Glucocorticoids are well known for altering bone structure and elevating fracture risk. Nevertheless, there are very few reports on pelvic ring fractures, compared to other bones, especially with a predominantly ligamentous insufficiency, resulting in a rotationally unstable pelvic girdle.We report a 39-year-old premenopausal woman suffering from an atraumatic symphysiolysis and disruption of the left sacroiliac joint. She presented with external rotational pelvic instability and immobilization. Prior to the injury, she received high-dose glucocorticoids for a tentative diagnosis of rheumatoid arthritis over two months. This diagnosis was not confirmed. Other causes leading to the unstable pelvic girdle were excluded by several laboratory and radiological examinations. Elevated basal cortisol and adrenocorticotropic hormone levels were measured and subsequent corticotropin-releasing hormone stimulation, dexamethasone suppression test, and petrosal sinus sampling verified the diagnosis of adrenocorticotropic hormonedependent Cushing’s disease. The combination of adrenocorticotropic hormone-dependent Cushing’s disease and the additional application of exogenous glucocorticoids is the most probable cause of a rare atraumatic rotational pelvic instability in a premenopausal patient. To the authors’ knowledge, this case presents the first description of a rotationally unstable pelvic ring fracture involving a predominantly ligamentous insufficiency in the context of combined exogenous and endogenous glucocorticoid elevation.

Darbo tikslas: palyginti paviršinių ir giliųjų liemens raumenų aktyvumo ir liemens stabilumo matavimų duomenis tarp asmenų, jaučiančių apatinės nugaros dalies skausmą (tiriamoji grupė) ir šio nusiskundimo neturinčių (kontrolinė grupė), pagrindinėse padėtyse. Pasirinktam darbo tikslui įgyvendinti buvo iškelti šie uždaviniai: 1. Palyginti giliųjų ir paviršinių liemens raumenų aktyvumą bei liemens stabilumą, atliekant izoliuotą skersinio pilvo raumens susitraukimą, tarp tiriamosios ir kontrolinės grupės. 2. Palyginti giliųjų ir paviršinių liemens raumenų aktyvumą bei liemens stabilumą, atliekant testus gulint ant pilvo, tarp tiriamosios ir kontrolinės grupės. 3. Palyginti giliųjų ir paviršinių liemens raumenų aktyvumą bei liemens stabilumą, atliekant testus gulint ant šono, tarp tiriamosios ir kontrolinės grupės. 4. Palyginti giliųjų ir paviršinių liemens raumenų aktyvumą, atliekant testus gulint ant nugaros, tarp tiriamosios ir kontrolinės grupės. Tyrimas atliktas poliklinikoje, Kaune. Tyrime dalyvavo 62 tiriamieji (28 vyrai ir 34 moterys). Tyrimo metodai: 1. Anketinė apklausa. 2. Elektromiografas su diferenciniu slėgio jutikliu (4 kanalų EMG + Stabilizer pressure biofeedback). 3.Statistinė analizė. Rezultatai: 1. Atliekant izoliuotą skersinio pilvo raumens susitraukimą, gauta, kad asmenų jaučiančių apatinės nugaros dalies skausmą tiesiamojo nugaros raumens juosmeninės dalies ir tiesiojo pilvo raumens apatinės dalies elektrinis aktyvumas buvo didesnis, o dauginio raumens ir... [toliau žr. visą tekstą] / The aim of the Master’s work is to compare the deep and surface torso muscle activity and stability measurement data, collected during main physical positions, of individuals that suffer from lower back pain (research group) and those who don’t (control group). The achievement of the works goal consists of the following tasks: 1. To compare deep and surface muscle activity and stability of the torso between both the research and control group individuals, during isolated transverse abdominal muscle contraction. 2 To compare deep and surface muscle activity and stability of the torso between both the research and control group individuals, during tests while lying on the abdomen. 3 To compare deep and surface muscle activity and stability of the torso between both the research and control group individuals, during tests while lying on the side. 4. To compare deep and surface muscle activity and stability of the torso between both the research and control group individuals, during tests while lying on the back. The study was conducted at a clinic in Kaunas. The study included 62 subjects (28 men and 34 women). Methods used within the study: 1. A questionnaire. 2. Electromyograph with a differential pressure sensor (4 channel EMG + Stabilizer pressure biofeedback). 3.Statistic analysis. The results: 1. It was found that while performing an isolated contraction of the transverse abdominal muscle, individuals with lower back pain had a considerably smaller electrical muscle... [to full text]

