Surgery – Diagnostic testing – Detecting muscle electrical signal
Patent
1997-12-30
1999-06-29
O'Connor, Cary
Surgery
Diagnostic testing
Detecting muscle electrical signal
600595, A61B 504
Patent
active
059161728
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
THIS INVENTION relates to diagnosis of neuromuscular dysfunction and , in particular, a system and a method for diagnosis of low back pain caused by neuromuscular dysfunction.
BACKGROUND ART
Low back pain (LBP) produces major societal, industrial, and personal problems, resulting in substantial annual health care costs, lost productivity, and disability (Flicker et al., 1993, Spine, 18, 582-586). Only a small percentage of low back complaints can be diagnosed definitively (Nachemson, 1975, NINCDS, Monograph No. 15, US Department of Health, Education and Welfare) because current techniques are effective only for diagnosis of LBP associated with damage or abnormality of the skeleton. However, a substantial percentage of these complaints can not be diagnosed because existing techniques are ineffective for diagnosis of LBP associated with muscular dysfunction.
The importance of the muscular system in stabilising the lumbar spine is summarised in an article by Goel et al., (1993, Spine, 18, 1531-1541). The paraspinal muscles, in particular, have been shown to play a vital role in the stability and functional movement of the vertebral column but their role in spinal dysfunction is unclear. In this respect, reference may be made to studies in which it was determined that the lumbar multifidus (Kalimo et al., 1989, Ann. Med., 21, 353-359; Punjabi et al., 1989, Spine, 14, 194-200; Wilke et al., 1995, Spine, 20, 192-198) and the lumbar erector spinae (McGill, 1991, Spine, 16, 809-815; Soderberg and Barr, 1993, Spine, 8, 79-85; Sullivan, 1989, Phys. Ther., 69, 38-45) are important in stabilisation of the lumbar spine.
Instability of the lumbar motion segment which often manifests in the neutral zone motion, is implicated as an important factor in the development of recurrent and chronic LBP (Punjabi, 1992, J. Spinal Disord., 5, 383-389; Panjabi, 1992, J. Spinal Disord., 5, 390-397). In an article by Hides et al. (1994, Spine, 19, 165-172) reference is made to unilateral wasting of paraspinal muscles localised to one vertebral level in patients with acute/subacute LBP. Paraspinal muscle wasting also has been documented in post-operative patients (Laasonen, 1984, Neuroradiology, 26, 9-13; Mayer et al., 1989, Spine, 14, 33-36; Sihvonen et al., 1993, Spine, 18, 575-581) and in subjects with chronic LBP (Cooper et al., 1992, Br. J. Rheumatol., 31, 389-394; Tertti et al., 1991, Radiology, 180, 503-507).
The muscle system, through specific joint stabilisation strategies, can help minimise joint displacement, aid stress absorption and generally prolong the "cartilage serving time" of the joint (Baratta et al., 1988, Am. J. Sp. Med., 16, 113-122). Several muscle recruitment strategies have been implicated in the development of active joint stabilisation. In this respect, reference may be made to articles by Gollhofer and Kyrolainen (1991, J. Sp. Med., 12, 3440), Johansson et al., (1991, CRC Crit., Rev. Biom. Eng., 18, 341-368), Woo and Winters (1990, Multiple Muscle Systems, New York, Springer-Verlag), Hoffer and Andreassen (1981, J. Neurophysiol., 45, 267-285) and Johansson and Sojka (1991, Med. Hypotheses, 35, 196-203).
One strategy which is described in conjunction with joint stabilisation, is the early pre-programmed recruitment of particular muscles. These muscles are activated in anticipation of a prime mover of voluntary limb or trunk movement in normal individuals and are hereinafter referred to as anticipatory muscles. Pre-programmed muscle recruitment serves to ensure that the joint is supported prior to movement. For example, during a jumping task, the leg extensor muscles are recruited prior to ground contact (Gollhofer and Kyrolainen, 1991, J. Sp. Med, 12, 34-40).
In addition, activation of postural muscles has been shown to occur in anticipation of the prime mover of voluntary limb or trunk movement to prevent the inevitable disturbance to balance. In this respect, reference may be made to Belen'kii et al., (1967, Biofizika, 12, 135-141), Bouisset and Zattara (1987, J. Biomech., 20, 73
REFERENCES:
patent: 4163440 (1979-08-01), DeLuca et al.
patent: 5085225 (1992-02-01), DeLuca et al.
DiFabio, R.P. 1987, Physical Therapy 67:43-48.
Troyer, A.D. et al., 1990, J. App. Physiol. 68:1010-1016.
Bouisset, S. et al., 1987, J. Biomechanics 20:735-742.
Panjabi, M.M., 1992, J. Spinal Disorders 5:383-389.
Panjabi, M.M., 1992, J. Spinal Disorders 4:390-397.
Cresswell, A.G., et al., 1994, Exp. Brain 98:336-341.
Cresswell, A.G., et al., 1992, Acta Physiol. Scand 144:409-418.
Soderberg, G.L. et al., 1983, Spine 8:79-85.
Belen'KII, V. Ye., et al., 1967, Biofizika 12:135-141.
Oddsson, L., 1989, Acta Physiol Scand 136:47-58.
Basmajian, J.V. et al., 1962, 849.
Mayer, T.G., et al. 1989, Spine.
Hides, J.A., et al. 1994, Spine 19:165-172.
Goel, V.K. et al. 1993, Spine 18:1531-1541.
Panjabi, M., et al. 1989, Spine 14:194-199.
Johansson, H., et al., 1991, Med. Hypoth. 35:196-203.
Hides, J.A., et al., 1995, Spine 20: 54-58.
Gollhofer, A., et al., 1991, Int. J. Sports Med. 12: 34-40.
Johansson, H., et al., 1991, Biomed. Eng 18:341-368.
Baratta, R., et al., 1988, Am J. Sports Med. 16:113-122.
Hoffer, J.A., et al., 1981, J. Neurophysiol. 45: 282-285.
Hodges Paul William
Richardson Carolyn Anne
O'Connor Cary
The University of Queensland
Wingood Pamela L.
LandOfFree
Diagnosis of neuromuscular dysfunction does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Diagnosis of neuromuscular dysfunction, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Diagnosis of neuromuscular dysfunction will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-1371554