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Clinics in Plastic Surgery Jan 2019Upper back deformity caused by aging or fluctuations in weight are cosmetically and functionally unappealing to patients. Natural upper torso adherence zones create... (Review)
Review
Upper back deformity caused by aging or fluctuations in weight are cosmetically and functionally unappealing to patients. Natural upper torso adherence zones create tether points that lead to horizontal and vertical laxity. Bra-line back lift is a versatile technique that can be used in any individual showing signs of redundant skin and adiposity. A 3-layered space-obliterating suture closure method prevents seroma and eliminates need for drain. Predictable outcomes correcting laxity from neck to lower back can be achieved. Gentle learning curve yields consistent and predictable results. Patient acceptance of the procedure, its results, and satisfactory morbidity rates have been universal.
Topics: Back; Body Contouring; Female; Humans; Obesity; Suture Techniques
PubMed: 30447831
DOI: 10.1016/j.cps.2018.08.010 -
Physical Therapy Jun 1990
Topics: Back; Biomechanical Phenomena; Braces; Humans; Muscles; Physical Exertion; Posture
PubMed: 2345782
DOI: 10.1093/ptj/70.6.394 -
Journal of Electromyography and... Oct 2022While a decreasing spectral content of surface electromyography reflects low back muscle fatigue development, reliability of these decreases may be insufficient....
While a decreasing spectral content of surface electromyography reflects low back muscle fatigue development, reliability of these decreases may be insufficient. Decreasing frequency content is largely determined by decreasing average motor unit action potential conduction velocities (CV), which is considered a more direct measure of muscle fatigue development. However, for the low back muscles it has been proven difficult to identify propagating potentials and consequently estimate the CV. The aim of this study was to estimate the low back muscle CV from high-density multi-channel electromyography by using peak-delay and cross-correlation methods. Fourteen healthy male participants without a history of low-back pain performed a 30 degrees lumbar flexion trial until exhaustion while standing. For 10 out of the 14 participants (118 out of 560 sites) realistic CV estimates were obtained using both methods, the majority likely over the iliocostalis lumborum muscle. Between-method CV differences appeared to be small. Close to the spine a considerable number of sites (79) yielded systematically overestimated low back muscle CV values. Estimating low back muscle CV may allow additional insight into low back muscle fatigue development and potentially improve its monitoring using (high-density) surface electromyography.
Topics: Action Potentials; Back; Electromyography; Humans; Male; Muscle Fatigue; Muscle, Skeletal; Reproducibility of Results
PubMed: 35858505
DOI: 10.1016/j.jelekin.2022.102679 -
Physical Therapy Jan 1989The ability of individuals to lift heavy loads without injury to the vertebral elements has led to the formulation of several explanations of this phenomenon. In this... (Review)
Review
The ability of individuals to lift heavy loads without injury to the vertebral elements has led to the formulation of several explanations of this phenomenon. In this article, the existing literature on lifting is reviewed and mechanisms of back support during lifting are described. These mechanisms include the intra-abdominal pressure mechanism, the thoracolumbar fascia mechanism, and combinations of these mechanisms with the use of the erector spinae, multifidus, and psoas muscles. Physical therapists are often responsible for teaching patients and workers "proper" lifting techniques; however, controversy exists concerning the proper lift. Although lifting with the lower back in flexion and lifting in extension have been proposed, there are indications for each depending on individual circumstances. Lifting instructions for workers without low back injuries should be distinguished from instructions for patients with low back pain. General rules for lifting include: plan the lift, avoid twisting, keep the load close to the body, and bend at the knees.
Topics: Back; Biomechanical Phenomena; Humans; Isotonic Contraction; Muscles; Physical Exertion; Posture; Spine
PubMed: 2643122
DOI: 10.1093/ptj/69.1.38 -
Journal of Biomechanics Jan 2023Previous studies that tested passive back-support exoskeletons focused only on active low-back tissue. Therefore, this study examines the effect from a passive...
