Structural behavior of human lumbar spinal motion segments

The objectives of this study were to obtain linearized stiffness matrices, and assess the linearity and hysteresis of the motion segments of the human lumbar spine under physiological conditions of axial preload and fluid environment. Also, the stiffness matrices were expressed in the form of an 'equivalent' structure that would give insights into the structural behavior of the spine. Mechanical properties of human cadaveric lumbar L2-3 and L4-5 spinal motion segments were measured in six degrees of freedom by recording forces when each of six principal displacements was applied. Each specimen was tested with axial compressive preloads of 0, 250 and 500 N. The displacements were four slow cycles of +/-0.5mm in anterior-posterior and lateral displacements, +/-0.35 mm axial displacement, +/-1.5 degrees lateral rotation and +/-1 degrees flexion-extension and torsional rotations. There were significant increases with magnitude of preload in the stiffness, hysteresis area (but not loss coefficient) and the linearity of the load-displacement relationship. The mean values of the diagonal and primary off-diagonal stiffness terms for intact motion segments increased significantly relative to values with no preload by an average factor of 1.71 and 2.11 with 250 and 500 N preload, respectively (all eight tests p<0.01). Half of the stiffness terms were greater at L4-5 than L2-3 at higher preloads. The linearized stiffness matrices at each preload magnitude were expressed as an equivalent structure consisting of a truss and a beam with a rigid posterior offset, whose geometrical properties varied with preload. These stiffness properties can be used in structural analyses of the lumbar spine.     

Effect of displacement rate on the tensile mechanics of pediatric cervical functional spinal units

This study examined the effect of loading (displacement) rate on the tensile mechanics of cervical spine functional spinal units. A total of 40 isolated functional spinal units (two vertebrae and the adjoining soft tissues) from juvenile male baboons (10+/-0.6-human equivalent years old) were subjected to tensile loading spanning four orders of magnitude from 0.5 to 5000 mm/s. The stiffness, ultimate failure load, and corresponding displacement at failure were measured for each specimen and normalized by spinal geometry to examine the material properties as well as the structural properties. The tensile stiffness, failure load, normalized stiffness, and normalized failure load significantly increased (ANOVA, p<0.001) with increasing displacement rate. From the slowest to fastest loading rate, a two-fold increase in stiffness and four-fold increase in failure load were observed. The tensile failure strains (1.07+/-0.31 mm/mm strain) were not significantly correlated with loading rate (ANOVA, p=0.146). Both the functional (non-destructive stiffness and normalized stiffness) and failure mechanics of isolated functional spinal units exhibited a power-law relationship with displacement rate. Modeling efforts utilizing these rate-dependent characteristics will enhance our understanding of the tensile viscoelastic response of the spine and enable improved dynamic injury prevention schemes.     

Intra-abdominal pressure increases stiffness of the lumbar spine

Intra-abdominal pressure (IAP) increases during many tasks and has been argued to increase stability and stiffness of the spine. Although several studies have shown a relationship between the IAP increase and spinal stability, it has been impossible to determine whether this augmentation of mechanical support for the spine is due to the increase in IAP or the abdominal muscle activity which contributes to it. The present study determined whether spinal stiffness increased when IAP increased without concurrent activity of the abdominal and back extensor muscles. A sustained increase in IAP was evoked by tetanic stimulation of the phrenic nerves either unilaterally or bilaterally at 20 Hz (for 5 s) via percutaneous electrodes in three subjects. Spinal stiffness was measured as the force required to displace an indentor over the L4 or L2 spinous process with the subjects lying prone. Stiffness was measured as the slope of the regression line fitted to the linear region of the force-displacement curve. Tetanic stimulation of the diaphragm increased IAP by 27-61% of a maximal voluntary pressure increase and increased the stiffness of the spine by 8-31% of resting levels. The increase in spinal stiffness was positively correlated with the size of the IAP increase. IAP increased stiffness at L2 and L4 level. The results of this study provide evidence that the stiffness of the lumbar spine is increased when IAP is elevated.     

