27 research outputs found
Clinical, Biomechanical, and Physiological Translational Interpretations of Human Resting Myofascial Tone or Tension
Background: Myofascial tissues generate integrated webs and networks of passive and active tensional forces that provide stabilizing support and that control movement in the body. Passive [central nervous system (CNS)–independent] resting myofascial tension is present in the body and provides a low-level stabilizing component to help maintain balanced postures. This property was recently called “human resting myofascial tone” (HRMT). The HRMT model evolved from electromyography (EMG) research in the 1950s that showed lumbar muscles usually to be EMG-silent in relaxed gravity-neutral upright postures.
Methods: Biomechanical, clinical, and physiological studies were reviewed to interpret the passive stiffness properties of HRMT that help to stabilize various relaxed functions such as quiet balanced standing. Biomechanical analyses and experimental studies of the lumbar multifidus were reviewed to interpret its passive stiffness properties. The lumbar multifidus was illustrated as the major core stabilizing muscle of the spine, serving an important passive biomechanical role in the body.
Results: Research into muscle physiology suggests that passive resting tension (CNS-independent) is generated in sarcomeres by the molecular elasticity of low-level cycling cross-bridges between the actomyosin filaments. In turn, tension is complexly transmitted to intimately enveloping fascial matrix fibrils and other molecular elements in connective tissue, which, collectively, constitute the myofascial unit. Postural myofascial tonus varies with age and sex. Also, individuals in the population are proposed to vary in a polymorphism of postural HRMT. A few people are expected to have outlier degrees of innate postural hypotonicity or hypertonicity. Such biomechanical variations likely predispose to greater risk of related musculoskeletal disorders, a situation that deserves greater attention in clinical practice and research. Axial myofascial hypertonicity was hypothesized to predispose to ankylosing spondylitis. This often-progressive deforming condition of vertebrae and sacroiliac joints is characterized by stiffness features and particular localization of bony lesions at entheseal sites. Such unique features imply concentrations and transmissions of excessive force, leading to tissue micro-injury and maladaptive repair reactions.
Conclusions: The HRMT model is now expanded and translated for clinical relevance to therapists. Its passive role in helping to maintain balanced postures is supported by biomechanical principles of myofascial elasticity, tension, stress, stiffness, and tensegrity. Further research is needed to determine the molecular basis of HRMT in sarcomeres, the transmission of tension by the enveloping fascial elements, and the means by which the myofascia helps to maintain efficient passive postural balance in the body. Significant deficiencies or excesses of postural HRMT may predispose to symptomatic or pathologic musculoskeletal disorders whose mechanisms are currently unexplained
Sexual Dimorphisms of Adrenal Steroids, Sex Hormones, and Immunological Biomarkers and Possible Risk Factors for Developing Rheumatoid Arthritis
Innate immunity and immunological biomarkers are believed to be interrelated with sex hormones and other neuroendocrine factors. Sexual dimorphism mechanisms may be operating in certain rheumatic and inflammatory diseases which occur more frequently in women than men, as rheumatoid arthritis (RA). Less data have been available on altered interrelations of the combined neuroendocrine and immune (NEI) systems as risk factors for development of certain diseases. In this study, serological interrelations of NEI biomarkers are analyzed before symptomatic onset of RA (pre-RA) versus control (CN) subjects, stratified by sex. Sexual dimorphism was found in serum levels of acute serum amyloid A (ASAA), soluble interleukin-2 receptor alpha (sIL-2Rα), and soluble tumor necrosis factor receptor 1 (sTNF-R1). Multiple steroidal and hormonal (neuroendocrine) factors also showed highly (p<0.001) significant sexual dimorphism in their assayed values, but less for cortisol (p=0.012), and not for 17-hydroxyprogesterone (p=0.176). After stratification by sex and risk of developing RA, differential NEI correlational patterns were observed in the interplay of the NEI systems between the pre-RA and CN groups, which deserve further investigation
Human Resting Muscle Tone (HRMT): Narrative Introduction and Modern Concepts
Human resting muscle
(myofascial) tone (HRMT) is the passive
tonus or tension of skeletal muscle that
derives from its intrinsic (EMG-silent)
molecular viscoelastic properties. The word
tone has been used to convey varying
clinical and physiological features that have
led to confusion and controversy. HRMT is
the vital low-level, passive tension, and
resistance to stretch that contributes
importantly to maintaining postural stability
in balanced equilibrium positions. In
contrast, co-contraction of muscle is an
active neuromotor control that provides
greater levels of tonus for increased
stabilization. Functionally, HRMT is
integrated with other passive fascial and
ligamentous tensional networks of the body
to form a biotensegrity system. This review
aims to achieve better understandings of
HRMT and its functional roles.
