RESEARCH PROJECT : DR ROB COLLINS (Cycling and Back/Neck Pain)

RESEARCH PROJECT : DR ROB COLLINS (Cycling and Back/Neck pain)

Search for: limit 4 to (english language and humans)

Results: 1-18

Database: Ovid MEDLINE(R) <1996 to November Week 2 2009> Search Strategy: ------1 Bicycling/ (3832) 2 back pain/ or neck pain/ (6552) 3 (back pain or neck pain).tw. or 2 (18618) 4 1 and 3 (21) 5 limit 4 to (english language and humans) (18) 6 from 5 keep 1-18 (18)

*************************** Result <1> Unique Identifier 19748441 Status MEDLINE Authors Ross DW. Wichman C. Mackinnon M. Authors Full Name Ross, David W. Wichman, Carol. Mackinnon, Mike. Institution [email protected] Title Car versus bicycle. Source Air Medical Journal. 28(5):208, 2009 Sep-Oct. Publication Type Case Reports. Journal Article.

Result <2> Unique Identifier 13680569 Status MEDLINE Authors Iversen MD. Fossel AH. Katz JN. Authors Full Name Iversen, Maura D. Fossel, Anne H. Katz, Jeffrey N. Institution Department of Physical Therapy, School of Health Studies, Simmons College, Boston, MA 02115, USA. Title Enhancing function in older adults with chronic low back pain: a pilot study of endurance training. Source Archives of Physical Medicine & Rehabilitation. 84(9):1324-31, 2003 Sep. Abstract OBJECTIVES: To assess the effectiveness of a bicycle endurance program in older adults with chronic low back pain (CLBP) and to identify correlates of exercise adherence. DESIGN: Prospective cohort. SETTING: Residential facilities and a tertiary care hospital. PARTICIPANTS: Adults with CLBP aged 55 years and older. Of 29 subjects who agreed to participate, 3 (10%) were deemed ineligible at baseline. Nineteen subjects (73%) were women, and the median age was 72 years. INTERVENTIONS: Subjects were assessed at baseline and at 6 and 12 weeks by using standardized questionnaires, physical examination, and endurance testing by a physical therapist. Subjects received a bicycle and instructions to exercise 3 times a week for 12 weeks at a set wattage. A trained rescarcher collected exercise data weekly.Main outcome measures The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), the lumbar spinal stenosis symptom severity and function scales, and kilocalories were use! d to assess change. RESULTS: At baseline, subjects were moderately impaired (mean SF-36 physical function score, 52.6). Eighteen (65%) completed the trial. At 12 weeks, physical functioning (SF-36) improved by 11%, mental health (Mental Health Inventory 5-Item Questionnaire) improved by 14%, and CLBP symptoms decreased by 8%. Reasons for withdrawing included illness, family issues, and bicycle-related discomfort. CONCLUSIONS: The bicycle program was safe and effective for improving functional status and well-being. Publication Type Journal Article. Research Support, Non-U.S. Gov't. Research Support, U.S. Gov't, P.H.S.. Result <3> Unique Identifier 17717059 Status MEDLINE Authors Little TL. Mansoor J. Authors Full Name Little, T L. Mansoor, J. Institution Physical Therapy, University of the Pacific, 3601 Pacific Avenue, Stockton, CA 95211, USA. [email protected] Title Low back pain associated with internal snapping hip syndrome in a competitive cyclist. Source British Journal of Sports Medicine. 42(4):308-9; discussion 309, 2008 Apr. Abstract Low back pain is a common complaint among cyclists. Here we present the case of a competitive master cyclist with low back pain and whose symptoms ultimately resolved when he was treated for internal snapping hip syndrome. Internal snapping hip syndrome is a painful lesion of the iliopsoas caused by snapping of the tendon over the iliopectineal eminence or anterior femoral head when the femur is extended from a flexed position. This is the first published report that we are aware of that describes this syndrome as a potential cause of low back pain in a competitive cyclist. Publication Type Case Reports. Journal Article.

