elastic bands, consisting of a total of 16 sessions that lasted 45 min. The control group, consisting of 27 participants, reported that they maintained their usual lifestyle throughout the study. The evaluation tools used in this research included the Visual Analogue Scale, Neck Flexor Endurance Test, Neck Extensor Muscle Endurance Test, and Scapular Muscle Endurance Test. ResultsThe experimental group obtained significant improvements in the measurements taken using the Visual Analogue Scale (p < 0.001, d = 4.2), the Neck Flexor Endurance Test (p < 0.001, d = 3.4), the Neck Extensor Endurance Test (p < 0.001, d = 6.3), in the Scapular Muscle Endurance Test (p = 0.016, d = 0.9). ConclusionsThe assessed exercise therapy program utilizing elastic bands demonstrated favorable outcomes in managing non-specific neck discomfort. This intervention resulted in pain reduction and enhanced endurance of the cervical flexor and extensor muscles, along with improved endurance of the scapular stabilizing muscles.Protocol registration in ClinicalTrials.gov: NCT05433649 (registered prospectively, date of registration: June 27, 2022).

Exploring the Interplay of Muscular Endurance, Functional Balance, and Limits of Stability: A Comparative Study in Individuals with Lumbar Spondylosis Using a Computerized Stabilometric Force Platform.

Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving the management and well-being of affected individuals. This study aimed to assess lumbar extensor endurance, functional balance, and limits of stability in individuals with lumbar spondylosis compared to age-matched healthy individuals and explore the correlations among these parameters within the lumbar spondylosis group. The lumbar spondylosis group consisted of 60 individuals initially screened by an orthopedician and referred to physical therapy. Age-matched healthy controls (n = 60) were recruited. Inclusion criteria encompassed adults aged 45-70 years for both groups. Lumbar extensor endurance was assessed using the Sorensen test, functional balance with the Berg Balance Scale, and limits of stability using a computerized stabilometric force platform. Lumbar extensor endurance was significantly lower in individuals with lumbar spondylosis compared to healthy controls (23.06 s vs. 52.45 s, p < 0.001). Functional balance, as assessed by the Berg Balance Scale, demonstrated a significant decrement in the lumbar spondylosis group (48.36 vs. 53.34, p < 0.001). Additionally, limits of stability variables, under both eyes-open and eyes-closed conditions, exhibited marked impairments in the lumbar spondylosis group (p < 0.001 for all variables). Within the lumbar spondylosis group, lumbar extensor endurance exhibited significant positive correlations with functional balance (0.46, p < 0.001) and negative correlations with limits of stability variables (r ranging from -0.38 to -0.49, p < 0.01 for all variables). This study underscores the significance of addressing lumbar extensor endurance, functional balance, and stability impairments in the comprehensive management of lumbar spondylosis.

Role of the Paraspinal Muscles in the Sagittal Imbalance Cascade: The Effects of Their Endurance and of Their Morphology on Sagittal Spinopelvic Alignment.

The role of paraspinal muscle degeneration in the cascade of sagittal imbalance is still unclear. This study aimed to compare paraspinal muscle degeneration in the 4 stages of sagittal imbalance: sagittal balance (SB), compensated sagittal balance (CSB), decompensated sagittal imbalance (DSI), and sagittal imbalance with failure of pelvic compensation (SI-FPC). In addition, it aimed to compare the effects paraspinal muscle endurance and morphology on sagittal spinopelvic alignment in patients with lumbar spinal stenosis. A cross-sectional study of 219 patients hospitalized with lumbar spinal stenosis was performed. The isometric paraspinal extensor endurance test and evaluation of atrophy and fat infiltration of the paraspinal extensor muscles and psoas major on magnetic resonance imaging were performed at baseline. Spinopelvic parameters including lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, and the sagittal vertical axis were measured. The patients with lumbar spinal stenosis were divided into 67 with SB, 85 with CSB, 49 with DSI, and 17 with SI-FPC. There were significant differences in paraspinal muscle endurance and morphology among the 4 groups. Furthermore, the SI-FPC group had poorer paraspinal muscle endurance than either the SB or the CSB group. In multiple linear regression analysis, paraspinal muscle endurance and the relative functional cross-sectional area of the paraspinal extensor muscles were the independent predictors of the sagittal vertical axis, and the relative functional cross-sectional area of the psoas major was the independent predictor of relative pelvic version. This study indicated that paraspinal muscle degeneration is not only an initiating factor in pelvic retroversion but also a risk factor for progression from a compensated to a decompensated stage. Specifically, the impairment of muscle endurance in the CSB stage may be the reason why patients experience failure of pelvic compensation. In addition, paraspinal muscle endurance and muscle morphology (relative functional cross-sectional area of the paraspinal extensor muscles and psoas major) had different clinical consequences. Prognostic Level II . See Instructions for Authors for a complete description of levels of evidence.

Relationship between Physical Activity and Sedentary Behavior, Spinal Curvatures, Endurance and Balance of the Trunk Muscles-Extended Physical Health Analysis in Young Adults.