Gender differences in active musculoskeletal stiffness. Part II. Quantification of leg stiffness during functional hopping tasks.

Leg stiffness was compared between age-matched males and females during hopping at preferred and controlled frequencies. Stiffness was defined as the linear regression slope between the vertical center of mass (COM) displacement and ground-reaction forces recorded from a force plate during the stance phase of the hopping task. Results demonstrate that subjects modulated the vertical displacement of the COM during ground contact in relation to the square of hopping frequency. This supports the accuracy of the spring-mass oscillator as a representative model of hopping. It also maintained peak vertical ground-reaction load at approximately three times body weight. Leg stiffness values in males (33.9+/-8.7 kN/m) were significantly (p<0.01) greater than in females (26.3+/-6.5 kN/m) at each of three hopping frequencies, 3.0, 2.5 Hz, and a preferred hopping rate. In the spring-mass oscillator model leg stiffness and body mass are related to the frequency of motion. Thus male subjects necessarily recruited greater leg stiffness to drive their heavier body mass at the same frequency as the lighter female subjects during the controlled frequency trials. However, in the preferred hopping condition the stiffness was not constrained by the task because frequency was self-selected. Nonetheless, both male and female subjects hopped at statistically similar preferred frequencies (2.34+/-0.22 Hz), therefore, the females continued to demonstrate less leg stiffness. Recognizing the active muscle stiffness contributes to biomechanical stability as well as leg stiffness, these results may provide insight into the gender bias in risk of musculoskeletal knee injury.     

Impedance response characteristics of the primate Mucaca mulatta exposed to seated whole-body gz vibration.

A mathematical model was used to quantify and describe the variability in the mechanical impedance response of the Rhesus monkey subjected to vibrations in the range 3-20 Hz at 0.5 g peak acceleration. Due to the similarities in response, a two-mass, one-degree-of-freedom (DOF) model was selected and the associated mechanical parameters determined using a nonlinear least-squares optimization program. For the six tests conducted on each of the four subjects, appreciable parameter variations were observed within a subject; however, the majority of the mean parameter values among different subjects and among the repeated tests on the population were within +/- 1 S.D. of each other. Significant differences were observed in the stiffness coefficient and the total mass among different subjects, and in the mass ratio (between inert and sprung masses) among the repeated tests. Variations in the profile shapes following resonance were described and limited by changes in the mass ratio and the damping factor. Higher mass ratios (greater than 1.0) were associated with lower damping factors (less than 0.50). The impedance response beyond resonance approached the response described by the impedance of the inert mass and the damper elements of the model combined in parallel, and supported the assumption that the lower torso was rigidly attached to the seat. Physically, the reactive force produced by the upper torso increasingly diminished following resonance, due to the load transmission/attenuation characteristics of the spinal structures at 0.5 g peak acceleration. The impedance measured at the seat becomes dominated by the transmitted damping force associated with the spine and the force generated by the rigid lower-torso mass.     

Spinal stiffness in asymptomatic subjects

The objective of the study was to measure postero-anterior stiffness of thoracolumbar spine from normal asymptomatic subjects at T₄, T₉, and L₂ levels using a standardized device and protocol. Sixteen volunteer subjects (eight males and eight females) meeting the inclusion and exclusion criteria were recruited for the study. Their T₄, T₉, and L₂ spinous processes were identified and marked. These spinous processes were cyclically loaded with 22.5 N, 45 N, 90 N, and 135 N fixed forces at 0.1 Hz in postero-anterior direction by a computer controlled and operated Therapeutic Spinal Mobilizer (TSM) for five cycles to the level of subject’s acceptance of the load magnitude. The magnitude of the force and displacement experienced at the spinal level were recorded using a load cell and linear variable differential transducer. The stiffness was obtained from the slope of the load/deformation curve. The stiffness values were subjected to analysis of variance to determine the effect of independent variables. The stiffness at different levels was significantly different (p < 0.0001) and it was significantly affected by the testing load (p < 0.0001). The age, sex, height and weight were not significantly associated with the stiffness, neither were the cycles at the same load. The postero-anterior stiffness of the thoracolumbar spine is different at different spinal levels and varies with testing loads.     