Result <4> Unique Identifier 10597848 Status MEDLINE Authors Salai M. Brosh T. Blankstein A. Oran A. Chechik A. Authors Full Name Salai, M. Brosh, T. Blankstein, A. Oran, A. Chechik, A. Institution Department of Orthopedic Surgery A, The Chaim Sheba Medical Center, Tel Hashomer, Israel. Title Effect of changing the saddle angle on the incidence of low back pain in recreational bicyclists. Source British Journal of Sports Medicine. 33(6):398-400, 1999 Dec. Other ID Source: NLM. PMC1756210 Abstract OBJECTIVE: According to the literature, 30-70% of cyclists suffer from cervical, dorsal, or lumbar back pain. This study was conducted to evaluate one of the possible causes of low back pain and to suggest a solution by appropriate adjustments to the bicycle. METHODS: Serial fluoroscopic studies were performed while cyclists sat on different types of bicycle (sports, mountain, and city). Pelvic/spine angles were measured at different seat angles, and the related force vectors analysed. RESULTS: There was a tendency towards hyperextension of the pelvic/spine angle which resulted in an increase in tensile forces at the promontorium. These forces can easily be reduced by appropriate adjustment of the seat angle--that is, by creating an anterior inclining angle. The findings of the biomechanical analysis were then applied to a group of cyclists who were members of a cycling club and who complained of low back pain. After appropriate adjustment of the saddle angle, most of the ! cyclists (>70%) reported major improvement in the incidence and magnitude of their back pain. CONCLUSIONS: The incidence and magnitude of back pain in cyclists can be reduced by appropriate adjustment of the angle of the saddle. It is important that these findings be conveyed to cyclists, bicycle salesmen, trainers, and members of the general public who engage in cycling, in order to decrease the prevalence of back pain. Publication Type Clinical Trial. Comparative Study. Journal Article.

Result <5> Unique Identifier 9015601 Status MEDLINE Authors Callaghan MJ. Jarvis C. Authors Full Name Callaghan, M J. Jarvis, C. Institution British Cycling Federation, Velodrome Physiotherapy and Sports Injuries Clinic, National Cycling Centre, Manchester, United Kingdom. Title Evaluation of elite British cyclists: the role of the squad medical. Source British Journal of Sports Medicine. 30(4):349-53, 1996 Dec. Other ID Source: NLM. PMC1332424 Abstract OBJECTIVE: To describe and report results from the procedures and protocols used by the British Cycling Federation during the squad medicals of its elite cyclists. METHODS: Screening of over 500 elite riders has been done by doctors, dentists, physiotherapists, opticians, and dietitians since 1990. A questionnaire provided additional information on musculoskeletal problems. RESULTS: 523 riders have been examined and 92 (17.5%) have been referred for further assessment or treatment. Most of these riders were sent either to their own general practitioner or to the British Olympic Medical Centre. The questionnaire was completed by 81% of riders. Low back pain was the most common problem that riders encountered (60%), and knee pain the second most common (33%). Four riders failed the eye examination, and a further 11 were classed as borderline. Twenty one per cent of riders undergoing dental examination needed further dental treatment. CONCLUSIONS: The squad medical is an impo! rtant and useful strategy for evaluating elite British cyclists. It shows that a structured system can help early diagnosis and treatment to provide injury-free cyclists at the start of a competitive season. The results from the questionnaire confirm previously unsubstantiated opinions about the incidence of musculoskeletal injuries in cyclists. Publication Type Journal Article.

