C A Richardson’s research while affiliated with Charité Universitätsmedizin Berlin and other places


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Publications (34)


Gebruik van real-time echografie voor feedback bij revalidatie
  • Article

May 2012

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49 Reads

Stimulus

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C. A. Richardson

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Op dit moment wordt in de geneeskunde uitgebreid gebruikgemaakt van real-time echografie. Deze methode is een veilige, kosteneffectieve en zeer toegankelijke onderzoekmethode ten aanzien van verschillende organen en weefsels. Een gebied waarop echografie heeft bewezen nuttig te zijn is onderzoek naar pathologie van het bewegingsapparaat. Weefsels die kunnen worden afgebeeld zijn onder andere spieren, pezen, gewrichten, banden en bursae. Een van de meest bruikbare eigenschappen van real-time echografie is dat de beweging bij anatomische structuren kan worden waargenomen terwijl ze daadwerkelijk optreedt. Dit heeft de ontwikkeling mogelijk gemaakt van real-time echografie voor revalidatie door middel van waarneming van de spiercontractie teneinde via deze manier feedback te geven. De mogelijkheid diepe spieren in beeld te brengen is een voordeel van de techniek en echografie is bijvoorbeeld met succes opgenomen in technieken voor beoordeling en facilitatie van de m. transversus abdominis en multifidus bij patiënten met lage-rugpijn (lrp). Het doel van dit artikel is een kort overzicht te verschaffen van de technieken, de voor- en nadelen van echografie en deze nieuwe toepassing van real-time echografie met betrekking tot revalidatie te bespreken. Het huidige gebruik van real-time echografie bij lrp-patiënten wordt beschreven en toekomstige mogelijkheden voor toepassing in revalidatie en de beperkingen worden besproken.



Table 1 Group characteristics
Fig. 2. Example of raw data traces from a child in the non-DCD group for the visual response signal (Go), hand movement (start), target depression (end), prime mover activity (AD) and postural muscle activity. Measures demonstrated are relative latency of the postural muscle to onset of AD (RL), and movement parameters of RT and MT.
Table 2 Movement ABC results according to group
Fig. 3. Mean relative latencies of muscles of (A) the shoulder and (B) the trunk for each group depicted with reference to the anticipatory period, )150 to þ50 ms in relation to AD.
Table 4 Between groups comparisons of movement parameters and mean relative latencies of muscle activity

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Postural control and movement performance during upper limb tasks in children with developmental co-ordination disorder (DCD)
  • Article
  • Full-text available

January 2011

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298 Reads

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2 Citations

At least 6% of primary school aged children present with DCD, where co-ordination is substantially below the normal range for the child’s age and intelligence. Motor skill difficulties negatively affect academic achievement, recreation and activities of daily living. Poor upper-limb co-ordination is a common difficulty for children with DCD. A possible cause of this problem is deviant muscle timing in proximal muscle groups, which results in poor postural and movement control. While studies have been published investigating postural control in response to external perturbations, detail about postural muscle activity during voluntary movement is limited even in children with normal motor development. No studies have investigated the relationship between muscle timing, resultant arm motion and upper-limb coordination deficits. Objectives: To investigate the relationship between functional difficulties with upper-limb motor skills and neuromuscular components of postural stability and coordination. Specifically, to investigate onset-timing of muscle activity, timing of arm movement, and resultant three-dimensional (3D) arm co-ordination during rapid, voluntary arm movement and to analyse differences arising due to the presence of DCD. This study is part of a larger research program investigating postural stability and control of upper limb movement in children. Design: A controlled, cross-sectional study of differences between children with and without DCD. Methods: This study included 50 children aged eight to 10 years (25 with DCD and 25 without DCD). Children participated in assessment of motor skills according to the Movement ABC Test and a laboratory study of rapid, voluntary arm movements. Parameters investigated included muscle activation timing of shoulder and trunk muscles (surface electromyography), arm movement timing (light sensor) and resultant 3D arm motion (Fastrak). Results: A MANOVA is being used to analyse between-group differences. Preliminary results indicate children with DCD demonstrate altered muscle timing during a rapid arm raise when compared with the control group of children. Conclusion: Differences in proximal muscle timing in children with DCD support the hypothesis that altered proximal muscle activity may contribute to poor proximal stability and consequently poor arm movement control. This has implications for clinical physiotherapy.

