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Julie A Hides - One of the best experts on this subject based on the ideXlab platform.

  • Ultrasound imaging: Reliability of measurements of abdominal and Multifidus Muscle thickness and Multifidus cross-sectional area of adults aged 50-79 years
    2015
    Co-Authors: Wa Cuellar, Julie A Hides, Christopher L. Blizzard, Michele L. Callisaya, Graeme Jones, Tania Winzenberg
    Abstract:

    Question: What is the procedural reliability of the measurement of abdominal and Multifidus Muscle thickness and cross-sectional area from ultrasound imaging of older adults? Design: Intra-examiner procedural reliability study with repeated measurements one week apart. Participants: Twenty-three older adults (70% male, age range 51-75 years) participating in a randomised controlled trial of vitamin D supplements for knee osteoarthritis. Outcome measures: Ultrasound images of abdominal and Multifidus Muscle thickness and Multifidus cross-sectional area. Results: Reliability of abdominal Muscle thickness measurements both at rest and contracted, and of Multifidus cross-sectional area, were substantial (ICC 0.81-1.0). Reliability of Multifidus measurements of Muscle thickness at rest and contracted ranged from fair to substantial (ICC 0.55-0.86). Conclusion: Abdominal Muscle thickness and Multifidus cross-sectional area of older adults can be measured using ultrasound imaging with similar reliability to that for younger adults. Reliability of Multifidus Muscle thickness at L4-5 level was lower than that reported previously for older adults.

  • Small Multifidus Muscle size predicts football injuries
    Orthopaedic journal of sports medicine, 2014
    Co-Authors: Julie A Hides, Warren R. Stanton, M. Dilani Mendis, Melinda M. Franettovich Smith, Margot J. Sexton
    Abstract:

    Background:In Australian football, lower limb injuries have had the highest incidence and prevalence rates. Previous studies have shown that football players with relatively more severe preseason and playing season hip, groin, and thigh injuries had a significantly smaller Multifidus Muscle compared with players with no lower limb injuries. Rehabilitation of the Multifidus Muscle, with restoration of its size and function, has been associated with decreased recurrence rates of episodic low back pain and decreased numbers of lower limb injuries in football players. Assessment of Multifidus Muscle size and function could potentially be incorporated into a model that could be used to predict injuries in football players.Purpose:To examine the robustness of Multifidus Muscle measurements as a predictor of lower limb injuries incurred by professional football players.Study Design:Cohort study; Level of evidence, 2.Methods:Ultrasound examinations were carried out on 259 male elite football players at the start ...

  • SMALL Multifidus Muscle SIZE PREDICTS FOOTBALL INJURIES
    British Journal of Sports Medicine, 2014
    Co-Authors: Julie A Hides, Warren R. Stanton, Melinda M. Franettovich Smith, D. Mendis, Margot J. Sexton
    Abstract:

    Background In Australian Football, hip, groin and thigh (HGT) Muscle injuries have had the highest incidence and prevalence. A previous study showed that football players with relatively more severe pre-season ‘HGT’ injuries had a significantly smaller size of the Multifidus Muscle. Objective This study was designed to examine the robustness of Multifidus Muscle measurements as a predictor of lower limb injuries incurred by Australian Football League players. Design This was a prospective quasi-experimental research design. Muscle measurements were conducted at the start of the pre-season to predict pre-season injuries, and at the start of the playing season to predict injuries in the playing season. Setting Players from 6 clubs of the Australian National football league were eligible for inclusion (n=275). Players were assessed on club premises. Participants Assessments were conducted on 259 elite football players for the pre-season (94.2% of eligible players), and 261 players at the start the playing season (94.9%). Risk factor assessment Morphology of the Multifidus Muscle was assessed using ultrasound imaging. Injury data were obtained from records collected by the AFL club staff during the pre-season and the playing season. Main outcome measurements The dependent variable in the binomial logistic regression was occurrence of lower limb injuries in the pre-season and the playing season. Results A lower limb injury was incurred by 38.2% of the players in the pre-season and 69.5% of the players in the playing season. A new model using cross-sectional area of the Multifidus Muscle reliably and consistently predicted lower limb injury in both the pre-season and playing season. In the season, ‘kicking leg’ was related to injury. Conclusions The results of this study have established the predictive power of Multifidus Muscle size to predict injury in elite football players. These results provide a strong direction for clinicians who screen and treat athletes.

