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RESEARCHING ANCIENT BEHAVIOURS:RESEARCHING ANCIENT BEHAVIOURS:a a bioculturalbiocultural approach to the study of MSM in a skeletal sample approach to the study of MSM in a skeletal sample from from ConstânciaConstância, Portugal (14, Portugal (14--19th centuries)19th centuries)
RESEARCH CENTRE FOR ANTHROPOLOGY AND HEALTH
WORKSHOP IN MUSCULOSKELETAL STRESS MARKERS (MSM)Department of AnthropologyUniversity of CoimbraJuly, 2-3, 2009, PORTUGAL
SANDRA ASSIS |ASSIS |
INTRODUCTION
Distinct skeletal traces that occur where a muscle, tendon Distinct skeletal traces that occur where a muscle, tendon or ligament inserts into the bone surface after recurrent useor ligament inserts into the bone surface after recurrent use**
MUSCULOSKELETAL STRESS MARKERS (MSM)MUSCULOSKELETAL STRESS MARKERS (MSM)
Bone hypertrophyBone hypertrophy EnthesopathiesEnthesopathies
* Hawkey and Mebs, 1995
To To analyse their nature and distribution by laterality, sex and analyse their nature and distribution by laterality, sex and age at deathage at death
To discuss their aetiology according to To discuss their aetiology according to ConstânciaConstância’’ss subsistence subsistence patterns until the 19patterns until the 19thth centurycentury
To describe the patterns of bone lesions found in To describe the patterns of bone lesions found in ConstânciaConstância’’ssancient inhabitantsancient inhabitants
MAIN GOALS
Skeletal dataSkeletal data Historical and Historical and ethnographical dataethnographical data
BIOCULTURAL APPROACHBIOCULTURAL APPROACH
MSM MSM Written documentsWritten documents
Oral sourcesOral sources
Material cultureMaterial culture
MAIN GOALS
OA OA
GEOGRAPHIC LOCATION
Constância Constância VillageVillage
ETHNOHISTORICAL BACKGROUND
FishingFishing
““Who doesn't row, has already rowedWho doesn't row, has already rowedIf it wasnIf it wasn’’t the father, it was the grandfathert the father, it was the grandfather””
(Local Proverb)(Local Proverb)
ETHNOHISTORICAL BACKGROUND
Bateira
Abringel
Boat Construction Boat Construction
Varino
Traditional boats
ETHNOHISTORICAL BACKGROUND
“In 1867, 60% of the males aged 20/21 years old worked in the manufacture of boats, or were sailors, shipping goods throughout the rivers.” (Coelho, 1991)
THE NECROPOLIS
S. JULIÃO CHURCHConstruction: 14th Century
Destruction: 1811
NECROPOLISConstruction: 14th Century
Destruction: 1833
MATERIAL AND METHODS
64 SKELETONS: 42 MALES + 22 FEMALES
(WITH SEX AND AGE AT DEATH ESTIMATED)
ROBUSTICITYROBUSTICITY
ENTHESOPATHIES:ENTHESOPATHIES:
a proliferative or a proliferative or osteophyticosteophytic form (OF)form (OF)
a erosive or osteolytic form (OL)a erosive or osteolytic form (OL)
((MariottiMariotti et alet al., 2004)., 2004)
MUSCULOSKELETAL STRESS MARKERS MUSCULOSKELETAL STRESS MARKERS
Upper limbUpper limb Lower limbLower limb36 MSM sites36 MSM sites
13 skeletal elements13 skeletal elements
MATERIAL AND METHODS
VERTEBRAEVERTEBRAEbody body –– osteophytesosteophytesjoint facetsjoint facets
PERIPHERAL JOINTSPERIPHERAL JOINTSlippinglippingsurface porositysurface porosityeburnationeburnation
BuikstraBuikstra and and UbelakerUbelaker, 1994, 1994
DEGENERATIVE JOINT DISEASE DEGENERATIVE JOINT DISEASE
Upper limbUpper limb
Lower limbLower limb
MATERIAL AND METHODS
RESULTS: MSM upper limb
MSM mean values are generally higher in middle aged males and MSM mean values are generally higher in middle aged males and
females. High values were also found in the oldest female groupfemales. High values were also found in the oldest female group
0
0,5
1
1,5
M 18-35 M 36-50 M +50 F 18-35 F 36-50 F +50
Age groups
MSM
mea
n sc
ore
RightLeftTotal
RESULTS: MSM upper limb
MSM mean values are higher for the MSM mean values are higher for the costoclavicularcostoclavicular andand conoideumconoideum
ligaments (right side) and ligaments (right side) and pectoralispectoralis majormajor muscle (left side) muscle (left side)
MALE HIGHER SCORES
0 0,2 0,4 0,6 0,8 1 1,2 1,4 1,6 1,8 2
Costoclavicularis l.