Previous studies that tested passive back-support exoskeletons focused only on active low-back tissue. Therefore, this study examines the effect from a passive back-support exoskeleton by investigating changes in the load transfer mechanism between active and passive tissue in the low back. Twelve healthy male participants performed a full range of trunk flexion-extension movements under three conditions-FREE (no exoskeleton), the backX, or the CoreBot exoskeleton-while holding 0 kg, 4 kg, and 8 kg loads. Body kinematics and electromyography were recorded. Results showed that the average muscle activity of the lumbar erector spinae (LES) was significantly reduced while wearing the exoskeletons, with a 5.9%MVC reduction with the backX and a 3.3%MVC reduction with the CoreBot. Earlier occurrence of the flexion-relaxation phenomenon induced by the trunk extension moment of exoskeletons played an important role in reducing LES muscle activity because the LES returned to a relaxed state earlier (EMG-Off: a 3.1° reduction with the backX, and a 1.8° reduction with the CoreBot; EMG-On: a 2.3° reduction with the backX, and a 1.4° reduction with the CoreBot). In addition, the maximum lumbar flexion angle (a 2.2° reduction with the backX and a 1.5° reduction with the CoreBot) showed significant decreases compared to the FREE condition, indicating that exoskeleton use can prevent low-back passive tissue from being fully activated. These results suggested the overall effects of passive back-support exoskeletons in reducing loads on both active and passive tissue in the low back.
Topics: Humans; Male; Muscle, Skeletal; Muscle Contraction; Back; Movement; Electromyography; Lumbosacral Region; Paraspinal Muscles; Biomechanical Phenomena
PubMed: 36680890
DOI: 10.1016/j.jbiomech.2023.111437 -
Clinics in Plastic Surgery Oct 2014Anatomic sequelae of the upper back that occur with age or weight loss have been somewhat underserved in the plastic surgery literature. Zones of adherence in the upper... (Review)
Review
Anatomic sequelae of the upper back that occur with age or weight loss have been somewhat underserved in the plastic surgery literature. Zones of adherence in the upper posterior trunk create overhanging folds of skin and subcutaneous tissue, which are disturbing to the patient both functionally and cosmetically. These adherence points prove challenging in that they prevent contouring of the upper back with procedures such as traditional abdominoplasty or lower body lift. The bra line back lift provides a reliable and consistent method of addressing these issues by eliminating excess redundant skin and adiposity from the region.
Topics: Aging; Back; Cosmetic Techniques; Dermatologic Surgical Procedures; Humans; Lipectomy; Weight Loss
PubMed: 25283457
DOI: 10.1016/j.cps.2014.06.007 -
Giornale Italiano Di Dermatologia E... Feb 2020
Topics: Back; Female; Humans; Male; Scabies
PubMed: 29781261
DOI: 10.23736/S0392-0488.18.05915-1 -
Journal of Medical Internet Research Oct 2019Hospital-based back surgery in the United States increased by 60% from January 2012 to December 2017, yet the supply of neurosurgeons remained relatively constant....
BACKGROUND
Hospital-based back surgery in the United States increased by 60% from January 2012 to December 2017, yet the supply of neurosurgeons remained relatively constant. During this time, adult obesity grew by 5%.
OBJECTIVE
This study aimed to evaluate the demand and associated costs for hospital-based back surgery by geolocation over time to evaluate provider practice variation. The study then leveraged hierarchical time series to generate tight demand forecasts on an unobserved test set. Finally, explanatory financial, technical, workload, geographical, and temporal factors as well as state-level obesity rates were investigated as predictors for the demand for hospital-based back surgery.
METHODS
Hospital data from January 2012 to December 2017 were used to generate geospatial-temporal maps and a video of the Current Procedural Terminology codes beginning with the digit 63 claims. Hierarchical time series modeling provided forecasts for each state, the census regions, and the nation for an unobserved test set and then again for the out-years of 2018 and 2019. Stepwise regression, lasso regression, ridge regression, elastic net, and gradient-boosted random forests were built on a training set and evaluated on a test set to evaluate variables important to explaining the demand for hospital-based back surgery.