  • The effect of chronic low back pain on size and contraction of the lumbar Multifidus Muscle
    Manual therapy, 2008
    Co-Authors: Tracy L Wallwork, Warren R. Stanton, Matt Freke, Julie A Hides
    Abstract:

    Decreases in the size of the Multifidus Muscle have been consistently documented in people with low back pain. Recently, ultrasound imaging techniques have been used to measure contraction size of the Multifidus Muscle, via comparison of the thickness of the Muscle at rest and on contraction. The aim of this study was to compare both the size (cross-sectional area, CSA) and the ability to voluntarily perform an isometric contraction of the Multifidus Muscle at four vertebral levels in 34 subjects with and without chronic low back pain (CLBP). Ultrasound imaging was used for assessments, conducted by independent examiners. Results showed a significantly smaller CSA of the Multifidus Muscle for the subjects in the CLBP group compared with subjects from the healthy group at the L5 vertebral level (F=29.1, p=0.001) and a significantly smaller percent thickness contraction for subjects of the CLBP group at the same vertebral level (F=6.6, p=0.02). This result was not present at other vertebral levels (p>0.05). The results of this study support previous findings that the pattern of Multifidus Muscle atrophy in CLBP patients is localized rather than generalized but also provided evidence of a corresponding reduced ability to voluntarily contract the atrophied Muscle.

  • effect of stabilization training on Multifidus Muscle cross sectional area among young elite cricketers with low back pain
    Journal of Orthopaedic & Sports Physical Therapy, 2008
    Co-Authors: Julie A Hides, Warren R. Stanton, Shaun Mcmahon, K Sims, Carolyn A Richardson
    Abstract:

    Study Design A single-blinded, pretreatment-posttreatment assessment. Objectives To investigate, using ultrasound imaging, the cross-sectional area (CSA) of the lumbar Multifidus Muscle at 4 vertebral levels (L2, L3, L4, L5) in elite cricketers with and without low back pain (LBP), and to document the effect of a staged stabilization training program on Multifidus Muscle CSA. Background Despite high fitness levels and often intensive strength training programs, athletes still suffer LBP. The incidence of LBP among Australian cricketers is 8% and as high as 14% among fast bowlers. Previous researchers have found that the Multifidus Muscle contributes to segmental stability of the lumbopelvic region; however, the CSA of this Muscle has not been previously assessed in elite cricketers. Methods and Measures CSAs of the Multifidus Muscles were assessed at rest on the left and right sides for 4 vertebral levels at the start and completion of a 13-week cricket training camp. Participants who reported current or ...

Paul W. Hodges - One of the best experts on this subject based on the ideXlab platform.

  • Fat infiltration in the Multifidus Muscle is related to inflammatory cytokine expression in the Muscle and epidural adipose tissue in individuals undergoing surgery for intervertebral disc herniation
    European Spine Journal, 2020
    Co-Authors: Greg James, Xiaolong Chen, Ashish Diwan, Paul W. Hodges
    Abstract:

    Purpose Recent animal studies have discovered dysregulation of local inflammatory activity as a novel mechanism to explain fat and connective tissue accumulation in the Multifidus Muscle in association with intervertebral disc (IVD) degeneration/injury. This study aimed to test whether similar mechanisms are active in humans by investigation of whether expression of inflammatory genes in the Multifidus Muscle differed between individuals with low and high levels of intra-muscular fat in the Muscle. The secondary aims were to compare inflammatory gene expression in the intra-muscular, subcutaneous and epidural fat between groups. Methods Muscle and fat were procured from 24 individuals undergoing spine surgery for IVD herniation. Gene expression was quantified using qPCR assays. Participants were allocated to high- and low-fat infiltration groups based on clinical assessment of Multifidus fat using Kjaer grading of MRI. Results TNF expression in the Multifidus Muscle was greater in participants with high rather than low levels of fat infiltration. This group also had greater expression of leptin, but lower arginase-1 (marker of anti-inflammatory M2 macrophages) in intra-muscular and subcutaneous adipose tissue, and greater expression of TNF, adiponectin and nitric oxide synthase 2 (marker of pro-inflammatory M1 macrophages) in epidural fat. Conclusion The results support the hypothesis that IVD degeneration is associated with dysregulation of the inflammatory state of the local Multifidus Muscle, which provides initial evidence for translation of some, but not all, observations from recent animal studies to humans. Discovery of inflammatory dysregulation in epidural adipose tissue has potential for broad impact on tissue health and LBP symptoms.