Result <6> Unique Identifier 18185040 Status MEDLINE Authors Smith TM. Sawyer SF. Sizer PS. Brismee JM. Authors Full Name Smith, Tanya M. Sawyer, Steven F. Sizer, Phillip S. Brismee, Jean-Michel. Institution Center of Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA. Title The double crush syndrome: a common occurrence in cyclists with ulnar nerve neuropathy-a case-control study. Source Clinical Journal of Sport Medicine. 18(1):55-61, 2008 Jan. Abstract OBJECTIVE: To evaluate the incidence of double crush syndrome in the upper limbs of cyclists with clinical diagnosis of ulnar nerve neuropathy. DESIGN: Case-control study. SETTING: Outpatient clinics and university setting. PARTICIPANTS: Consecutive sampling of 70 cyclists (140 upper limbs) with a mean age of 36 years (+/-11.3). Seventy-two upper limbs were excluded, leaving 40 upper limbs with a clinical diagnosis of ulnar nerve neuropathy [ULNN (+)] and 28 without symptoms of ulnar nerve neuropathy [ULNN (-)]. ASSESSMENT: Cyclists were examined clinically for the presence of proximal dysfunction using the following testing (independent variables): (1) thoracic outlet syndrome provocation testing: elevated arm stress test and modified Cyriax release test; (2) presence of an elevated first rib: cervical rotation lateral flexion test; and (3) presence of proximal symptoms: reports of neck pain and shoulder pain. MAIN OUTCOME MEASUREMENTS: The upper limbs of cyclists were ca! tegorized into 2 groups (dependent variable)-ULNN (+) and ULNN (-)-based on history, symptoms, motor, sensory, and provocative clinical testing. RESULTS: A significantly greater number of upper limbs of cyclists with ULNN (+) presented with positive provocative testing for thoracic outlet syndrome (elevated arm stress test P = 0.005; modified Cyriax release test P = 0.002) than did the upper limbs of cyclists with ULNN (-). The likelihood for the presence of neck pain, shoulder pain, and an elevated first rib was 3, 5, and 12 times greater, respectively, in the ULNN (+) than the ULNN (-) group. CONCLUSION: A statistically significant greater number of the upper limbs of cyclists with clinical diagnosis of ulnar nerve neuropathy presented with proximal dysfunctions suggestive of double crush syndrome. Publication Type Journal Article.

Result <7> Unique Identifier 16144585 Status MEDLINE Authors Asplund C. Webb C. Barkdull T. Authors Full Name Asplund, Chad. Webb, Charles. Barkdull, Thad. Institution Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650, USA. [email protected] Title Neck and back pain in bicycling. Source Current Sports Medicine Reports. 4(5):271-4, 2005 Oct. Abstract Neck and back pain are among the most common overuse injuries in cyclists. Bicycle fit, improper equipment, training errors, and individual anatomic factors are important evaluation considerations. By learning how to recognize and treat contributing factors, as well as learning a few simple bike-fitting techniques, physicians can treat and prevent many common problems of this popular activity. Publication Type Journal Article.

Result <8> Unique Identifier 17059104 Status MEDLINE Authors Watanabe S. Eguchi A. Kobara K. Ishida H. Otsuki K. Authors Full Name Watanabe, S. Eguchi, A. Kobara, K. Ishida, H. Otsuki, K. Institution Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288, Matsushima, Kurashiki City 701-0193, Japan. [email protected] Title Electromyographic activity of selected trunk muscles during bicycle ergometer exercise and walking. Source Electromyography & Clinical Neurophysiology. 46(5):311-5, 2006 Sep. Abstract Recently, active treatment such as exercise has been increasingly advocated for CLBP (chronic low back pain). Specially, exercise to improve fitness has been recommended for the prevention of back injuries. The bicycle ergometer or walking have often been used to improve the fitness of CLBP patients. However, little is known about the activity levels of the trunk muscles during such exercise. In this study, the electromyographic (EMG) activities of the trunk muscles during bicycle ergometer exercises and walking were compared and the load level on these muscles during such exercises was investigated. The present study provides basic information concerning fitness exercise in CLBP patients. Eleven healthy male volunteers (21.7 +/- 2.5 years old) without low back pain participated in the study. Bipolar surface electrodes were attached to the right side of the rectus abdominis, the obliquus externus abdominis and lower back extensor muscles (L3). EMG signals were continuously! recorded while walking and during gradual loading exercises and normalized to maximal voluntary contractions (% MVC). One way analysis of variance (ANOVA) was performed on the % MVC from each exercise and walking for each of the three trunk muscle sites (p < 0.05). The rectus abdominis muscle showed activity of about 6% MVC during any grade of exercise and walking and no significant differences were found between these forms of exercise. The obliquus externus abdominis muscle showed about 30% MVC during any grade of exercise and walking, but no significant difference was found between them. The low back muscles showed activity of about 12% MVC while walking, whereas activity level increased as the exercise load using the bicycle ergometer increased. More significant low back muscles activity was observed while walking than during exercises of 25 w and 50 w. The results of this study indicated that exercise using the bicycle ergometer should be useful for maintaining or imp! roving fitness in CLBP patients, because it results in less load on th e trunk muscles and relatively more oxygen uptake than walking. Publication Type Comparative Study. Journal Article.

