Trunk muscle activity during holding two types of dynamic loads in subjects with nonspecific low back pain.

BACKGROUND: Chronic low back pain due to manual lifting continues to be one of the significant common public health challenges in modern societies despite increased automation. While there are extensive studies on the biomechanics of lifting as associated with LBP, the role of unstable and time-varying dynamic loads, quite common in industrial lifting and daily life, remains elusive. OBJECTIVES: The present study aimed to investigate the response of trunk muscles in subjects with chronic non-specific low back pain (CNLBP) while holding unstable dynamic loads. METHODS: Twelve male patients with CNLBP and twelve healthy controls participated in this cross-sectional study. The subjects held static and dynamic loads in neutral positions. Normalized EMG data of the trunk muscles were captured and analyzed by repeated-measures ANOVA test. RESULTS: The low back pain group demonstrated significantly higher activation levels of the internal and external abdominal oblique muscles while holding dynamic loads (p < 0.05). CONCLUSION: Our results suggest that the neuromusculoskeletal system in low back patients holding dynamic loads may invoke a motor control strategy that significantly increases muscle co-activation leading to higher joint stiffness at the expense of higher compressive loads on the lumbar spine. Importantly, the type of load plays a critical role in terms of external perturbations that may lead to spinal injury in CNLBP patients and must, therefore, be considered in the risk prevention and assessment of lifting and other manual material handling tasks.

Intra-bladder wall transplantation of bone marrow mesenchymal stem cells improved urinary bladder dysfunction following spinal cord injury.

BACKGROUND: In the most of previous experiments, intrathecal administration of stem cells (SCs) was seen in the management of neurogenic bladder (NGB) following contusion or complete transaction in the rodent model of spinal cord injury (SCI). Here, we aimed to investigate whether intra bladder wall autologous bone marrow mesenchymal SC (BM-MSCs) transplantation, as a minimally invasive method, could improve bladder dysfunctions after a chronic phase of hemi- and complete-transection SCI in a female rat model. MATERIAL AND METHODS: A total of forty-two female Wistar rats were randomly divided into 6 groups (each in 7) and subjected to complete and incomplete spinal cord transection by a laminectomy at the T9 vertebral level. Four weeks after SCI operation, BM-MSCs (1 × 106/120 µl) were transplanted in six areas of the bladder muscle in rats with complete SCI (cSCI) and hemi SCI (hSCI) groups. In the rats from sham, cSCI and hSCI negative control groups, normal saline was injected instead of BM-MSCs. Four weeks post-cell transplantation, rats were subjected to conscious urodynamic for voiding function assessment. RESULTS: All bladders in cSCI and hSCI groups were the hyperreflexic type. The amplitude of uninhibited contraction in cSCI + BM-MSC group was decreased (p = 0.046). we noted that compliance was recovered in the hSCI + BM-MSCs group (p = 0.041). Residual volume was increased significantly after SCI while cell transplantation decreased this index in both hSCI and cSCI +BM-MSCs groups. The statistically significant result was only seen in the hSCI group (p = 0.046). Data showed that collagen deposition was markedly increased in the SCI group compared to the control or sham groups. These changes were decreased post-treatment in the hSCI group (p = 0.042). CONCLUSION: Our study added a notion that urinary dysfunction associated with SCI, was improved following direct injection of autologous BM-MSC transplantation to bladder wall in the chronic phase of SCI injury.

Effects of McGill stabilization exercises and conventional physiotherapy on pain, functional disability and active back range of motion in patients with chronic non-specific low back pain.

[Purpose] The aim of this study was to compare the effects of "McGill stabilization exercises" and "conventional physiotherapy" on pain, functional disability and active back flexion and extension range of motion in patients with chronic non-specific low back pain. [Subjects and Methods] Thirty four patients with chronic non-specific low back pain were randomly assigned to McGill stabilization exercises group (n=17) and conventional physiotherapy group (n=17). In both groups, patients performed the corresponding exercises for six weeks. The visual analog scale (VAS), Quebec Low Back Pain Disability Scale Questionnaire and inclinometer were used to measure pain, functional disability, and active back flexion and extension range of motion, respectively. [Results] Statistically significant improvements were observed in pain, functional disability, and active back extension range of motion in McGill stabilization exercises group. However, active back flexion range of motion was the only clinical symptom that statistically increased in patients who performed conventional physiotherapy. There was no significant difference between the clinical characteristics while compared these two groups of patients. [Conclusion] The results of this study indicated that McGill stabilization exercises and conventional physiotherapy provided approximately similar improvement in pain, functional disability, and active back range of motion in patients with chronic non-specific low back pain. However, it appears that McGill stabilization exercises provide an additional benefit to patients with chronic non-specific low back, especially in pain and functional disability improvement.