  • issls prize in basic science 2019 physical activity attenuates fibrotic alterations to the Multifidus Muscle associated with intervertebral disc degeneration
    European Spine Journal, 2019
    Co-Authors: G. James, D. M. Klyne, M. Millecamps, L. S. Stone, Paul W. Hodges
    Abstract:

    Chronic low back pain causes structural remodelling and inflammation in the Multifidus Muscle. Collagen expression is increased in the Multifidus of humans with lumbar disc degeneration. However, the extent and mechanisms underlying the increased fibrotic activity in the Multifidus are unknown. Physical activity reduces local inflammation that precedes Multifidus fibrosis during intervertebral disc degeneration (IDD), but its effect on amelioration of fibrosis is unknown. This study aimed to assess the development of fibrosis and its underlying genetic network during IDD and the impact of physical activity. Wild-type and SPARC-null mice were either sedentary or housed with a running wheel, to allow voluntary physical activity. At 12 months of age, IDD was assessed with MRI, and Multifidus Muscle samples were harvested from L2 to L6. In SPARC-null mice, the L1/2 and L3/4 discs had low and high levels of IDD, respectively. Thus, Multifidus samples from L2 and L4 were allocated to low- and high-IDD groups compared to assess the effects of IDD and physical activity on connective tissue and fibrotic genes. High IDD was associated with greater connective tissue thickness and dysregulation of collagen-III, fibronectin, CTGF, substance P, TIMP1 and TIMP2 in the Multifidus Muscle. Physical activity attenuated the IDD-dependent increased connective tissue thickness and reduced the expression of collagen-I, fibronectin, CTGF, substance P, MMP2 and TIMP2 in SPARC-null animals and wild-type mice. Collagen-III and TIMP1 were only reduced in wild-type animals. These data reveal the fibrotic networks that promote fibrosis in the Multifidus Muscle during chronic IDD. Furthermore, physical activity is shown to reduce fibrosis and regulate the fibrotic gene network. These slides can be retrieved under Electronic Supplementary Material.

  • Dysregulation of the Inflammatory Mediators in the Multifidus Muscle After Spontaneous Intervertebral Disc Degeneration SPARC-null Mice is Ameliorated by Physical Activity.
    Spine, 2018
    Co-Authors: G. James, M. Millecamps, L. S. Stone, Paul W. Hodges
    Abstract:

    STUDY DESIGN: A longitudinal case-control animal model.OBJECTIVE: The aim of this study was to investigate the inflammatory pathways active in the Multifidus Muscle after spontaneous intervertebral disc degeneration (IDD), and whether these IDD-related Muscle changes can be ameliorated by exercise.SUMMARY OF BACKGROUND DATA: A pro-inflammatory response is present in the Multifidus Muscle after an intervertebral disc lesion and has been proposed to drive the structural alterations present during low back pain. However, it is not known whether spontaneous IDD produces an inflammatory response. Furthermore, exercise/physical activity produces a strong anti-inflammatory response, but its effectiveness in ameliorating inflammation in the Multifidus is unknown. We assessed the inflammatory profile of the Multifidus and the effectiveness of physical activity as a treatment using an animal model of spontaneous model of IDD.METHODS: Wild-type and SPARC null mice that were sedentary or housed with a running wheel were used in this study. Multifidus Muscle segments were harvested from L2-L6 from the mice at 9 months of age after they had undergone a magnetic resonance imaging (MRI) scan to determine levels with IDD. The inflammatory profile of the Multifidus was examined using quantitative polymerase chain reaction (PCR) assays.RESULTS: Spontaneous IDD in the SPARC-null mice caused a dysregulation of interleukin (IL)-1β, IL6, transforming growth factor-beta (TGFβ1), and adiponectin expression. More specifically, the proximity and degree of IDD was related to levels of IL-1β expression. Physical activity reduced the pro-inflammatory response to IDD in the Multifidus. IL-1β, tumor necrosis factor (TNF), IL-10, adiponectin, and leptin levels were lower in the physically active group.CONCLUSION: These results reveal that spontaneous IDD causes dysregulation of the inflammatory pathways active in the Multifidus Muscle. These alterations were related to the severity of IDD and were prevented by physical activity.N/A.