Result <9> Unique Identifier 12928857 Status MEDLINE Authors Sjolie AN. Authors Full Name Sjolie, Astrid N. Institution Department of Public Health and Primary Health Care, University of Bergen, Norway. [email protected] Title Active or passive journeys and low back pain in adolescents. Source European Spine Journal. 12(6):581-8, 2003 Dec. Abstract The objective of this cross-sectional study was to study associations between low back pain (LBP) and modes of transport to school and leisure activities among adolescents. The study population included all adolescents in eighth and ninth grade in two geographic areas in eastern Norway. Eighty-eight adolescents participated (mean age 14.7 years), making the response rate 84%. Data concerning active (walking/bicycling) and passive (bus/car) journeys were obtained from lists and maps from local authorities, and from the pupils, using a questionnaire that also included LBP, activities and wellbeing. Distance walked/bicycled to school was slightly shorter among those reporting LBP in bivariate analyses. Walking/bicycling more than 8 km weekly to regular activities was inversely associated with LBP in multivariate analysis (OR 0.3; 95% confidence interval 0.1-1.0). No associations were found between passive journeys and LBP. The results raise the question for future research of! whether lack of active transport may be one cause behind the increase in juvenile LBP. Publication Type Journal Article.

Result <10> Unique Identifier 19118791 Status MEDLINE Authors Balasubramanian V. Jayaraman S. Authors Full Name Balasubramanian, Venkatesh. Jayaraman, Srinivasan. Institution Rehabilitation Bioengineering Group (RBG), Department of Biotechnology, IIT Madras, Chennai 600036, India. [email protected] Title Surface EMG based muscle activity analysis for aerobic cyclist. Source Journal of Bodywork & Movement Therapies. 13(1):34-42, 2009 Jan. Abstract In this study, we determined the muscle activity of aerobic cyclist on biceps brachii medial, trapezius medial, latissimus dorsi medial, and erector spinae muscles bilaterally during 30 min of cycling. Thirteen male volunteers were chosen and placed in two groups (with and without low back pain (LBP)). Surface electromyography (sEMG) was recorded bilaterally from selected muscle groups for 30 min of cycling for each subject. Statistical tests were performed to determine the difference in fatigue, using mean power frequency difference. LBP group showed a significantly higher fatigue (p<0.05) in left biceps brachii medial when compared to the control group. High fatigue in the back muscles in the LBP group was not found; however, when linear regression was performed for these individuals, the data showed a possibility of worsening in their condition due to 30 min of cycling. Publication Type Comparative Study. Controlled Clinical Trial. Journal Article. Research Support, Non-U.S. Gov't.

