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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The frontalis muscle spontaneous (SEMG) and electrically evoked (EEMG) electromyograms were recorded in 4 different clinical settings. Using a standardized isoflurane-based anesthetic protocol. Study 1 examined the SEMG response to both surgical and acoustic stimuli. The acoustic SEMG response was also examined in comatose head-injured patients. Study 2 used the EEMG to compare the extent of vecuronium-induced neuromuscular blockade on the frontalis and hypothenar muscles in both anesthetized and comatose patients. In Study 3 head-injured comatose patients were used to investigate the relationship between SEMG changes and transient elevations in intracranial pressure (ICP). The effect of opiate analgesics on the pain-activated SEMG in conscious post-operative patients was investigated in Study 4. These studies illustrate the following phenomena. First, in conscious, unparalyzed or lightly anesthetized patients, painful (stressful) stimuli are associated with increases in SEMG amplitude. Thus, the SEMG may indicate periods of inadequate analgesia, not only post-operatively (Study 4) but also intra-operatively (Study 1), since we found the frontalis to be relatively insensitive to a non-depolarizing neuromuscular blocker (Study 2). However, the interpretation of intra-operative SEMG changes may be confounded by opiates (Study 4) and perhaps other agents capable of influencing the frontalis through either non-nociceptive central or peripheral mechanisms. Second, the opiate analgesics consistently decreased SEMG amplitude in non-tolerant conscious patients (Study 4. Although this opiate-induced decrease is not necessarily indicative of opiate analgesia, it may provide an objective, quantifiable measure of a central opiate effect. The SEMG is particularly well-suited to determine the precise timecourse of this effect. Third, in deeply anesthetized or comatose patients, unresponsive to either surgical or electrical stimulation. SEMG amplitude may increase in response to elevated ICP or certain sounds (Study 3). The stress (pain) and auditory-evoked SEMGs may thus provide measures of brainstem function that are independent of the level of consciousness.
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PMID:Quantitative surface electromyography in anesthesia and critical care. 378 22

Since several years our group is working on a project to merge into a full 3D reliable and detailed human skeleton representation various segmental biomechanical models presented in literature. The obtained 3D skeleton model is fully parametric and can be fitted to each subject anthropometric characteristics. A non-ionising approach based on 3D opto-electronic measurements of body landmarks labelled by passive markers has been chosen to build the 3D parametric biomechanical skeleton model. A special focus has been devoted to identify and model the spine with a correct degree of accuracy and reliability. In spine pain related pathologies is of major importance the evaluation of functional limitations associated. This requires to integrate morphological characteristics with information deriving from other measurements devices as force platform data, surface EMG, foot pressure maps. The aim of this study is to present a multi-factorial approach which integrates rachis morphological characteristics with full skeleton kinematic, dynamic and SEMG measurements to quantify spine function and mobility in particular for neck and low back pain. A set of clinical-biomechanical tests have been implemented. Static posture characteristics are first evaluated. After that, patient is asked to perform specific motion test batteries in order to fully measure the whole ROMs (spine angles ranges and spine shape modifications) for Axial rotations, forward-backward flexion-extension, lateral bendings per each spine functional units (Skull and neck, thoracic and lumbar districts). During forward bending also a digital Schober test is performed. Such data are correlated to simultaneous SEMG muscle activities recording to investigate motor co-ordination/dysfunction as well as the presence absence of flexion-relaxation phenomena associated to pain.
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PMID:A 3-D skeleton model & SEMG approach for integrated neck and low back pain analysis test batteries. 1881 4

This study evaluated the relationship between post-treatment paraspinal surface EMG improvement in the static sitting and standing postures, with patient post-treatment subjective regional spinal pain and/or related neuromusculoskeletal symptoms, using hand held scanning electrodes. A retrospective review of consecutive files of patients who had presented with regional spinal pain and/or related neuromusculoskeletal symptoms was undertaken. The files considered for this study needed to meet a set of pre-established criteria in order to qualify for selection. Forty-two patients met the criteria for review. Forty-one patients reported post-treatment reduction in their symptoms. Of the 42 patients indicating improvement on post-treatment static scanning SEMG examination, 41 (97.6%) had indicated symptomatic improvement as well. The findings warrant further investigation to determine whether hand-held surface EMG scanners can be reliably utilized as a post-treatment objective instrument for determining symptomatic improvement in commonly seen physical conditions of the spine which are of spinal biomechanical/postural etiology.
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PMID:Scanning paraspinal surface EMG: A method for corroborating post-treatment spinal and related neuromusculoskeletal symptom improvement. 2423 93

Low back pain (LBP) is a major public health problem and the leading disabling musculoskeletal disorder globally. A number of biomechanical methods using kinematic, kinetic and/or neuromuscular approaches have been used to study LBP. In this narrative review, we report recent developments in two biomechanical methods: estimation of lower back loads and large-array surface electromyography (LA-SEMG) and the findings associated with LBP. The ability to estimate lower back loads is very important for the prevention and the management of work-related low back injuries based on the mechanical loading model as one category of LBP classification. The methods used for estimation of lower back loads vary from simple rigid link-segment models to sophisticated, optimization-based finite element models. In general, reviewed reports of differences in mechanical loads experienced in lower back tissues between patients with LBP and asymptomatic individuals are not consistent. Such lack of consistency is primarily due to differences in activities under which lower back mechanical loads were investigated as well as heterogeneity of patient populations. The ability to examine trunk neuromuscular behavior is particularly relevant to the motor control model, another category of LBP classification. LA-SEMG not only is noninvasive but also provides spatial resolution within and across muscle groups. Studies using LA-SEMG showed that healthy individuals exhibit highly organized, symmetric back muscle activity patterns, suggesting an orderly recruitment of muscle fibers. In contrast, back muscle activity patterns in LBP patients are asymmetric or multifocal, suggesting lack of orderly muscle recruitment. LA-SEMG was also shown capable of capturing unique back muscle response to manual therapy. In conclusion, estimation of low back load and LA-SEMG techniques demonstrated promising potentials for understanding LBP and treatment effects. Future studies are warranted to fully establish clinical validity of these two biomechanical methods.
J Pain Res 2017
PMID:Application of advanced biomechanical methods in studying low back pain - recent development in estimation of lower back loads and large-array surface electromyography and findings. 2876 72