  • Macrophage polarization contributes to local inflammation and structural change in the Multifidus Muscle after intervertebral disc injury.
    European spine journal : official publication of the European Spine Society the European Spinal Deformity Society and the European Section of the Cerv, 2018
    Co-Authors: G. James, Leanne M. Hall, Annina B. Schmid, Cindy C. Shu, Christopher B. Little, James Melrose, Linda V. Blomster, Kathleen A. Sluka, Paul W. Hodges
    Abstract:

    Intervertebral disk (IVD) lesion and its subsequent degeneration have a profound effect on the Multifidus Muscle. The subacute/early chronic phase of Multifidus remodeling after IVD lesion has been proposed to be regulated by inflammatory processes. The balance between pro-inflammatory (M1) and anti-inflammatory (M2) macrophages plays an important role in maintaining tissue integrity after injury. The localization, polarization of macrophage subtypes and their mediation of the pro-inflammatory cytokine tumor necrosis factor (TNF) are unknown in paraspinal Muscles during IVD degeneration. A sheep model of IVD degeneration was used to investigate the role of macrophages and TNF in the structural alterations that occur within the Multifidus Muscle. Anterolateral lesions were induced at L3–4 IVD in sheep. Multifidus Muscle tissue at L4 was harvested 3 and 6 months after lesion and used for immunofluorescence assays to examine total macrophage number, macrophage polarization between M1 and M2, and to assess the localization of TNF expression in Muscle, adipose and connective tissues from injured and naive control animals. A greater proportion of M1 macrophages is present in Muscle at both 3 and 6 months after IVD lesion, and adipose tissue at 6 months. Total number of macrophages is unchanged. At 6 months, expression of TNF is increased in adipose and connective tissue and the proportion of TNF expressed by M1 macrophages is increased. These data support the proposal that macrophages and TNF (pro-inflammatory cytokine) play an active role in the subacute/early chronic phase of remodeling in Muscle, adipose and connective tissues of the Multifidus during IVD degeneration. This presents a novel target for treatment. These slides can be retrieved under Electronic Supplementary Material.

  • Mesenchymal stem cell treatment of intervertebral disc lesion prevents fatty infiltration and fibrosis of the Multifidus Muscle, but not cytokine and Muscle fiber changes
    Spine, 2016
    Co-Authors: G. James, Leanne M. Hall, Annina B. Schmid, Cindy C. Shu, Christopher B. Little, James Melrose, Linda V. Blomster, Paul W. Hodges
    Abstract:

    Study Design. Longitudinal case-control animal model. Objective. To investigate effects of mesenchymal stem cell (MSC) treatment on Multifidus Muscle remodeling after intervertebral disc (IVD) lesion. Summary of Background Data. Lesion and degeneration of IVDs cause structural remodeling of the Multifidus Muscle. Proinflammatory cytokines are thought to contribute. MSC treatment restores IVD health after lesion but its effects on surrounding tissues remains unknown. Using an animal model of IVD degeneration, we assessed the effects of MSC treatment of IVDs on the structural remodeling and cytokine expression within the Multifidus Muscle. Methods. An anterolateral lesion was performed on the L1-2, L3-4, and L5-6 IVDs in sheep. At either 4 (early treatment) or 12 (late treatment) weeks after IVD lesion, MSCs were injected into the lesioned IVD. Multifidus Muscle was harvested from L2 (gene expression analysis) and L4 (histological analysis) at 3 or 6 months after IVD lesion and naive controls for histological analysis of Muscle, adipose, and connective tissue cross-sectional areas, and immunohistochemistry to study Muscle fiber types. Real-time polymerase chain reactions quantified expression of tumor necrosis factor, interleukin-1β, and transforming growth factor-β1. Results. MSC treatment of IVD lesion prevented the increased adipose and connective tissue cross-sectional area expected after IVD lesion. MSC treatment did not prevent slow-to-fast Muscle fiber type transformation. Gene expression of proinflammatory cytokines within the Muscle was altered by the MSC treatment of IVD. Increased interleukin-1β expression was prevented in the early treatment group and tumor necrosis factor and transforming growth factor-β1 expression was upregulated at 6 months. Conclusion. Results show that although MSC treatment prevents fatty infiltration and fibrosis of the Multifidus Muscle after IVD lesion, it cannot prevent a Muscle inflammatory response and Muscle fiber transformation. These findings highlight the potential role of MSC therapy after IVD injury, but reveals that other interventions may also be necessary to optimize recovery of Muscle.

