Rebecca J. Crawford

Disorders affecting the neurological and musculoskeletal systems represent international health burdens. A significant impediment to progress with interventional trials is the absence of responsive, objective, and valid outcome measures sensitive to early disease or disorder change. A key finding in individuals with spinal disorders is compositiona...

Disorders affecting the neurological and musculoskeletal systems represent international health priorities. A significant impediment to progress in trials of new therapies is the absence of responsive, objective, and valid outcome measures sensitive to early disease changes. A key finding in individuals with neuromuscular and musculoskeletal disord...

Purpose Fat infiltration (FI) of the paraspinal muscles (PSMs) measured using MRI is an aspect of muscle quality and is considered to be worse in chronic low back pain (cLBP) patients. However, there is not a clear association between paraspinal muscle FI and cLBP, leaving the clinical importance of paraspinal muscle composition unestablished. The...

Background Measures of hip muscle morphology and composition (e.g., muscle size and fatty infiltration) are possible with magnetic resonance imaging (MRI). Standardised protocols or guidelines do not exist for evaluation of hip muscle characteristics, hindering reliable and valid inter-study analysis. This scoping review aimed to collate and synthe...

Background Measures of hip muscle morphology and composition (e.g., muscle size and fatty infiltration) are possible with magnetic resonance imaging (MRI). Standardised protocols or guidelines do not exist for evaluation of hip muscle characteristics, hindering reliable and valid inter-study analysis. This scoping review aimed to collate and synthe...

Background context: For chronic low back pain, the causal mechanisms between pathological features from imaging and patient symptoms are unclear. For instance, disc herniations can often be present without symptoms. There remains a need for improved knowledge of the pathophysiological mechanisms that explore spinal tissue damage and clinical manif...

Previous preliminary work mapped the distribution of neck muscle fat infiltration (MFI) in the deep cervical extensor muscles (multifidus and semispinalis cervicis) in a small cohort of participants with chronic whiplash associated disorders (WAD), recovered, and healthy controls. While MFI was reported to be concentrated in the medial portion of t...

Abstract Lumbar disc‐displacement, Modic changes (MCs), and UTE Disc Sign (UDS) on MRI are clinically relevant spinal phenotypes that can lead to sciatica/LBP. Not all degenerated discs result in disc‐displacement, MCs and UDS, suggesting varied etiologies. Spinopelvic parameters have been implicated in various spinal disorders. Pelvic incidence (P...

A wonky footpath is good for you! Challenging safety policy toward healthy ageing. Policy surrounding pedestrian safety is arguably based more on risk-mitigation (and avoiding litigation) than on empirical evidence showing proven benefit to the safety of the individual and/or their health. Our bodies need to move often, and meaningfully, to age h...

Dr. Rebecca Crawford founded the Body Urbanism Movement; she wants cities that make people move more and to meaningfully engage and challenge the human body toward healthy ageing! Public space and art are key ingredients of that recipe! Rebecca has helped people move better for over thirty years as a human movement scientist and a specialist muscul...

Background: A simple clinical test involving subject tracing zigzag (ZZ) and figure of eight (F8) patterns with a head mounted laser device in determining cervical movement sense has proven reliability and feasibility. However, its validity in comparing individuals with and without neck pain (NP) has not been examined. Methods: Seventy-six subj...

Study design: Cross-sectional. Objective: We quantified fatty infiltration (FI) geography of the lumbar spine to identify whether demographics, temporal low back pain (LBP), and disability influence FI patterns. Summary of background data: Lumbar paravertebral muscle FI has been associated with age, sex, LBP, and disability; yet, FI accumulati...

Synopsis: The development of persistent spinal (traumatic and non-traumatic) pain is common and contributes to high societal and personal costs, globally. There is an acknowledged urgency for new and interdisciplinary approaches to the problem, and soft tissues including skeletal muscles, the spinal cord, and brain are rightly receiving increased...

An introduction to the body urbanism movement, founded by Dr. Rebecca J. Crawford in 2018 in response to the emerging global crisis that musculoskeletal disease, and ageing, represent. Building cities that meaningfully engage and challenge human movement. This bespoke webinar, written for musculoskeletal scientists and clinicians at the Universit...