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Figure 1 MRI of the trunk at the level of the L3-4 disc showing crosssectional area measurements of the psoas, quadratus lumborum and multifidus + lumbar erector spinae muscles. 
Figure 2 MRI of the trunk at the level of the L3-L4 disc (at rest) showing measurements of cross-sectional area of the trunk and thickness of the transversus abdominis and internal oblique muscles. 
Figure 3 MRI of the trunk at the level of the L3-L4 disc (after drawing in the abdominal wall) showing measurements of cross-sectional area of the trunk, thickness of the transversus abdominis and internal oblique muscles, and slide of the AAF. 
MRI study of the size, symmetry and function of the trunk muscles among elite cricketers with and without low back pain

October 2008

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2,592 Reads

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220 Citations

British Journal of Sports Medicine

To determine if asymmetry of trunk muscles and deficits of motor control exist among elite cricketers with and without low back pain (LBP). Single-blinded observational quasi-experimental design study Assessments were conducted in a hospital setting. Among a total eligible sample of 26 male elite cricketers (mean age 21.2 (SD 2.0) years), selected to attend a national training camp, 21 participated in the study. Risk factors: The independent variables were 'group' (LBP or asymptomatic) and 'cricket position' (fast bowler versus the rest of the squad). Main outcome measurements: The dependent variables were the cross-sectional areas (CSA) of the quadratus lumborum (QL), lumbar erector spinae plus multifidus (LES + M) and psoas muscles, the thickness of the internal oblique (IO) and transversus abdominis (TrA) muscles, and the amount of lateral slide of the anterior abdominal fascia. The QL and LES + M muscles were larger ipsilateral to the dominant arm. In the subgroup of fast bowlers with LBP, the asymmetry in the QL muscle was the greatest. The IO muscle was larger on the side contralateral to the dominant arm. No difference between sides was found for the psoas and TrA muscles. Cricketers with LBP showed a reduced ability to draw in the abdominal wall and contract the TrA muscle independently of the other abdominal muscles. This study provides new insights into trunk muscle size and function in elite cricketers, and evidence of impaired motor control in elite cricketers with LBP. Rehabilitation using a motor control approach has been shown to be effective for subjects with LBP, and this may also benefit elite cricketers.


Mean values (sds) and within subject percentage change for the balance and strength measures at pre-and post-intervention assessments
Mean values (sds) and within subject percentage change for the bmd measures at pre-and post-intervention assessments
Positive effects of exercise on falls and fracture risk in osteopenic women

July 2008

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128 Reads

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91 Citations

Osteoporosis International

Exercise may affect osteopenic women at risk of falls and fractures. A workstation approach to exercise was evaluated in a randomised study of 98 women. The intervention group improved in measures of balance, strength and bone density. This study supports a preventative exercise approach that aims to reduce risk factors for fractures and falls, in women already at risk, through balance training and weight-bearing activity. The objective of this study was to determine the effects of a workstation balance training and weight-bearing exercise program on balance, strength and bone mineral density (BMD) in osteopenic women. A single-blinded randomised controlled trial (RCT) was undertaken for 20 weeks with measurements at baseline and completion. Ninety-eight (98) community-dwelling osteopenic women aged 41-78 years were recruited through the North Brisbane electoral roll. Subjects were randomised via computer-generated random numbers lists into either a control (receiving no intervention), or exercise group (two one-hour exercise sessions per week for 20 weeks with a trained physiotherapist). Assessments at baseline and post-intervention included balance testing (five measures), strength testing (quadriceps, hip adductors / abductors / external rotators and trunk extensors), and DXA scans (proximal femur and lumbar spine). Baseline assessment showed no significant differences between groups for all demographics and measures except for subjects taking osteoporosis medication. The percentage differences between pre- and post-intervention measurements were examined for group effect by ANOVA using an intention-to-treat protocol. Ninety-eight women (mean age 62.01 years, SD 8.9 years) enrolled in the study. The mean number of classes attended for the 42 participants in the exercise group who completed the program was 28.2 of a possible 40 classes (71%). At the completion of the trial the intervention group showed markedly significant better performances in balance (unilateral and bilateral stance sway measures, lateral reach, timed up and go and step test) (p < 0.05) with strong positive training effects reflecting improvements of between 10% to 71%. Similarly there were gains in strength of the hip muscles (abductors, adductors, and external rotators), quadriceps and trunk extensors with training effects between 9% and 23%. Specific workstation exercises can significantly improve balance and strength in osteopenic women. This type of training may also positively influence bone density although further study is required with intervention over a longer period. A preventative exercise program may reduce the risk of falls and fractures in osteopenic women already at risk.


