Publications
83 results found
Chiou S, Koutsos E, Georgiou P, et al., 2018, Association between spectral characteristics of paraspinal muscles and functional disability in low back pain patients: a cohort study, BMJ Open, Vol: 8, ISSN: 2044-6055
Objectives. Characteristics of muscle activity, represented by surface electromyography (EMG), have revealed differences between patients with low back pain and healthy adults; how they relate to functional and clinical parameters remains unclear. The purpose of the current study was to examine the correlation between frequency characteristics of EMG (analysed using continuous wavelet transform (CWT) analysis) and patients’ self-rated score of disability. Design and setting. This is a case control study with fifteen patients with mechanical low back pain (LBP) without radicular symptoms. Patients were recruited from the orthopaedic clinic at Charing Cross Hospital. Ten healthy adults were recruited from the staff working in the hospital and associated university. Patients completed the Roland-Morris Disability Questionnaire (RMDQ) and bilateral EMG activity was obtained from erector spinae at vertebral levels L4 and T12. Subjects performed 3 brief maximal isometric voluntary contractions (MVCs) of the back extensors and the torque was measured using a dynamometer. CWT was applied to the EMG signals of each muscle in a 200ms window centred around the peak torque obtained during the MVCs. The ratio (low/high frequencies) of the energy, the peak power, and the frequency of the peak power were calculated for each recording site, averaged and correlated with the individual’s RMDQ score. Results. Patients had lower peak power (T12 and L4) and lower frequency of the peak power (at T12) than the healthy adults. Additionally, RMDQ positively correlated to the average ratio of energy at T12 (rho=0.63; p=0.012), i.e. greater self-rated disability corresponded to a dominant distribution of energy in the lower frequencies. Conclusion. The current findings reveal alterations in EMG profile and its association with self-related back pain disability, suggesting that spectral characteristics of EMG reflect muscle function.
Chiou SY, Hellyer PJ, Sharp DJ, et al., 2017, Relationships between the integrity and function of lumbar nerve roots as assessed by diffusion tensor imaging and neurophysiology, NEURORADIOLOGY, Vol: 59, Pages: 893-903, ISSN: 0028-3940
PurposeDiffusion tensor imaging (DTI) has shown promise in the measurement of peripheral nerve integrity, although the optimal way to apply the technique for the study of lumbar spinal nerves is unclear. The aims of this study are to use an improved DTI acquisition to investigate lumbar nerve root integrity and correlate this with functional measures using neurophysiology.MethodsTwenty healthy volunteers underwent 3 T DTI of the L5/S1 area. Regions of interest were applied to L5 and S1 nerve roots, and DTI metrics (fractional anisotropy, mean, axial and radial diffusivity) were derived. Neurophysiological measures were obtained from muscles innervated by L5/S1 nerves; these included the slope of motor-evoked potential input-output curves, F-wave latency, maximal motor response, and central and peripheral motor conduction times.ResultsDTI metrics were similar between the left and right sides and between vertebral levels. Conversely, significant differences in DTI measures were seen along the course of the nerves. Regression analyses revealed that DTI metrics of the L5 nerve correlated with neurophysiological measures from the muscle innervated by it.ConclusionThe current findings suggest that DTI has the potential to be used for assessing lumbar spinal nerve integrity and that parameters derived from DTI provide quantitative information which reflects their function.
Chiou S-Y, Gottardi SE, Hodges PW, et al., 2016, Corticospinal Excitability of Trunk Muscles during Different Postural Tasks, PLoS One, Vol: 11, ISSN: 1932-6203
Evidence suggests that the primary motor cortex (M1) is involved in both voluntary, goal-directed movements and in postural control. Trunk muscles are involved in both tasks, however, the extent to which M1 controls these muscles in trunk flexion/extension (voluntary movement) and in rapid shoulder flexion (postural control) remains unclear. The purpose of this study was to investigate this question by examining excitability of corticospinal inputs totrunk muscles during voluntary and postural tasks. Twenty healthy adults participated. Transcranial magnetic stimulation was delivered to the M1 to examine motor evoked potentials (MEPs) in the trunk muscles (erector spinae (ES) and rectus abdominis (RA)) during dynamic shoulder flexion (DSF), static shoulder flexion (SSF), and static trunk extension (STE). The level of background muscle activity in the ES muscles was matched across tasks. MEP amplitudes in ES were significantly larger in DSF than in SSF or in STE; however, this was not observed for RA. Further, there were no differences in levels of muscleactivity in RA between tasks. Our findings reveal that corticospinal excitability of the ES muscles appears greater during dynamic anticipatory posture-related adjustments than during static tasks requiring postural (SSF) and goal-directed voluntary (STE) activity. These results suggest that task-oriented rehabilitation of trunk muscles should be considered for optimal transfer of therapeutic effect to function.
