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Frontiers in Bioscience (Scholar... Jan 2014Parkinson's Disease is the second most common progressive neurodegenerative disorder affecting older American adults and is predicted to increase in prevalence as the... (Review)
Review
Parkinson's Disease is the second most common progressive neurodegenerative disorder affecting older American adults and is predicted to increase in prevalence as the United States population ages. Resulting from a pathophysiologic loss or degeneration of dopaminergic neurons in the substantia nigra of the midbrain and the development of neuronal Lewy Bodies, idiopathic Parkinson's Disease is associated with risk factors including aging, family history, pesticide exposure and environmental chemicals (e.g., synthetic heroin use). Its ultimate cause(s) is (are) unknown. Characterized by both motor and non-motor symptoms, PD patients classically display rest tremor, rigidity, bradykinesia, and stooping posture. PD can also be associated with neurobehavioral disorders (depression, anxiety), cognitive impairment (dementia), and autonomic dysfunction (e.g., orthostasis and hyperhidrosis). Recent decades have witnessed a proliferation of medical pharmacologic therapies and innovative surgical interventions like deep brain stimulation (DBS). However, definitive disease-modifying therapy is still lacking. Experimental therapies are being developed and tested with limited results. Knowledge of strategies to promote optimal quality of life for PD patients is of paramount importance for caregivers, health providers and patients themselves.
Topics: Age Factors; Humans; Parkinson Disease
PubMed: 24389262
DOI: 10.2741/s415 -
Clinics in Orthopedic Surgery Feb 2023Corrective osteotomy is an effective surgery for correcting posture in patients with ankylosing spondylitis (AS). Despite satisfactory correction, some patients...
BACKGROUND
Corrective osteotomy is an effective surgery for correcting posture in patients with ankylosing spondylitis (AS). Despite satisfactory correction, some patients experience re-stooping during follow-up. However, there have been no studies on re-stooping in AS. We aimed to analyze the factors that affect re-stooping.
METHODS
Fifty patients (50 cases) who underwent thoracolumbar corrective osteotomy for AS from March 2006 to April 2018 were analyzed. We defined re-stooping as global kyphosis that recurs after corrective osteotomy. The patients were divided into two groups based on the ratio of correction loss: non-re-stooping group (N group) and re-stooping group (R group). We analyzed the demographic data and radiological parameters, such as modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), sagittal vertical axis, and various angles. We also investigated the factors affecting re-stooping by analyzing the correlation between the ratio of correction loss and various factors.
RESULTS
A significant difference was seen in the change in the mSASSS from before surgery to the last follow-up between the N group (2.87 ± 3.08) and the R group (9.20 ± 5.44). In multivariate analysis, only the change in the mSASSS from before surgery to the last follow-up was significantly correlated with the ratio of correction loss.
CONCLUSIONS
Thoracolumbar corrective osteotomy seems to provide high satisfaction among patients with AS but can lead to re-stooping during follow-up. The change in mSASSS was related with re-stooping in the current study. We recommend active rehabilitative exercises and appropriate medication depending on the patient's condition, which may help delay the postoperative progression of AS.
Topics: Humans; Spondylitis, Ankylosing; Treatment Outcome; Spine; Kyphosis; Osteotomy; Phenolphthalein; Lumbar Vertebrae; Thoracic Vertebrae; Retrospective Studies
PubMed: 36778985
DOI: 10.4055/cios22075 -
International Journal of Sports... 2022Lifting something off the ground is an essential task and lifting is a documented risk factor for low back pain (LBP). The standard lifting techniques are stoop (lifting...
