The Effect of a New Neck Support Tying Method Using Thera-Band on Cervical ROM and Shoulder Muscle Pain after Overhead Work

[Purpose] This study proposed a new neck support tying (NST) method using Thera-Band for the prevention of neck and shoulder pain in workers doing overhead work. The purpose of this study was to investigate the effect of the new NST method using Thera-Band on cervical ROM and shoulder pain after overhead work. [Subjects] Fourteen male subjects were recruited. [Methods] This study measured the cervical ROM and pressure pain threshold (PPT) of the upper and middle trapezius (UT and MT) muscles after the control and NST groups had performed overhead work. [Results] The cervical flexion, extension, and lateral flexion angles of the NST group were significantly larger than those of the control group. The PPTs of UT and MT of the NST group were significantly higher than those of the control group [Conclusion] The NST prevented ROM reduction and pain in the cervical and shoulder regions.Key words: Neck supporter, Overhead work, Thera-Band     

超声测量内脏脂肪厚度和胰岛素抵抗相关性研究

目的应用超声测量内脏脂肪厚度（VFT）,并评价其临床意义。方法收集了2005年3月至2005年12月在我院体检中心符合入选标准的可用资料210份,均进行人体指标测量、空腹血生化检查和经超声测量内脏脂肪厚度、腹壁脂肪厚度（SFT）。采用稳态模式胰岛素抵抗指数（HOMA-IR）评价胰岛素抵抗。用SPSS13.0软件进行统计分析。结果简单相关分析显示内脏脂肪厚度和腰围、血压、血尿酸、空腹血糖、甘油三酯、空腹胰岛素（FINS）和胰岛素抵抗指数（HOMA-IR）呈正相关,和胰岛素敏感指数（Si）呈负相关,P〈0.05。经年龄、性别、腰围和体质量指数（BMI）调整后的偏相关分析显示,内脏脂肪厚度和收缩压、甘油三酯、FINS、HOMA-IR呈正相关,相关系数分别为0.184、0.213、0.179、0.196,P〈0.05;和Si呈负相关,相关系数-0.196,P〈0.05。逐步法多元线性回归分析显示,内脏脂肪厚度和甘油三酯、收缩压、血尿酸、HOMA-IR呈正相关,相关系数分别为0.224、0.239、0.272、0.231,P〈0.01。结论由超声测量的内脏脂肪厚度是一种简单、实用的评价内脏型肥胖的方法,和胰岛素抵抗相关,可能是一个新的心血管危险标志。     

Comparison of Abdominal Muscle Thickness with Vaginal Pressure Changes in Healthy Women

[Purpose] The purpose of this study was to verify the efficacy of a pelvic floor muscle exercise program by comparing subjects’ muscle thickness with changes in vaginal pressure. [Subjects] Two groups of female participants without a medical history of pelvic floor muscle dysfunction were evaluated. The mean age of Group I was 33.5 years and that of Group II was 49.69 years. [Methods] The participants were instructed to perform a pelvic floor muscle contraction. While measuring the vaginal pressure of the pelvic floor muscle, biofeedback was given on five levels, and the thicknesses of the transversus abdominis, external oblique, and internal oblique muscles were measured with ultrasound. [Results] The thickness of the transversus abdominis muscle was significantly increased at 30 cmH₂O in Group I, and at 20 cmH₂O in Group II. The thickness of the internal oblique abdominal muscle significantly increased at maximum contraction in Group II. [Conclusion] Different abdominal muscles contracted depending on vaginal pressure. The result may be used to create and implement an exercise program that effectively strengthens the pelvic floor muscles.Key words: Pelvic floor muscle contraction, Vaginal pressure, Abdominis muscle     

Differences in Transversus Abdominis Muscle Function between Chronic Low Back Pain Patients and Healthy Subjects at Maximum Expiration: Measurement with Real-time Ultrasonography

The purpose of the present study was to compare the contraction ability at maximum expiration of the transversus abdominis (TrA) in patients with chronic low-back pain (CLBP) with that of healthy individuals. [Subjects] We studied 15 patients with CLBP and 15 healthy subjects. The subjects were informed of the study''s aim and methods, and the experiment was performed after obtaining the consent of the subjects. [Methods] The thickness of the abdominal muscles was measured using a LOGIQ Book XP (GE, USA). The main outcome variable was the ratio of TrA thickness at maximum expiration versus in the relaxed position (TrA activation ratio). [Results] There was a difference between the healthy subjects and the back pain subjects with regard to the thickness of the TrA at rest and the thickness of the muscle during contraction. However, there was no difference in the rate of change in the muscle activity. [Conclusion] In conclusion, CLBP patients exhibited atrophy of the TrA muscle, but voluntary TrA muscle activation was similar to that of the normal subjects.Key words: Low back pain, Transversus abdominis, Maximum expiration     