Effect of stimulation frequency on contraction-induced glucose transport in rat skeletal muscle

Previous studies have indicated that frequency of stimulation is a major determinant of glucose transport in contracting muscle. We have now studied whether this is so also when total force development or metabolic rate is kept constant. Incubated soleus muscles were electrically stimulated to perform repeated tetanic contractions at four different frequencies (0.25, 0.5, 1, and 2 Hz) for 10 min. Resting length was adjusted to achieve identical total force development or metabolic rate (glycogen depletion and lactate accumulation). Overall, at constant total force development, glucose transport (2-deoxyglucose uptake) increased with stimulation frequency (P < 0.05; basal: 25 +/- 2, 0.25 Hz: 50 +/- 4, 0.5 Hz: 50 +/- 3, 1 Hz: 81 +/- 5, 2 Hz: 79 +/- 3 nmol. g(-1). 5 min(-1)). However, glucose transport was identical (P > 0.05) at the two lower (0.25 and 0.5 Hz) as well as at the two higher (1 and 2 Hz) frequencies. Glycogen decreased (P < 0.05; basal: 19 +/- 1, 0.25 Hz: 13 +/- 1, 0.5 Hz: 12 +/- 2, 1 Hz: 7 +/- 1, 2 Hz: 7 +/- 1 mmol/kg) and 5'-AMP-activated protein kinase (AMPK) activity increased (P < 0. 05; basal: 1.7 +/- 0.4, 0.25 Hz: 32.4 +/- 7.0, 0.5 Hz: 36.5 +/- 2.1, 1 Hz: 63.4 +/- 8.0, 2 Hz: 67.0 +/- 13.4 pmol. mg(-1). min(-1)) when glucose transport increased. Experiments with constant metabolic rate were carried out in soleus, flexor digitorum brevis, and epitrochlearis muscles. In all muscles, glucose transport was identical at 0.5 and 2 Hz (P > 0.05); also, AMPK activity did not increase with stimulation frequency. In conclusion, muscle glucose transport increases with stimulation frequency but only in the face of energy depletion and increase in AMPK activity. This indicates that contraction-induced glucose transport is elicited by metabolic demands rather than by events occurring early during the excitation-contraction coupling.     

Force-frequency relationship and potentiation in mammalian skeletal muscle.

Repetitive activation of a skeletal muscle results in potentiation of the twitch contractile response. Incompletely fused tetanic contractions similar to those evoked by voluntary activation may also be potentiated by prior activity. We aimed to investigate the role of stimulation frequency on the enhancement of unfused isometric contractions in rat medial gastrocnemius muscles in situ. Muscles set at optimal length were stimulated via the sciatic nerve with 50-micros duration supramaximal pulses. Trials consisted of 8 s of repetitive trains [5 pulses (quintuplets) 2 times per second or 2 pulses (doublets) 5 times per second] at 20, 40, 50, 60, 70, and 80 Hz. These stimulation frequencies represent a range over which voluntary activation would be expected to occur. When the frequency of stimulation was 20, 50, or 70 Hz, the peak active force (highest tension during a contraction - rest tension) of doublet contractions increased from 2.2 +/- 0.2, 4.1 +/- 0.4, and 4.3 +/- 0.5 to 3.1 +/- 0.3, 5.6 +/- 0.4, and 6.1 +/- 0.7 N, respectively. Corresponding measurements for quintuplet contractions increased from 2.2 +/- 0.2, 6.1 +/- 0.5, and 8.7 +/- 0.7 to 3.2 +/- 0.3, 7.3 +/- 0.6, and 9.0 +/- 0.7 N, respectively. Initial peak active force values were 27 +/- 1 and 61.5 +/- 5% of the maximal (tetanic) force for doublet and quintuplet contractions, respectively, at 80 Hz. With doublets, peak active force increased at all stimulation frequencies. With quintuplets, peak active force increased significantly for frequencies up to 60 Hz. Twitch enhancement at the end of the 8 s of repetitive stimulation was the same regardless of the pattern of stimulation during the 8 s, and twitch peak active force returned to prestimulation values by 5 min. These experiments confirm that activity-dependent potentiation is evident during repeated, incompletely fused tetanic contractions over a broad range of frequencies. This observation suggests that, during voluntary motor unit recruitment, derecruitment or decreased firing frequency would be necessary to achieve a fixed (submaximal) target force during repeated isometric contractions over this time period.     

