- Email: [email protected]
Poster 1 Spectral Electromyographic Fatigue as a Potential Screening and Outcome Monitoring Tool of Sarcopenic Back Muscle Alterations
S182
Friday, November 14, 2014 1:30 PM - 2:30 PM Poster Hall (Hall F), Ground Floor, Convention Center
FRIDAY POSTER PRESENTATIONS - POSTER HALL EXERCISE Poster 1 Spectral Electromyographic Fatigue as a Potential Screening and Outcome Monitoring Tool of Sarcopenic Back Muscle Alterations. Gerold Ebenbichler, MD (Vienna Medical University, Vienna, Austria); Richard Habenicht, student; Josef Kollmitzer, PhD; Patrick Mair, PhD; Christian Starek, BSc; Thomas Kienbacher, MD. Disclosures: G. Ebenbichler, No Disclosures: I Have No Relevant Financial Relationships to Disclose. Objective: To examine whether or not median frequency surface electromyographic (MF-SEMG) fatigue of the back extensors would be able to identify alterations in back muscle structure and function in elderly persons, if a protocol was used that allowed optimum standardization of the underlying back muscle fatigue process, and whether these tests were reliable from day to day. Design: Cross-sectional and retest reliability study. Setting: Outpatient rehabilitation department. Participants: 42 older (21 females; 67 [10.5] years) and 44 younger healthy persons (19 females; 33 [ 10] years). Interventions: Maximum isometric back extensions were followed by one 30s lasting 80% submaximum extension with participants seated on a back dynamometer and with their trunks 30 anteflexed. They repeated all tests after 1-2 days and 6 weeks. SEMG was recorded bilaterally from the L1 (iliocostalis lumborum), L2 (longissimus), and L5 (multifidus) recording sites. Main Outcome Measures: Maximum back extension torque, initial MF-EMG (IMF-EMG), MF-EMG slope declines. Results or Clinical Course: Maximum back extension moment was non-significantly smaller in elders. IMF-EMG was overall higher in elders, with significant differences at the L5 recordings sites. In the elderly, MF-SEMG fatigue declines were significantly smaller in L5, in the recording with the most negative slope, or if the slope of all electrodes was considered. Re-test reliability was unanimous in young and older persons. ICC-type measurements from GeneralizabilityTheory of both the IMF and the fatigue slopes ranged from 0.7 to 0.85. Absolute SEM values were found clinically acceptable for the IMF-EMG, but relatively high for the fatigue slope declines. Conclusions: The MF-SEMG fatigue method is able to reliably elucidate both functional and structural alterations of aging back muscles. Thus, this method could be considered as a screening tool to objectively identify persons at risk for sarcopenia, as well as an outcome monitoring tool in elderly populations.
PRESENTATIONS
Poster 2 Successful Management of Headaches in Cervicocephalic-Thoracolumbar Mal-Posture: Significance of Mechanical Counterstrain and Spinal Proprioceptive Extension Exercise Dynamic (S.P.E.E.D.) Program. Mehrsheed Sinaki, MD, MS (Mayo Clinic, Rochester, MN, United States). Disclosures: M. Sinaki, No Disclosures: I Have No Relevant Financial Relationships to Disclose. Objective: The aim of this study was to determine the outcome of dynamic counterstrain and proprioceptive stimulation of specific vertebral facet joints to achieve reduction in axial mal posture and related headache. A common disfiguring effect of axial loss of muscle strength and bone is the anterior wedging of the thoracic spine due to the effect of gravity on the natural thoracic kyphosis accentuated by forward position of the cervical spine and head. Design: 20 patients with headache and neck pain with hyperkyphosis (thoracic kyphosis greater than 40 degrees), who had not responded to common interventions were included in this intervention program. AP and lateral spine x-rays were obtained on all patients. All had neurological and musculoskeletal evaluations, assessment of pain, gait and physical activity. They were all instructed in a home exercise program, with emphasis on spinal extensor muscle strengthening in addition to education on the use of a weighted kypho-orthosis (WKO) to be worn 20-30 minutes 2-3 times daily until the individual could perform axial posture training exercises without any difficulty. Setting: This outcome study took place in the outpatient facilities of our institution. Results or Clinical Course: All had trial of WKO before their enrollment and only if their pain was reduced were they included in the study. At 4-12 weeks, 10 were available for follow-up assessment, considering their geographic location. They all showed reduction of headaches and use of analgesics. No new vertebral compression fractures were seen. There was also significant improvement in their posture and pain scale. Conclusions: Headaches are complicated and their etiology needs elaborate work ups. We report the headaches related to overuse of posterior cervical muscles in the setting of mal-posture of the spine. The S.P.E.E.D. program affects reorientation of cervicothoracic facet joints through dynamic reduction of kyphosis. Application of WKO allowed for static reduction of kyphosis, facilitation of neck extensor counterstrain, trapezius relaxation and pain relief. Poster 3 Relationship Between Physical Activity, Knee Muscle Strength and Gait Performance in Persons with Late Effects of Polio. Jan Lexell, MD, PhD (Lund University, Lund, Sweden); Cecilia Winberg, MSc; Ulla-Britt Flansbjer, PhD; James H. Rimmer, PhD. Disclosures: J. Lexell, No Disclosures: I Have No Relevant Financial Relationships to Disclose. Objective: Physical activity (PA) is equally beneficial and improves quality of life for people with or without disability. In