Nature is frugal and Man’s adaptations to
gravitational forces and erect postures
seemingly evolved mechanisms in skeletal
muscle tissues to economically enhance
stability. Normal passive muscle tone helps
maintain relaxed standing body posture with
minimally increased energy costs (circa 7%
over supine), and often for prolonged
durations without fatigue. Available data
infer polymorphic variations in normal
myofascial tone. However, few quantitative
studies have been performed to establish
normal frequency distributions of degrees of
myofascial tone. Clinical experience
indicates that persons with certain
symptomatic musculoskeletal conditions
may have palpably increased resting muscle
firmness or hardness (EMG-silent), such as
that of the upper trapezius in tension-type
headache, and the lumbodorsal extensors
(hartspann) in degenerative lumbar disc
disease and ankylosing spondylitis.
In summary, resting skeletal muscle tone is
an intrinsic viscoelastic tension exhibited
within the body’s kinematic chains. It
functions inseparably from fascial (i.e.
myofascial) tissues and ligamentous
structures. Thus, HRMT is a passive
myofascial property which operates within
networks of tensional tissues, i.e.,
biotensegrity. This passive tension is the
CNS-independent component resulting from
intrinsic molecular interactions of the
actomyosin filaments in sarcomeric units of
skeletal muscle and myofibroblast cells.
The overarching CNS-activated muscle
contractions generate far greater tensions
transmitted by fascial elements.
Interdisciplinary research on HRMT and its
biodynamics promises greater effectiveness
of clinical practitioners and productivity of
investigators, which warrants priority
attention
Do women with premenopausal-onset rheumatoid arthritis have relative insufficiency or imbalance of adrenocortical steroids?
Adrenocortical steroids may influence susceptibility to rheumatoid arthritis (RA). Serum levels of adrenocortical steroids in female RA patients not previously treated with glucocorticoids were reviewed in this paper, as were controlled cohort studies of predisease (pre-RA) and control (CN) women. Serum dehydroepiandrosterone sulfate (DHEAS) levels were lower in most reports of premenopausal-onset RA patients not treated with glucocorticoids and in the baseline levels in one cohort study of pre-RA females compared with CN subjects. The pre-RA versus CN cohort difference was confirmed in an independent laboratory. Basal DHEAS and cortisol levels correlated oppositely in pre-RA versus CN women, suggesting relative adrenocortical androgenic insufficiency in case subjects. Clinical observations of lower androstenedione levels in premenopausal RA patients were also reported in pre-RA versus CN subjects who had lower DHEAS and cortisol values. In summary, a minority of premenopausal-onset RA females had decreased adrenocortical androgenic steroid levels and exhibited an adrenal androgen-to-cortisol steroid imbalance
Lower Serum Androstenedione Levels in Pre-Rheumatoid Arthritis versus Normal Control Women: Correlations with Lower Serum Cortisol Levels
Serum adrenal androgens (AAs), including androstenedione (Δ4A) and dehydroepiandrosterone sulfate (DHEAS), have been reported to be lower in female rheumatoid arthritis (RA) patients with early disease. Few data are available on hormonal status of women before the onset of clinical rheumatoid arthritis (pre-RA). A broad baseline panel of serum adrenal and sex steroids was compared in 36 female pre-RA to 144 matched cohort control (CN) subjects to determine differences in their mean values and in patterns of hormonal correlations. Study subjects having lower versus higher baseline serum cortisol levels than the total group's mean value were also analyzed separately to investigate differences in their hormonal levels and correlational patterns. In total subjects, mean (±SE) Δ4A level (nmol/L) was lower (P=0.018) in 28 pre-RA cases (6.4±0.40) versus 108 CN (7.8±0.28). The significant (P=0.013) difference was restricted to 9 pre-RA versus 53 CN subjects having lower cortisol levels (5.6±0.73 versus 8.0±0.42 nmol/L, resp.). In total subjects, no significant difference was found between study subjects in their bivariate correlations of the hormonal panel variables, unlike results found in the subgroups stratified by lower versus higher cortisol levels. A subgroup of pre-RA females may have relative adrenal cortical insufficiency, as reflected by lower Δ4A, especially observed among those subjects with lower cortisol levels