Intracellular PO(2) decreases with increasing stimulation frequency in contracting single Xenopus muscle fibers.

There is currently some controversy regarding the manner in which skeletal muscle intracellular PO(2) changes with work intensity. Therefore, this study investigated the relationship between intracellular PO(2) and stimulation frequency in intact, isolated, single skeletal muscle fibers. Single, living muscle fibers (n = 7) were microdissected from the lumbrical muscles of Xenopus and injected with the oxygen-sensitive probe palladium-meso-tetra(4-carboxyphenyl)porphine (0.5 mM). Fibers were mounted with platinum clips to a force transducer in a chamber, which was continuously perfused with Ringer solution (pH = 7.0) at a PO(2) of approximately 30 Torr. Fibers were then stimulated sequentially for 3 min, followed by a 3-min rest, at each of five contraction frequencies (0.15, 0.2, 0.25, 0.33, and 0.5 Hz), in a random order, using tetanic contractions. Resting intracellular PO(2) averaged 31.2 +/- 0.9 Torr. During steady-state stimulation, intracellular PO(2) declined to 21.2 +/- 2.3, 17.1 +/- 2.4, 15.3 +/- 1.9, 9.8 +/- 2.0, and 5.8 +/- 1.4 Torr for 0.15, 0.2, 0.25, 0.33, and 0.5-Hz stimulation, respectively. Significant fatigue, as defined by a decrease in force to <50% of the initial force, occurred only at the highest (0.5 Hz) stimulation frequency in five of the cells and at 0.33 Hz in the other two. Regression analysis demonstrated that there was a significant (P < 0.0001, r = 0.82) negative correlation between intracellular PO(2) and contraction frequency in these isolated, single cells. The linear decrease in intracellular PO(2) with stimulation frequency, and thus energy demand, suggests that a fall in intracellular PO(2) correlates with increased oxygen uptake in these single contracting cells.     

Reversal of muscle fatigue during 16 h of heavy intermittent cycle exercise.

This study examined the effects of extended sessions of heavy intermittent exercise on quadriceps muscle fatigue and weakness. Twelve untrained volunteers (10 men and 2 women), with a peak oxygen consumption of 44.3 +/- 2.3 ml.kg(-1).min(-1), exercised at approximately 91% peak oxygen consumption for 6 min once per hour for 16 h. Muscle isometric properties assessed before and after selected repetitions (R1, R2, R4, R7, R12, and R15) were used to quantitate fatigue (before vs. after repetitions) and weakness (before vs. before repetitions). Muscle fatigue at R1 was indicated by reductions (P < 0.05) in peak twitch force (135 +/- 13 vs. 106 +/- 11 N) and by a reduction (P < 0.05) in the force-frequency response, which ranged between approximately 53% at 10 Hz (113 +/- 12 vs. 52.6 +/- 7.4 N) and approximately 17% at 50 Hz (324 +/- 27 vs. 270 +/- 30 N). No recovery of force, regardless of stimulation frequency, was observed during the 54 min between R1 and R2. At R2 and for all subsequent repetitions, no reduction in force, regardless of stimulation frequency, was generally found after the exercise. The only exception was for R2, where, at 20 Hz, force was reduced (P < 0.05) by 18%. At R15, force before repetitions for high frequencies (i.e., 100 Hz) returned to R1 (333 +/- 29 vs. 324 +/- 27 N), whereas force at low frequency (i.e., 10 Hz) was only partially (P < 0.05) recovered (113 +/- 12 vs. 70 +/- 6.6 N). It is concluded that multiple sessions of heavy exercise can reverse the fatigue noted early and reduce or eliminate weakness depending on the frequency of stimulation.     

