Motor Control Changes in Trunk Muscles after Using Anatomical Posture Control Orthosis in the Elderly Hyperkyphotic Subjects
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Abstract
Introduction: Hyperkyphosis is known to interfere with the normal function of the trunk musculature in the elderly. Although the effectiveness of orthoses in improving posture and balance in hyperkyphotic elderly people has received much attention, the effect of an orthosis on motor control of muscles remains unknown. This study aimed to evaluate changes in motor control strategies of trunk muscles during walking in elderly hyperkyphotic subjects after using an anatomical posture control (APC) orthosis.
Materials and Methods: A total of 19 elderlies (11 women and 8 men) with thoracic hyperkyphosis of more than 45 degrees were enrolled in the study. Surface electromyography (EMG) signals were recorded from 6 trunk muscles bilaterally with and without orthosis. The voluntary response index (VRI) was calculated from quantitative analysis of surface electromyography (sEMG) data during level walking in those with and without orthosis. The outcome variables of VRI included the similarity index (SI) and electromyographic magnitude (MAG) of muscle groups. The effects of APC orthosis on trunk motor control were tested using a Wilcoxon non-parametric test. Cohen’s d effect sizes were also calculated.
Results: A significant improvement was observed (P<0.05) in MAG and response vector (RV) of five muscles from the right and left sides and the VRI increased significantly after using this posture control orthosis (P<0.05; effect size [ES]: 0.27).
Conclusion: Improving trunk motor control after using orthosis, with relatively medium effect sizes, was observed in the elderly with hyperkyphosis during walking.
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16. Hajouj E, Hadian MR, Mir SM, Talebian S, Ghazi S. Motor Control Changes after Innovative Aquatic Proprioceptive Training in Athletes with Anterior Cruciate Ligament Reconstruction: Voluntary Response Index Analysis. Arch Neurosci. 2021;8(2):e112185. 10.5812/ans.112185.
17. Ghofrani M, Olyaei GR, Talebian S, Bagheri H. Effect of lumbo-pelvic belt on motor control strategy of trunk muscles during lifting and lowering of different loads symmetrically. J. Mod. Rehabil. 2012; 6(1):22-24 http://mrj.tums.ac.ir/article-1-49-en.html.
18. Alin CK, Uzunel E, Kronhed AC, Alinaghizadeh H, Salminen H. Effect of treatment on back pain and back extensor strength with a spinal orthosis in older women with osteoporosis: a randomized controlled trial. Arch. Osteoporos. 2019; 14(1): 5.10.1007/s11657-018-0555-0 .
19. Dionyssiotis, Y., Management of osteoporotic vertebral fractures. Int J Gen Med. 2010; 3: 167-71. https://doi.org/10.2147/IJGM.S11751.
20. Hosseinabadi M, Kamyab M, Azadinia F, Sarrafzadeh J. The effect of spinal orthosis on trunk muscle force control in hyperkyphotic elderly. Tehran Univ Med J. 2019; 77(3): 179-185. http://tumj.tums.ac.ir/article-1-9715-en.html
21. Pfeifer M, Kohlwey L, Begerow B, Pyrmont B. Effects of two newly developed spinal orthoses on trunk muscle strength, posture, and quality-of-life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil. 2011; 90(10): 805-815. 10.1097/PHM.0b013e31821f6df3
22. Valentin GH, Pedersen LN, Maribo T. Wearing an active spinal orthosis improves back extensor strength in women with osteoporotic vertebral fractures. Prosthet Orthot Int. 2014; 38(3): 232-238.10.1177/0309364613497393
23. Ishida, H., et al., Immediate effects of a rucksack type orthosis on the elderly with decreased lumbar lordosis during standing and walking. Electromyography and clinical neurophysiology, 2008. 48(1): p. 53-61.
24. Cholewicki J, Reeves NP, Everding VQ, Morrisette DC. Lumbosacral orthoses reduce trunk muscle activity in a postural control task. J Biomech. 2007; 40(8): 1731-1736. https://doi.org/10.1016/j.jbiomech.2006.08.005.
25. Khalkhali M, Kalantari KK. A Comparative Study of the Effect of Local and General Fatigue on Sense. J Rehabil Med. 2007; 88(3): 52-60.
26. Namdar N, Arazpour M, Ahmadi Bani M. Comparison of the immediate efficacy of the Spinomed® back orthosis and posture training support on walking ability in elderly people with thoracic kyphosis. Disabil Rehabil Assist Technol. 2019; 14(3): 217-220. https://doi.org/10.1080/17483107.2017.1419295.
27. Ribeiro F, Oliveira J. Aging effects on joint proprioception: the role of physical activity in proprioception preservation. Eur Rev Aging Phys Act. 2007; 4(2): 71-76. 10.1007/s11556-007-0026-x.
