Avaliação de parâmetros de desempenho muscular em jovens sedentárias com dor lombar

Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

The effects of isoflurane minimum alveolar concentration on withdrawal reflex activity evoked by repeated transcutaneous electrical stimulation in ponies

The aim of this study was to quantify the effects of isoflurane at approximately the minimum alveolar concentration (peri-MAC) on the temporal summation (TS) of reflex activity in ponies. TS was evoked by repeated electrical stimulations applied at 5 Hz for 2 s on the digital nerve of the left forelimb of seven ponies. Surface electromyographic activity was recorded from the deltoid and common digital extensor muscles. TS thresholds and amplitude of response to stimulations of increasing intensities were assessed during anaesthesia at 0.85, 0.95 and 1.05 times the individual MAC, and after anaesthesia in standing animals. Under isoflurane anaesthesia, TS thresholds increased significantly in a concentration-dependent fashion and at each isoflurane MAC, the responses increased significantly for increasing stimulation intensities. A concentration-dependent depression of evoked reflexes with a reduction in the slopes of the stimulus-response function was observed for both muscles. The results demonstrated that with this model it is possible to describe and quantify the effects of anaesthetics on spinal sensory-motor processing in ponies.

Studies from the Museum of Zoology in University College, Dundee.

Editor: D. W. Thompson.

Core stability exercise in chronic low back pain

Exercise is commonly used in the management of chronic musculoskeletal conditions, including chronic low back pain (CLBP). The focus of exercise is varied and may include parameters ranging from strength and endurance training, to specific training of muscle coordination and control. The assumption underpinning these approaches is that improved neuromuscular function will restore or augment the control and support of the spine and pelvis. In a biomechanical model of CLBP, which assumes that pain recurrence is caused by repeated mechanical irritation of pain sensitive structures [1], it is proposed that this improved control and stability would reduce mechanical irritation and lead to pain relief [1]. Although this model provides explanation for the chronicity of LBP, perpetuation of pain is more complex, and contemporary neuroscience holds the view that chronic pain is mediated by a range of changes including both peripheral (eg, peripheral sensitization) and central neuroplastic changes [2]. Although this does not exclude the role of improved control of the lumbar spine and pelvis in management of CLBP, particularly when there is peripheral sensitization, it highlights the need to look beyond outdated simplistic models. One factor that this information highlights is that the refinement of control and coordination may be more important than simple strength and endurance training for the trunk muscles. The objective of this article is to discuss the rationale for core stability exercise in the management of CLBP, to consider critical factors for its implementation, and to review evidence for efficacy of the approach.

Spatio-temporal evaluation of neck muscle activation during postural perturbations in healthy subjects

The purpose of this study was to examine the spatio-temporal activation of the sternocleidomastoid (SCM) and cervical extensor (CE) muscles with respect to the deltoid muscle onset during rapid voluntary upper limb movement in healthy volunteers. The repeatability and reliability of the spatio-temporal aspects of the myoelectric signals were also examined. Ten subjects performed bilateral and unilateral rapid upper limb flexion, abduction and extension in response to a visual stimulus. EMG onsets and normalised root mean square (nRMS) values were calculated for the SCM and CE muscles. Subjects attended three testing sessions over non-consecutive days allowing the repeatability and reliability of these measures to be assessed. The SCM and CE muscles demonstrated feed-forward activation (activation within 50 ms of deltoid onset) during rapid arm movements in all directions. The sequence and magnitude of neck muscle activation displayed directional specificity, however, the neck flexor and extensor muscles displayed co-activation during all perturbations. EMG onsets demonstrated high repeatability in terms of repeated measure precision (nSEM in the range 1.9-5.7%). This was less evident for the repeatability of nRMS values. The results of this study provide a greater understanding of cervical neuromotor control strategies. During bilateral and unilateral upper limb perturbations, the SCM and CE muscles demonstrate feed-forward co-activation. It seems apparent that feed-forward activation of neck muscles is a mechanism necessary to achieve stability for the visual and vestibular systems, whilst ensuring stabilisation and protection of the cervical spine. (C) 2004 Elsevier Ltd. All rights reserved.