Result <11> Unique Identifier 10863116 Status MEDLINE Authors Lee WW. Jensen ER. Authors Full Name Lee, W W. Jensen, E R. Institution Division of Emergency Medicine, University of Utah Medical Center, Salt Lake City, UT 84132, USA. Title Bilateral internal carotid artery dissection due to trivial trauma. Source Journal of Emergency Medicine. 19(1):35-41, 2000 Jul. Abstract Internal carotid artery dissection (ICAD) is a known cause of unilateral headache and focal cerebral ischemic symptoms. Other symptoms include oculosympathetic paresis, facial pain, neck pain, subjective carotid bruits, and cranial nerve deficits. Traumatic dissection has an obvious precipitating incident preceding the neurologic or visual symptoms. An ICAD that occurs spontaneously or from trivial trauma usually lacks an obvious incident and thus requires awareness of its possibility for accurate detection and treatment. Dissections arise from a defect in the internal elastic lamina allowing penetration of blood into the arterial wall. Despite its low incidence, ICAD must be considered in young to middle-aged patients who present with headache and transient cerebral or retinal ischemic symptoms. This report describes a patient who had bilateral internal carotid artery dissections following trivial trauma. The etiologies, clinical manifestations, diagnostic modalities, tre! atment options, and outcomes of ICAD are discussed. Publication Type Case Reports. Journal Article. Result <12> Unique Identifier 15522646 Status MEDLINE Authors Burnett AF. Cornelius MW. Dankaerts W. O'sullivan PB. Authors Full Name Burnett, Angus F. Cornelius, Mary W. Dankaerts, Wim. O'sullivan, Peter B. Institution School of Biomedical and Sports Science, Edith Cowan University, 100 Joondalup Drive, Joondalup, 6027 Western Australia, Australia. [email protected] Title Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation. Source Manual Therapy. 9(4):211-9, 2004 Nov. Abstract The aim of this pilot study was to examine whether differences existed in spinal kinematics and trunk muscle activity in cyclists with and without non-specific chronic low back pain (NSCLBP). Cyclists are known to be vulnerable to low back pain (LBP) however, the aetiology of this problem has not been adequately researched. Causative factors are thought to be prolonged forward flexion, flexion-relaxation or overactivation of the erector spinae, mechanical creep and generation of high mechanical loads while being in a flexed and rotated position. Nine asymptomatic cyclists and nine cyclists with NSCLBP with a flexion pattern disorder primarily related to cycling were tested. Spinal kinematics were measured by an electromagnetic tracking system and EMG was recorded bilaterally from selected trunk muscles. Data were collected every five minutes until back pain occurred or general discomfort prevented further cycling. Cyclists in the pain group showed a trend towards increased! lower lumbar flexion and rotation with an associated loss of co-contraction of the lower lumbar multifidus. This muscle is known to be a key stabiliser of the lumbar spine. The findings suggest altered motor control and kinematics of the lower lumbar spine are associated with the development of LBP in cyclists. Publication Type Journal Article.

Result <13> Unique Identifier 12569224 Status MEDLINE Authors Bressel E. Larson BJ. Authors Full Name Bressel, Eadric. Larson, Brad J. Institution Biomechanics Laboratory, HPER Department, Utah State University, Logan, UT 84322, USA. [email protected] Title Bicycle seat designs and their effect on pelvic angle, trunk angle, and comfort. Source Medicine & Science in Sports & Exercise. 35(2):327-32, 2003 Feb. Abstract PURPOSE: To examine whether bicycle seats with anterior-medial cutouts influence pelvic angle, trunk angle, and comfort in female subjects during cycling. METHODS: Twenty female cyclists pedaled a stationary bicycle with their hands on the tops and drops of the handlebars under three different saddle conditions (standard, partial, and complete cutout designs). Pelvic angle was measured using an inclinometer attached to a caliper whereas trunk angle was quantified from digitization of video images. Comfort level was assessed subjectively by having participants rank the saddles from most to least comfortable. RESULTS: Anterior pelvic tilt angles for the partial and complete cutout saddles were 8% and 16% greater, respectively, than values for the standard saddle condition ( P < 0.05). Trunk flexion angles were greater for the complete versus standard and partial cutout designs ( P< 0.05). Participants displayed a 77% greater anterior pelvic tilt angle and an 11% greater trun! k flexion angle in the drop versus top handlebar positions ( P < 0.05). A total of 55% of the subjects ranked the partial cutout saddle as the most comfortable, and 30% ranked the standard saddle as the most comfortable. CONCLUSIONS: These data indicate that partial and complete cutout saddle designs may increase anterior pelvic tilt, and saddles with a complete cutout design may increase trunk flexion angles under select cycling conditions. A saddle with a partial cutout design may be more comfortable than a standard or complete cutout saddle design. Publication Type Evaluation Studies. Journal Article. Research Support, Non-U.S. Gov't.