28. Dupuy EG, Leconte P, Vlamynck E, Sultan A, Chesneau C. Ehlers-Danlos syndrome, hypermobility type: impact of somatosensory orthoses on postural control (a pilot study). Front Neurol. 2017; 11: 283. https://doi.org/10.3389/fnhum.2017.00283.
29. MOBERG E. The role of cutaneous afferents in position sense, kinaesthesia, and motor function of the hand. Brain. 1983; 106(1): 1-19. https://doi.org/10.1093/brain.
30. Gandevia SC, Refshauge KM, Collins DF. Proprioception: peripheral inputs and perceptual interactions: Sensorimotor control of movement and posture, 2002, 61-68. 10.1007/978-1-4615-0713-0_8.
31. Gandevia SC, McCloskey DI, Burke D. Kinaesthetic signals and muscle contraction. Trends in neurosciences. 1992; 15(2): 62-65. https://doi.org/10.1016/0166-2236(92)90028-7.
2. McGill SM, Hughson RL, Parks K. Changes in lumbar lordosis modify the role of the extensor muscles. Clinical biomechanics. 2000; 15(10): 777-780. https://doi.org/10.1016/S0268-0033(00)00037-1
3. Arnold CM, Busch AJ, Schachter CL, Harrison L, Olszynski W. The relationship of intrinsic fall risk factors to a recent history of falling in older women with osteoporosis. J Orthop Sports Phys Ther. 2005; 35(7): 452-460. https://www.jospt.org/doi/10.2519/jospt.2005.35.7.452
4. Darainy M, Ostry DJ. Muscle cocontraction following dynamics learning. Exp Brain Res, 2008; 190(2): 153-163. 10.1007/s00221-008-1457-y
5. Hortobágyi T, Solnik S, Gruber A, Rider P, Steinweg K, Helseth J, DeVita P. Interaction between age and gait velocity in the amplitude and timing of antagonist muscle coactivation. Gait Posture. 2009; 29(4): 558-564. https://doi.org/10.1016/j.gaitpost.2008.12.007
6. Raeissadat SA, Sedighipour L, Pournajaf S, Vahab Kashani R, Sadeghi S. Effect of posture training with weighted kypho-orthosis (WKO) on improving balance in women with osteoporosis. Journal of aging research. 2014. https://doi.org/10.1155/2014/427903
7. Hosseinabadi M, Kamyab M, Azadinia F, Sarrafzadeh J. Effect of a Spinomed orthosis on balance performance, spinal alignment, joint position sense and back muscle endurance in elderly people with hyperkyphotic posture: A randomized controlled trial. Prosthet Orthot Int. 2020; 44(4):234-244. https://doi.org/10.1177/0309364620923816
8. Sinaki M, Lynn SG. Reducing the risk of falls through proprioceptive dynamic posture training in osteoporotic women with kyphotic posturing: a randomized pilot study. Am J Phys Med Rehabil. 2002; 81(4): 241-246. 10.1097/00002060-200204000-00001
9. Pfeifer M, Begerow B, Minne HW. Effects of a new spinal orthosis on posture, trunk strength, and quality of life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil. 2004; 83(3): 177-186. 10.1097/01.phm.0000113403.16617.93
10. Veiskarami M, Aminian G, Bahramizadeh M, Ebrahimzadeh F, Arazpour M, Abdollahi I, Fadayevatan R. Design, implementation and preliminary testing of a novel orthosis for reducing erector spinae muscle activity, and improving balance control for hyperkyphotic elderly subjects. Journal of Biomedical Physics & Engineering. 2020; 10(1): 75.10.31661/jbpe.v0i0.1200.
11. Lee DC, Lim HK, McKay WB, Priebe MM, Holmes SA, Sherwood AM. Toward an objective interpretation of surface EMG patterns: a voluntary response index (VRI). J Electromyogr Kinesiol, 2004; 14(3): 379-388. https://doi.org/10.1016/j.jelekin.2003.10.006.
12. Hosseinabadi, M., et al., Effect of a Spinomed orthosis on balance performance, spinal alignment, joint position sense and back muscle endurance in elderly people with hyperkyphotic posture: A randomized controlled trial. Prosthet Orthot Int. 2020; 44(4):234-244.10.1177/0309364620923816 .
13. Greig AM, Bennell KL, Briggs AM, Hodges PW. Postural taping decreases thoracic kyphosis but does not influence trunk muscle electromyographic activity or balance in women with osteoporosis. Man Ther, 2008; 13(3): 249-257. https://doi.org/10.1016/j.math.2007.01.011.
14. Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000;10(5):361-74.https://doi.org/10.1016/S1050-6411(00)00027-4
15. Sullivan GM, Feinn R. Using effect size—or why the P value is not enough. J. Grad. Med. Educ. 2012; 4(3): 279-282. https://doi.org/10.4300/JGME-D-12-00156.1 .
