0000000000266066
AUTHOR
Tapio Videman
Disc degeneration and bone density in monozygotic twins discordant for insulin-dependent diabetes mellitus
The effects of insulin-dependent diabetes mellitus on bone density and connective tissue degeneration have theoretical interest and practical relevance. Several experimental studies in animals have demonstrated the harmful effects of insulin deficiency on connective tissues. However, clinical studies in humans have produced somewhat contradictory results, most likely due to difficulties controlling for general degeneration and factors associated with diabetes. In nine pairs of monozygotic twins discordant for insulin-dependent diabetes mellitus, we compared femoral and lumbar bone mineral density (assessed by dual-energy x-ray absorptiometry) and spinal degeneration (assessed by magnetic re…
The role of genetics and environment in lifting force and isometric trunk extensor endurance.
Background and Purpose. Our understanding of what different back performance tests are measuring is limited. The purpose of this study was to investigate the relative contributions of genetics and unique and common environmental factors for 3 tests of back muscle performance in a classic twin analysis. Subjects. The subjects were a population-based sample of 122 monozygotic and 131 dizygotic male twin pairs aged 35 to 69 years (X̄=49.9, SD=7.7). Methods. Variance component analysis was applied to estimate genetic and environmental influences on isokinetic and psychophysical lifting and isometric trunk extensor endurance test performance. The Cholesky decomposition genetic factor model was u…
Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters.
Objective. To determine the relationship between different physical loading conditions and findings of knee osteoarthritis (OA). Methods. We selected 117 male former top-level athletes (age range 45–68 years) who had participated in sports activities with distinctly different loading conditions: 28 had been long-distance runners, 31 soccer players, 29 weight lifters, and 29 shooters. Histories of lifetime occupational and athletic knee loading, knee injuries, and knee symptoms were obtained, and subjects were examined clinically and radiographically for knee findings of OA. Results. The prevalence of tibiofemoral or patellofemoral OA based on radiographic examination was 3% in shooters, 29%…
Allelic variants of IL1R1gene associate with severe hand osteoarthritis
Background In search for genes predisposing to osteoarthritis (OA), several genome wide scans have provided evidence for linkage on 2q. In this study we targeted a 470 kb region on 2q11.2 presenting the locus with most evidence for linkage to severe OA of distal interphalangeal joints (DIP) in our genome wide scan families. Methods We genotyped 32 single nucleotide polymorphisms (SNPs) in this 470 kb region comprising six genes belonging to the interleukin 1 superfamily and monitored for association with individual SNPs and SNP haplotypes among severe familial hand OA cases (material extended from our previous linkage study; n = 134), unrelated end-stage bilateral primary knee OA cases (n =…
Differences in psychomotor reaction time in male monozygotic twins discordant for lifetime cigarette smoking.
The effects of long-term cigarette smoking on psychomotor reaction time were investigated among 8 pairs of monozygotic male twins highly discordant for lifetime smoking (means 32.4 versus 0.6 pack-years). The men had no diagnosed cardiovascular disease or other major diseases, musculoskeletal complaints, or vision problems that might interfere with reaction time testing. The twins had similar education, work, and exercise histories; alcohol and coffee consumption and exposure to solvents were examined as possible confounds. Direct comparison of cotwins also controlled for age, genetics, and possible early environmental factors. Simple and choice reaction time were measured in the dominant h…
Differences in hand and foot psychomotor speed among 18 pairs of monozygotic twins discordant for lifelong vehicular driving.
The purpose of this study was to examine driving as a determinant of hand and foot psychomotor reaction times. Visual simple and choice hand and foot psychomotor reaction times were measured. The occupational driving contrast was determined by an interview reviewing every job held during each subject's lifetime. Comparison was made of psychomotor speed among 18 pairs of 39- to 62-year-old monozygotic male twins discordant for lifelong occupational driving. The mean discordance was the equivalent of 16 years of full-time driving. The twins who drove more tended to have slower hand simple and choice reaction times, although only the difference in hand-choice decision time was statistically si…
The relative roles of intragenic polymorphisms of the vitamin d receptor gene in lumbar spine degeneration and bone density.