Result <14> Unique Identifier 17112197 Status MEDLINE Authors Villavicencio AT. Burneikiene S. Hernandez TD. Thramann J. Authors Full Name Villavicencio, Alan T. Burneikiene, Sigita. Hernandez, Theresa D. Thramann, Jeff. Institution Boulder Neurosurgical Associates, Boulder, Colorado 80304, USA. [email protected] Title Back and neck pain in triathletes. Source Neurosurgical Focus. 21(4):E7, 2006. Abstract OBJECT: As the sport of triathlon has continued to grow, increasing numbers of triathletes have presented in the neurosurgery clinics with various spinal disorders. This epidemiological study was undertaken to establish the lifetime incidence of neck and back pain, to gauge the prevalence of discogenic pain, and to identify risk factors among triathletes in the Boulder, Colorado, area. METHODS: A live online questionnaire was developed that was used to collect information about physical characteristics, training habits, athletic status, number of races completed, and back pain among triathletes. The incidence of cervical and/or lumbar discogenic back pain was defined according to the duration of symptoms for the most recent pain episode. The lifetime incidence of low-back pain was 67.8%, with 23.7% of cases possibly being discogenic in origin. The number of triathlons in which the respondents had participated and the presence of previous sports-related injuries were predic! tive of low-back pain (p = 0.02 and p < 0.00001, respectively). The lifetime incidence of neck pain was 48.3%, with 21.4% of cases being consistent with intervertebral disc involvement. The number of previous sports-related injuries was predictive of neck pain (p < 0.00001), and a strong tendency toward neck pain was observed for athletes with more total years of participation in sports (p = 0.06). CONCLUSIONS: The two main risk factors for long-term spinal problems include sports-related injuries and overuse. The study results definitely support the influence of both mechanisms for low-back pain. Neck pain was associated with an injury event, and a strong (although not statistically significant) tendency toward neck pain was observed in respondents with overuse injuries. Publication Type Journal Article. Research Support, Non-U.S. Gov't.

Result <15> Unique Identifier 12589270 Status MEDLINE Authors Fanucci E. Masala S. Fasoli F. Cammarata R. Squillaci E. Simonetti G. Authors Full Name Fanucci, Ezio. Masala, Salvatore. Fasoli, Fabrizio. Cammarata, Rita. Squillaci, Ettore. Simonetti, Giovanni. Institution Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, Universita degli Studi di Roma Tor Vergata, Roma, Italy. [email protected] Title Cineradiographic study of spine during cycling: effects of changing the pedal unit position on the dorso-lumbar spine angle. Source Radiologia Medica. 104(5-6):472-6, 2002 Nov-Dec. Abstract PURPOSE: Low back pain is a frequent pathology among bicyclists, probably due to unappropriate saddle position. This radiographic study was conducted to evaluate dorso-lumbar angular values in two different pedal unit positions; the first one in a bicycle frame type with pedals in front of the saddle axis and the second one with the pedals behind the saddle axis, in order to define the most physiological sitting position. MATERIALS AND METHODS: Ten voluntary healthy adults, ranging in age between 21 to 45 years, were randomly choosen among a group of cyclist not involved in competition and underwent serial fluoroscopic studies while cyclists sit on two different saddles of a prototype cyclette; dorso-lumbar angles at both different sitting positions were measured on film according to modified Lippmann-Cobb method using as reference the upper somatic limitant of the eleventh or twelth dorsal vertebra and the lower somatic limitant of the third lumbar vertebra. RESULTS: Stat! istical analysis of the measured angles demonstrates that the differences between the dorso-lumbar spine angle in the different saddle positions are statistically significative with a coefficient correlation equals to 0.64015 and p>0.01; angular values are more physiological in the second position with pedal unit behind the saddle axis. CONCLUSIONS: The incidence and importance of low back pain in cyclists can be reduced with appropriate pedal unit position; the position with pedals behind the saddle axis permits more physiological spine angles in comparison with the classic one having the pedals in front of the saddle axis; this fact is due to a different pelvic position which coincides with lumbar angles. Publication Type Clinical Trial. Journal Article. Randomized Controlled Trial.