Evans DR, Williams KJ, Strutton PH, et al., 2016, The comparative hemodynamic efficacy of lower limb muscles using transcutaneous electrical stimulation., Journal of vascular surgery. Venous and lymphatic disorders, Vol: 4, Pages: 206-214, ISSN: 2213-3348
BACKGROUND: Circulation in the limbs can be augmented using transcutaneous electrical stimulation devices. The optimum muscle stimulation sites for enhancement of vascular hemodynamic parameters have not been identified. METHODS: Seven suitable anatomic sites were identified within the right leg. Twelve healthy participants were recruited (mean age, 23.1 ± 3 years; body mass index, 23.1 ± 3 kg/m(2)). Muscles were stimulated by transcutaneous bipolar electrodes at a current twice their motor threshold, at 1 Hz, for 5 minutes. Hemodynamic ultrasound measurements were taken from the right femoral vein. Laser Doppler measurements from the feet of the stimulated and nonstimulated sides were obtained. Baseline measurements were compared with readings after 5 minutes of stimulation, with device active. Discomfort experienced for stimulation of each muscle was rated out of 100. RESULTS: Hemodynamic changes displayed large intersubject variation, with no muscle statistically superior to the others. All muscles increased peak velocity; contraction of medial gastrocnemius increased time-averaged maximum velocity and volume flow. All muscles increased foot fluximetry (P < .05). Discomfort correlated weakly with current applied. Tibialis anterior and vastus lateralis were most tenable. CONCLUSIONS: Transcutaneous stimulation increases hemodynamic parameters significantly, locally and systemically. No optimum stimulation site has been identified, and it is limited by comfort and variability in the subject's response. Gastrocnemius, tibialis anterior, and vastus lateralis all provoke large changes in hemodynamic parameters, but clinical efficacy in disease prevention and management has not been explored.
Chiou SY, Jeevathol A, Odedra A, et al., 2015, Voluntary activation of trunk extensors appears normal in young adults who have recovered from low back pain, European Journal of Pain, Vol: 19, Pages: 1506-1515, ISSN: 1090-3801
BackgroundLow back pain (LBP) is associated with alterations in control of trunk movements and changes within central nervous system (CNS). Evidence shows that some of these alterations within the CNS are reversible when the symptoms are relieved, whereas other shows the opposite. Therefore, the purpose of the current study was to investigate whether alterations in voluntary activation (VA) of central neural drive, as assessed using twitch interpolation to measure VA, are present in subjects with a history of low back pain (HLBP), who are free from pain at the time of experiment.MethodsTwelve adults with HLBP and 12 controls participated. Bilateral electromyographic recordings were obtained from erector spiane muscles at two vertebral levels (T12 and L4) and from rectus abdominis. Participants performed a series of brief isometric back extensions (50–100% maximum voluntary contraction) during which transcranial magnetic stimulation was delivered. The sizes of the evoked (superimposed) twitches were measured using dynamometry and VA was derived. The amplitude of motor evoked potentials (MEPs) and duration of cortical silent period (CSP) in erector spinae muscles were calculated; questionnaires were used to evaluate disability, levels of physical activity, quality of life and pain.ResultsThe level of VA was not significantly different between HLBP and control groups. Additionally, there were no between‐group differences in the time‐to‐peak amplitudes of the twitches, MEP amplitudes or duration of CSP.ConclusionsThe ability to voluntarily activate back extensor muscles maximally does not appear to be impaired in subjects with a history of LBP during pain‐free episodes.
Mullington C, Wrench C, He J, et al., 2014, Thermal gradient: the primary driver of thermal perception?, Annual Congress of the Association-of-Anaesthetists-of-Great-Britain-and-Ireland (AAGBI), Publisher: WILEY-BLACKWELL, Pages: 38-38, ISSN: 0003-2409
Chiou SY, Shih YF, Chou LW, et al., 2014, Impaired neural drive in patients with low back pain, European Journal of Pain, Vol: 18, Pages: 794-802, ISSN: 1090-3801
BackgroundControl of trunk movement relies on the integration between central neuronal circuits and peripheral skeletomuscular activities and it can be altered by pain. There is increasing evidence that there are deficits within the central nervous system controlling the trunk muscles in people with low back pain (LBP). However, it is unclear how LBP impacts upon neural drive to back muscles at different levels of voluntary contraction. Therefore, the purpose of this study was to investigate if neural drive is impaired in these patients.MethodsSeventeen patients with LBP and 11 healthy controls were recruited. Bilateral electromyographic (EMG) recordings were obtained from the erector spinae (ES) muscles at two vertebral levels (T12 and L4). Participants performed a series of brief isometric back extensions (50–100% maximum voluntary contraction – MVC), during which transcranial magnetic stimulation was delivered. The size of the evoked (superimposed) twitch was measured using dynamometry.ResultsThe size of the superimposed twitch decreased linearly with increasing contraction strength in the controls; however, this linear relationship was not observed in the patients. Additionally, patients had larger superimposed twitches and longer time‐to‐peak amplitudes during MVCs than those observed in controls. Furthermore, patients had lower MVC and root‐mean‐square EMG activity of ES muscles during MVCs.ConclusionsA decline of central neural drive to the back muscles at high level of voluntary contraction was observed in patients with LBP. These results suggest that it might be pertinent to include neuromuscular facilitation programmes and therapeutic exercise utilizing high voluntary contractions for patients with LBP.