Trunk stiffness and dynamics during active extension exertions

Spinal stability is related to the recruitment and control of active muscle stiffness. Stochastic system identification techniques were used to calculate the effective stiffness and dynamics of the trunk during active trunk extension exertions. Twenty-one healthy adult subjects (10 males, 11 females) wore a harness with a cable attached to a servomotor such that isotonic flexion preloads of 100, 135, and 170 N were applied at the T10 level of the trunk. A pseudorandom stochastic force sequence (bandwidth 0-10 Hz, amplitude +/-30 N) was superimposed on the preload causing small amplitude trunk movements. Nonparametric impulse response functions of trunk dynamics were computed and revealed that the system exhibited underdamped second-order behavior. Second-order trunk dynamics were determined by calculating the best least-squares fit to the IRF. The quality of the model was quantified by comparing estimated and observed displacement variance accounted for (VAF), and quality of the second-order fits was calculated as a percentage and referred to as fit accuracy. Mean VAF and fit accuracy were 87.8 +/- 4.0% and 96.0 +/- 4.3%, respectively, indicating that the model accurately represented active trunk kinematic response. The accuracy of the kinematic representation was not influenced by preload or gender. Mean effective stiffness was 2.78 +/- 0.96 N/mm and increased significantly with preload (p < 0.001), but did not vary with gender (p = 0.425). Mean effective damping was 314 +/- 72 Ns/m and effective trunk mass was 37.0 +/- 9.3 kg. We conclude that stochastic system identification techniques should be used to calculate effective trunk stiffness and dynamics.     

Tensile cervical facet capsule ligament mechanics: failure and subfailure responses in the rat

Clinical, epidemiological, and biomechanical studies suggest the involvement of the cervical facet joint in neck pain. Mechanical studies have suggested the facet capsular ligament to be at risk for subfailure tensile injury during whiplash kinematics of the neck. Ligament mechanical properties can be altered by subfailure injury and such loading can induce cellular damage. However, at present, there is no clear understanding of the physiologic context of subfailure facet capsular ligament injury and mechanical implications for whiplash-related pain. Therefore, this study aimed to define a relationship between mechanical properties at failure and a subfailure condition associated with pain for tension in the rat cervical facet capsular ligament. Tensile failure studies of the C6/C7 rat cervical facet capsular ligament were performed using a customized vertebral distraction device. Force and displacement at failure were measured and stiffness and energy to failure were calculated. Vertebral motions and ligament deformations were tracked and maximum principal strains and their directions were calculated. Mean tensile force at failure (2.96 +/- 0.69 N) was significantly greater (p < 0.005) than force at subfailure (1.17 +/- 0.48 N). Mean ligament stiffness to failure was 0.75 +/- 0.27 N/mm. Maximum principal strain at failure (41.3 +/- 20.0%) was significantly higher (p = 0.003) than the corresponding subfailure value (23.1 +/- 9.3%). This study determined that failure and a subfailure painful condition were significantly different in ligament mechanics and findings provide preliminary insight into the relationship between mechanics and pain physiology for this ligament. Together with existing studies, these findings offer additional considerations for defining mechanical thresholds for painful injuries.     

Validation of vibration testing for the assessment of the mechanical properties of human lumbar motion segments