Quantification of the timing of continuous modulated muscle activity in a repetitive-movement task

December 2006

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18 Reads

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5 Citations

Physiological Measurement

The timing of muscle activity is commonly measured in studies of motor control. In repetitive-movement tasks, muscle activity may be continuous, and no defined onset or offset of activity may be measured. This does not imply that no timing of muscle activity occurs. Where activity is continuous, this timing will typically be exhibited by modulation of the amplitude of the signal in specific movement phases. The existence of this electromyographic (EMG) timing is dependent upon the existence of EMG amplitude modulation. This paper investigates this relationship in developing a quantification algorithm of EMG timing in a repetitive-movement task. A frequency domain quantification algorithm involving EMG linear-envelope generation is used. An EMG simulation algorithm is used to test this algorithm and determine the minimal amplitude-modulation threshold for timing detection. At five repetitive-movement speeds (25, 50, 75, 100 and 125 cycles of movement per minute), thresholds between 1.558 and 2.326 times maximal to minimal linear-envelope amplitude are required for reliability of timing detection. Analysis of variance indicates that the robustness of the quantification algorithm was not significantly affected by burst width (F = 3.69, p = 0.055) or the underling input timing parameter (F = 0.52, p = 0.992). The phase-lead/lag quantification algorithm represents a useful tool for the analysis motor control via EMG during repetitive-movement tasks.



Low-Back Pain in Microgravity: Causes and Countermeasures

June 2005

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9 Reads

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2 Citations

Low-back pain (LBP) is common not only on Earth, but also in space.This is remarkable because, on Earth, LBP is ascribed mostly to heavy spinal loading.The Topical Team was established by ESA to answer the question "What is the aetiology of LBP during flight and what countermeasures may be developed?" The starting point for the Team's activities is a biomechanical model developed at the Erasmus Medical Centre in Rotterdam (NL) that describes the function of a deep-muscle corset to stabilise lumbar and pelvic joints. For spaceflight, the hypothesis was formulated that muscle atrophy and neuroplasticity in the absence of gravity loading destabilises the lumbopelvic area. The outcome of the Team activities is the development of a theory for the source of pain in microgravity that identifies in particular the iliolumbar ligaments.To help verify the theory,Team members were involved in the Berlin Bedrest Study and the Dutch Soyuz Mission. Based on the results of these studies, countermeasures can be developed and implemented.


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Citations (25)


... Multifidus and erector spinae are spine extensor muscles that are often perceived to perform different primary functions. While the large erector spinae muscles stabilize and move the spine, multifidus is perceived to be preferentially suited for stabilizing intervertebral segments (Donisch and Basmajian, 1972;Richardson and Jull, 1995;Moseley et al., 2002). By increasing its ability to generate passive tension, a primarily stabilizing muscle like multifidus would require less energy. ...

Reference:

Characterization of the passive mechanical properties of spine muscles across species
An historical perspective on the development of clinical techniques to evaluate and treat the active stabilising system of the lumbar spine
  • Citing Article
  • January 1995

... A MCT programme demonstrated effectiveness at decreasing LBP and restoring trunk muscle size and function after prolonged bed rest . As outlined in Section 3.3, and in an ESA TT report on inflight CM for LBP (Snijders & Richardson 2005), LBP is an important consideration in the reconditioning of astronauts postflight and MCT is a vital part of early ESA postflight reconditioning (Section 4.4.2) but research is needed to provide evidence of the effectiveness of MCT in astronauts. ...

Low-Back Pain in Microgravity: Causes and Countermeasures
  • Citing Article
  • June 2005

... Similar changes occur to ground-based analogs. The knee and ankle extensors incur among the largest losses (Belavy et al., 2009;Riley et al., 2002;Widrick et al., 1998). A 14-day bed rest led to a 9% knee extensor torque loss (Bamman et al., 1998). ...