Electromyographic Study of Neck Muscle Activity According to Head Position in Rugby Tackles

[Purpose] This study examined differences in neck muscle activity in two different head positions during tackles with the aim of contributing to the prevention of sports injuries. [Subjects] The subjects were 28 male high-school rugby players. [Methods] Two tackle positions were considered: a head-up position and a head-down position. Muscle activities of the sternocleidomastoid muscles and the upper, middle, and lower parts of the trapezius muscles were measured. [Results] Muscle activities of the sternocleidomastoid muscles and the right upper trapezius muscle were significantly increased in the head-up position, and the activity of the lower trapezius was significantly increased in the head-down position. [Conclusion] Tackling with the head-up position increases neck muscle activity and stability of the head and the neck.Key words: Sternocleidomastoid muscle, Trapezius muscle, Rugby     

Ultrasound Evaluation of Muscle Thickness Changes in the External Oblique, Internal Oblique,and Transversus Abdominis Muscles Considering the Influence of Posture and Muscle Contraction

[Purpose] The aim of this study was to investigate muscle thickness changes in the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) muscles between the neutral position and trunk rotation, under a state of rest without voluntary contractions, and isometric contractions to both sides with resistance of 50% of the maximum trunk rotation strength. [Subjects] The subjects of this study were 21 healthy young men. [Methods] Muscle thickness changes in the EO, IO, and TrA in each position and state were evaluated by ultrasound. The range of motion at maximum trunk rotation and the maximum strength of trunk rotation were measured using a hand-held dynamometer. [Results] In the neutral position and at 50% trunk rotation to the right side, the thicknesses of the IO and TrA significantly increased with resistance. In both states, the thicknesses of the IO and TrA significantly increased at 50% trunk rotation to the right side. [Conclusion] The muscular contractions of the IO and TrA were stronger during ipsilateral rotation than in the neutral position and with resistance than at rest. Moreover, the muscular contraction was strongest in the resistive state during ipsilateral rotation.Key words: Trunk rotation, Low back pain, Functional evaluation     

Relationship Between Muscle Quality or Stiffness Measured by Ultrasonography and Range of Motion in Hospitalized Older Adults

Older adults who require nursing care have joint contractures characterized by limited range of motion (ROM). The present study investigated age-related muscle changes using ultrasonography and the relationship between ROM and muscle changes in older adults. Twenty-two healthy young adults (mean age: 23.3 y) and 60 hospitalized older adults (mean age: 86.1 y) participated. ROM of hip abduction was measured using a goniometer. Echo intensity (EI), reflecting interstitial fibrous tissue or fat within adductor longus (ADDl) was measured using B-mode ultrasonography, and strain ratio (SR), reflecting ADDl stiffness, was measured by strain elastography. The Mann–Whitney U-test and Spearman's correlation test were used for analysis. The ROM and SR of older adults were significantly lower than those of young adults (both p values <0.001). The EI was significantly higher in older adults than in young adults (p < 0.001). In older adults, the SR was moderately correlated with ROM (ρ = 0.49, p < 0.001). In conclusion, limited ROM and increase in interstitial fibrous tissue or fat and stiffness occur with aging, and the SR measured by strain elastography is useful for investigating the effect of muscle stiffness on the ROM of hospitalized older adults.     