Carolyn A Richardson - One of the best experts on this subject based on the ideXlab platform.

  • effect of stabilization training on Multifidus Muscle cross sectional area among young elite cricketers with low back pain
    Journal of Orthopaedic & Sports Physical Therapy, 2008
    Co-Authors: Julie A Hides, Warren R. Stanton, Shaun Mcmahon, K Sims, Carolyn A Richardson
    Abstract:

    Study Design A single-blinded, pretreatment-posttreatment assessment. Objectives To investigate, using ultrasound imaging, the cross-sectional area (CSA) of the lumbar Multifidus Muscle at 4 vertebral levels (L2, L3, L4, L5) in elite cricketers with and without low back pain (LBP), and to document the effect of a staged stabilization training program on Multifidus Muscle CSA. Background Despite high fitness levels and often intensive strength training programs, athletes still suffer LBP. The incidence of LBP among Australian cricketers is 8% and as high as 14% among fast bowlers. Previous researchers have found that the Multifidus Muscle contributes to segmental stability of the lumbopelvic region; however, the CSA of this Muscle has not been previously assessed in elite cricketers. Methods and Measures CSAs of the Multifidus Muscles were assessed at rest on the left and right sides for 4 vertebral levels at the start and completion of a 13-week cricket training camp. Participants who reported current or ...

  • the use of real time ultrasound imaging for biofeedback of lumbar Multifidus Muscle contraction in healthy subjects
    Journal of Orthopaedic & Sports Physical Therapy, 2006
    Co-Authors: Khai Van, Julie A Hides, Carolyn A Richardson
    Abstract:

    Study Design Randomized controlled trial. Objective To determine if the provision of visual biofeedback using real-time ultrasound imaging enhances the ability to activate the Multifidus Muscle. Background Increasingly clinicians are using real-time ultrasound as a form of biofeedback when re-educating Muscle activation. The effectiveness of this form of biofeedback for the Multifidus Muscle has not been reported. Methods and Measures Healthy subjects were randomly divided into groups that received different forms of biofeedback. All subjects received clinical instruction on how to activate the Multifidus Muscle isometrically prior to testing and verbal feedback regarding the amount of Multifidus contraction, which occurred during 10 repetitions (acquisition phase). In addition, 1 group received visual biofeedback (watched the Multifidus Muscle contract) using real-time ultrasound imaging. All subjects were reassessed a week later (retention phase). Results Subjects from both groups improved their volunta...

  • Multifidus Muscle recovery is not automatic after resolution of acute, first-episode low back pain.
    Spine, 1996
    Co-Authors: Julie A Hides, Carolyn A Richardson, Gwendolen Jull
    Abstract:

    Study Design. A clinical study was conducted on 39 patients with acute, first-episode, unilateral low back pain and unilateral, segmental inhibition of the Multifidus Muscle. Patients were allocated randomly to a control or treatment group. Objectives. To document the natural course of lumbar Multifidus recovery and to evaluate the effectiveness of specific, localized, exercise therapy on Muscle recovery. Summary of Background Data. Acute low back pain usually resolves spontaneously, but the recurrence rate is high. Inhibition of Multifidus occurs with acute, first-episode, low back pain, and pathologic changes in this Muscle have been linked with poor outcome and recurrence of symptoms. Methods. Patients in group 1 received medical treatment only. Patients in group 2 received medical treatment and specific, localized, exercise therapy. Outcome measures for both groups included 4 weekly assessments of pain, disability, range of motion, and size of the Multifidus cross-sectional area. Independent examiners were blinded to group allocation. Patients were reassessed at a 10-week follow-up examination. Results. Multifidus Muscle recovery was not spontaneous on remission of painful symptoms in patients in group 1. Muscle recovery was more rapid and more complete in patients in group 2 who received exercise therapy (P = 0.0001). Other outcome measurements were similar for the two groups at the 4-week examination. Although they resumed normal levels of activity, patients in group 1 still had decreased Multifidus Muscle size at the 10-week follow-up examination. Conclusions. Multifidus Muscle recovery is not spontaneous on remission of painful symptoms. Lack of localized, Muscle support may be one reason for the high recurrence rate of low back pain following the initial episode.