Glucocorticoids are well known for altering bone structure and elevating fracture risk. Nevertheless, there are very few reports on pelvic ring fractures, compared to other bones, especially with a predominantly ligamentous insufficiency, resulting in a rotationally unstable pelvic girdle.We report a 39-year-old premenopausal woman suffering from an atraumatic symphysiolysis and disruption of the left sacroiliac joint. She presented with external rotational pelvic instability and immobilization. Prior to the injury, she received high-dose glucocorticoids for a tentative diagnosis of rheumatoid arthritis over two months. This diagnosis was not confirmed. Other causes leading to the unstable pelvic girdle were excluded by several laboratory and radiological examinations. Elevated basal cortisol and adrenocorticotropic hormone levels were measured and subsequent corticotropin-releasing hormone stimulation, dexamethasone suppression test, and petrosal sinus sampling verified the diagnosis of adrenocorticotropic hormonedependent Cushing’s disease. The combination of adrenocorticotropic hormone-dependent Cushing’s disease and the additional application of exogenous glucocorticoids is the most probable cause of a rare atraumatic rotational pelvic instability in a premenopausal patient. To the authors’ knowledge, this case presents the first description of a rotationally unstable pelvic ring fracture involving a predominantly ligamentous insufficiency in the context of combined exogenous and endogenous glucocorticoid elevation.

In recent years, the scientific community has emphasized the importance of the core both in the sports context and in rehabilitation. The core is an area of the body, responsible for generating force from the center and dissipating it to the extremities. In this perspective, specific exercises have been used for this area in functional training, in order to promote improvements in functional and core performance. However, it is not clear in what magnitude the core actually participates in performing functional actions in young adults and yet whether the inclusion of core-specific physical exercises in functional training causes more pronounced functional adaptations than when this inclusion does not occur. Thus, the objectives of this dissertation were: I) To analyze the association between the endurance of the core and measures of functional performance in young individuals. II). To analyze the effects of 12 weeks of specific core training and functional training, with and without the inclusion of core-specific exercises, on core performance and performance in functional tests. This dissertation was composed of three studies: A study of protocol / trial (Study I), transversal (Study II) and experimental (Study III). Participating in the study sample were young and healthy individuals, classified as insufficiently active by the International Questionnaire of Physical Activity. In the study II a multiple linear regression was performed with the purpose of explaining in what magnitude the endurance of the core contributes to the performance of functional tests. The findings of this study showed that there is a participation of core endurance ranging from 1.4 to 46.9% depending on the functional test performed. In addition, most of these interactions were statistically significant. In study III, the participants were allocated to three intervention groups: Functional Training with core, which performed global exercises in addition to specific exercises for the core; Functional training, which performed only functional global exercises; and Core training, which performed only exercises that caused greater activation in the core muscles. After 12 weeks of training, all groups improved significantly in both functional and core performance, but there were no significant differences between them. Thus, it is concluded that the endurance of the core is important for the functionality of young adults and that when core-specific exercises are included in the functional training, the gains related to functional and core performance are enhanced. / Nos últimos anos a comunidade científica tem destacado a importância do core tanto no contexto esportivo, quanto na reabilitação. O core é uma zona do corpo, responsável por gerar força do centro e dissipá-la para as extremidades. Nessa perspectiva, tem sido utilizado exercícios específicos para essa zona no treinamento funcional, com o intuito de promover melhorias na performance funcional e do core. No entanto, não está claro em que magnitude o core realmente participa da realização de ações funcionais em jovens adultos e ainda se a inclusão de exercícios físicos específicos para o core no treinamento funcional provoca adaptações funcionais mais acentuadas do que quando não ocorre essa inclusão. Sendo assim, os objetivos da presente dissertação foram: I) Analisar a associação entre a endurance do core e medidas de performance funcional em indivíduos jovens. II). Analisar os efeitos de 12 semanas de treinamento específico do core e treinamento funcional, com e sem a inclusão de exercícios específicos do core, sobre a performance do core e a performance em testes funcionais. Esta dissertação foi composta por três estudos: Um estudo de protocolo/ trial (Estudo I), transversal (Estudo II) e experimental (Estudo III). Participaram da amostra dos estudos, indivíduos jovens e saudáveis, classificados como insuficientemente ativos pelo Questionário Internacional de Atividade Física. No estudo II foi realizado uma regressão linear múltipla com o intuito de explicar em que magnitude a endurance do core contribui para a realização de testes funcionais. Os achados desse estudo demonstraram que há uma participação da endurance do core que varia entre 1,4 e 46,9 % a depender do teste funcional executado. Ademais, a maioria dessas interações foram estatisticamente significativas. Já no estudo III, os participantes foram alocados em três grupos de intervenção: Treinamento Funcional com core, que realizava exercícios globais além de exercícios específicos para o core; Treinamento funcional, que executava apenas exercícios globais de caráter funcional; e Treinamento do core, que executava apenas exercícios que provocassem maior ativação na musculatura do core. Após 12 semanas de treinamento, todos os grupos melhoraram de maneira significativa tanto na performance funcional quanto do core, entretanto não houveram diferenças significativas entre eles. Assim, conclui-se que a endurance do core é importante para a funcionalidade de jovens adultos e que, quando incluído exercícios específicos para o core no treinamento funcional, os ganhos referentes à performance funcional e do core são potencializados. / São Cristóvão, SE