Conoideum l.
Pectoralis major m.
Flexor digitorum sp. m.
Subscapularis m.
Biceps brachii m.
Deltoideus m.
MSM mean score
LeftRight
RESULTS: MSM upper limb
a
b
a
b
Osteolytic lesions at the site of insertion of the Osteolytic lesions at the site of insertion of the
costoclavicularcostoclavicular ligament. Symmetric lesion. ligament. Symmetric lesion.
““KayakerKayaker’’s clavicles clavicle””
Bone hypertrophy at Bone hypertrophy at
the site of insertion of: the site of insertion of:
(a) (a) pectoralispectoralis major m.major m.
(b) (b) teresteres majormajor m. m. S.13Sk.4 - ♂, 35-50 y.o.
RESULTS: MSM upper limb
Bone hypertrophy at the site Bone hypertrophy at the site
of insertion of of insertion of deltoideusdeltoideus m. m.
Bone hypertrophy at the site of Bone hypertrophy at the site of
insertion of biceps insertion of biceps brachiibrachii m.m.
S.33Sk.32 - ♂, 35-50 y.o.
S.13Sk.3 - ♂, + 50 y.o.
MSM mean values are higher for supinator m. and rotator cuff capsule
(right side) and conoideum ligament. (left side)
FEMALE HIGHER SCORES
RESULTS: MSM upper limb
0 0,5 1 1,5 2 2,5 3
Supinator m.
Rotator cuff m.
Subscapularis m.
Conoideum l.
Pectoralis majorm.
Brachialis m.
Biceps Brachii
MSM mean score
LeftRight
Rotator cuff capsule: osteolytic lesion at the insertion of Rotator cuff capsule: osteolytic lesion at the insertion of the the supraspinatussupraspinatus musclemuscle
S.33S.33Sk.32 Sk.32 -- ♀♀, + 50 , + 50 y.oy.o..
RESULTS: MSM upper limb
Higher dimorphism in females. Statistical differences for supinator m.
(p=0,006, right side) and pronator teres m. (p=0,013, left side)
SEXUAL DIMORPHISM (%)
Right
-300-200-100
0100200
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28MSM
Left
-600-450-300-150
0150
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28MSM
RESULTS: MSM upper limb
Sexual dimorphismSexual dimorphismMDI = XMDI = X♂♂ –– XX♀♀/ X/ X♂♂ x 100x 100
EshedEshed et al.et al. (2004)(2004)
FISHING ACTIVITY– CORRELATION WITH ROWING MOVEMENTS
RESULTS: MSM upper limb
▲▲▲▲▲rs(10)=0,783**p=0,007
▲▲28: FP(F)
▄▄▄▄rs(10)=0,667*p=0,035
▄▄▄20: SUP(R)
▲▲▲▲▄rs(6)=1,000** --
▲rs(3)=1,000**--
24: SUP(C)
1rs(3)=1,000** --
rs(6)=0,950**
p=0,04
▲▄▲rs(5)=0,918*p=0,028
rs(5)=0,884*p=0,047
21: TRIB(C)
1▲▲rs(10)=0,745*p=0,013
rs(7)=0,780*p=0,039
▲▲10: LATD(U)
1▲▲▲▲rs(9)=0,849**p=0,004
12: TEMJ(U)
1▲▲▲▲11: PEMJ(U)
1▄▲▲5: PEMJ(CL)
1▲rs(6)=1,000** --
13: DEL(Ú)
1rs(11)=0,731*p=0,011
4: DEL(CL)
12: LIGCO(CL)
2110121151342Males
UPPER LIMB – RIGHT SIDE, *Spearman rank correlation test
between the deltoideus m. and costoclavicular ligament
*Sig
nific
ancy
*Sig
nific
ancy
a 0,
05.
a 0,
05.
**Si
gnifi
canc
ya**
Sign
ifica
ncya
0,01
0,
01
RESULTS: MSM lower limb
MSM mean values are higher in middle aged males and older femalMSM mean values are higher in middle aged males and older femaleses
0
0,5
1
1,5
M 18-35 M 36-50 M +50 F 18-35 F 36-50 F +50Age groups
MSM
mea
n sc
ore
RightLeftTotal
MSM mean values are higher for MSM mean values are higher for quadratusquadratus femorisfemoris muscle (right side) and muscle (right side) and
gluteus gluteus maximusmaximus muscle (left side)muscle (left side)
MALE HIGHER SCORES
0 0,2 0,4 0,6 0,8 1 1,2 1,4 1,6
Quadratus femoris m.