Result <16> Unique Identifier 12056361 Status MEDLINE Authors Keytel LR. Noakes TD. Authors Full Name Keytel, L R. Noakes, T D. Institution Department of Human Biology, University of Cape Town Medical School, Sports Science Institute of South Africa. Title Effects of a novel bicycle saddle on symptoms and comfort in cyclists.[see comment]. Comments Comment in: S Afr Med J. 2002 Dec;92(12):928-9; author reply 929-30; PMID: 12561398 Source South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 92(4):295-8, 2002 Apr. Abstract BACKGROUND: While the bicycle frame and other parts of the bicycle have undergone many improvements, the bicycle saddle has remained relatively unchanged since it was first designed more than 100 years ago. Given the number and range of cycling injuries believed to result from the saddle, this is surprising. This study investigated the effects of a novel bicycle saddle on saddle-related comfort and symptoms during cycling. METHOD: Eleven competitive or recreational cyclists, 6 females and 5 males, performed three 2-hour stationary cycle rides in the laboratory, using their personal bicycles. Ride 1 was performed using the standard bicycle saddle and rides 2 and 3 using the novel bicycle saddle. Subjects reported saddle comfort rating scores (SC) while using the different saddles. Subjects also completed a questionnaire evaluating saddle symptoms (SS) when using either the conventional or the novel bicycle saddle during daily cycling. RESULTS: The most common saddle-related! medical complaint with chronic use of the conventional saddle was painful pubic bones, with or without chaffing. Others were severe chaffing, saddle sores, chaffing and back pain, and painful pubic bones associated with a loss of feeling in the pelvic area. The mean SS rating score during the 2-hour laboratory ride was significantly less for the novel saddle (11.6 +/- 1.2 versus 19.1 +/- 3.2 arbitrary units, P < 0.01). Similarly the mean SC score was significantly lower for the novel saddle (36.2 +/- 10.5 v. 54.7 +/- 11.2 arbitrary units). Values for both SC scores were similar for rides 2 and 3. On completion of the trial all subjects indicated that they would continue to use the novel saddle in preference to the conventional saddle. Three months later 9 subjects (82%) reported continued use of this saddle in preference to the conventional saddle. CONCLUSION: These results show conclusively that this novel bicycle saddle: (i) significantly reduced reported symptoms during! daily cycling compared with the conventionally designed cycling saddl e; (ii) significantly improved saddle comfort during 2-hour cycles in the laboratory, such that (iii) when given the option the majority (82%) of the subjects chose to use this saddle 3 months later. Furthermore, the beneficial effects of the novel saddle were apparent during its first use, suggesting that the novel saddle is effective because the design is anatomically correct. Publication Type Clinical Trial. Journal Article. Research Support, Non-U.S. Gov't.

Result <17> Unique Identifier 19333089 Status MEDLINE Authors Blondel B. Metellus P. Fuentes S. Dutertre G. Dufour H. Authors Full Name Blondel, Benjamin. Metellus, Philippe. Fuentes, Stephane. Dutertre, Guillaume. Dufour, Henry. Institution Department of Neurosurgery, CHU Timone, Marseille, France. Title Single anterior procedure for stabilization of a three-part fracture of the axis (odontoid dens and hangman fracture): case report. Source Spine. 34(7):E255-7, 2009 Apr 1. Abstract STUDY DESIGN: A case of a 3-part fracture of the axis combining an odontoid dens and a hangman fracture is reported. OBJECTIVE: To describe a single anterior procedure allowing stabilization with an odontoid screw fixation and a C2-C3 fusion in a case of complex fracture of the axis. SUMMARY OF BACKGROUND DATA: Even if fractures of the axis are common, multiples fractures of the axis are rare and their management is still challenging for surgeons who have to achieve primary stability, early mobilization, preserved cervical range of motion, and favorable outcome. METHODS: A 79-year-old man was referred in our neurosurgical department 3 weeks after a bicycle accident. He had persistent neck pain without radicular pain. Neurologic examination was normal. The initial CT scan showed a rare and complex fracture of the axis consisting of a fracture of the dens and a traumatic spondylolisthesis of C2-C3. RESULTS: The surgical procedure was performed using an anterior cervical appr! oach under fluoroscopic guidance. First, a C2-C3 fusion was performed using an iliac crest graft. Then an anterior odontoid screw was placed under fluoroscopic guidance. Finally, an anterior plating of C2-C3 covering the odontoid screw was achieved. Postoperative course was uneventful and patient was discharged at day 6. CONCLUSION: This single time procedure was able to achieve primary stability of the fractures of the axis and offers the possibility of an early mobilization of the patient with a good outcome. This approach allowed a better preservation of the cervical range of motion compared with a classic posterior fusion. Publication Type Case Reports. Journal Article.