Intra-abdominal pressure increases stiffness of the lumbar spine

Intra-abdominal pressure (IAP) increases during many tasks and has been argued to increase stability and stiffness of the spine. Although several studies have shown a relationship between the IAP increase and spinal stability, it has been impossible to determine whether this augmentation of mechanical support for the spine is due to the increase in IAP or the abdominal muscle activity which contributes to it. The present study determined whether spinal stiffness increased when IAP increased without concurrent activity of the abdominal and back extensor muscles. A sustained increase in IAP was evoked by tetanic stimulation of the phrenic nerves either. unilaterally or bilaterally at 20 Hz (for 5 s) via percutaneous electrodes in three subjects. Spinal stiffness was measured as the force required to displace an indentor over the L4 or L2 spinous process with the subjects lying prone. Stiffness was measured as the slope of the regression line fitted to the linear region of the force-displacement curve. Tetanic stimulation of the diaphragm increased IAP by 27-61% of a maximal voluntary pressure increase and increased the stiffness of the spine by 8-31% of resting levels. The increase in spinal stiffness was positively correlated with the size of the IAP increase. IAP increased stiffness at L2 and L4 level. The results of this:study provide evidence that the stiffness of the lumbar spine is increased when IAP is elevated. (C) 2004 Elsevier Ltd. All rights reserved.

Effects of hypergravity on fiber type and muscle mass in ankle extensors, including a compartmentalized muscle

Mice (30+-3 days old) were exposed to hypergravity (4G, one hour/day). Cross-sections of ankle extensor muscles stained immunohistochemically against slow myosin (MHC) determined if hypergravity affects the distribution of slow muscle fibers. Comparisons (ANOVA) between exposed and unexposed animals show hypergravity causes increases in slow fiber density in soleus after fourteen (p=0.049) and thirty day (p=0.Ol9) exposures. Therefore, loading may induce faster development of soleus through increased slow fiber density. Slow fibers increase in plantaris in males after seven (p=0.008) and in females after fourteen days (p=0.003), suggesting hypergravity delays normal elimination of slow fibers. Lateral and intermediate heads of lateral gastrocnemius (LG) show greater numbers of slow fibers, overall, in exposed mice (p=0.003 both). A proximal compartment of LG (LGp) and medial gastrocnemius (MG) are minimally affected by hypergravity. In LGp, only males exposed for fourteen days show decreased slow fiber density (p=0.047), but MG increased slow fiber numbers in exposed females compared to controls (p=0.04).

Muscular anatomy of the pectoral and forelimb of caiman crocodilus crocodilus (linnaeus, 1758) (crocodylia: alligatoridae)

v. 17, n. 2, p. 285-295, abr./jun. 2016.

Educação em neurofisiologia da dor e exercício em adolescentes com dor cervical: um estudo piloto da sua efetividade

Enquadramento: A prevalência da dor cervical crónica em adolescentes está a aumentar. Estudos recentes têm comprovado a eficácia de programas de educação com base na neurofisiologia da dor e exercício na diminuição da dor, incapacidade, medo e ansiedade associados à dor crónica. Contudo, apesar deste tipo de programas apresentar resultados promissores em adultos, a sua aplicação e efetividade em populações mais jovens tem sido pouco estudada. Objetivos: Avaliar a efetividade de um programa de educação com base na neurofisiologia da dor associado a exercícios na dor cervical crónica em adolescentes na 1) frequência e intensidade da dor, 2) incapacidade associada, 3) capacidade de resistência dos músculos flexores e extensores profundos da cervical e estabilizadores da omoplata, 4) ansiedade e 5) catastrofização. Métodos: Um total de 43 adolescentes com idade entre os 15 e os 18 anos da Escola Secundária Dr. João Carlos Celestino Gomes participaram neste estudo. Foram avaliadas a intensidade, duração e frequência da dor cervical, a incapacidade associada e a resistência dos músculos flexores e extensores profundos da cervical e estabilizadores da omoplata através dos testes dos flexores e extensores profundos e estabilizadores da omoplata, respetivamente. Foram também avaliados os níveis de ansiedade, catastrofização e perceção de mudança através do Inventário de Ansiedade Estado-Traço, da Escala de Catastrofização da Dor e da Escala de Perceção Global de Mudança. Resultados: O número de participantes a referir dor na semana que precedeu a avaliação no grupo experimental reduziu em 28,5%. Verificou-se uma interação significativa entre o momento de avaliação (antes da intervenção vs após a intervenção) e o grupo (experimental vs. controlo) para as variáveis resistência dos flexores profundos e catastrofização e um efeito do momento e do grupo (mas não uma interação) para a dor, incapacidade, resistência dos músculos extensores e estabilizadores da omoplata e ansiedade traço (p<0.05). Dos 21 participantes do grupo experimental, 85,7% referiu mudanças significativas na Escala de Perceção Global de Mudança. Conclusão: A educação em neurofisiologia da dor é uma intervenção que poderá ser utilizada em adolescentes com dor crónica, com resultados significativos na redução da dor, melhoria da resistência muscular dos músculos flexores e extensores profundos da cervical e estabilizadores da omoplata e diminuição da catastrofização.