  • Magnetic resonance imaging and ultrasonography of the lumbar Multifidus Muscle. Comparison of two different modalities.
    Spine, 1995
    Co-Authors: Julie A Hides, Carolyn A Richardson, Gwendolen Jull
    Abstract:

    Study Design.An operator-blinded dual modality trial of measurement of lumbar Multifidus Muscle cross-sectional area was performed.Objective.To compare two imaging modalities used for measurement of the lumbar Multifidus Muscle.Methods.Ten normal female subjects aged 21–31 years were imaged on two s

Henning Grasshoff - One of the best experts on this subject based on the ideXlab platform.

  • Morphological changes of the Multifidus Muscle in patients with symptomatic lumbar disc herniation.
    Journal of neurosurgery. Spine, 2009
    Co-Authors: Jörg Franke, Thomas Hesse, Clément Tournier, Walter Schuberth, Christian Mawrin, Jean Carles Lehuec, Henning Grasshoff
    Abstract:

    Object Lumbar disc herniations are associated with segmental Muscle alterations of the ipsilateral segmental Multifidus Muscle. The aim of the present study was a histopathological analysis of the myopathological changes of the Multifidus Muscle and correlation with the duration of radicular symptoms. Methods Multifidus Muscle biopsies were performed in 20 patients during discectomy. Specimens were obtained from the area of the Multifidus Muscle innervated by the nerve from the level of the affected disc. Histopathological findings were classified according as neurogenic tissue syndrome and nonspecific myopathological syndrome, and these results were correlated with the duration of radicular symptoms. Results Results of Multifidus Muscle biopsies were classified as neurogenic tissue syndrome in 12 patients and as nonspecific myopathological syndrome in 8. The mean (± SD) duration of radicular symptoms was 10.75 ± 7.9 months in patients with neurogenic tissue syndrome and 4.37 ± 3.9 months in patients with...

G. James - One of the best experts on this subject based on the ideXlab platform.

  • ISSLS Prize in Basic science 2019: Physical activity attenuates fibrotic alterations to the Multifidus Muscle associated with intervertebral disc degeneration
    European Spine Journal, 2019
    Co-Authors: G. James, D. M. Klyne, M. Millecamps, L. S. Stone, P. W. Hodges
    Abstract:

    Purpose Chronic low back pain causes structural remodelling and inflammation in the Multifidus Muscle. Collagen expression is increased in the Multifidus of humans with lumbar disc degeneration. However, the extent and mechanisms underlying the increased fibrotic activity in the Multifidus are unknown. Physical activity reduces local inflammation that precedes Multifidus fibrosis during intervertebral disc degeneration (IDD), but its effect on amelioration of fibrosis is unknown. This study aimed to assess the development of fibrosis and its underlying genetic network during IDD and the impact of physical activity. Methods Wild-type and SPARC-null mice were either sedentary or housed with a running wheel, to allow voluntary physical activity. At 12 months of age, IDD was assessed with MRI, and Multifidus Muscle samples were harvested from L2 to L6. In SPARC-null mice, the L1/2 and L3/4 discs had low and high levels of IDD, respectively. Thus, Multifidus samples from L2 and L4 were allocated to low- and high-IDD groups compared to assess the effects of IDD and physical activity on connective tissue and fibrotic genes. Results High IDD was associated with greater connective tissue thickness and dysregulation of collagen-III, fibronectin, CTGF, substance P, TIMP1 and TIMP2 in the Multifidus Muscle. Physical activity attenuated the IDD-dependent increased connective tissue thickness and reduced the expression of collagen-I, fibronectin, CTGF, substance P, MMP2 and TIMP2 in SPARC-null animals and wild-type mice. Collagen-III and TIMP1 were only reduced in wild-type animals. Conclusions These data reveal the fibrotic networks that promote fibrosis in the Multifidus Muscle during chronic IDD. Furthermore, physical activity is shown to reduce fibrosis and regulate the fibrotic gene network. Graphical abstract These slides can be retrieved under Electronic Supplementary Material.

