Sling-based infant carrying affects lumbar and thoracic spine neuromechanics during standing and walking

Publication date: Available online 12 October 2018

Source: Gait & Posture

Author(s): Stefan Schmid, Michèle Stauffer, Judit Jäger, Renate List, Silvio Lorenzetti

Abstract

Background

Regular infant carrying might be a contributing factor for the development and progression of low back and pelvic girdle pain in mothers after childbirth. However, the neuromechanical adaptations of the spine due to different sling-based carrying techniques are not sufficiently well understood in order to provide evidence-based carrying recommendations.

Research question

What are the immediate effects of different sling-based infant carrying techniques on trunk neuromechanics?

Methods

Using a Vicon motion capture and a wireless surface electromyography system, three-dimensional pelvis and spinal kinematics as well as activation patterns of eight trunk muscles were derived from fifteen healthy young women during upright standing and level walking without carrying a load and while carrying a 6 kg-dummy with a sling in front and on either side. Data were analyzed using Statistical Parametric Mapping, allowing group comparisons of discrete parameters (standing) as well as continuous data (walking). To distinguish between clinically relevant and clinically not relevant kinematic findings, statistically significant differences were only considered in case of ≥5°.

Results

Compared to unloaded walking, carrying the dummy in front was mainly associated with increased lumbar lordosis (standing: (Δ8.8°, p = 0.006; walking: (Δ≥8.2°, 1-100% of gait cycle [%GC], p < 0.001). When carrying the dummy on the preferred side, increased thoracic kyphosis (standing: ≥6.4°, p ≤ 0.003; walking: Δ≥5.6°, 1-100%GC, p < 0.001) and axial rotation towards the ipsilateral side (standing: Δ5.3°, p = 0.003; walking: Δ≥5.0°, 46-58%GC, p = 0.002) were observed. All three conditions entailed increased paraspinal muscle activity during walking, although only unilaterally in side carrying (lumbar, preferred condition: Δ≥13.2%maxMVIC, 49-57%GC, p < 0.001; thoracic, non-preferred condition: Δ≥5.3%maxMVIC, 47-58%GC, p < 0.001).

Significance

Carrying an infant alternating on both sides using a sling could be advantageous for preventing musculoskeletal pain resulting from excessive lumbar hyperextension and paraspinal muscle hyperactivation in women after childbirth.

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Sling-based infant carrying affects lumbar and thoracic spine neuromechanics during standing and walking

Publication date: Available online 12 October 2018

Source: Gait & Posture

Author(s): Stefan Schmid, Michèle Stauffer, Judit Jäger, Renate List, Silvio Lorenzetti

Abstract

Background

Regular infant carrying might be a contributing factor for the development and progression of low back and pelvic girdle pain in mothers after childbirth. However, the neuromechanical adaptations of the spine due to different sling-based carrying techniques are not sufficiently well understood in order to provide evidence-based carrying recommendations.

Research question

What are the immediate effects of different sling-based infant carrying techniques on trunk neuromechanics?

Methods

Using a Vicon motion capture and a wireless surface electromyography system, three-dimensional pelvis and spinal kinematics as well as activation patterns of eight trunk muscles were derived from fifteen healthy young women during upright standing and level walking without carrying a load and while carrying a 6 kg-dummy with a sling in front and on either side. Data were analyzed using Statistical Parametric Mapping, allowing group comparisons of discrete parameters (standing) as well as continuous data (walking). To distinguish between clinically relevant and clinically not relevant kinematic findings, statistically significant differences were only considered in case of ≥5°.

Results

Compared to unloaded walking, carrying the dummy in front was mainly associated with increased lumbar lordosis (standing: (Δ8.8°, p = 0.006; walking: (Δ≥8.2°, 1-100% of gait cycle [%GC], p < 0.001). When carrying the dummy on the preferred side, increased thoracic kyphosis (standing: ≥6.4°, p ≤ 0.003; walking: Δ≥5.6°, 1-100%GC, p < 0.001) and axial rotation towards the ipsilateral side (standing: Δ5.3°, p = 0.003; walking: Δ≥5.0°, 46-58%GC, p = 0.002) were observed. All three conditions entailed increased paraspinal muscle activity during walking, although only unilaterally in side carrying (lumbar, preferred condition: Δ≥13.2%maxMVIC, 49-57%GC, p < 0.001; thoracic, non-preferred condition: Δ≥5.3%maxMVIC, 47-58%GC, p < 0.001).

Significance

Carrying an infant alternating on both sides using a sling could be advantageous for preventing musculoskeletal pain resulting from excessive lumbar hyperextension and paraspinal muscle hyperactivation in women after childbirth.

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Expert specification of the ACMG/AMP variant interpretation guidelines for genetic hearing loss.