Jones P, Sorinola I, Strutton PH, 2014, Effect of dual tasking on postural responses to rapid lower limb movement while seated on an exercise ball, GAIT & POSTURE, Vol: 40, Pages: 297-304, ISSN: 0966-6362
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- Citations: 4
Nicotra A, King NKK, Catley M, et al., 2013, Evaluation of corticospinal excitability in cervical myelopathy, before and after surgery, with transcranial magnetic stimulation: a pilot study, EUROPEAN SPINE JOURNAL, Vol: 22, Pages: 189-196, ISSN: 0940-6719
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- Citations: 11
Bottle E, Strutton PH, 2012, Relationship between back muscle endurance and voluntary activation, JOURNAL OF ELECTROMYOGRAPHY AND KINESIOLOGY, Vol: 22, Pages: 383-390, ISSN: 1050-6411
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- Citations: 6
Weaver H, Vichas D, Strutton PH, et al., 2012, The effect of an exercise ball on trunk muscle responses to rapid limb movement, GAIT & POSTURE, Vol: 35, Pages: 70-77, ISSN: 0966-6362
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- Citations: 6
Guzman-Lopez J, Buisson Y, Strutton PH, et al., 2011, Interaction between vestibulo-spinal and corticospinal systems: a combined caloric and transcranial magnetic stimulation study, EXPERIMENTAL BRAIN RESEARCH, Vol: 214, Pages: 37-45, ISSN: 0014-4819
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- Citations: 6
Wightman F, Delves S, Alexander CM, et al., 2011, Differences in descending control of external oblique and latissimus dorsi muscles in humans: a preliminary study, Motor Control, Vol: 15, Pages: 405-418
Descending bilateral control of external oblique (EO) and latissimus dorsi (LD) was investigated using transcranial magnetic stimulation. Contralateral (CL) motor evoked potential (MEP) thresholds were lower and latencies were shorter than for ipsilateral (IL) MEPs. Hotspots for EO were symmetrical; this was not the case for LD. The volumes of drive to the left and right muscles were not different. The laterality index was not different between the left and right muscles. The average index for the EO muscles was closer to zero than that for LD, suggesting a stronger IL drive to EO. The symmetry of drive to each muscle did not differ; however, the symmetry of drive varies within a subject for different muscles and between subjects for the same muscle. The findings may be useful in understanding a number of clinical conditions relating to the trunk and also for predicting the outcome of rehabilitative strategies
Duffell LD, Dharni H, Strutton PH, et al., 2011, Electromyographic activity of the quadriceps components during the final degrees of knee extension, JOURNAL OF BACK AND MUSCULOSKELETAL REHABILITATION, Vol: 24, Pages: 215-223, ISSN: 1053-8127
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- Citations: 6
Katakura M, Duffell LD, Strutton PH, et al., 2011, Effects of a 60 second maximum voluntary isometric contraction on torque production and EMG output of the quadriceps muscle group, ISOKINETICS AND EXERCISE SCIENCE, Vol: 19, Pages: 13-22, ISSN: 0959-3020
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- Citations: 4
Strutton P, 2010, Basic Concepts in Neurophysiology, Psychiatry: An Evidence Based Text, Editors: Puri, Treasaden, Publisher: Oxford University Press, USA, ISBN: 9780340950050
Mullington CJ, Klungarvuth L, Catley M, et al., 2009, Trunk muscle responses following unpredictable loading of an abducted arm, GAIT & POSTURE, Vol: 30, Pages: 181-186, ISSN: 0966-6362
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- Citations: 10
Lagan J, Lang P, Strutton PH, 2008, Measurement of voluntary activation of the back muscles using transcranial magnetic stimulation, CLINICAL NEUROPHYSIOLOGY, Vol: 119, Pages: 2839-2845, ISSN: 1388-2457
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- Citations: 11
Kuppuswamy A, Catley M, King NKK, et al., 2008, Cortical control of erector spinae muscles during arm abduction in humans, GAIT & POSTURE, Vol: 27, Pages: 478-484, ISSN: 0966-6362
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- Citations: 14
Everett R, Strutton PH, McGregor AH, 2008, Do asymmetries exist in the trunk muscles and is this influenced by sporting task?, ISOKINETICS AND EXERCISE SCIENCE, Vol: 16, Pages: 255-262, ISSN: 0959-3020
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- Citations: 4