Use of Optical Flow to Estimate Continuous Changes in Muscle Thickness from Ultrasound Image Sequences

Muscle thickness is one of the most widely used parameters for quantifying muscle function. Ultrasonography is frequently used to estimate changes in muscle thickness in both static and dynamic contractions. Conventionally, most such measurements are conducted by manual analysis of ultrasound images. This manual approach is time consuming, subjective, susceptible to error and not suitable for measuring dynamic change. In this study, we developed an automated tracking method based on an optical flow algorithm using an affine motion model. The goal of the study was to evaluate the performance of the proposed method by comparing it with the manual approach and by determining its repeatability. Real-time B-mode ultrasound was used to examine the rectus femoris during voluntary contraction. The coefficient of multiple correlation (CMC) was used to quantify the level of agreement between the two methods and the repeatability of the proposed method. The two methods were also compared by linear regression and Bland-Altman analysis. The findings indicated that the results obtained using the proposed method were in good agreement with those obtained using the manual approach (CMC = 0.97 ± 0.02, difference = −0.06 ± 0.22 mm) and were highly repeatable (CMC = 0.91 ± 0.07). In conclusion, the automated method proposed here provides an accurate, highly repeatable and efficient approach to the estimation of muscle thickness during muscle contraction.     

Placental Volumes Measured by 3‐Dimensional Ultrasonography in Normal Pregnancies From 12 to 40 Weeks' Gestation

Objective. The purpose of this study was to construct nomograms of placental volumes according to gestational age and estimated fetal weight. Methods. From March to November 2007, placental volumes were prospectively measured by ultrasonography in 295 normal pregnancies from 12 to 40 weeks' gestation and correlated with gestational age and estimated fetal weight. Inclusion criteria were healthy women, singleton pregnancies with normal fetal morphologic characteristics on ultrasonography, and confirmed gestational age by first‐trimester ultrasonography. Results. The mean placental volume ranged from 83 cm³ at 12 weeks to 427.7 cm³ at 40 weeks. Linear regression yielded the following formula for the expected placental volumes (ePV) according to gestational age (GA): ePV (cm³) = ?64.68 + 12.31 × GA (r = 0.572; P < .001). Placental volumes also varied according to estimated fetal weight (EFW), and the following mathematical equation was also obtained by linear regression: ePV = 94.19 + 0.09 × EFW (r = 0.505; P < 0.001). Conclusions. Nomograms of placental volumes according to gestational age and estimated fetal weight were constructed, generating reference values.     

Age-related Changes in Maximum Pelvic Anteversion and Retroversion Angles Measured in the Sitting Position

[Purpose] The purpose of this study was to investigate the relationship between age and the maximum pelvic anteversion and retroversion angles, as well as the associated pelvic range of motion, measured in a sitting position with free knee movement. [Subjects] A total of 132 healthy volunteers (74 women, 58 men; age range, 20–79 years) were divided into six groups based on age (20–29, 30–39, 40–49, 50–59, 60–69, and 70–79 years). [Methods] The maximum pelvic anteversion and retroversion angles were measured manually five times by a goniometer in a sitting position that allowed free movement of the knee joints. [Results] There was a significant effect of age group on the maximum pelvic anteversion and retroversion angles and pelvic range of motion (the difference between these angles). There was a significant correlation between age and the maximum pelvic anteversion angle, maximum pelvic retroversion angle, and pelvic range of motion. [Conclusion] The maximum pelvic anteversion and retroversion angles and pelvic range of motion were significantly correlated with age. The maximum pelvic anteversion angle and pelvic range of motion were most affected by age.Key words: Aging, Mobility limitation, Pelvis     

Effects of Cervical Deep Muscle Strengthening in a Neck Pain: A Patient with Klippel-Feil Syndrome

[Purpose] This study aimed to identify the effects of cervical deep muscle strengthening (CDS) on neck pain in a patient with Klippel-Feil syndrome (KFS). [Subjects and Methods] The subjects was a 39 year-old woman with neck pain and KFS that included incomplete block vertebrae in the C2–3 segments and block vertebrae in the C6–7 segments. The subject performed an exercise program including cervical strengthening exercise (level 1) and CDS exercise (level 2) for 6 weeks. Neck pain intensity was measured using the visual analogue scale (VAS) and the pressure pain threshold (PPT). All measurements were obtained before and after the CDS exercise program. [Results] The VAS and PPT measurements decreased; range of motion in the cervical joint increased. [Conclusion] CDS exercises were effective interventions for reducing neck pain in a patient with Klippel-Feil syndrome.Key words: Cervical deep muscle strengthening, Neck pain, Klippel-Feil syndrome     

Changes in Respiratory Function Following Intermittent Living in the Upland Environment and the Lowland Environment

