ABSTRACT
AIM: Progressive resistance exercises (PRE) are prescribed to reverse the deconditioning associated with chronic back pain. The spine rehabilitation program has utilized 2 sets of progressive resistance exercises during each session, with increased resistance between sets, and with successive sessions. Exercise literature has challenged the need for multiple sets of resistance exercises, with a single set producing similar functional benefits. The authors studied whether completing 1 versus 2 sets of resistance exercises would affect strength, pain and disability outcomes in subjects with chronic low back pain (CLBP). METHODS: The study randomly assigned subjects with CLBP to perform either 1 set or 2 sets of progressive resistance exercises during otherwise identical spine rehabilitation programs. The patient sample included 100 subjects (36 male patients, 64 female patients, mean age 46 years) with chronic back pain referred to spine rehabilitation. Primary outcomes were back strength and progressive isoinertial lifting evaluation (PILE) at discharge. Secondary outcomes were Oswestry disability (0-100) and pain scores (0-10). Exercises consisted of Cybex back extension, rotary torso, pull downs, and multi-hip; lifting of crates from floor-to-waist (lumbar) and waist-to-shoulder (cervical) heights. The maximum levels of exercises were determined using a four repetition to maximum protocol, and the PILE. RESULTS: At discharge, there was no significant difference in strength, disability or pain measures between subjects completing 1 versus 2 sets of resistance exercises. CONCLUSION: These findings suggest that there were no added benefits for completing a second set of resistance exercises during therapy sessions for patients with CLBP.
Subject(s)
Low Back Pain/rehabilitation , Resistance Training/methods , Adult , Female , Humans , Low Back Pain/physiopathology , Male , Middle Aged , Muscle Strength , Muscle, Skeletal/physiopathology , Outpatients , Pain Measurement , Treatment OutcomeABSTRACT
Unionized carpenters (n = 522) participated in a telephone interview regarding their jobs and musculoskeletal symptoms. From this group, a nested case-control study was conducted on 25 symptomatic carpenters who met a hand or wrist work-related musculoskeletal disorder (WMD) case definition and on 35 asymptomatic carpenters who were of similar age, sex, height, and weight. The purpose of the study was to determine if questionnaire symptom data could be used to estimate the prevalence of hand/wrist WMDs. To test this hypothesis, a subset of subjects underwent physical examination and electrodiagnostic testing to determine if these symptom-derived cases had findings of carpal tunnel syndrome or other hand or wrist musculoskeletal disorders. Standardized upper extremity physical examinations and unilateral ulnar and median nerve conduction studies were administered. Physical examination findings of CTS were significantly increased among WMD cases. Mean median sensory and motor distal latencies were significantly longer (P < 0.05) and median sensory amplitudes smaller in cases compared to controls. Median relative to ulnar sensory and motor latencies also were longer in cases. A median mononeuropathy at the wrist was found in 78% of the cases. These findings suggest that symptom-derived WMD data are useful in estimating estimating the prevalence of CTS among carpenters.
Subject(s)
Hand , Musculoskeletal Diseases/epidemiology , Occupational Diseases/epidemiology , Wrist , Adult , Age Factors , Body Height , Body Weight , Carpal Tunnel Syndrome/diagnosis , Carpal Tunnel Syndrome/epidemiology , Case-Control Studies , Electrodiagnosis , Female , Hand/innervation , Humans , Labor Unions , Male , Median Nerve/physiopathology , Motor Neurons/physiology , Musculoskeletal Diseases/diagnosis , Neural Conduction , Neurons, Afferent/physiology , Occupational Diseases/diagnosis , Ohio/epidemiology , Physical Examination , Prevalence , Reaction Time , Sex Factors , Surveys and Questionnaires , Ulnar Nerve/physiopathology , Wood , Wrist/innervationABSTRACT
The aim of this research was to study the neurophysiology of the anterior horn cell (AHC) using single-fiber EMG (SFEMG) study of the flexor carpi radialis (FCR) H-reflex. Twelve men and 7 women, ages 20-80 years, were studied. The mean H-jitter was 138 +/- 59 microseconds. H-jitter increased with age (while the M-jitter did not) and was greater in men than in women. There was a direct correlation between the H-jitter and H-latency which was used as an indirect measure of the AHC's size. Given that small AHCs have a higher input resistance than large ones, the H-jitter can be used as an indirect indicator of the AHC's input resistance and therefore its size. When subjects fell asleep, the H-jitter increased over tenfold the baseline value, raising the possibility of an alternative, oligosynaptic pathway. H-reflex jitter studies provide a useful clinical neurophysiological tool for the study of AHC physiology.