Result <18> Unique Identifier 14588388 Status MEDLINE Authors Sculco AD. Paup DC. Fernhall B. Sculco MJ. Authors Full Name Sculco, A D. Paup, D C. Fernhall, B. Sculco, M J. Institution The School of Public Health and Health Services, The George Washington University Medical Center, 817 23rd St., NW, Washington, DC 20052, USA. Title Effects of aerobic exercise on low back pain patients in treatment. Source Spine Journal: Official Journal of the North American Spine Society. 1(2):95-101, 2001 Mar-Apr. Abstract BACKGROUND CONTEXT: Aerobic exercise (AE) has been prescribed to improve fitness and well-being in apparently healthy individuals and cardiac, orthopedic, and other patient populations. AE has not previously been studied as a sole treatment for low back pain patients (LBPP). PURPOSE: This study evaluated the effects of low to moderate aerobic exercise as an adjunct treatment for LBPP, 30 to 60 years of age, in a neurosurgical practice during a 2.5-year follow-up to an initial 10-week exercise program. The purpose of this study was to determine the effects of short- and long-term AE on LBPP. The initial 10-week phase compared AE and nonexercising controls on mood states and pain/symptoms. STUDY DESIGN/SETTING: A matched stratified design was used to input LBPP with similar previous clinical treatments as well as age and sex into AE or control groups. PATIENT SAMPLE: After screening 68 LBPP from a New England private neurosurgical practice, 40 patients met qualification crit! eria, and 35 volunteered for this AE research study. The LBPP in this study were 30 to 60 years old and had the following medical diagnoses: herniated nucleus pulposus at one or more lumbar levels, degenerative discopathy, lumbosacral strain, and spinal canal and/or foraminal stenosis. OUTCOME MEASURES: The measure of mood states was the Profile of Mood States, and the measure of pain was the Brief Pain Inventory. The 2.5-year follow-up phase compared AE and nonexercise patients on the following treatment variables: medical office visits for pain/symptoms, physical therapy referrals, epidural steroid injections for pain/symptoms, prescription of pain medications, and work status. METHODS: Thirty-five LBPP were matched stratified into an AE or nonexercise control group for a 10-week exercise program. After the 10-week exercise program, all subjects were given the opportunity to cross over to the opposite group. Those patients choosing to exercise were advised to follow a low! to moderate aerobic exercise prescription (walking or cycling, 60% ag e-predicted maximal heart rate, 4 days per week for 45 minutes per day). None of the original AE group crossed over to the nonexercise group because of symptoms relating to their previous exercise participation. All participants were contacted at 6-month intervals, and the number of medical office visits for pain/symptoms, physical therapy referrals, number of epidural steroid injections, and number of prescriptions for pain was charted for 2.5 years. Work status was evaluated by comparing the change in number of patients not working, working part time, working full time, or number changing from full time to part time or not working from randomization to the end of follow-up. Patients following the exercise prescription at least 50% of the time were compared with those exercising less than 50% of the time during the 2.5-year follow-up. Significance was determined at the.05 level using Fisher's exact test or the Kruskal-Wallis test. RESULTS: The initial 10-week AE phase of th! e study indicated that low to moderate AE significantly improved mood profile (AE X=-9.58; control X=19.11; p<.01) but did not alter pain levels. AE patients in the 2.5-year follow-up phase received significantly fewer pain medication prescriptions (AE X=2.76; control X=13.35; p<.02) and were given fewer physical therapy referrals (AE X=0.17; control X=1.64; p<.002). There was no significant difference in the number of medical office visits for pain or epidural blocks administered to either group. Work status was improved only in exercising patients (AE X=+0.24; control X=-0.35; p<.04). CONCLUSIONS: Low to moderate aerobic exercise appears to improve mood states and work status and reduce the need for physical therapy referrals and pain medication prescriptions for LBPP in the care of a neurosurgeon. Publication Type Clinical Trial. Journal Article. Randomized Controlled Trial.