Experimental modal analysis is a non-destructive measurement technique, which applies low forces and small deformations to assess the integrity of a structure. It is therefore a promising method to study the mechanical properties of the spine in vivo. Previously, modal parameters successfully revealed artificially induced spinal injuries. The question remains however, whether experimental modal analysis can be applied successfully in human spinal segments with mechanical changes due to physiological processes. Since quasi-static mechanical testing is considered the "gold standard" for assessing intervertebral stiffness, the purpose of our study was to examine if the mechanical properties derived from vibration testing and quasi-static testing correlate. Six cadaver human spines (L1-L5) were loaded quasi-statically in bending and torsion, while an optical system measured the angular rotations of the individual motion segments. Subsequently, the polysegmental spines were divided into L2-L3 and L4-L5 segments and a shaker was used to vibrate the upper vertebra, while its response was obtained from accelerometers in anteroposterior and mediolateral directions. From the resulting frequency response function the eigenfrequencies (ratio between stiffness and mass) and vibration modes (pattern of motion) were determined. The vibration results showed clear eigenfrequencies for flexion-extension (mean 121.83Hz, SD 40.05Hz), lateroflexion (mean 132.17, SD 34.80Hz) and axial rotation (mean 236.17Hz, SD 81.45Hz). Furthermore, the correlation between static and dynamic tests was significant (r=0.73, p=0.01). In conclusion, the findings from this study show that experimental modal analysis is a valid method to assess the mechanical properties of human lumbar motion segments.     

Spring-like leg behaviour, musculoskeletal mechanics and control in maximum and submaximum height human hopping

The purpose of this study was to understand how humans regulate their 'leg stiffness' in hopping, and to determine whether this regulation is intended to minimize energy expenditure. 'Leg stiffness' is the slope of the relationship between ground reaction force and displacement of the centre of mass (CM). Variations in leg stiffness were achieved in six subjects by having them hop at maximum and submaximum heights at a frequency of 1.7 Hz. Kinematics, ground reaction forces and electromyograms were measured. Leg stiffness decreased with hopping height, from 350 N m(-1) kg(-1) at 26 cm to 150 N m(-1) kg(-1) at 14 cm. Subjects reduced hopping height primarily by reducing the amplitude of muscle activation. Experimental results were reproduced with a model of the musculoskeletal system comprising four body segments and nine Hill-type muscles, with muscle stimulation STIM(t) as only input. Correspondence between simulated hops and experimental hops was poor when STIM(t) was optimized to minimize mechanical energy expenditure, but good when an objective function was used that penalized jerk of CM motion, suggesting that hopping subjects are not minimizing energy expenditure. Instead, we speculated, subjects are using a simple control strategy that results in smooth movements and a decrease in leg stiffness with hopping height.     

Effect of habitual running on human Achilles tendon load-deformation properties and cross-sectional area.

Whether the cross-sectional area (CSA) and mechanical properties of the human Achilles tendon change in response to habitual exercise remains largely unexplored. The present study evaluated the CSA and contraction-induced displacement of the aponeurosis-tendon complex of the triceps surae in 11 untrained subjects before (tests 1 and 2) and after (test 3) approximately 9 mo of regular running ( approximately 78 training sessions). Displacement of the tendon-aponeurosis complex obtained by ultrasonography; electromyography of the gastrocnemius, soleus, and dorsiflexor muscles; and joint angular rotation were recorded during graded isometric plantarflexion ramps. Tendon CSA and moment arm were measured by using MRI, and tendon force was calculated from joint moments and tendon moment arm. A treadmill test was used to determine submaximal oxygen consumption (Vo2) at a given speed and maximal Vo2. The total running duration was approximately 43 h, distributed over 34 wk. Maximal Vo2 increased 8.6% (P < 0.01), and submaximal Vo2 decreased 6.2% (P < 0.05). Tendon-aponeurosis displacement during maximal voluntary contraction was unchanged (tests 1-3, 5.2 +/- 0.6, 5.2 +/- 0.5, and 5.3 +/- 0.4 mm, respectively) and yielded a structural stiffness of 365 +/- 50, 358 +/- 40, and 384 +/- 52 N/mm for tests 1-3, respectively (P > 0.05). Tendon CSA also remained unchanged (tests 1-3, 34.2 +/- 2.2, 33.9 +/- 2.2, and 33.8 +/- 2.1 mm2, respectively). In conclusion, a total training stimulus of approximately 9 mo of running in previously untrained subjects was adequate to induce significant cardiovascular improvements, although it did not result in any changes in the mechanical properties of the triceps surea tendon-aponeurosis complex or in the dimensions of Achilles tendon.     