[Purpose] The purpose of this study is to examine the effects on respiratory function and oxygen saturation of intermittent life in the uplands at an altitude above sea level of approximately 850 m. [Subjects and Methods] The study subjects were on 100 female student subjects attending a university located in the uplands. The subjects’ oxygen saturation, heart rates and respiratory functions were measured at the university, which has campuses both in the uplands and the lowlands. [Results] Freshmen showed differences in oxygen saturation, heart rate, and most respiratory function items between the different altitudes; however, seniors did not exhibit any differences. There were no differences in oxygen saturation and heart rate between the uplands and the lowlands either group. In the uplands, peak forced expiratory flow was shown to be high in the seniors, who also had better cardiopulmonary function. [Conclusion] Senior students, who had been exposed to the upland environment for a longer period of time, generally showed better respiratory function. Therefore, alternating living between the uplands and the lowlands can be said to improve an individual’s respiratory function.Key words: Altitude above sea level, Oxygen saturation, Respiratory function     

Changes in Cell Morphology Due to Plasma Membrane Wounding by Acoustic Cavitation

Acoustic cavitation-mediated wounding (i.e., sonoporation) has great potential to improve medical and laboratory applications requiring intracellular uptake of exogenous molecules; however, the field lacks detailed understanding of cavitation-induced morphologic changes in cells and their relative importance. Here, we present an in-depth study of the effects of acoustic cavitation on cells using electron and confocal microscopy coupled with quantitative flow cytometry. High resolution images of treated cells show that morphologically different types of blebs can occur after wounding conditions caused by ultrasound exposure as well as by mechanical shear and strong laser ablation. In addition, these treatments caused wound-induced nonlytic necrotic death resulting in cell bodies we call wound-derived perikarya (WD-P). However, only cells exposed to acoustic cavitation experienced ejection of intact nuclei and nearly instant lytic necrosis. Quantitative analysis by flow cytometry indicates that wound-derived perikarya are the dominant morphology of nonviable cells, except at the strongest wounding conditions, where nuclear ejection accounts for a significant portion of cell death after ultrasound exposure. (E-mail:prausnitz@gatech.edu)     

An Investigation into Reliability of Knee Extension Muscle Strength Measurements,and into the Relationship between Muscle Strength and Means of Independent Mobility in the Ward: Examinations of Patients Who Underwent Femoral Neck Fracture Surgery

[Purpose] The purpose of the present study was to investigate the reliability of isometric knee extension muscle strength measurement of patients who underwent femoral neck fracture surgery, as well as the relationship between independent mobility in the ward and knee muscle strength. [Subjects] The subjects were 75 patients who underwent femoral neck fracture surgery. [Methods] We used a hand-held dynamometer and a belt to measure isometric knee extension muscle strength three times, and used intraclass correlation coefficients (ICCs) to investigate the reliability of the measurements. We used a receiver operating characteristic curve to investigate the cutoff values for independent walking with walking sticks and non-independent mobility. [Results] ICCs (1, 1) were 0.9 or higher. The cutoff value for independent walking with walking sticks was 0.289 kgf/kg on the non-fractured side, 0.193 kgf/kg on the fractured side, and the average of both limbs was 0.238 kgf/kg. [Conclusion] We consider that the test-retest reliability of isometric knee extension muscle strength measurement of patients who have undergone femoral neck fracture surgery is high. We also consider that isometric knee extension muscle strength is useful for investigating means of independent mobility in the ward.Key words: Muscle strength, Test-retest reliability, Independent walking     

Differences in Muscle Activities of the Infraspinatus and Posterior Deltoid during Shoulder External Rotation in Open Kinetic Chain and Closed Kinetic Chain Exercises

[Purpose] This study investigated the changes in electromyographic (EMG) activities of the infraspinatus and posterior deltoid muscles during shoulder external rotation under open kinetic chain (OKC) and closed kinetic chain (CKC) exercise conditions. [Subjects] In total, 15 healthy males participated in this study. [Methods] Subjects performed shoulder external rotations under CKC and OKC conditions while standing with and without weight support provided by a height-adjustable table. Pressure biofeedback was used to ensure a constant amount of weight support. The activities of the infraspinatus and posterior deltoid muscles during shoulder external rotation were measured using a wireless surface EMG system. The paired t-test was used to compare the EMG activities of the infraspinatus and the posterior deltoid muscles and the ratio of the infraspinatus to the posterior deltoid during shoulder external rotation under OKC and CKC conditions. [Results] The EMG activity of the infraspinatus and the ratio of the infraspinatus to the posterior deltoid activities were significantly increased, whereas the posterior deltoid activity was significantly decreased under the CKC condition compared to the OKC condition. [Conclusion] Clinicians should consider the CKC shoulder external rotation exercise when they wish to selectively strengthen the infraspinatus.Key words: Infraspinatus, Posterior deltoid, Selective muscle strengthening     