Study Design. A retrospective cohort study. Objectives. To compare the magnitudes of the associations of TaqI polymorphisms of the vitamin D receptor gene with bone density and lumbar spine degeneration in the same sample. Summary of Background Data. Vitamin D receptor gene variations are associated with osteoporosis, osteoarthritis, and disc degeneration. Their role in these conditions remains poorly understood. Methods. Bone density of the spine and femur were determined through DEXA, and lumbar disc degeneration was determined from magnetic resonance imaging assessments of signal intensity, disc narrowing, bulging, anular tears, herniations, and osteophytes. Associations between these me…
Digital assessment of MRI for lumbar disc desiccation. A comparison of digital versus subjective assessments and digital intensity profiles versus discogram and macroanatomic findings.
During magnetic resonance imaging, a vast amount of digital data on anatomic structures is translated into images, which are then assessed subjectively. The development of an objective, sensitive method to directly assess the digital data would have clear benefits, particularly for clinical research on disc degeneration. The study goals were to develop a method of digital assessment of disc desiccation and to compare digital signal intensity profiles with discographic patterns and macroanatomic findings. Proton density-weighted MRIs were obtained from 45 males (9-77 years) and digital analysis was done with a freely selectable region of interest facility. The adjacent cerebrospinal fluid (C…
Lumbar mobility in former élite male weight-lifters, soccer players, long-distance runners and shooters
OBJECTIVE: To investigate the long-term effects of different loading conditions in sports and work on lumbar mobility. DESIGN: Factors associated with lumbar mobility were sought by examining sports experience, occupational history, back pain history, anthropometric characteristics, and lumbar magnetic resonance images in 114 former Finnish male élite athletes: 30 soccer players, 29 weight-lifters, 27 long-distance runners, and 28 shooters, aged 45-68 yr. BACKGROUND: Back pain and aging reduce spinal mobility, whereas some sports may increase it. Little is known about the effects of common loading conditions found in work and sports, that do not require extremes of spinal motion on lumbar m…
Neck trouble in machine operating, dynamic physical work and sedentary work: a prospective study on occupational and individual risk factors.
A prospective study on the effects of occupational and individual factors on neck trouble was carried out among 1832 men representing static work with whole-body vibration (machine operators), dynamic physical work (construction carpenters) and sedentary work (office workers). Neck trouble and occupational and individual factors were inquired about via postal questionnaires in 1984 and 1987. Machine operating was associated with an increased risk to contract severe neck trouble, and machine operating and dynamic physical work were associated with persistently severe neck trouble. Other predictors for contracting severe neck trouble were age and current smoking. Physical exercise decreased t…
Comparison of Foot and Hand Reaction Times among Men: A Methodologic Study Using Simple and Multiple-Choice Repeated Measurements
The primary study goal was to compare visual simple and choice reaction times of the hand and foot to assess validity of measurements for evaluating subjects' ability to perform rapid, controlled movements. First, we examined the repeatability ( N = 34) for four different data-sampling methods from a series of 12 trials within sessions and between two test sessions. Simple and choice reaction times with the preferred hand and both feet were then compared among 153 healthy male volunteers aged 35 to 67 years. Pearson correlations for hand and ipsilateral and contralateral foot reaction times on simple and choice tasks (.53 to .80, p<.001) showed that psychomotor foot reaction time is a v…
Association study of MMP8 gene in osteoarthritis.