Friday, November 14, 2014 1:30 PM - 2:30 PM Poster Hall (Hall F), Ground Floor, Convention Center
FRIDAY POSTER PRESENTATIONS - POSTER HALL EXERCISE Poster 1 Spectral Electromyographic Fatigue as a Potential Screening and Outcome Monitoring Tool of Sarcopenic Back Muscle Alterations. Gerold Ebenbichler, MD (Vienna Medical University, Vienna, Austria); Richard Habenicht, student; Josef Kollmitzer, PhD; Patrick Mair, PhD; Christian Starek, BSc; Thomas Kienbacher, MD. Disclosures: G. Ebenbichler, No Disclosures: I Have No Relevant Financial Relationships to Disclose. Objective: To examine whether or not median frequency surface electromyographic (MF-SEMG) fatigue of the back extensors would be able to identify alterations in back muscle structure and function in elderly persons, if a protocol was used that allowed optimum standardization of the underlying back muscle fatigue process, and whether these tests were reliable from day to day. Design: Cross-sectional and retest reliability study. Setting: Outpatient rehabilitation department. Participants: 42 older (21 females; 67 [10.5] years) and 44 younger healthy persons (19 females; 33 [ 10] years). Interventions: Maximum isometric back extensions were followed by one 30s lasting 80% submaximum extension with participants seated on a back dynamometer and with their trunks 30 anteflexed. They repeated all tests after 1-2 days and 6 weeks. SEMG was recorded bilaterally from the L1 (iliocostalis lumborum), L2 (longissimus), and L5 (multifidus) recording sites. Main Outcome Measures: Maximum back extension torque, initial MF-EMG (IMF-EMG), MF-EMG slope declines. Results or Clinical Course: Maximum back extension moment was non-significantly smaller in elders. IMF-EMG was overall higher in elders, with significant differences at the L5 recordings sites. In the elderly, MF-SEMG fatigue declines were significantly smaller in L5, in the recording with the most negative slope, or if the slope of all electrodes was considered. Re-test reliability was unanimous in young and older persons. ICC-type measurements from GeneralizabilityTheory of both the IMF and the fatigue slopes ranged from 0.7 to 0.85. Absolute SEM values were found clinically acceptable for the IMF-EMG, but relatively high for the fatigue slope declines. Conclusions: The MF-SEMG fatigue method is able to reliably elucidate both functional and structural alterations of aging back muscles. Thus, this method could be considered as a screening tool to objectively identify persons at risk for sarcopenia, as well as an outcome monitoring tool in elderly populations.
PRESENTATIONS
Poster 2 Successful Management of Headaches in Cervicocephalic-Thoracolumbar Mal-Posture: Significance of Mechanical Counterstrain and Spinal Proprioceptive Extension Exercise Dynamic (S.P.E.E.D.) Program. Mehrsheed Sinaki, MD, MS (Mayo Clinic, Rochester, MN, United States). Disclosures: M. Sinaki, No Disclosures: I Have No Relevant Financial Relationships to Disclose. Objective: The aim of this study was to determine the outcome of dynamic counterstrain and proprioceptive stimulation of specific vertebral facet joints to achieve reduction in axial mal posture and related headache. A common disfiguring effect of axial loss of muscle strength and bone is the anterior wedging of the thoracic spine due to the effect of gravity on the natural thoracic kyphosis accentuated by forward position of the cervical spine and head. Design: 20 patients with headache and neck pain with hyperkyphosis (thoracic kyphosis greater than 40 degrees), who had not responded to common interventions were included in this intervention program. AP and lateral spine x-rays were obtained on all patients. All had neurological and musculoskeletal evaluations, assessment of pain, gait and physical activity. They were all instructed in a home exercise program, with emphasis on spinal extensor muscle strengthening in addition to education on the use of a weighted kypho-orthosis (WKO) to be worn 20-30 minutes 2-3 times daily until the individual could perform axial posture training exercises without any difficulty. Setting: This outcome study took place in the outpatient facilities of our institution. Results or Clinical Course: All had trial of WKO before their enrollment and only if their pain was reduced were they included in the study. At 4-12 weeks, 10 were available for follow-up assessment, considering their geographic location. They all showed reduction of headaches and use of analgesics. No new vertebral compression fractures were seen. There was also significant improvement in their posture and pain scale. Conclusions: Headaches are complicated and their etiology needs elaborate work ups. We report the headaches related to overuse of posterior cervical muscles in the setting of mal-posture of the spine. The S.P.E.E.D. program affects reorientation of cervicothoracic facet joints through dynamic reduction of kyphosis. Application of WKO allowed for static reduction of kyphosis, facilitation of neck extensor counterstrain, trapezius relaxation and pain relief. Poster 3 Relationship Between Physical Activity, Knee Muscle Strength and Gait Performance in Persons with Late Effects of Polio. Jan Lexell, MD, PhD (Lund University, Lund, Sweden); Cecilia Winberg, MSc; Ulla-Britt Flansbjer, PhD; James H. Rimmer, PhD. Disclosures: J. Lexell, No Disclosures: I Have No Relevant Financial Relationships to Disclose. Objective: Physical activity (PA) is equally beneficial and improves quality of life for people with or without disability. In