16. Hajouj E, Hadian MR, Mir SM, Talebian S, Ghazi S. Motor Control Changes after Innovative Aquatic Proprioceptive Training in Athletes with Anterior Cruciate Ligament Reconstruction: Voluntary Response Index Analysis. Arch Neurosci. 2021;8(2):e112185. 10.5812/ans.112185.
17. Ghofrani M, Olyaei GR, Talebian S, Bagheri H. Effect of lumbo-pelvic belt on motor control strategy of trunk muscles during lifting and lowering of different loads symmetrically. J. Mod. Rehabil. 2012; 6(1):22-24 http://mrj.tums.ac.ir/article-1-49-en.html.
18. Alin CK, Uzunel E, Kronhed AC, Alinaghizadeh H, Salminen H. Effect of treatment on back pain and back extensor strength with a spinal orthosis in older women with osteoporosis: a randomized controlled trial. Arch. Osteoporos. 2019; 14(1): 5.10.1007/s11657-018-0555-0 .
19. Dionyssiotis, Y., Management of osteoporotic vertebral fractures. Int J Gen Med. 2010; 3: 167-71. https://doi.org/10.2147/IJGM.S11751.
20. Hosseinabadi M, Kamyab M, Azadinia F, Sarrafzadeh J. The effect of spinal orthosis on trunk muscle force control in hyperkyphotic elderly. Tehran Univ Med J. 2019; 77(3): 179-185. http://tumj.tums.ac.ir/article-1-9715-en.html
21. Pfeifer M, Kohlwey L, Begerow B, Pyrmont B. Effects of two newly developed spinal orthoses on trunk muscle strength, posture, and quality-of-life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil. 2011; 90(10): 805-815. 10.1097/PHM.0b013e31821f6df3
22. Valentin GH, Pedersen LN, Maribo T. Wearing an active spinal orthosis improves back extensor strength in women with osteoporotic vertebral fractures. Prosthet Orthot Int. 2014; 38(3): 232-238.10.1177/0309364613497393
23. Ishida, H., et al., Immediate effects of a rucksack type orthosis on the elderly with decreased lumbar lordosis during standing and walking. Electromyography and clinical neurophysiology, 2008. 48(1): p. 53-61.
24. Cholewicki J, Reeves NP, Everding VQ, Morrisette DC. Lumbosacral orthoses reduce trunk muscle activity in a postural control task. J Biomech. 2007; 40(8): 1731-1736. https://doi.org/10.1016/j.jbiomech.2006.08.005.
25. Khalkhali M, Kalantari KK. A Comparative Study of the Effect of Local and General Fatigue on Sense. J Rehabil Med. 2007; 88(3): 52-60.
26. Namdar N, Arazpour M, Ahmadi Bani M. Comparison of the immediate efficacy of the Spinomed® back orthosis and posture training support on walking ability in elderly people with thoracic kyphosis. Disabil Rehabil Assist Technol. 2019; 14(3): 217-220. https://doi.org/10.1080/17483107.2017.1419295.
27. Ribeiro F, Oliveira J. Aging effects on joint proprioception: the role of physical activity in proprioception preservation. Eur Rev Aging Phys Act. 2007; 4(2): 71-76. 10.1007/s11556-007-0026-x.
28. Dupuy EG, Leconte P, Vlamynck E, Sultan A, Chesneau C. Ehlers-Danlos syndrome, hypermobility type: impact of somatosensory orthoses on postural control (a pilot study). Front Neurol. 2017; 11: 283. https://doi.org/10.3389/fnhum.2017.00283.
29. MOBERG E. The role of cutaneous afferents in position sense, kinaesthesia, and motor function of the hand. Brain. 1983; 106(1): 1-19. https://doi.org/10.1093/brain.
30. Gandevia SC, Refshauge KM, Collins DF. Proprioception: peripheral inputs and perceptual interactions: Sensorimotor control of movement and posture, 2002, 61-68. 10.1007/978-1-4615-0713-0_8.
31. Gandevia SC, McCloskey DI, Burke D. Kinaesthetic signals and muscle contraction. Trends in neurosciences. 1992; 15(2): 62-65. https://doi.org/10.1016/0166-2236(92)90028-7.
| Files | ||
| Issue | Vol 16 No 4 (2022) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v16i4.10762 | |
| Keywords | ||
| Hyperkyphosis Orthosis Electromyography Motor control | ||
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How to Cite
1.
Veiskarami M, Gholami M, Aboutorabi A, Ahmadi Bani M, Khamesi E. Motor Control Changes in Trunk Muscles after Using Anatomical Posture Control Orthosis in the Elderly Hyperkyphotic Subjects. jmr. 2022;16(4):347-354.