Related Articles

Expert specification of the ACMG/AMP variant interpretation guidelines for genetic hearing loss.

Hum Mutat. 2018 Nov;39(11):1593-1613

Authors: Oza AM, DiStefano MT, Hemphill SE, Cushman BJ, Grant AR, Siegert RK, Shen J, Chapin A, Boczek NJ, Schimmenti LA, Murry JB, Hasadsri L, Nara K, Kenna M, Booth KT, Azaiez H, Griffith A, Avraham KB, Kremer H, Rehm HL, Amr SS, Abou Tayoun AN, ClinGen Hearing Loss Clinical Domain Working Group

Abstract
Due to the high genetic heterogeneity of hearing loss (HL), current clinical testing includes sequencing large numbers of genes, which often yields a significant number of novel variants. Therefore, the standardization of variant interpretation is crucial to provide consistent and accurate diagnoses. The Hearing Loss Variant Curation Expert Panel was created within the Clinical Genome Resource to provide expert guidance for standardized genomic interpretation in the context of HL. As one of its major tasks, our Expert Panel has adapted the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) guidelines for the interpretation of sequence variants in HL genes. Here, we provide a comprehensive illustration of the newly specified ACMG/AMP HL rules. Three rules remained unchanged, four rules were removed, and the remaining 21 rules were specified. These rules were further validated and refined using a pilot set of 51 variants assessed by curators and disease experts. Of the 51 variants evaluated in the pilot, 37% (19/51) changed category based upon application of the expert panel specified rules and/or aggregation of evidence across laboratories. These HL-specific ACMG/AMP rules will help standardize variant interpretation, ultimately leading to better care for individuals with HL.

PMID: 30311386 [PubMed - in process]

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Quinoxaline protects zebrafish lateral line hair cells from cisplatin and aminoglycosides damage.

Related Articles

Quinoxaline protects zebrafish lateral line hair cells from cisplatin and aminoglycosides damage.

Sci Rep. 2018 Oct 11;8(1):15119

Authors: Sanchez SMR, Fuson O, Tarang S, Goodman L, Pyakurel U, Liu H, He DZ, Zallocchi M

Abstract
Hair cell (HC) death is the leading cause of hearing and balance disorders in humans. It can be triggered by multiple insults, including noise, aging, and treatment with certain therapeutic drugs. As society becomes more technologically advanced, the source of noise pollution and the use of drugs with ototoxic side effects are rapidly increasing, posing a threat to our hearing health. Although the underlying mechanism by which ototoxins affect auditory function varies, they share common intracellular byproducts, particularly generation of reactive oxygen species. Here, we described the therapeutic effect of the heterocyclic compound quinoxaline (Qx) against ototoxic insults in zebrafish HCs. Animals incubated with Qx were protected against the deleterious effects of cisplatin and gentamicin, and partially against neomycin. In the presence of Qx, there was a reduction in the number of TUNEL-positive HCs. Since Qx did not block the mechanotransduction channels, based on FM1-43 uptake and microphonic potentials, this implies that Qx's otoprotective effect is at the intracellular level. Together, these results unravel a novel therapeutic role for Qx as an otoprotective drug against the deleterious side effects of cisplatin and aminoglycosides, offering an alternative option for patients treated with these compounds.

PMID: 30310154 [PubMed - in process]

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Expert specification of the ACMG/AMP variant interpretation guidelines for genetic hearing loss.

Related Articles

Expert specification of the ACMG/AMP variant interpretation guidelines for genetic hearing loss.

Hum Mutat. 2018 Nov;39(11):1593-1613

Authors: Oza AM, DiStefano MT, Hemphill SE, Cushman BJ, Grant AR, Siegert RK, Shen J, Chapin A, Boczek NJ, Schimmenti LA, Murry JB, Hasadsri L, Nara K, Kenna M, Booth KT, Azaiez H, Griffith A, Avraham KB, Kremer H, Rehm HL, Amr SS, Abou Tayoun AN, ClinGen Hearing Loss Clinical Domain Working Group

Abstract
Due to the high genetic heterogeneity of hearing loss (HL), current clinical testing includes sequencing large numbers of genes, which often yields a significant number of novel variants. Therefore, the standardization of variant interpretation is crucial to provide consistent and accurate diagnoses. The Hearing Loss Variant Curation Expert Panel was created within the Clinical Genome Resource to provide expert guidance for standardized genomic interpretation in the context of HL. As one of its major tasks, our Expert Panel has adapted the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) guidelines for the interpretation of sequence variants in HL genes. Here, we provide a comprehensive illustration of the newly specified ACMG/AMP HL rules. Three rules remained unchanged, four rules were removed, and the remaining 21 rules were specified. These rules were further validated and refined using a pilot set of 51 variants assessed by curators and disease experts. Of the 51 variants evaluated in the pilot, 37% (19/51) changed category based upon application of the expert panel specified rules and/or aggregation of evidence across laboratories. These HL-specific ACMG/AMP rules will help standardize variant interpretation, ultimately leading to better care for individuals with HL.