Brenton H, Hernandez J, Bello F, et al., 2007, Using multimedia and Web3D to enhance anatomy teaching, International Workshop on Web3D Technologies for Learning, Education and Training, Publisher: PERGAMON-ELSEVIER SCIENCE LTD, Pages: 32-53, ISSN: 0360-1315
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- Citations: 115
Crowther A, McGregor AH, Strutton PH, 2007, Testing isometric fatigue in the trunk muscles, ISOKINETICS AND EXERCISE SCIENCE, Vol: 15, Pages: 91-97, ISSN: 0959-3020
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- Citations: 4
Ellaway PH, Catley M, Davey NJ, et al., 2007, Review of physiological motor outcome measures in spinal cord injury using transcranial magnetic stimulation and spinal reflexes., J Rehabil Res Dev, Vol: 44, Pages: 69-76
This article reviews methods that have been developed as part of a clinical initiative on improving outcome measures for motor function assessment in subjects with spinal cord injury (SCI). Physiological motor outcome measures originally developed for limbs-transcranial magnetic stimulation (TMS) of the motor cortex to elicit motor-evoked potentials (MEPs) and mechanical stimulation to elicit spinal reflexes-have been extended to muscles of the trunk. The impetus for this development is the lack of a motor component in the American Spinal Injury Association clinical assessment for the thoracic myotomes. The application of TMS to the assessment of limb muscles is reviewed, followed by consideration of its application to the assessment of paravertebral and intercostal muscles. Spinal reflex testing of paravertebral muscles is also described. The principal markers for the thoracic SCI motor level that have emerged from this clinical initiative are (1) the threshold of MEPs in paravertebral muscles in response to TMS of the motor cortex, (2) the facilitation pattern and latency of MEPs in intercostal muscles during voluntary expiratory effort, and (3) the absence of long-latency reflex responses and the exaggeration of short-latency reflex responses in paravertebral muscles.
Abdalla S, McGregor AH, Strutton PH, 2007, Time course of trunk extensor muscle fatigue as measured using dynamometry and electromyography, ISOKINETICS AND EXERCISE SCIENCE, Vol: 15, Pages: 225-231, ISSN: 0959-3020
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- Citations: 2
Ellaway PH, Catley M, Davey NJ, et al., 2007, Review of physiological motor outcome measures in spinal cord injury using transcranial magnetic stimulation and spinal reflexes, 57th Annual Meeting of the American-Academy-of-Neurology, Publisher: JOURNAL REHAB RES & DEV, Pages: 69-75, ISSN: 0748-7711
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- Citations: 41
O'Donovan O, Cheung J, Catley M, et al., 2006, An investigation of leg and trunk strength and reaction times of hard-style martial arts practitioners, JOURNAL OF SPORTS SCIENCE AND MEDICINE, Vol: 5, Pages: 5-12, ISSN: 1303-2968
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- Citations: 39
Coen CW, Grimshaw SE, Goubillon ML, et al., 2006, Effects of fasting and refeeding on luteinising hormone pulses and on multiple indices of metabolic state in female rats, 6th International Congress of Neuroendocrinology, Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE, Pages: 70-70, ISSN: 0091-3022
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- Citations: 1
King NKK, Kuppuswamy A, Strutton PH, et al., 2006, Estimation of cortical silent period following transcranial magnetic stimulation using a computerised cumulative sum method, JOURNAL OF NEUROSCIENCE METHODS, Vol: 150, Pages: 96-104, ISSN: 0165-0270
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- Citations: 30
Corin G, Strutton PH, McGregor AH, 2005, Establishment of a protocol to test fatigue of the trunk muscles, BRITISH JOURNAL OF SPORTS MEDICINE, Vol: 39, Pages: 731-735, ISSN: 0306-3674
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- Citations: 25
Kuppuswamy A, Theodorou S, Catley M, et al., 2005, Motor neurone excitability in back muscles assessed using mechanically evoked reflexes in spinal cord injured patients, JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, Vol: 76, Pages: 1259-1263, ISSN: 0022-3050
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- Citations: 6
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