Differential atrophy of the lower-limb musculature during prolonged bed-rest: Implications for the management of the immobilised patient
  • Citing Article
  • May 2009

Bone

... Regarding the concept of the core and motor control, it is understood that it is not only the individual contraction and structure of the muscles that are important but also the coordination between the various muscle groups that comprise this functional unit [10]. Consequently, research that examines the overall muscle behavior of the core and its structure in the context of pain compared to healthy individuals would provide valuable insights into the potential differences between these groups and their possible role in NSLBP. ...

Co-activation of the abdominal and pelvic floor muscles during voluntary exercise
  • Citing Article
  • January 2001

Neurourology and Urodynamics

... The measuring muscles were the right trapezius, sternocleidomastoid, pectoralis major, diaphragm, rectus abdominis, external oblique, and internal oblique. Electrodes were attached to the muscles at the midpoint between the line connecting the shoulder peak and the 7th cervical vertebra for the trapezius; the center of the abdominal muscles for the sternocleidomastoid; the upper part of the axilla pectoralis major and the 6th-7th intercostal 6) on the central line of the right clavicle for the diaphragm; 1 cm superior to the umbilicus and 2 fingerbreadths lateral to the white line for the rectus abdominis; in the 8th lateral 16) for the external oblique; and in the anterior iliac spine at 1 cm and below the line connecting the left and right anterior superior iliac spines for the internal oblique. For the electrode attachment site of the diaphragm, a sonogram diagnostic device (LOGIQ P6 Expert, GE Healthcare, Tokyo, Japan) was used to confirm the diaphragm's position. ...

Muscle fibre orientation of abdominal muscles and suggested surface EMG electrode positions
  • Citing Article
  • January 1998

Electromyography and Clinical Neurophysiology

... 8 A sedentary lifestyle is also associated with weakness, which compromises the stability of the trunk. 9 Chronic low back pain is etiologically related to the core trunk musculature, a box-like structure surrounded by the abdominal, paraspinal, diaphragm, and pelvic floor muscles, 10 which provides primary stability to the lumbar spine. Core trunk muscles have been classified into global and local according to location and function. ...

A clinical palpation test to check the activation of the deep stabilizing muscles of the lumbar spine
  • Citing Article
  • January 2000

... Exercises that are used in Pilates programs involve performing movements with a neutral spine alignment and a co-contraction of the deep abdominal and pelvic floor muscles [14]. Some examples of common exercises are the supine hook lying abdominal drawing-in maneuver (ADIM) [15], the hundred A and B exercises, which involve holding a static position with arm and leg movements while breathing deeply [16], and the leg raise and roll up exercises, which challenge the trunk stability and mobility while moving the legs or the upper body [17]. The ADIM is a slow and gentle abdominal hollowing [18] maneuver where individuals gently pull the umbilicus towards the spine, hold the contraction, and breathe normally [19][20][21] for up to 10 s. ...

A New Clinical Model of the Muscle Dysfunction Linked to the Disturbance of Spinal Stability: Implications for Treatment of Low Back Pain
  • Citing Article

... This might be a factor in accidents, such as falls, due to delayed initiation of limb movements. A previous study reported that patients with chronic low back pain have reduced, delayed, or absent TrA activity and excessive IO and EO muscle activities among global muscles 8) . ...

Therapeutic exercise for spinal segmental stabilization in low back pain: scientific basis and clinical approach
  • Citing Article
  • January 1999

... However, the data used in the EMG signal synthesis algorithm evaluation were chosen at random from each subject's overall pool of data. Random selection was used to avoid bias in EMG patterns due to motor control changes occurring over the study period (see Belavy et al., 2005 andBelavý et al., 2007 for findings on motor control changes). ...

Long-term overactivity in the abdominal oblique muscles after 8 weeks bed-rest - Possible implications for musculoskeletal health
  • Citing Conference Paper
  • January 2005

... The muscles of the abdomen play an important role in stabilization of lumbar vertebra. Especially, the abdominal muscles, such as the transversus abdominis (Tra) and the internus obliquus (IO), enable functional movements by providing stability to each segment of the lumbo-pelvic region when supporting the body's weight 2,3) . In short, the inner abdominal muscles, such as TrA, have impacts on balance by reacting to changes in body posture 4) . ...

The rationale for a motor control programme for the treatment of spinal muscle dysfunction
  • Citing Article
  • January 2004