UNLABELLED
Lifting something off the ground is an essential task and lifting is a documented risk factor for low back pain (LBP). The standard lifting techniques are stoop (lifting with your back), squat (lifting with your legs), and semi-squat (midway between stoop and squat). Most clinicians believe the squat technique is optimal; however, training on squat lifting does not prevent LBP and utilizing greater lumbar flexion (i.e. stoop) when lifting is not a risk factor for LBP. The disconnect between what occurs in clinical practice and what the evidence suggests has resulted in ongoing debate. Clinicians must ask the right questions in order to apply the evidence appropriately. A proposed clinical framework of calm tissue down, build tissue up, improve work capacity can be used to determine which lifting technique is optimal for a patient at any given time. When applying this clinical framework, clinicians should consider metabolic, biomechanical, physical stress tolerance, and pain factors in order to address the movement system. For example, stoop lifting is more metabolically efficient and less challenging to the cardiopulmonary system. There may be few biomechanical differences in spinal postures and gross loads on the lumbar spine between stoop, squat, and semi-squat lifting; however, each lift has distinct kinematic patterns that affects muscle activation patterns, and ultimately the movement system. Clinicians must find the optimal dosage of physical stress to address all aspects of the movement system to minimize the risk of injury. There is no universal consensus on the optimal lifting technique which will satisfy every situation; however, there may be a lifting technique that optimizes movement to achieve a specific outcome. The calm tissue down, build tissue up, improve work capacity framework offers an approach to determine the best lifting technique for an individual patient at any give time.
LEVEL OF EVIDENCE
5.
PubMed: 35024210
DOI: 10.26603/001c.30023 -
Journal of Biomechanics Feb 2017While stooping and crouching postures are critical for many activities of daily living, little is known about the balance control mechanisms employed during these...
BACKGROUND
While stooping and crouching postures are critical for many activities of daily living, little is known about the balance control mechanisms employed during these postures. Accordingly, the purpose of this study was to characterize the mechanisms driving net center of pressure (COP) movement across three postures (standing, stooping, and crouching) and to investigate if control in each posture was influenced by time.
METHODS
Ten young adults performed the three postures for 60s each. Kinetic signals were collected via a force platform under each foot. To quantify mechanisms of control, correlations (Correl) were calculated between the left and right COP trajectories in the anterior-posterior (AP) and medio-lateral (ML) directions. To examine the potential effects of time on balance control strategies, outcomes during the first 30s were compared to the last 30s.
RESULTS
Correl values did not differ across postures (AP: p = 0.395; ML: p = 0.647). Further, there were no main effects of time on Correl (AP: p = 0.976; ML: p = 0.105). A significant posture-time interaction was observed in the ML direction (p = 0.045) characterized by 35% decreases in Correl over time for stooping (p = 0.022).
CONCLUSION
The dominant controllers of sway (i.e., AP: ankle plantar/dorsi flexors; ML: hip load/unload mechanism) are similar across quiet stance stooping, and crouching. Changes in ML control strategies over time suggests that fatigue could affect prolonged stooping more so than crouching or standing.
Topics: Activities of Daily Living; Ankle Joint; Female; Foot; Humans; Kinetics; Male; Movement; Postural Balance; Posture; Pressure; Young Adult
PubMed: 28093258
DOI: 10.1016/j.jbiomech.2017.01.003 -
Frontiers in Bioengineering and... 2021Lifting up objects from the floor has been identified as a risk factor for low back pain, whereby a flexed spine during lifting is often associated with producing higher...