Objectives: Osteoarthritis (OA) is a joint disease common in the elderly. There is a prior functional evidence for different matrix metalloproteinases (MMPs), such as MMP8 and MMP9, having a role in the breakdown of cartilage extracellular matrix in OA. Thus, we analyzed whether the common genetic variants of MMP8 and MMP9 contribute to the risk of OA. Materials and methods: In total, 13 common tagging single-nucleotide polymorphisms (SNPs) were studied in a discovery knee OA cohort of 185 cases and 895 controls. For validation, two knee OA replication cohorts and two hand OA replication cohorts were studied (altogether 1369 OA cases, 4445 controls in the five cohorts). The chi(2) test for …
Hip fractures and femoral bone mineral density in male former elite athletes
We studied whether vigorous physical activity in young adulthood is associated with higher femoral bone density and lower risk of hip fracture at older age in men.A cohort of former male elite athletes (n=2147) and matched control subjects (n=1467) were studied for their leisure physical activity, and for fragility fractures at the hip (proximal femur) by Cox regression. Areal bone mineral densities (aBMD) at femoral neck and trochanter region were measured using dual-energy X-ray absorptiometry in a subgroup of the former athletes (n=87; median age 59 years) and in a population-based control group (n=194) and compared by general linear models.After their active sporting careers, the former…
Repeatability of lifetime exercise reporting
The purpose of the study was to determine the reliability of lifetime exercise data obtained through a structured interview. Interviews were conducted in 1992-1993 and repeated in 1997 in 150 monozygotic male twins, aged 35-69 years, from the population-based Finnish Twin Cohort. Exercise mode, frequency, duration, intensity and period of participation were solicited for each regularly performed exercise from 12 years of age to the present. Questions related to the most common exercise mode reported in the initial interview were repeated in all subjects and the entire exercise interview was repeated in a subgroup of 38 subjects. The repeatability was highest for exercise years and mean hour…
Correlations of isokinetic and psychophysical back lift and static back extensor endurance tests in men
Isokinetic lift, psychophysical lift, and static back endurance tests are among the most widely used measurements of muscle function for determining risk for, and recovery from, back problems. After determining test repeatability we examined the degree of association between these test measures in 100 men selected to represent a variety of occupations and lifestyles. Isokinetic lifting had low correlations with test results for psychophysical lifting (r = 0.28) and static back endurance (r = 0.24). Static back endurance and psychophysical lift test results were not at all correlated (r = 0.03). RELEVANCE--:Muscle function measurements for back problems are sometimes arbitrarily selected due…
Physical loading and performance as predictors of back pain in healthy adults. A 5-year prospective study.
We investigated muscle strength, aerobic power, and occupational and leisure-time physical loading as predictors of back pain in a 5-year follow-up study. A cohort of 456 adults aged 25, 35, 45 and 55 years, free of back pain, participated in measurements of anthropometric characteristics, aerobic power and muscle strength characteristics at baseline. The subjects' levels and types of physical activity and occupational physical loading were also determined. At 5 years after the baseline examinations 356 of these subjects (78.1 %) were reached by mail, and 262 of them (73.6%) properly completed and returned a questionnaire including a detailed back pain history for the 5 years following the …
Lumbar Disc Degeneration and Sagittal Flexibility
It is uncertain whether intervertebral disc degeneration is associated with reduced or increased flexibility, although lumbar flexibility is known to reduce with advancing age. This cross-sectional study of 214 middle-aged men attempted to determine the influence on lumbar sagittal flexibility from intervertebral disc degeneration parameters measured from magnetic resonance images (disc height, signal intensity, bulging, osteophytes). Multivariate analyses showed that a reduced extent of lumbar flexibility could be accounted for by the combined effect of decreasing disc height together with increasing age, weight, and back pain frequency. Although it remains possible that single degenerate …
Interexaminer reliability of low back pain assessment using the McKenzie method.
STUDY DESIGN A test-retest design was used. OBJECTIVE To assess interexaminer reliability of the McKenzie method for performing clinical tests and classifying patients with low back pain. SUMMARY OF BACKGROUND DATA Clinical methods and tests classifying patients with nonspecific low back pain have been based mainly on symptom duration or extent of pain referral. The McKenzie mechanical diagnostic and classification approach is a widely used noninvasive, low-technology method of assessing patients with low back pain. However, little is known about the interexaminer reliability of the method, previous studies having yielded conflicting results. METHODS For this study, 39 volunteers with low b…
Lifetime exercise and disk degeneration: an MRI study of monozygotic twins.
