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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 -
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 -
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 -
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 -
Danish Medical Journal Apr 2016Low back pain (LBP) constitutes a major economic problem in many countries. The causes of LBP are still largely unknown and several risk factors have been suggested... (Review)
Review
Low back pain (LBP) constitutes a major economic problem in many countries. The causes of LBP are still largely unknown and several risk factors have been suggested including heavy lifting, which causes high compression forces of the tissues in the low back. Micro-fractures in the endplates of the vertebrae caused by compression forces have been suggested as a source of unspecific pain. Although airport baggage handlers exhibit a high prevalence of musculoskeletal complaints the amount of biomechanical research within this and similar areas is limited. The aims of this thesis were to perform a general description of the lumbar loading in baggage handlers (Paper I), to develop a generically useful tool to examine specific lumbar compression in a valid manner (Paper II & III), and to investigate the spinal loading in common work tasks for baggage handlers. (Paper III). We recorded electromyography during baggage handling in the baggage hall, by a conveyor, and inside the aircraft baggage compartment. Electromyography was analyzed using amplitude probability distribution functions (APDF) on both tasks and full day recordings and root mean square (RMS) values on tasks. Furthermore, we estimated L4/L5 compression and moment along with shoulder flexor moment with a Watbak model based on more specific subtasks. In addition, we built an inverse dynamics-based musculoskeletal computer model using the AnyBody Modeling System (AMS). Motion capture recorded the movements in 3D during a stooped and a kneeling lifting task simulating airport baggage handler work. Marker trajectories were used to drive the model. The AMS-models computed estimated compression forces, shear forces and the moments around the L4/L5 joint. The compression forces were used for comparison with the vertebral compression tolerances reported in the literature. The RMS muscle activity was high in all tasks. The average peak RMS muscle activity was up to 120% EMGmax in the erector spinae during the baggage hall task. There were no significant differences between the tasks in the APDF analyses. The L4/L5 compression and extensor moment from Watbak were significantly higher in the baggage compartment task than in both the conveyor and baggage hall tasks. The stooped lifting task produced 5,541 N compression in the L4/L5 joint and a kneeling task produced 4,197 N in the AMS models. These compression forces were close to the average compression tolerance and exceed the recommended limits for compression during lifting.
Topics: Adult; Humans; Image Processing, Computer-Assisted; Lifting; Low Back Pain; Lumbar Vertebrae; Middle Aged; Models, Biological; Occupational Injuries; Prevalence; Risk Factors; Task Performance and Analysis; Weight-Bearing; Young Adult
PubMed: 27034189
DOI: No ID Found -
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 -
Journal of Parkinson's Disease Jun 2016Camptocormia is a disabling pathological, non-fixed, forward bending of the trunk. The clinical definition using only the bending angle is insufficient; it should... (Review)
Review
Camptocormia is a disabling pathological, non-fixed, forward bending of the trunk. The clinical definition using only the bending angle is insufficient; it should include the subjectively perceived inability to stand upright, occurrence of back pain, typical individual complaints, and need for walking aids and compensatory signs (e.g. back-swept wing sign). Due to the heterogeneous etiologies of camptocormia a broad diagnostic approach is necessary. Camptocormia is most frequently encountered in movement disorders (PD and dystonia) and muscles diseases (myositis and myopathy, mainly facio-scapulo-humeral muscular dystrophy (FSHD)). The main diagnostic aim is to discover the etiology by looking for signs of the underlying disease in the neurological examination, EMG, muscle MRI and possibly biopsy. PD and probably myositic camptocormia can be divided into an acute and a chronic stage according to the duration of camptocormia and the findings in the short time inversion recovery (STIR) and T1 sequences of paravertebral muscle MRI. There is no established treatment of camptocormia resulting from any etiology. Case series suggest that deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) is effective in the acute but not the chronic stage of PD camptocormia. In chronic stages with degenerated muscles, treatment options are limited to orthoses, walking aids, physiotherapy and pain therapy. In acute myositic camptocormia an escalation strategy with different immunosuppressive drugs is recommended. In dystonic camptocormia, as in dystonia in general, case reports have shown botulinum toxin and DBS of the globus pallidus internus (GPi-DBS) to be effective. Camptocormia in connection with primary myopathies should be treated according to the underlying illness.
Topics: Humans; Muscular Atrophy, Spinal; Parkinson Disease; Spinal Curvatures
PubMed: 27314757
DOI: 10.3233/JPD-160836 -
International Journal of Environmental... Jul 2022Musculoskeletal disorders (MSDs) induced by industrial manual handling tasks are a major issue for workers and companies. As flexible ergonomic solutions, occupational...
Musculoskeletal disorders (MSDs) induced by industrial manual handling tasks are a major issue for workers and companies. As flexible ergonomic solutions, occupational exoskeletons can decrease critically high body stress in situations of awkward postures and motions. Biomechanical models with detailed anthropometrics and motions help us to acquire a comprehension of person- and application-specifics by considering the intended and unintended effects, which is crucial for effective implementation. In the present model-based analysis, a generic back-support exoskeleton model was introduced and applied to the motion data of one male subject performing symmetric and asymmetric dynamic manual handling tasks. Different support modes were implemented with this model, including support profiles typical of passive and active systems and an unconstrained optimal support mode used for reference to compare and quantify their biomechanical effects. The conducted simulations indicate that there is a high potential to decrease the peak compression forces in L4/L5 during the investigated heavy loaded tasks for all motion sequences and exoskeleton support modes (mean reduction of 16.0% without the optimal support mode). In particular, asymmetric motions (mean reduction of 11.9%) can be relieved more than symmetric ones (mean reduction of 8.9%) by the exoskeleton support modes without the optimal assistance. The analysis of metabolic energy consumption indicates a high dependency on lifting techniques for the effectiveness of the exoskeleton support. While the exoskeleton support substantially reduces the metabolic cost for the free-squat motions, a slightly higher energy consumption was found for the symmetric stoop motion technique with the active and optimal support mode.
Topics: Biomechanical Phenomena; Electromyography; Exoskeleton Device; Humans; Lifting; Male; Posture
PubMed: 35897411
DOI: 10.3390/ijerph19159040