Post-traumatic Winking Induced by Extension of the Hand: A Case Report of a Novel Synkinesis

Several synkinesis syndromes have been reported in the literature. Synkinesis syndromes are rare and are most commonly congenital or follow post-traumatic reinnervation. We describe a novel synkinesis syndrome that developed several months after cervical spinal cord infarction due to a herniated disc in a 29-year-old woman. When the patient overstretched the extensor muscles of the right hand, the right upper eyelid raised automatically and nasal congestion developed. We hypothesize that aberrant reinnervation of the intermediolateral columns of the spinal cord at level C8–T2 by motor neurons of the extensor muscles of the hand occurred.

Gait analysis of the hind limb in Labrador Retrievers with and without cranial cruciate ligament disease

Cranial cruciate ligament (CCL) deficiency is the leading cause of lameness affecting the stifle joints of large breed dogs, especially Labrador Retrievers. Although CCL disease has been studied extensively, its exact pathogenesis and the primary cause leading to CCL rupture remain controversial. However, weakening secondary to repetitive microtrauma is currently believed to cause the majority of CCL instabilities diagnosed in dogs. Techniques of gait analysis have become the most productive tools to investigate normal and pathological gait in human and veterinary subjects. The inverse dynamics analysis approach models the limb as a series of connected linkages and integrates morphometric data to yield information about the net joint moment, patterns of muscle power and joint reaction forces. The results of these studies have greatly advanced our understanding of the pathogenesis of joint diseases in humans. A muscular imbalance between the hamstring and quadriceps muscles has been suggested as a cause for anterior cruciate ligament rupture in female athletes. Based on these findings, neuromuscular training programs leading to a relative risk reduction of up to 80% has been designed. In spite of the cost and morbidity associated with CCL disease and its management, very few studies have focused on the inverse dynamics gait analysis of this condition in dogs. The general goals of this research were (1) to further define gait mechanism in Labrador Retrievers with and without CCL-deficiency, (2) to identify individual dogs that are susceptible to CCL disease, and (3) to characterize their gait. The mass, location of the center of mass (COM), and mass moment of inertia of hind limb segments were calculated using a noninvasive method based on computerized tomography of normal and CCL-deficient Labrador Retrievers. Regression models were developed to determine predictive equations to estimate body segment parameters on the basis of simple morphometric measurements, providing a basis for nonterminal studies of inverse dynamics of the hind limbs in Labrador Retrievers. Kinematic, ground reaction forces (GRF) and morphometric data were combined in an inverse dynamics approach to compute hock, stifle and hip net moments, powers and joint reaction forces (JRF) while trotting in normal, CCL-deficient or sound contralateral limbs. Reductions in joint moment, power, and loads observed in CCL-deficient limbs were interpreted as modifications adopted to reduce or avoid painful mobilization of the injured stifle joint. Lameness resulting from CCL disease affected predominantly reaction forces during the braking phase and the extension during push-off. Kinetics also identified a greater joint moment and power of the contralateral limbs compared with normal, particularly of the stifle extensor muscles group, which may correlate with the lameness observed, but also with the predisposition of contralateral limbs to CCL deficiency in dogs. For the first time, surface EMG patterns of major hind limb muscles during trotting gait of healthy Labrador Retrievers were characterized and compared with kinetic and kinematic data of the stifle joint. The use of surface EMG highlighted the co-contraction patterns of the muscles around the stifle joint, which were documented during transition periods between flexion and extension of the joint, but also during the flexion observed in the weight bearing phase. Identification of possible differences in EMG activation characteristics between healthy patients and dogs with or predisposed to orthopedic and neurological disease may help understanding the neuromuscular abnormality and gait mechanics of such disorders in the future. Conformation parameters, obtained from femoral and tibial radiographs, hind limb CT images, and dual-energy X-ray absorptiometry, of hind limbs predisposed to CCL deficiency were compared with the conformation parameters from hind limbs at low risk. A combination of tibial plateau angle and femoral anteversion angle measured on radiographs was determined optimal for discriminating predisposed and non-predisposed limbs for CCL disease in Labrador Retrievers using a receiver operating characteristic curve analysis method. In the future, the tibial plateau angle (TPA) and femoral anteversion angle (FAA) may be used to screen dogs suspected of being susceptible to CCL disease. Last, kinematics and kinetics across the hock, stifle and hip joints in Labrador Retrievers presumed to be at low risk based on their radiographic TPA and FAA were compared to gait data from dogs presumed to be predisposed to CCL disease for overground and treadmill trotting gait. For overground trials, extensor moment at the hock and energy generated around the hock and stifle joints were increased in predisposed limbs compared to non predisposed limbs. For treadmill trials, dogs qualified as predisposed to CCL disease held their stifle at a greater degree of flexion, extended their hock less, and generated more energy around the stifle joints while trotting on a treadmill compared with dogs at low risk. This characterization of the gait mechanics of Labrador Retrievers at low risk or predisposed to CCL disease may help developing and monitoring preventive exercise programs to decrease gastrocnemius dominance and strengthened the hamstring muscle group.