  • issls prize in basic science 2019 physical activity attenuates fibrotic alterations to the Multifidus Muscle associated with intervertebral disc degeneration
    European Spine Journal, 2019
    Co-Authors: G. James, D. M. Klyne, M. Millecamps, L. S. Stone, Paul W. Hodges
    Abstract:

    Chronic low back pain causes structural remodelling and inflammation in the Multifidus Muscle. Collagen expression is increased in the Multifidus of humans with lumbar disc degeneration. However, the extent and mechanisms underlying the increased fibrotic activity in the Multifidus are unknown. Physical activity reduces local inflammation that precedes Multifidus fibrosis during intervertebral disc degeneration (IDD), but its effect on amelioration of fibrosis is unknown. This study aimed to assess the development of fibrosis and its underlying genetic network during IDD and the impact of physical activity. Wild-type and SPARC-null mice were either sedentary or housed with a running wheel, to allow voluntary physical activity. At 12 months of age, IDD was assessed with MRI, and Multifidus Muscle samples were harvested from L2 to L6. In SPARC-null mice, the L1/2 and L3/4 discs had low and high levels of IDD, respectively. Thus, Multifidus samples from L2 and L4 were allocated to low- and high-IDD groups compared to assess the effects of IDD and physical activity on connective tissue and fibrotic genes. High IDD was associated with greater connective tissue thickness and dysregulation of collagen-III, fibronectin, CTGF, substance P, TIMP1 and TIMP2 in the Multifidus Muscle. Physical activity attenuated the IDD-dependent increased connective tissue thickness and reduced the expression of collagen-I, fibronectin, CTGF, substance P, MMP2 and TIMP2 in SPARC-null animals and wild-type mice. Collagen-III and TIMP1 were only reduced in wild-type animals. These data reveal the fibrotic networks that promote fibrosis in the Multifidus Muscle during chronic IDD. Furthermore, physical activity is shown to reduce fibrosis and regulate the fibrotic gene network. These slides can be retrieved under Electronic Supplementary Material.

  • Dysregulation of the Inflammatory Mediators in the Multifidus Muscle After Spontaneous Intervertebral Disc Degeneration SPARC-null Mice is Ameliorated by Physical Activity.
    Spine, 2018
    Co-Authors: G. James, M. Millecamps, L. S. Stone, Paul W. Hodges
    Abstract:

    STUDY DESIGN: A longitudinal case-control animal model.OBJECTIVE: The aim of this study was to investigate the inflammatory pathways active in the Multifidus Muscle after spontaneous intervertebral disc degeneration (IDD), and whether these IDD-related Muscle changes can be ameliorated by exercise.SUMMARY OF BACKGROUND DATA: A pro-inflammatory response is present in the Multifidus Muscle after an intervertebral disc lesion and has been proposed to drive the structural alterations present during low back pain. However, it is not known whether spontaneous IDD produces an inflammatory response. Furthermore, exercise/physical activity produces a strong anti-inflammatory response, but its effectiveness in ameliorating inflammation in the Multifidus is unknown. We assessed the inflammatory profile of the Multifidus and the effectiveness of physical activity as a treatment using an animal model of spontaneous model of IDD.METHODS: Wild-type and SPARC null mice that were sedentary or housed with a running wheel were used in this study. Multifidus Muscle segments were harvested from L2-L6 from the mice at 9 months of age after they had undergone a magnetic resonance imaging (MRI) scan to determine levels with IDD. The inflammatory profile of the Multifidus was examined using quantitative polymerase chain reaction (PCR) assays.RESULTS: Spontaneous IDD in the SPARC-null mice caused a dysregulation of interleukin (IL)-1β, IL6, transforming growth factor-beta (TGFβ1), and adiponectin expression. More specifically, the proximity and degree of IDD was related to levels of IL-1β expression. Physical activity reduced the pro-inflammatory response to IDD in the Multifidus. IL-1β, tumor necrosis factor (TNF), IL-10, adiponectin, and leptin levels were lower in the physically active group.CONCLUSION: These results reveal that spontaneous IDD causes dysregulation of the inflammatory pathways active in the Multifidus Muscle. These alterations were related to the severity of IDD and were prevented by physical activity.N/A.

