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Emg evidence of paraspinal muscle spasm during sleep in patients with low back pain
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PAIN-RELATED CORRELATES OF MMPI PROFILE SUBGROUPS AMONG BACK I 308 Slide PAIN PATIENTS. L . A . Bra__~_~ I, L.H. Van der Heide 2., M. [ Eri 1 4 : 0 0 Byrne 2., A. Troy ~, E.J. Prieto 2., & P.J. Marchisello 3., Theaire C iBowman Gray School of Medicine, Winston-Salem, NC, 27103, 2Fordham University, Bronx, NY, 10458, 3Hospital for Special Surgery, New York Hospital-Cornell Medical Center, NY, NY, 10021, USA. Aim o f Investigation: This study empirically derived MMPI profile subg r o u ~ among a sample of 218 female and 97 male back pain patients seen consecutively for evaluation at a back pain clinic in a university affiliated, o r t h o ~ d i c hospital. In addition, demographic, self-report, and behavioral correlates of the profile subgroups were identified. Methods: All patients who provided informed consent were administered the MMPI and several self-report inventories regarding their health and personal characteristics and given a structured interview. Male and female patients' MMPI T-scores were entered in separate cluster analyses. The derived subgroups were examined by means of multiple discriminant analysis and profile subgroup differences on the self-report and behavioral variables were analyzed by means of analysis of variance. Results: Four male and four female profile subgroups were identified. Multiple discriminant analysis revealed that there were substantial differences between and minimal differences within the male and female profile subgroups, respectively. ANOVAS showed numerous significant differences between the profile subgroups including the number of symptoms reported on the Cornell Medical Index, intelligence quotient, age, duration of pain, and pain intensity ratings. Conclusions: The MMPI profile subgroups differed from one another on a large number of pain-related variables. This suggests it would be useful to develop in clinical settings actuarial systems similar to that presented herein that would allow optimal use of the MMPI for diagnostic purposes. EMG EVTDENCE OF PARASPINAL F~SCLE SPASM DURING SLEEP IN 209 S l i d e PATIENTS WITH LOW BACK PAIN. A.A. Fiscber, C. Chang*, Fri 14:15 Rehabilitation Medicine Service, Veterans Administration Theatre C Medical Center, Bronx, New York 10468, USA ---Electromyogram was recorded by surface electrodes from lumbar paraspina] muscles during a 24 hour period using Medilog 4 channel battery operated portable tape recorder. The tapes were replayed on an Oxford BP-2 and recorded on a Siemens-Elema Mingograph. The total electrical activity was then evaluated in units expressing amplitude (]mm=2.5uV) combined with the duration of tile activity. Nine patients with low back pain and palpable paraspinal muscle spasm (PS) present unilaterally or expressed more on one side were evaluated. The control group without PS consisted of 2 normal subjects and 7 inpatients with different diagnoses: 4 amputees and 1 it hemiparesis, all ~ithout low back pain, one it S] joint sprain and one rt pyrifo~lis syndrome. The control group showed no paraspinal EMG activity during sleep except for one patient with rt B/K amputation who had 3 units of EMG activity Patients with unilateral spasm (2+ on a 4+ scale) showed 0, 1 or 2 units EMC activity on the side without spasm or with i+ spasm only. EMG activity on the spasmotic side (averaging 2+ spasm) was very significantly higher than on the nonspasmotic side of the same patient, averaging 11.8 EM(] units. Conclusions: Sustained electrical activity was documented during sleep in lumbar paraspinal muscles which demonstrated palpable spasm during the day. The nocturnal activity corresponding to spasm is related to low back pain. In normal subjects without ]ow back pain there is no EMG activity in lumbar paraspinal muscles during sleep. The results support the spasmpain-spasm theory, indicate the significance of muscle spasm in LBP and have diagnostic as well as therapeutic implications.
$255
PAIN-RELATED CORRELATES OF MMPI PROFILE SUBGROUPS AMONG BACK I 308 Slide PAIN PATIENTS. L . A . Bra__~_~ I, L.H. Van der Heide 2., M. [ Eri 1 4 : 0 0 Byrne 2., A. Troy ~, E.J. Prieto 2., & P.J. Marchisello 3., Theaire C iBowman Gray School of Medicine, Winston-Salem, NC, 27103, 2Fordham University, Bronx, NY, 10458, 3Hospital for Special Surgery, New York Hospital-Cornell Medical Center, NY, NY, 10021, USA. Aim o f Investigation: This study empirically derived MMPI profile subg r o u ~ among a sample of 218 female and 97 male back pain patients seen consecutively for evaluation at a back pain clinic in a university affiliated, o r t h o ~ d i c hospital. In addition, demographic, self-report, and behavioral correlates of the profile subgroups were identified. Methods: All patients who provided informed consent were administered the MMPI and several self-report inventories regarding their health and personal characteristics and given a structured interview. Male and female patients' MMPI T-scores were entered in separate cluster analyses. The derived subgroups were examined by means of multiple discriminant analysis and profile subgroup differences on the self-report and behavioral variables were analyzed by means of analysis of variance. Results: Four male and four female profile subgroups were identified. Multiple discriminant analysis revealed that there were substantial differences between and minimal differences within the male and female profile subgroups, respectively. ANOVAS showed numerous significant differences between the profile subgroups including the number of symptoms reported on the Cornell Medical Index, intelligence quotient, age, duration of pain, and pain intensity ratings. Conclusions: The MMPI profile subgroups differed from one another on a large number of pain-related variables. This suggests it would be useful to develop in clinical settings actuarial systems similar to that presented herein that would allow optimal use of the MMPI for diagnostic purposes. EMG EVTDENCE OF PARASPINAL F~SCLE SPASM DURING SLEEP IN 209 S l i d e PATIENTS WITH LOW BACK PAIN. A.A. Fiscber, C. Chang*, Fri 14:15 Rehabilitation Medicine Service, Veterans Administration Theatre C Medical Center, Bronx, New York 10468, USA ---Electromyogram was recorded by surface electrodes from lumbar paraspina] muscles during a 24 hour period using Medilog 4 channel battery operated portable tape recorder. The tapes were replayed on an Oxford BP-2 and recorded on a Siemens-Elema Mingograph. The total electrical activity was then evaluated in units expressing amplitude (]mm=2.5uV) combined with the duration of tile activity. Nine patients with low back pain and palpable paraspinal muscle spasm (PS) present unilaterally or expressed more on one side were evaluated. The control group without PS consisted of 2 normal subjects and 7 inpatients with different diagnoses: 4 amputees and 1 it hemiparesis, all ~ithout low back pain, one it S] joint sprain and one rt pyrifo~lis syndrome. The control group showed no paraspinal EMG activity during sleep except for one patient with rt B/K amputation who had 3 units of EMG activity Patients with unilateral spasm (2+ on a 4+ scale) showed 0, 1 or 2 units EMC activity on the side without spasm or with i+ spasm only. EMG activity on the spasmotic side (averaging 2+ spasm) was very significantly higher than on the nonspasmotic side of the same patient, averaging 11.8 EM(] units. Conclusions: Sustained electrical activity was documented during sleep in lumbar paraspinal muscles which demonstrated palpable spasm during the day. The nocturnal activity corresponding to spasm is related to low back pain. In normal subjects without ]ow back pain there is no EMG activity in lumbar paraspinal muscles during sleep. The results support the spasmpain-spasm theory, indicate the significance of muscle spasm in LBP and have diagnostic as well as therapeutic implications.
$255