Participation in some competitive sports has been shown to increase disk degeneration; however, the long-term effects of recreational physical activities are unclear. We investigated the effects of endurance exercise and power sports on disk degeneration in monozygotic male twins with contrasting lifetime exercise histories. The effects of endurance exercise were studied in 22 discordant twin pairs (mean lifetime frequencies of 3.9 vs 1.1 times/wk), and the effects of power sports were investigated in 12 discordant pairs (2,300 vs 200 h of weightlifting). The age range of the twins was from 35 to 69 yr. No differences in MRI findings between co-twins discordant for endurance exercise were f…
The long-term effects of rally driving on spinal pathology
Abstract Objectives. To investigate the consequences of rally driving on lumbar degenerative changes. Background. Vehicular driving is suspected to accelerate disc degeneration through whole-body vibration, leading to back problems. However, in an earlier well-controlled study of lumbar MRI findings in monozygotic twins, significant effects of lifetime driving on disc degeneration were not demonstrated. Another study of machine operators found only long-term exposure to vibration on unsprung seats led to a reduction in disc height. Design. Case-control study comparing rally drivers with population sample. Methods. Eighteen top rally drivers and co-drivers, mean age 43 yrs (SD, 10), voluntee…
The effect of lifelong exercise on psychomotor reaction time: a study of 38 pairs of male monozygotic twins
Purpose: The aim was to study the effect of lifetime physical activity on psychomotor speed. Methods: Foot and dominant hand visual simple and choice psychomotor reaction times were studied among monozygotic twins (38 pairs) aged 35-69, discordant for lifetime exercise histories. Results: There was a trend that some components of psychomotor reaction time were faster for frequent than for occasional exercisers. but the findings were not consistent for the hand and feet. After controlling for occupational physical activity, only choice decision time for the hand (26 ms, P < 0.01) and choice reaction time for the contralateral foot (51 ms, P < 0.05) both remained 7% faster. There was no trend…
The Long-Term Effects of Physical Loading and Exercise Lifestyles on Back-Related Symptoms, Disability, and Spinal Pathology Among Men
Study design Historical cohort, including selected subgroups. Objectives To understand the long-term effects of exercise on back-related outcomes, back pain, sciatica, back-related hospitalizations, pensions, and magnetic resonance imaging findings were studied among former elite athletes. Summary of background data Exercise and sports participation have become increasingly popular, as have recommendations of exercises for back problems, but little is known about their long-term effects. Methods Questionnaires were returned by 937 former elite athletes and 620 control subjects (83% response rate). Identification codes allowed record linkage to hospital discharge and pension registers. Magne…
Magnetic resonance imaging findings and their relationships in the thoracic and lumbar spine. Insights into the etiopathogenesis of spinal degeneration.
Study design Descriptive epidemiologic study about magnetic resonance imaging findings in the spine. Objectives To describe the prevalence of magnetic resonance imaging findings in a general population at spinal levels T6-S1, and to examine the relationships of these findings within each spinal level and between levels. Summary of background data The prevalence of specific findings and the associations between findings and spinal levels can provide general insights into the etiopathogenesis of spinal degeneration. Methods Subjects consisted of 232 men from a population sample (mean age 49.3 years). Signal intensity, disc bulging, disc herniation, and endplate irregularities were among 11 fi…
Outcome comparison among working adults with centralizing low back pain: Secondary analysis of a randomized controlled trial with 1-year follow-up
Our purpose was to examine if adults with centralizing pain might achieve better treatment outcomes when treated by individually designed therapy than “given advice only to stay active”. One hundred and nineteen working adults with first or a recurrent episode of low back pain (LBP) were classified as centralizers and were randomly allocated to orthopaedic manual therapy (OMT; n=42), the McKenzie (n=48) or “advice only to stay active” (Advice-only; n=29) groups. Back and leg pain were assessed by the visual analogue scale, disability with the Roland–Morris questionnaire and functional status with an activities of daily living (ADL) index. Immediately after the treatment period, LBP decrease…
Orthopaedic manual therapy, McKenzie method or advice only for low back pain in working adults: a randomized controlled trial with one year follow-up.
OBJECTIVE: To examine the effects of 2 manual therapy methods compared with one counselling session with a physiotherapist with "advice-only to stay active" for treating low back pain/leg pain and disability. DESIGN: A randomized, controlled trial with a 1-year follow-up. SUBJECTS: A total of 134 subjects with low back disorders. METHODS: Participants with acute to chronic first or recurrent low back pain, excluding those with "red flag" criteria, were assigned randomly to one of the 3 intervention groups: an orthopaedic manual therapy group (n=45), a McKenzie method group (n=52), and an "advice only to be active" group (advice-only) (n=37). Data on leg and low back pain intensity and disab…