GSJ765483_suppl_mat - Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review

The influence of age on spinal muscle activation patterns and its relation to kinematics is poorly understood. We aimed at understanding age-related changes to spine and trunk muscle activity in addition to spinal and lower limb kinematics during treadmill walking under various conditions. An observational study was conducted evaluating asymptomati...

Background: Low back pain (LBP) and neck pain (NP) are of considerable socioeconomic burden. Considering the escalating demand on health services that LBP and NP have globally, they represent an arguably unsustainable drain on resources with the projected increased demand secondary to an ageing population. Identifying populations at risk for LBP an...

Background: Pattern tracing tasks can be used to assess cervical spine movement sense (CMS). A simple clinical measure of CMS (tracing fixed figure-of-eight (F8) and zigzag (ZZ) patterns with a head mounted laser) has been proposed and assessed in asymptomatic subjects. It is important to determine if examiner ratings of the traces are reliable an...

Background: It has been suggested that the quantification of paravertebral muscle composition and morphology (e.g. size/shape/structure) with magnetic resonance imaging (MRI) has diagnostic, prognostic, and therapeutic potential in contributing to overall musculoskeletal health. If this is to be realised, then consensus towards standardised MRI me...

Objective: We aimed to provide mean values for fat-fraction and volume for full-length bilateral rotator cuff and deltoid muscles in asymptomatic adults selected on the basis of their good musculoskeletal and systemic health, and to understand the influence of gender, age, and arm dominance. Materials and methods: Seventy-six volunteers aged 20...

Study Design Systematic review. Objectives To review the current literature on the treatment efficacy, clinical utility, and cost-effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) for patients suffering from persistent (nonspecific) lower back pain (LBP) in relation to pain intensity, disability, health-related quality of lif...

Purpose: Fatty infiltration (FI) is a feature of degenerating muscle that predominates in the low lumbar spine, associates with pain, and is confounded by age, spinal degeneration, and curvature. We determined rates for decline of lumbar muscle quality according to ethnicity, muscle, and spinal level in asymptomatic subjects. Methods: Cross-sect...

Objectives: Our study aimed to describe temporal changes in self-rated health status (SRH) from 1997 to 2012 in adults aged 25 to 84 residing in Switzerland with a view to identifying groups at risk for declining health. Study design: Secondary analysis of population-based cross-sectional health surveys. Methods: Data were collected from the cross-...

Background: Ethnicities differ in prevalence of blood groups and antigens. Substantial donor-recipient mismatch within mixed-ethnic societies may render certain recipients at higher risk for alloimmunization. Data regarding antigen distribution within Switzerland by ethnicity is limited. We examined immigration patterns against the distribution of...

Background context: Radiological observations of soft-tissue changes that may relate to clinical symptoms in patients with traumatic and non-traumatic spinal disorders are highly controversial. Studies are often of poor quality and findings inconsistent. A plethora of evidence suggests some pathoanatomical findings from traditional imaging applica...

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Introduction: The power locus during walking shifts proximally from ankle to hip with age. Lower limb muscle activity patterns have been well examined, yet surprisingly few studies measure lumbar paravertebral muscle activity during walking. Multifidus is a complex muscle with differential activation of deep and superficial fibres shown in young ad...

Background: Lateral gliding cervical spine mobilisation is shown to improve shoulder pain, disability and function. However, despite common clinical-use, no study reports the effect of unilateral anterior-posterior (A-P) cervical mobilisation on shoulder pain and function, and particularly in patients after arthroscopic shoulder surgery. Objectiv...

Background Interspinous spacer/implants like the Device for Intervertebral Assisted Motion (DIAM™) are controversially yet commonly used in the surgical treatment of lumbar degenerative pathologies. Criticism is based on ill-defined indications, lack of superiority over decompression, and a poorly understood mechanical effect. Yet, continued use by...

Background There is increasing interest in paravertebral muscle composition as a potential prognostic and diagnostic element in lumbar spine health. As a consequence, it is becoming popular to use magnetic resonance imaging (MRI) to examine muscle volume and fatty infiltration in lumbar paravertebral muscles to assess both age-related change and th...

Background The spinal column including its vertebrae and disks has been well examined and extensively reported in relation to age-aggregated degeneration. In contrast, paravertebral muscles are poorly represented in describing normative degeneration. Increasing evidence points to the importance of paravertebral muscle quality in low back health, an...