RESULTS
Widespread, unexplained practice variation over time was seen using geographical information systems (GIS) multimedia mapping. Hierarchical time series provided accurate forecasts on a blind dataset and suggested a 6.52% (from 497,325 procedures in 2017 to 529,777 in 2018) growth of hospital-based back surgery in 2018 (529,777 and up to 13.00% by 2019 [from 497,325 procedures in 2017 to 563,023 procedures in 2019]). The increase in payments by 2019 are estimated to be US $323.9 million. Extreme gradient-boosted random forests beat constrained and unconstrained regression models on a 20% unobserved test set and suggested that obesity is one of the most important factors in explaining the increase in demand for hospital-based back surgery.
CONCLUSIONS
Practice variation and obesity are factors to consider when estimating demand for hospital-based back surgery. Federal, state, and local planners should evaluate demand-side and supply-side interventions for this emerging problem.
Topics: Adult; Back; Hospitals; Humans; Research Design; United States
PubMed: 31663856
DOI: 10.2196/14609 -
Rheumatic Diseases Clinics of North... Nov 1990Some of the positive benefits from participating in aerobic activity have already been addressed. However, an individual's ability to participate in many aerobic... (Review)
Review
Some of the positive benefits from participating in aerobic activity have already been addressed. However, an individual's ability to participate in many aerobic activities may be contingent on the ability to maintain a neutral or a stabilized spine. For example, the individual for whom jogging has been painful may be able to jog after he or she has learned trunk stabilization and is able to keep the spine in his or her pain-free position. Although Williams contended that jogging was an inappropriate activity for the individual with a low-back problem, contrary to this notion, White believes that jogging is more apt to protect a person from low-back pain than to cause it. Although no association was found between mileage run and osteoarthritis, jogging is not for all individuals who present with LBP or related arthritic conditions. Moreover, poor biomechanics in running can exacerbate existing low-back problems as well as bring about new ones as compensatory adaptations are made. For example, poor running technique might include excessive forward lean; this must be counterbalanced by contraction of the back extensors, which then may become overly tired or produce high intersegmental forces on the discs. We advocate an upright posture with minimal forward lean. The biomechanics of running also are most important from the perspective of shock absorption. Factors to consider in addition to running within the neutral spine excursion include cushioning footstrike by "giving" at the ankle, knee, and hip joints. In addition to good biomechanics, it would also be important to use an excellent quality training shoe and to run on a soft track as opposed to harder surfaces; hills should probably be avoided for most symptomatic individuals until they become strong. Nachemson indicates that in addition to recommending jogging for LBP, he most commonly recommends backstroke swimming, brisk walking, and stairclimbing. Bicycle riding (stationary or actual) would be another good activity; I personally endorse cross-country ski machines such as the NordicTrack (Chaska, Minnesota). The latter provides an excellent opportunity to develop aerobic conditioning without impact; moreover it incorporates the tenets of stabilization training because it is essential that the skier uses the abdominal muscles to brace and stabilize the trunk. Cross-country ski machines do, however, present certain coordination requirements to which not all individuals can adapt readily. In conclusion, although exercise is by no means a panacea, it very well may be nature's elixir that will enable some individuals beset by mechanical problems of the back to assume a more active and enjoyable life.
Topics: Arthritis; Back; Exercise; Exercise Therapy; Humans; Movement; Physical Fitness; Weight Lifting
PubMed: 2087586
DOI: No ID Found -
Plastic and Reconstructive Surgery Oct 2008
Topics: Adipose Tissue; Adult; Aged; Back; Dermatologic Surgical Procedures; Female; Humans; Middle Aged; Plastic Surgery Procedures
PubMed: 18827659
DOI: 10.1097/PRS.0b013e3181858fa4