Lifting up objects from the floor has been identified as a risk factor for low back pain, whereby a flexed spine during lifting is often associated with producing higher loads in the lumbar spine. Even though recent biomechanical studies challenge these assumptions, conclusive evidence is still lacking. This study therefore aimed at comparing lumbar loads among different lifting styles using a comprehensive state-of-the-art motion capture-driven musculoskeletal modeling approach. Thirty healthy pain-free individuals were enrolled in this study and asked to repetitively lift a 15 kg-box by applying 1) a freestyle, 2) a squat and 3) a stoop lifting technique. Whole-body kinematics were recorded using a 16-camera optical motion capture system and used to drive a full-body musculoskeletal model including a detailed thoracolumbar spine. Continuous as well as peak compressive, anterior-posterior shear and total loads (resultant load vector of the compressive and shear load vectors) were calculated based on a static optimization approach and expressed as factor body weight (BW). In addition, lumbar lordosis angles and total lifting time were calculated. All parameters were compared among the lifting styles using a repeated measures design. For each lifting style, loads increased towards the caudal end of the lumbar spine. For all lumbar segments, stoop lifting showed significantly lower compressive and total loads (-0.3 to -1.0BW) when compared to freestyle and squat lifting. Stoop lifting produced higher shear loads (+0.1 to +0.8BW) in the segments T12/L1 to L4/L5, but lower loads in L5/S1 (-0.2 to -0.4BW). Peak compressive and total loads during squat lifting occurred approximately 30% earlier in the lifting cycle compared to stoop lifting. Stoop lifting showed larger lumbar lordosis range of motion (35.9 ± 10.1°) than freestyle (24.2 ± 7.3°) and squat (25.1 ± 8.2°) lifting. Lifting time differed significantly with freestyle being executed the fastest (4.6 ± 0.7 s), followed by squat (4.9 ± 0.7 s) and stoop (5.9 ± 1.1 s). Stoop lifting produced lower total and compressive lumbar loads than squat lifting. Shear loads were generally higher during stoop lifting, except for the L5/S1 segment, where anterior shear loads were higher during squat lifting. Lifting time was identified as another important factor, considering that slower speeds seem to result in lower loads.
PubMed: 34805121
DOI: 10.3389/fbioe.2021.769117 -
Neurosurgical Focus Jul 2015Of the multitude of medical and psychiatric conditions ascribed to Hitler both in his lifetime and since his suicide in April 1945, few are more substantiated than...
Of the multitude of medical and psychiatric conditions ascribed to Hitler both in his lifetime and since his suicide in April 1945, few are more substantiated than parkinsonism. While the timeline of the development of this condition, as well as its etiology, are debated, there is clear evidence for classic manifestations of the disease, most prominently a resting tremor but also stooped posture, bradykinesia, micrographia, and masked facial expressions, with progression steadily seen over his final years. Though ultimately speculation, some have suggested that Hitler suffered from progressive cognitive and mood disturbances, possibly due to parkinsonism, that affected the course of events in the war. Here, the authors discuss Hitler's parkinsonism in the context of the Third Reich and its eventual destruction, maintaining that ultimately his disease had little effect on the end result.
Topics: Famous Persons; Germany; History, 20th Century; Humans; Male; Middle Aged; Parkinsonian Disorders; World War II
PubMed: 26126407
DOI: 10.3171/2015.4.FOCUS1563 -
Tidsskrift For Den Norske Laegeforening... May 2017
Topics: Female; Humans; Magnetic Resonance Imaging; Middle Aged; Multiple System Atrophy; Neck Muscles; Parkinson Disease; Posture
PubMed: 28468480
DOI: 10.4045/tidsskr.16.0993 -
Military Psychology : the Official... 2023The reported that 39.1% of the civilian workforce in the United States performs physically demanding jobs that require lifting, carrying, pushing/pulling, kneeling,... (Review)
Review
The reported that 39.1% of the civilian workforce in the United States performs physically demanding jobs that require lifting, carrying, pushing/pulling, kneeling, stooping, crawling, and climbing activities in varied environmental conditions. United States military occupations are similar to those in the civilian sector involving equipment installation, emergency rescues, and maintenance, along with combat arms occupations. This article provides an overview of the types of criterion measures used to assess the physical domain and approaches for designing and evaluating the criteria. It also includes a method for generating criterion measures that are applicable across multiple jobs.
Topics: Humans; Military Personnel; Occupations; Posture; United States; Workforce
PubMed: 37352446
DOI: 10.1080/08995605.2022.2063008 -
Facts, Views & Vision in ObGyn 2010
Review
PubMed: 25206964
DOI: No ID Found