Time-dependent deformations in bone cells exposed to fluid flow in vitro: investigating the role of cellular deformation in fluid flow-induced signaling

Numerous experiments have shown fluid flow to be a potent stimulator of bone cells in vitro, suggesting that fluid flow is an important physical signal in bone mechanotransduction. In fluid flow experiments, bone cells are exposed to both time-dependent (e.g., oscillating or pulsing) and time-independent (e.g., steady) flow profiles. Interestingly, the signaling response of bone cells shows dependence on loading frequency and/or rate that has been postulated to be due to viscoelastic behavior. Thus, the objective of this study was to investigate the time-dependent deformations of bone cells exposed to fluid flow in vitro. Specifically, our goal was to characterize the mechanical response of bone cells exposed to oscillatory flow from 0.5 to 2.0 Hz and steady flow, since these flow profiles have previously been shown to induce different morphological and biochemical responses in vitro. By tracking cell-bound sulfate and collagen coated fluorescent beads of varying sizes, we quantified the normalized peak deformation (peak displacement normalized by the maximum peak displacement observed for all frequencies) and phase lag in bone cells exposed to 1.0 Pa oscillating flow at frequencies of 0.5-2.0 Hz. The phase lag was small (3-10 degrees ) and frequency dependent, while the normalized peak displacements decreased as a weak power law of frequency ( approximately f(-0.2)). During steady flow, the cells exhibited a nearly instantaneous deformation, followed by creep. Our results suggest that while substantial viscous deformation may occur during steady flow (compared to oscillating flow at approximately 1 Hz), bone cells behave primarily as elastic bodies when exposed to flow at frequencies associated with habitual loading.     

Cervical spine posteroanterior stiffness differs with neck position

PurposeSpinal stiffness is commonly considered when treating patients with neck pain, but there are few studies reporting the objective measurement of cervical spine stiffness or the possible kinesiological factors that may affect its quantification. The aim of this study was to determine if the position of the neck affects cervical spine stiffness.MethodsAn instrumented stiffness assessment device measured posteroanterior cervical spine stiffness at C4 of 25 prone-lying asymptomatic subjects in three neck positions in randomised order: maximal flexion, maximal extension, and neutral. The device applied five standardised mechanical oscillatory pressures while measuring the applied force and concurrent displacement, defining stiffness as the slope of the linear portion of the force–displacement curve. Repeated measures analysis of variance with Bonferroni-adjusted post hoc comparisons determined whether stiffness differed between neck positions.ResultsThere was a significant difference in cervical spine stiffness between different neck positions (F_(1.6,38.0) = 16.6, P < 0.001). Stiffness was least in extension with a mean of 3.09 N/mm (95% CI 2.59, 3.58) followed by neutral (3.94, 95% CI 3.49, 4.39), and then flexion (4.32, 95% CI 3.96, 4.69).ConclusionWhen assessing cervical spine stiffness, neck position should be standardised to ensure maximal reliability and utility of stiffness judgments.     

Intracellular PO2 kinetics at different contraction frequencies in Xenopus single skeletal muscle fibers.