  • Macrophage polarization contributes to local inflammation and structural change in the Multifidus Muscle after intervertebral disc injury.
    European spine journal : official publication of the European Spine Society the European Spinal Deformity Society and the European Section of the Cerv, 2018
    Co-Authors: G. James, Leanne M. Hall, Annina B. Schmid, Cindy C. Shu, Christopher B. Little, James Melrose, Linda V. Blomster, Kathleen A. Sluka, Paul W. Hodges
    Abstract:

    Intervertebral disk (IVD) lesion and its subsequent degeneration have a profound effect on the Multifidus Muscle. The subacute/early chronic phase of Multifidus remodeling after IVD lesion has been proposed to be regulated by inflammatory processes. The balance between pro-inflammatory (M1) and anti-inflammatory (M2) macrophages plays an important role in maintaining tissue integrity after injury. The localization, polarization of macrophage subtypes and their mediation of the pro-inflammatory cytokine tumor necrosis factor (TNF) are unknown in paraspinal Muscles during IVD degeneration. A sheep model of IVD degeneration was used to investigate the role of macrophages and TNF in the structural alterations that occur within the Multifidus Muscle. Anterolateral lesions were induced at L3–4 IVD in sheep. Multifidus Muscle tissue at L4 was harvested 3 and 6 months after lesion and used for immunofluorescence assays to examine total macrophage number, macrophage polarization between M1 and M2, and to assess the localization of TNF expression in Muscle, adipose and connective tissues from injured and naive control animals. A greater proportion of M1 macrophages is present in Muscle at both 3 and 6 months after IVD lesion, and adipose tissue at 6 months. Total number of macrophages is unchanged. At 6 months, expression of TNF is increased in adipose and connective tissue and the proportion of TNF expressed by M1 macrophages is increased. These data support the proposal that macrophages and TNF (pro-inflammatory cytokine) play an active role in the subacute/early chronic phase of remodeling in Muscle, adipose and connective tissues of the Multifidus during IVD degeneration. This presents a novel target for treatment. These slides can be retrieved under Electronic Supplementary Material.

  • Mesenchymal stem cell treatment of intervertebral disc lesion prevents fatty infiltration and fibrosis of the Multifidus Muscle, but not cytokine and Muscle fiber changes
    Spine, 2016
    Co-Authors: G. James, Leanne M. Hall, Annina B. Schmid, Cindy C. Shu, Christopher B. Little, James Melrose, Linda V. Blomster, Paul W. Hodges
    Abstract:

    Study Design. Longitudinal case-control animal model. Objective. To investigate effects of mesenchymal stem cell (MSC) treatment on Multifidus Muscle remodeling after intervertebral disc (IVD) lesion. Summary of Background Data. Lesion and degeneration of IVDs cause structural remodeling of the Multifidus Muscle. Proinflammatory cytokines are thought to contribute. MSC treatment restores IVD health after lesion but its effects on surrounding tissues remains unknown. Using an animal model of IVD degeneration, we assessed the effects of MSC treatment of IVDs on the structural remodeling and cytokine expression within the Multifidus Muscle. Methods. An anterolateral lesion was performed on the L1-2, L3-4, and L5-6 IVDs in sheep. At either 4 (early treatment) or 12 (late treatment) weeks after IVD lesion, MSCs were injected into the lesioned IVD. Multifidus Muscle was harvested from L2 (gene expression analysis) and L4 (histological analysis) at 3 or 6 months after IVD lesion and naive controls for histological analysis of Muscle, adipose, and connective tissue cross-sectional areas, and immunohistochemistry to study Muscle fiber types. Real-time polymerase chain reactions quantified expression of tumor necrosis factor, interleukin-1β, and transforming growth factor-β1. Results. MSC treatment of IVD lesion prevented the increased adipose and connective tissue cross-sectional area expected after IVD lesion. MSC treatment did not prevent slow-to-fast Muscle fiber type transformation. Gene expression of proinflammatory cytokines within the Muscle was altered by the MSC treatment of IVD. Increased interleukin-1β expression was prevented in the early treatment group and tumor necrosis factor and transforming growth factor-β1 expression was upregulated at 6 months. Conclusion. Results show that although MSC treatment prevents fatty infiltration and fibrosis of the Multifidus Muscle after IVD lesion, it cannot prevent a Muscle inflammatory response and Muscle fiber transformation. These findings highlight the potential role of MSC therapy after IVD injury, but reveals that other interventions may also be necessary to optimize recovery of Muscle.