Patients with spinal muscular atrophy use high percentages of trunk muscle capacity to perform seated tasks

Laura H C Peeters; Mariska M H P Janssen; Idsart Kingma; Jaap H van Dieën; Imelda J M de Groot

doi:10.1097/PHM.0000000000001258

Patients with spinal muscular atrophy use high percentages of trunk muscle capacity to perform seated tasks

Laura H C Peeters, Mariska M H P Janssen, Idsart Kingma, Jaap H van Dieën, Imelda J M de Groot

Biomechanics

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Abstract

OBJECTIVE: To investigate trunk function during seated upper extremity tasks in patients with spinal muscular atrophy (SMA) type 2 and 3.

DESIGN: 17 persons with SMA and 15 healthy controls (HC) performed several tasks when sitting unsupported, such as reaching (and placing) forward and sideward. Joint torque and muscle activity were measured during maximum voluntary isometric contractions (MVIC). Three-dimensional kinematics and normalized muscle activity were analyzed when performing tasks.

RESULTS: Trunk joint torques were significantly decreased, approximately 45%, in patients with SMA compared to HC. Active range of trunk motion was also significantly decreased in all directions. When performing tasks, the average back muscle activity was 27% and 56% of MVIC for respectively HC and SMA, and for abdominal muscles respectively 10% and 44% of MVIC. Trunk range of motion did not differ when performing daily tasks.

CONCLUSION: The trunk of patients with SMA is weaker compared to HC, reflected by reduced trunk torques and decreased active range of motion. Additionally, patients with SMA use high percentages of their trunk muscle capacity to perform tasks. Clinicians should take this into account for intervention development, because using high percentages of the maximum muscle capacity results in fatigue and muscle overloading.

Original language	English
Pages (from-to)	1110-1117
Number of pages	8
Journal	American Journal of Physical Medicine and Rehabilitation
Volume	98
Issue number	12
Early online date	2 Jul 2019
DOIs	https://doi.org/10.1097/PHM.0000000000001258
Publication status	Published - Dec 2019

Funding

This work was supported by the Netherlands Organisation for Scientific Research (Grant Numbers 13524 and 13525), Duchenne Parent Project, Stichting FSHD, Foundation to Eradicate Duchenne, Parent Project: Muscular Dystrophy, Focal Meditech, BAAT Medical, Summit Revalidatietechniek, Hankamp Rehab, Intespring, and Yumen Bionics.

Funders	Funder number
Stichting FSHD
Yumen Bionics
Nederlandse Organisatie voor Wetenschappelijk Onderzoek	13525, 13524
Duchenne Parent Project
Muskelsvindfonden

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Patients With Spinal Muscular Atrophy Use High Percentages of Trunk Muscle Capacity to Perform Seated TasksFinal published version, 514 KBLicence: Article 25fa Dutch Copyright Act

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title = "Patients with spinal muscular atrophy use high percentages of trunk muscle capacity to perform seated tasks",

abstract = "OBJECTIVE: To investigate trunk function during seated upper extremity tasks in patients with spinal muscular atrophy (SMA) type 2 and 3.DESIGN: 17 persons with SMA and 15 healthy controls (HC) performed several tasks when sitting unsupported, such as reaching (and placing) forward and sideward. Joint torque and muscle activity were measured during maximum voluntary isometric contractions (MVIC). Three-dimensional kinematics and normalized muscle activity were analyzed when performing tasks.RESULTS: Trunk joint torques were significantly decreased, approximately 45%, in patients with SMA compared to HC. Active range of trunk motion was also significantly decreased in all directions. When performing tasks, the average back muscle activity was 27% and 56% of MVIC for respectively HC and SMA, and for abdominal muscles respectively 10% and 44% of MVIC. Trunk range of motion did not differ when performing daily tasks.CONCLUSION: The trunk of patients with SMA is weaker compared to HC, reflected by reduced trunk torques and decreased active range of motion. Additionally, patients with SMA use high percentages of their trunk muscle capacity to perform tasks. Clinicians should take this into account for intervention development, because using high percentages of the maximum muscle capacity results in fatigue and muscle overloading.",

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AU - Peeters, Laura H C

AU - Janssen, Mariska M H P

AU - Kingma, Idsart

AU - van Dieën, Jaap H

AU - de Groot, Imelda J M

PY - 2019/12

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N2 - OBJECTIVE: To investigate trunk function during seated upper extremity tasks in patients with spinal muscular atrophy (SMA) type 2 and 3.DESIGN: 17 persons with SMA and 15 healthy controls (HC) performed several tasks when sitting unsupported, such as reaching (and placing) forward and sideward. Joint torque and muscle activity were measured during maximum voluntary isometric contractions (MVIC). Three-dimensional kinematics and normalized muscle activity were analyzed when performing tasks.RESULTS: Trunk joint torques were significantly decreased, approximately 45%, in patients with SMA compared to HC. Active range of trunk motion was also significantly decreased in all directions. When performing tasks, the average back muscle activity was 27% and 56% of MVIC for respectively HC and SMA, and for abdominal muscles respectively 10% and 44% of MVIC. Trunk range of motion did not differ when performing daily tasks.CONCLUSION: The trunk of patients with SMA is weaker compared to HC, reflected by reduced trunk torques and decreased active range of motion. Additionally, patients with SMA use high percentages of their trunk muscle capacity to perform tasks. Clinicians should take this into account for intervention development, because using high percentages of the maximum muscle capacity results in fatigue and muscle overloading.

AB - OBJECTIVE: To investigate trunk function during seated upper extremity tasks in patients with spinal muscular atrophy (SMA) type 2 and 3.DESIGN: 17 persons with SMA and 15 healthy controls (HC) performed several tasks when sitting unsupported, such as reaching (and placing) forward and sideward. Joint torque and muscle activity were measured during maximum voluntary isometric contractions (MVIC). Three-dimensional kinematics and normalized muscle activity were analyzed when performing tasks.RESULTS: Trunk joint torques were significantly decreased, approximately 45%, in patients with SMA compared to HC. Active range of trunk motion was also significantly decreased in all directions. When performing tasks, the average back muscle activity was 27% and 56% of MVIC for respectively HC and SMA, and for abdominal muscles respectively 10% and 44% of MVIC. Trunk range of motion did not differ when performing daily tasks.CONCLUSION: The trunk of patients with SMA is weaker compared to HC, reflected by reduced trunk torques and decreased active range of motion. Additionally, patients with SMA use high percentages of their trunk muscle capacity to perform tasks. Clinicians should take this into account for intervention development, because using high percentages of the maximum muscle capacity results in fatigue and muscle overloading.

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Patients with spinal muscular atrophy use high percentages of trunk muscle capacity to perform seated tasks

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