Physical inactivity and sedentary behavior are associated with poor well-being in young people with adverse effects extending into adulthood. To date, there are many studies investigating the relationship between physical activity (PA) and posture, but there are no data on the relationship between the type and intensity of PA and sedentary behavior, their association with thoracic and lumbar spine angles, and with endurance and balance of the trunk muscles, especially in healthy young adults aged 18-25 years. Moreover, there are no data on the relationship between PA and sedentary behavior and musculoskeletal and cardiopulmonary health, as well as quality of life (QoL) and sleep that would provide a more comprehensive picture of physical health status. Therefore, the aim of this cross-sectional study was to investigate the extent to which PA and sedentary behavior are associated with each other and with changes in spinal curvatures, endurance and balance of trunk muscles in an extended analysis of physical health status in young adults aged 18-25 years by additionally including measures of body composition, cardiorespiratory capacity, and QoL and sleep. A total of 82 students (58% female, 42% male) aged 18-25 years completed all required tests. Primary outcome measures included the following: PA and sedentary behavior calculated from the long form of International PA Questionnaire (IPAQ-LF), spinal curvatures measured by a Spinal Mouse® device, endurance and balance of the trunk muscles measured using trunk endurance tests and their ratio. Overall, 50% of students were classified as minimally active and 50% as health-enhancing PA (HEPA) active. The angles of thoracic kyphosis and lumbar lordosis showed no correlation with PA or time spent sitting. However, students with the lowest PA had significantly higher scores on the trunk extensor endurance test and trunk extensor/flexor endurance test ratio, indicating imbalanced trunk muscles. Moreover, these students spent the most their time sitting. Only PA of vigorous intensity and PA during recreation, leisure, and sports significantly correlated with QoL related to physical health. QoL related to physical and psychosocial health had significantly higher scores when students spent less time sitting. In addition, we found significantly better respiratory performance and SQ at higher PA values, i.e., PA during recreation, leisure, and sport. Our results suggest that students with low PA levels and more time spent sitting have imbalanced trunk muscles, worse respiratory function, and poorer QoL and sleep. Moreover, these findings in college students may reflect their lifestyle and suggest that more PA needs to be promoted to prevent the development of chronic diseases including musculoskeletal disorders.

The Magnitude of Physical and Sensory Impairments in Post-traumatic and Non-traumatic Cervicogenic Headaches: A Comparative Study.

Background Cervicogenic headaches can significantly deteriorate the quality of life of patients and decrease their productivity. Few studies have been conducted to assess the magnitude of physical impairments among patients with non-traumatic and post-traumatic cervicogenic headaches. Therefore, this study was conducted to examine and compare the magnitude of cervical physical impairments among patients with post-traumatic cervicogenic headaches in contrast to patients with non-traumatic cervicogenic headaches, migraine, and a group of sex- and age-matched controls who did not have headaches. Methodology This was a comparative study. A total of 104 patients and 30 sex- and age-matched controls were included. The patients were stratified into three groups: post-traumatic cervicogenic headaches (n = 42), non-traumatic cervicogenic headaches (n = 30), and migraines (n = 32). The cervical active range of motion and proprioception were assessed using a goniometer, the craniovertebral angle was measured while the heads of the subjects rested in a comfortable position, the strength of the cervical flexors and extensors was assessed using a hand-held dynamometer, and endurance of the short cervical flexors was assessed while the subjects were in a supine position with no pillow. Skin roll tests were performed in the trapezius and mandibular areas, and pain was measured using the McGill Pain Questionnaire-Short Form. Results Patients in the post-traumatic cervicogenic headache group reported a significantly higher number of headache days (p < 0.001) compared to the controls, patients with migraines, and those with non-traumatic cervicogenic headaches. Patients with post-traumatic cervicogenic headaches showed a significant reduction in total rotation, flexion and extension, lateral bending, and craniovertebral angle compared to the controls, patients with migraines, and those with non-traumatic cervicogenic headaches. On the other hand, the controls endured significantly longer and had stronger neck flexors and extensors compared to the patients in the migraine, non-traumatic, and post-traumatic cervicogenic headache groups, respectively. Patients with post-traumatic cervicogenic headaches significantly reported higher affective and total pain compared to the controls and patients in the migraine group. Conclusions Patients with post-traumatic cervicogenic headaches had significant deficits in the cervical active range of motion in the different planes, endurance, and strength of cervical flexors and extensors compared to the controls and patients with migraine and non-traumatic cervicogenic headaches. Similarly, patients with post-traumatic cervicogenic headaches reported higher affective pain compared to the controls and patients with migraines. The results of this study indicated that patients with post-traumatic cervicogenic headaches have significantly higher physical impairments compared to patients with non-traumatic cervicogenic headaches. These differences warrant caution when combining data from patients with non-traumatic and post-traumatic cervicogenic headaches.

Trunk extensor muscle endurance and its relationship to action potential conduction velocity and spectral parameters estimated using high-density electromyography

Trunk extensor muscle fatigue typically manifests as a decline in spectral content of surface electromyography. However, previous research on the relationship of this decline with trunk extensor muscle endurance have shown inconsistent results. The decline of spectral content mainly reflects the decrease in average motor unit action potential conduction velocity (CV). We evaluated whether the rate of change in CV, as well as two approaches employing the change in spectral content, are related to trunk extensor muscle endurance. Fourteen healthy male participants without a low-back pain history performed a non-strictly controlled static forward trunk bending trial until exhaustion while standing. For 13 participants, physiologically plausible CV estimates were obtained from high-density surface electromyography bilaterally from T6 to L5. Laterally between L1 and L2, the linear rate of CV change was strongly correlated to endurance time (R2 = 0.79), whereas analyses involving the linear rate of change in spectral measures showed a lower (R2 = 0.38) or no correlation. For medial electrode locations, estimating CV and its relationship with endurance time was less successful, while the linear rate of change in spectral measures correlated moderately to endurance time (R2 = 0.44; R2 = 0.56). This study provides guidance on monitoring trunk extensor muscle fatigue development using electromyography.

Effect of Individualized Mat Pilates Exercises on Speed, Agility and Back Extensor Endurance in a Deconditioned Athelte – A Case Study

Effect of Individualized Mat Pilates Exercises on Speed, Agility and Back Extensor Endurance in a Deconditioned Athelte – A Case Study