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Citations
The authors report the diffusion tensor tractography (DTT) findings of three pediatric patients with gait dysfunction and corticoreticular tract (CRT) disruption. All three patients showed unilateral trunk instability, but they did not show any spasticity or weakness of the distal extremities. Clinical evaluation of trunk instability using a Trunk Control Measurement Scale (TCMS) revealed that the more affected side had a lower score than the contralateral side. DTT showed disrupted CRTs in hemispheres contralateral to the hemiparetic sides, which were associated with unilateral proximal instability, although conventional MRI showed no abnormal lesion explaining the hemiplegic symptom. Compared to the results in age-matched controls, these three patients had decreased values of fractional anisotropy (FA) and tract volumes (TV) of the affected CRTs, and these values were also decreased compared to those in the contralateral side. On the other hand, values of FA and TV of the corticospinal tracts on the ipsilateral and contralateral sides were only marginally different. In conclusion, diffusion tensor imaging can be helpful for investigating the state of the CRT in pediatric patients with trunk instability and gait dysfunction.
Citations
To examine using surface electromyography whether stair climbing with abdominal hollowing (AH) is better at facilitating local trunk muscle activity than stair climbing without AH.
Twenty healthy men with no history of low back pain participated in the study. Surface electrodes were attached to the multifidus (MF), lumbar erector spinae, thoracic erector spinae, transverse abdominus - internal oblique abdominals (TrA-IO), external oblique abdominals (EO), and the rectus abdominis. Amplitudes of electromyographic signals were measured during stair climbing. Study participants performed maximal voluntary contractions (MVC) for each muscle in various positions to normalize the surface electromyography data.
AH during stair climbing resulted in significant increases in normalized MVCs in both MFs and TrA-IOs (p<0.05). Local trunk muscle/global trunk muscle ratios were higher during stair climbing with AH as compared with stair climbing without AH. Especially, right TrA-IO/EO and left TrA-IO/EO were significantly increased (p<0.05).
Stair climbing with AH activates local trunk stabilizing muscles better than stair climbing without AH. The findings suggest that AH during stair climbing contributes to trunk muscle activation and trunk stabilization.
Citations
Objective: To evaluate (1) the effect of chronic low back pain on bone mineral density, and (2) the effect of chronic low back pain on trunk muscle strength in women.
Method: Subjects were 118 women patients (ages of 28∼65 years) suffering from chronic low back pain more than three months and control groups were 218 healthy women (age of 26∼72 years). We measured bone mineral density (BMD) at the lumbar spine and proximal femur using Dual X-ray absorptiometry and trunk muscle strength using Cybex 660 dynamometer.
Results: There was no significant difference between groups in lumbar spine BMD, in proximal femur BMD, or in trunk flexor muscle strength. However, trunk extensor muscle strength was reduced significantly in patient group. Trunk extensor muscle peak torque was 64.69⁑18.48 Nm in the patient group and 73.84⁑22.50 Nm in the control group in 30o/sec, and 58.65⁑18.59 Nm in the patient group and 65.68⁑20.28 Nm in the control group in 60o/sec.
Conclusion: The results suggest that chronic low back pain does not affect the BMD. However, it causes trunk extensor muscle weakness; therefore, trunk extension exercise will be help to the patients with chronic low back pain.
Objective: The purpose of this study was to investigate a correlation between the muscle strength of trunk and bone mineral density (BMD) in women.
Method: A total of 218 healthy women participated in the study. Their age ranged from 26 to 72 years. Dual X-ray absorptiometry was used to measure the BMD of lumbar spine and the trunk muscle strength was assessed by a Cybex NORMTM system. Under the standard criteria of World Health Organization for the dual X-ray absorptiometry analysis, we divided spine T-score into three groups(group 1: osteoporosis, group 2: osteopenia, and group 3: normal).
Results: The data revealed a siginificant correlation (r=0.455, p=0.0001) between the age and BMD of lumbar spine. Trunk extensor muscle strength revealed 56.27⁑18.08 Nm (mean⁑SD) in osteoporosis group, 72.84⁑21.69 Nm in osteopenic group, and 77.90⁑22.28 Nm in normal group. Trunk flexor muscle strength was 82.73⁑23.30 Nm in osteoporosis group, 86.00⁑19.77 Nm in osteopenic group, and 98.91⁑18.29 Nm in normal group.
Conclusion: These results indicated that the trunk extensor muscle was weaker than the flexor muscle in osteoporotic group. As the bone mineral density reduced, the strength of both trunk extensor and flexor decreased. However the weakness of trunk flexor occurred at the earlier stage of osteoporosis than the weakness of trunk extensor.
Method: This study was performed retrospectively on 102 patients with acute stroke who were admitted to Department of Rehabilitation Medicine. The inpatients, clinical and functional evaluation were carried out at admission. Functional abilities were measured with the use of the Functional Ambulatory Category (FAC) and the modified Barthel Index (MBI).
Results: The significant prognostic factors of FAC improvement rate were age, National Institute of Health Stroke Scale (NIHSS), Morticity Index, MBI, Mini-Mental State Examination (MMSE), aphasia and Trunk Control Test (TCT) (p＜0.01). The most valuable single factor of FAC improvement rate was TCT. The significant prognostic factors of MBI improvement rate were age, NIHSS, Morticity Index, MMSE, aphasia and TCT (p＜0.01). The most valuable single factor of MBI improvement rate was TCT.
Conclusion: We concluded that TCT could be the most valuable prognostic factor in rehabilitation management outcome of stroke.
Objective: The purpose of this study is to evaluate concentric and eccentric trunk muscle strength in patients with chronic low back pain and compare it with healthy controls to determine the role of trunk muscle in chronic low back pain
Method: Subjects were 20 chronic low back pain patients with the duration at least 6 months and 20 normal adults. Concentric and eccentric isokinetic trunk muscle test was performed at specific speeds (30o, 60o, 120o/sec) with Cybex 770 machine in back pain patients and healthy control.
Results: The strength of trunk flexor and extensor muscles of chronic low back pain patients was significantly weaker than that of normal controls. Eccentric peak torque was significantly higher than concentric peak torque in both patients and healthy control. A concentric and eccentric ratio of patients was lower than that of normal controls. The correlation between concentric and eccentric variables was high. Our results show that concentric peak torque has the highest correlation with eccentric peak torque.
Conclusion: Isokinetic evaluations of the trunk muscle offer objective and quantitative data of patients with chronic low back pain and will be clinically useful in muscle power measurement of lumbar muscles.
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