Comparison of the Changes in Thickness of the Abdominal Wall Muscles of Stroke Patients According to the Duration of Their Illness as Observed Using Ultrasonographic Images

[Purpose] This study was conducted in order to investigate the importance of trunk muscle strength in stroke patients. By comparing the thicknesses of the abdominal wall muscles through ultrasonography, relative to the duration of illness, the results of the objective data were applied. [Methods] Thirty stroke patients were divided into three groups including an acute phase group participating in the study within 1 month after the onset of a stroke (n=10), a subacute phase group participating less than 6 months (n=10) after a stroke, and a chronic phase group participating more than 6 months (n=10) after suffering a stroke. The thicknesses of the transversus abdominis muscles (TrA), internal oblique muscle (IO), and the external oblique muscle (EO) were measured at rest and during abdominal draw-in maneuver (ADIM) in a supine hook-lying position, and their differences were compared. [Results] The results showed that, in comparison of the thicknesses of the paretic and nonparetic sides, the TrA of the subacute phase and chronic phase groups showed significant differences. In addition, the IO of the subacute phase group and the EO of the chronic phase groups also showed significant differences. [Conclusion] According to the duration of illness in stroke patients, the abdominal wall muscles become noticeably infirm and asymmetric. By improving their symmetry, the functions of the trunk muscles can be recovered.Key words: Stroke, Sonographic image, Abdominal wall muscles     

A Comparison of the Deep Cervical Flexor Muscle Thicknesses in Subjects with and without Neck Pain during Craniocervical Flexion Exercises

[Purpose] The purpose of the present study was to examine the amount of change in the thicknesses of the deep cervical flexor (DCF) and sternocleidomastoid (SCM) muscles in subjects with neck pain and subjects without neck pain during craniocervical flexion exercise (CCFE). [Subjects] The total number of subjects was 40, comprising 20 in the no-pain group (males 11, females 9) and 20 in the pain group (males 8, females 12). [Methods] Muscle images were obtained using ultrasound, and the thicknesses of the individual muscles were measured using the NIH ImageJ software. [Results] During CCFE, as pressure increased, the no-pain group recruited the DCF more than the pain group, while the pain group recruited the SCM more. [Conclusion] Selective DCF contraction exercises are considered very useful in the treatment of patients with neck pain.Key words: Craniocervical flexion exercise, Deep cervical flexor, Sternocleidomastoid     

Higher Muscle Passive Stiffness in Parkinson's Disease Patients Than in Controls Measured by Myotonometry

Marusiak J, Kisiel-Sajewicz K, Jaskólska A, Jaskólski A. Higher muscle passive stiffness in Parkinson's disease patients than in controls measured by myotonometry.

Objective

To assess muscle passive stiffness in medicated Parkinson's disease patients using myotonometry.

Design

Case-control study.

Setting

Kinesiology laboratory.

Participants

Women with Parkinson's disease (PD) (n=8) and healthy matched elderly women (controls) (n=10) (mean age: PD, 77±3y; controls, 77±4y).

Interventions

Not applicable.

Main Outcome Measures

Passive stiffness of relaxed biceps brachii (BB) muscle was measured using myotonometry. Additionally, surface electromyographic and mechanomyographic signals were recorded from the muscle at rest, and amplitude of those signals was analyzed offline.

Results

The values of BB muscle passive stiffness were significantly (P=.004) higher in PD than in the controls, with a statistically significant influence of parkinsonian rigidity score (Unified Parkinson's Disease Rating Scale) on intergroup differences (P<.001). The Spearman correlation coefficient ρ value showed a significant (P=.005) positive relationship (ρ=.866) between the parkinsonian rigidity score and passive stiffness values of BB in PD. The groups did not differ significantly in the electromyogram amplitude (P=.631) and mechanomyogram amplitude (P=.593) of the BB muscle, and values of these parameters did not correlate significantly with rigidity score (P=.555, P=.745, respectively) in the patients.

Conclusions

Myotonometer is a sensitive enough tool to show that PD patients have higher muscle passive stiffness than healthy controls.