Purpose: Lumbar multifidus is a complex muscle with multi-fascicular morphology shown to be differentially controlled in healthy individuals during sagittal-plane motion. The normal behaviour of multifidus muscle regions during walking has only received modest attention in the literature. This study aimed to determine activation patterns for deep...

General poster

Modern man is the epitome of efficient upright walking, yet with up to 80% lifetime prevalence for low back pain (LBP) as a potential trade-off, the consequences to present day society are vast. Despite significant global resources directed at understanding and managing this condition, outcomes have not improved, incidence has not decreased, and it...

Background To our knowledge, there are no methods allowing for quantification of the spatial distribution of lumbar paravertebral muscle fatty infiltration (FI) in the transverse plane. There is an increasing emphasis on muscle tissues as modifiable factors in lumbar spine health. Population datasets based on conventional T1-weighted (T1-W) magneti...

Introduction: Lumbar paravertebral muscles are receiving mounting recognition as modifiable targets for preventing and managing low back pain (LBP). Fatty infiltration is an established marker of muscle decline, and is linked to ageing and LBP. Disc degeneration (DD) is prevalent in asymptomatic and symptomatic populations, yet the relationship of...

Introduction: Paravertebral muscles represent a promising target in personalised management of low back pain. While normative degeneration of lumbar vertebra and disks has been well-examined, only modest literature describes adjacent muscles. Aim: Compare decline rates for muscles, vertebra, and disks of the lumbar spine in asymptomatic adults to i...

Introduction: Fatty infiltration (FI) of paravertebral muscles has been associated with ageing and low back pain. Quantifiable assessment of where fat predominates in these muscles has tremendous clinical relevance. While T1-weighted MRI (T1-WI) is a common imaging modality employed globally, no established or reliable method for defining the spati...

In: ISSLS General posters

In: ISSLS General posters

Background and purpose: Normative age-related decline in paravertebral muscle quality is important for reference to disease and risk identification in patients. We aimed to establish age- and vertebral level-dependence of paravertebral (multifidus and erector spinae) muscle volume and fat content in healthy adult volunteers. Materials and methods...

Background: In New Zealand the Accident Compensation Corporation (ACC) is a state-funded insurance agency that accepts claims for accidental injuries, including lumbar spine injuries. It is unknown whether ACC claim status (accepted, not accepted) affects low back pain (LBP) outcomes, or whether benefit status (e.g., sickness, disability) further...

Neck pain is a common problem in the general population with high risk of ongoing complaints or relapses. Range of motion (ROM) assessment is scientifically established in the clinical process of diagnosis, prognosis and outcome evaluation in neck pain. Anatomically, the cervical spine (CS) has been considered in two regions, the upper and lower CS...

Purpose: To examine clinical outcomes after decompressive lumbar surgery for herniated nucleus pulposus (HNP) in two cohorts from a single surgeon: Microdiscectomy alone [MICRO] versus microdiscectomy augmented with the Device for Intervertebral Assisted Motion [DIAMTM, Medtronic Sofamor Danek, Memphis, USA]. We hypothesized that DIAM-augmented mic...

Purpose: The device for intervertebral assisted motion (DIAMTM) is an interspinous (ISP) implant used to augment surgical decompression of lumbar degenerative conditions: Lumbar spinal stenosis [LSS; foraminal (FS) or central canal (CS)], herniated and degenerated disc disease, facet joint pain syndrome (FJPS) and minor degenerative spondylolisthes...

Interspinous implants (ISP) represent a contemporary non-fusion surgical option in the treatment of lumbar segment disease. Several devices have been developed within the last two decades and have been variously supported by investigations into their clinical and biomechanical efficacy. Spinal Stenosis and facet arthropathy are reported as the prim...

Posterior interspinous dynamic stabilization is used increasingly in the treatment of lumbar degenerative spinal conditions, with preliminary evidence for its clinical and biomechanical efficacy emerging. The need remains to define patients who respond best to this form of surgery. This study examined clinical outcomes in 39 patients (21 females) w...

Interspinous process implants, used to augment lumbar spine surgery, putatively induce a local segmental lumbar kyphosis yet few investigations outline the effect in vivo on thoracolumbar sagittal curvature. Changes in lumbar skeletal alignment and posture have traditionally relied upon radiographic and back surface spinal curvature measurements, r...