Efeito do encurtamento muscular dos flexores da anca na actividade muscular dos extensores da anca, durante uma tarefa de agachamento, em jovens jogadores de futebol

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia

Histochemical study of the extensor digitorum longus and soleus muscles in alcoholic rats

The extensor digitorum longus (EDL) and soleus (SOL) muscle fibres from albino rats submitted to experimental chronic alcoholism were evaluated in accordance with their metabolic and morphometric profiles. Twenty-seven male animals aged 4 months and weighing approximately 400 g were used. The animals were divided into three groups: control, isocaloric and alcoholic and sacrifices were carried out after 5, 10 and 15 months. The muscles were dissected, removed, cross-sectioned in a cryostat and submitted to the NADH (nicotinamide adenine dinucleotide) reaction. The SO (slow-twitch-oxidative), FG (fast-twitch-glycolytic) and FOG (fast-twitch-oxidative-glycolytic) muscle fibre types exhibited a polygonal, triangular or rounded shape and did not present noteworthy modifications in either muscles during the study. The cross-sectional areas of the fibres from the studied muscles did not present significant differences during the observations. Fibre area behaved similarly in the alcoholic animals up to the 10th month, i.e. it was decreased, as also observed in the other groups. At 15 months, however, all fibres were increased, with a predominance of FG fibres in the SOL muscle. Changes in fibre population were observed mainly in the SOL muscle of alcoholic animals: SO fibres were initially increased in number but decreased after the 10th month, and the opposite was observed for the population of FG fibres. FOG fibres increased linearly in number throughout the experiment. The statistical analysis showed nevertheless that the fibre population and cross-sectional area changes were not significant. In the alcoholic animals quantitative variations of muscle fibres were more evident in the SOL muscle, suggesting that the SOL muscle is more sensitive to the toxic action of ethanol. The results concerning the increased fibre diameter in alcoholic animals would be associated with muscle oedema induced directly or indirectly by the ethanol.

The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study

Objectives: To study the effect of additional strengthening of hip abductor and lateral rotator muscles in a strengthening quadriceps exercise rehabilitation programme for patients with the patellofemoral pain syndrome. Design: Randomized controlled pilot trial. Setting: Clinical setting with home programme. Participants: Fourteen patients with patellofemoral pain syndrome. Intervention: The subjects were randomly assigned to the intervention group (strengthening of quadriceps plus strengthening of hip abductor and lateral rotator muscles) or to the control group (strengthening of quadriceps). Both groups participated in a six-week home exercise protocol. Main outcome measures: The perceived pain symptoms, isokinetic eccentric knee extensor, hip abductor and lateral rotator torques and the gluteus medius electromyographic activity were assessed before and after treatment. Parametric and non-parametric tests were used to compare the groups before and after treatment with alpha = 0.05. Results: Only the intervention group improved perceived pain symptoms during functional activities (P=0.02-0.04) and also increased their gluteus medius electromyographic activity during isometric voluntary contraction (P=0.03), Eccentric knee extensors torque increased in both groups (P=0.04 and P=0.02). There was no statistically significant difference in the hip muscles torque in either group. Conclusion: Supplementation of strengthening of hip abductor and lateral rotator muscles in a strengthening quadriceps exercise programme provided additional benefits with respect to the perceived pain symptoms during functional activities in patients with patellofemoral pain syndrome after six weeks of treatment.

The friction force mouse-pad and the forearm muscles efforts (preliminary results)

The objective of the article is to evaluate the impact of the friction force mouse-pad in the contraction level of the forearm muscles M. extensor carpi ulnaris, M. extensor digitorum and M. extensor carpi radialis longus. A standard protocol of mouse movements was performed involving horizontal, vertical and diagonal mouse displacements drag-and-drop type. The operators were instructed to execute the protocol with their normal working speed. The movements protocol were performed by each subject (n=17) with three selected pairs mouse-pad, classified as low, medium and high friction force pairs. The mean time to execute the protocol with each mouse was ~138s. Mean values of ~13%MVE and ~17%MVE were found in the M. extensor carpi ulnaris and in the M. extensor digitorum respectively when performing the movements’ protocol. A 8.1% increase in %MVE was observed in the M. extensor digitorum and a 9.4% increase in %MVE was observed in the M. extensor carpi ulnaris when the high friction force pair was operated, relatively to the low friction force pair (p<0.05). The main preliminary conclusions of this study is that operating a high friction force mouse-pad may increase the risk to symptoms or disorders in the wrist due to an increase in the forearm muscles contraction levels, particularly during work with drawing application