Increasing contraction frequency in single skeletal muscle fibers has been shown to increase the magnitude of the fall in intracellular Po(2) (Pi(O(2))), reflecting a greater metabolic rate. To test whether Pi(O(2)) kinetics are altered by contraction frequency through this increase in metabolic stress, Pi(O(2)) was measured in Xenopus single fibers (n = 11) during and after contraction bouts at three different frequencies. Pi(O(2)) was measured via phosphorescence quenching at 0.16-, 0.25-, and 0.5-Hz tetanic stimulation. The kinetics of the change in Pi(O(2)) from resting baseline to end-contraction values and end contraction to rest were described as a mean response time (MRT) representing the time to 63% of the change in Pi(O(2)). As predicted, the fall in Pi(O(2)) from baseline following contractions was progressively greater at 0.5 and 0.25 Hz than at 0.16 Hz (32.8 +/- 2.1 and 29.3 +/- 2.0 Torr vs. 23.6 +/- 2.2 Torr, respectively) since metabolic demand was greater. The MRT for the decrease in Pi(O(2)) was progressively faster at the higher frequencies (0.5 Hz: 45.3 +/- 4.5 s; 0.25 Hz: 63.3 +/- 4.1 s; 0.16 Hz: 78.0 +/- 4.1 s), suggesting faster accumulation of stimulators of oxidative phosphorylation. The MRT for Pi(O(2)) off-kinetics (0.5 Hz: 84.0 +/- 11.7 s; 0.25 Hz: 79.1 +/- 8.4 s; 0.16 Hz: 81.1 +/- 8.3 s) was not different between trials. These data demonstrate in single fibers that the rate of the fall in Pi(O(2)) is dependent on contraction frequency, whereas the rate of recovery following contractions is independent of either the magnitude of the fall in Pi(O(2)) from baseline or the contraction frequency. This suggests that stimulation frequency plays an integral role in setting the initial metabolic response to work in isolated muscle fibers, possibly due to temporal recovery between contractions, but it does not determine recovery kinetics.     

The effect of degenerative morphological changes of the intervertebral disc on the lumbar spine biomechanics: a poroelastic finite element investigation

Intervertebral disc degeneration involves changes in the spinal anatomical structures. The mechanical relevance of the following changes was investigated: disc height, endplate sclerosis, disc water content, permeability and depressurisation. A poroelastic nonlinear finite element model of the L4-L5 human spine segments was employed. Loads represented a daily cycle (500 N compression combined with flexion-extension motion for 16 h followed by 200 N compression for 8 h). In non-degenerative conditions, the model predicted a diurnal axial displacement of 1.32 mm and a peak intradiscal pressure of 0.47 MPa. Axial displacement, facet force and range of motion in flexion-extension are decreased by decreasing disc height. By decreasing the initial water content, axial displacement, facet force and fluid loss were all reduced. Endplate sclerosis did not have a significant influence on the calculated results. Depressurisation determined an increase of the disc effective stress, possibly inducing failure. Degenerative instability was not calculated in any simulations.     

Sex-based differences in myocardial contractile reserve

Recent studies have identified sex differences in heart function that may affect the risk of developing heart failure. We hypothesized that there are fundamental differences in calcium (Ca) regulation in cardiac myocytes of males and premenopausal females. Isometric force transients (n = 45) were measured at various stimulation frequencies to define the force frequency responses (FFR) (0.5, 1.0, 1.5, and 2.0 Hz) during either changes in bath Ca ([Ca]o) (1.0, 1.75, 3.5, and 7.0 mM) or length-tension (20, 40, 60, 80, and 100% L(max)) in right ventricle trabeculae from normal male (MT) and premenopausal female (FT) cats. Force-Ca measurements were also obtained in chemically skinned trabeculae. Under basal conditions (0.5 Hz, 1.75 mM Ca, 80% L(max)) both MT and FT achieved similar developed forces (DF) (MT 11 +/- 1, FT = 10 +/- 1 mN/mm2). At low rates and lengths, there is no sex difference. At higher preloads and rates, there is a separation in DF in MT and FT. At basal [Ca]o both MT and FT exhibited positive FFR (2.0 Hz, 1.75 mM Ca: MT 38 +/- 3, FT 21 +/- 4 mN/mm2); however, at higher [Ca]o, MT achieved greater DF (2.0 Hz, 7.0 mM Ca: MT 40 +/- 3 and FT = 24 +/- 4 mN/mm2). We detected no sex difference in myofilament Ca sensitivity at a sarcomere length of 2.1 mum. However, rapid cooling contractures indicated greater sarcoplasmic reticulum (SR) Ca load in MT at higher frequencies. Despite virtually identical contractile performance under basal conditions, significant sex differences emerge under conditions of increased physiological stress. Given the lack of sex differences in myofilament Ca sensitivity, these studies suggest fundamental sex differences in cellular Ca regulation to achieve contractile reserve, with myocardium from males exhibiting higher SR Ca load.