PMID: 30311386 [PubMed - in process]

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via IFTTT

Quinoxaline protects zebrafish lateral line hair cells from cisplatin and aminoglycosides damage.

Related Articles

Quinoxaline protects zebrafish lateral line hair cells from cisplatin and aminoglycosides damage.

Sci Rep. 2018 Oct 11;8(1):15119

Authors: Sanchez SMR, Fuson O, Tarang S, Goodman L, Pyakurel U, Liu H, He DZ, Zallocchi M

Abstract
Hair cell (HC) death is the leading cause of hearing and balance disorders in humans. It can be triggered by multiple insults, including noise, aging, and treatment with certain therapeutic drugs. As society becomes more technologically advanced, the source of noise pollution and the use of drugs with ototoxic side effects are rapidly increasing, posing a threat to our hearing health. Although the underlying mechanism by which ototoxins affect auditory function varies, they share common intracellular byproducts, particularly generation of reactive oxygen species. Here, we described the therapeutic effect of the heterocyclic compound quinoxaline (Qx) against ototoxic insults in zebrafish HCs. Animals incubated with Qx were protected against the deleterious effects of cisplatin and gentamicin, and partially against neomycin. In the presence of Qx, there was a reduction in the number of TUNEL-positive HCs. Since Qx did not block the mechanotransduction channels, based on FM1-43 uptake and microphonic potentials, this implies that Qx's otoprotective effect is at the intracellular level. Together, these results unravel a novel therapeutic role for Qx as an otoprotective drug against the deleterious side effects of cisplatin and aminoglycosides, offering an alternative option for patients treated with these compounds.

PMID: 30310154 [PubMed - in process]

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Hyperbaric Oxygen Therapy Key to Curing SSNHL

The addition of hyperbaric oxygen therapy (HBOT) to standard corticosteroid treatment is associated with higher rates of hearing recovery in patients with sudden sensorineural hearing loss (SSNHL), according to a new study (JAMA Otolaryngol Head Neck Surg 2018 Sep 27. doi: 10.1001/jamaoto.2018.2133). A systematic review, which included three randomized clinical trials and 16 nonrandomized studies, found that the rate of complete hearing recovery in SSNHL patients who received both HBOT and medical therapy of systemic and/or intratympanic corticosteroids was 29.4 percent, compared with 20.7 percent in those who were only treated with medications. Absolute hearing gain was also significantly greater in the HBOT and medical treatment group than in the medical treatment alone group for the overall frequencies. Furthermore, the benefit of this treatment approach was greater in those with severe to profound hearing loss.

The authors wrote that this study demonstrates for the first time to date that HBOT combined with medical treatment is associated with a significant improvement in complete hearing recovery and any hearing recovery. "Using HBOT, it is possible to maximize the oxygen partial pressure supplied to the inner ear," they wrote. "This process can minimize ischemic damage after SSNHL and aid vascular recovery. Furthermore, it can provide antibacterial effects through oxygen radicals and promote angiogenesis with tissue regeneration." 

Published: 10/12/2018 1:29:00 PM

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Hyperbaric Oxygen Therapy Key to Curing SSNHL

The addition of hyperbaric oxygen therapy (HBOT) to standard corticosteroid treatment is associated with higher rates of hearing recovery in patients with sudden sensorineural hearing loss (SSNHL), according to a new study (JAMA Otolaryngol Head Neck Surg 2018 Sep 27. doi: 10.1001/jamaoto.2018.2133). A systematic review, which included three randomized clinical trials and 16 nonrandomized studies, found that the rate of complete hearing recovery in SSNHL patients who received both HBOT and medical therapy of systemic and/or intratympanic corticosteroids was 29.4 percent, compared with 20.7 percent in those who were only treated with medications. Absolute hearing gain was also significantly greater in the HBOT and medical treatment group than in the medical treatment alone group for the overall frequencies. Furthermore, the benefit of this treatment approach was greater in those with severe to profound hearing loss.

The authors wrote that this study demonstrates for the first time to date that HBOT combined with medical treatment is associated with a significant improvement in complete hearing recovery and any hearing recovery. "Using HBOT, it is possible to maximize the oxygen partial pressure supplied to the inner ear," they wrote. "This process can minimize ischemic damage after SSNHL and aid vascular recovery. Furthermore, it can provide antibacterial effects through oxygen radicals and promote angiogenesis with tissue regeneration." 

Published: 10/12/2018 1:29:00 PM

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