Longis, brevis, magnusm.
Gluteus maximus m.
Pectineus m.
MSM mean score
LeftRight
RESULTS: MSM lower limb
Bone hypertrophy at the site of insertion in the Bone hypertrophy at the site of insertion in the quadratusquadratus femorisfemoris muscle.muscle.
S.33S.33Sk.32 Sk.32 -- ♂♂, + 50 , + 50 y.oy.o..
RESULTS: MSM lower limb
Bone hypertrophy at the site of insertion of Bone hypertrophy at the site of insertion of longislongis, , brevisbrevis, magnum m. , magnum m.
S.20S.20Sk.10 Sk.10 -- ♂♂, + 50 , + 50 y.oy.o..
RESULTS: MSM lower limb
MSM mean values are higher for MSM mean values are higher for sacroiliacussacroiliacus ligament and ligament and gluteus gluteus maximusmaximus
muscle (right side) muscle (right side)
FEMALE HIGHER SCORES
0 0,2 0,4 0,6 0,8 1 1,2 1,4 1,6 1,8
Sacroiliacus l.
Gluteus maximus m.
Extensors m.
Gluteus medius, minimus m.
MSM mean scores
LeftRight
RESULTS: MSM lower limb
RobusticityRobusticity in the in the gluteus gluteus maximusmaximus
muscle insertion.muscle insertion.
Symmetric lesion.Symmetric lesion.
S.33S.33Sk.32 Sk.32 -- ♀♀, + 50 , + 50 y.oy.o..
RESULTS: MSM lower limb
6
910
3 3
11
0
2
4
6
8
10
12
18-35 36-50 > 50
Age groups
N
MaleFemale
RESULTS: DJD upper limb
Total percentage of affected individuals: 65,6% (42/64)Total percentage of affected individuals: 65,6% (42/64)
Higher number of joint lesions in males, except for old female iHigher number of joint lesions in males, except for old female individualsndividuals
S.13S.13Sk.4 Sk.4 -- ♂♂, 35, 35--50 50 y.oy.o..
S.20S.20Sk.8 Sk.8 -- ♂♂, 35, 35--50 50 y.oy.o..
RESULTS: DJD upper limb
High frequency in both sexes and in middle/old aged individualsHigh frequency in both sexes and in middle/old aged individuals
sternoclavicularsternoclavicular jointjoint acromioclavicularacromioclavicular jointjoint
DJD in the hand joints:
Middle aged males and older females more affected
S.32S.32Sk.4 Sk.4 -- ♂♂, , > > 50 50 y.oy.o..
RESULTS: DJD upper limb
Percentage of affected individuals: 67,2% (43/64)Percentage of affected individuals: 67,2% (43/64)
Higher number of affected joints in older malesHigher number of affected joints in older males
RESULTS: DJD lower limb
5
14
6
34
11
0
5
10
15
18-35 36-50 > 50
Age groups
N
MaleFemale
A
B
CS.32S.32Sk.7Sk.7-- ♂♂, , > > 50 50 y.oy.o..
Knee most affected joint in oldest groupsKnee most affected joint in oldest groups
RESULTS: DJD lower limb
RESULTS: DJD vertebrae
%%Number of case (N)Number of case (N)Peripheral osteoarthritisPeripheral osteoarthritis
38,724 (62)Lumbar
27,417 (62)Thoracic
29,018 (62)Cervical
19,412(62)Lumbar
25,816(62)Thoracic
27,417(62)Cervical
%%Number of cases (N)Number of cases (N)Vertebral Vertebral osteophytosisosteophytosis
Frequency of affected individualsFrequency of affected individualsVertebra typeVertebra type
Percentage of affected individualsPercentage of affected individuals
HighHigh frequencyfrequency ofof vertebral vertebral osteophytosisosteophytosis inin cervical cervical andand thoracicthoracic vertebravertebra
HighHigh frequencyfrequency ofof jointjoint lesionslesions inin cervical cervical andand lumbarlumbar vertebravertebra
C3
C4
C5
C6
C7
S.7S.7--88--99Sk.4Sk.4-- ♀♀, > 50 , > 50 y.oy.o..
Vertebral Vertebral osteophytosisosteophytosis in the in the cervical vertebracervical vertebra
RESULTS: DJD vertebrae
S. 33S. 33SkSk. 32. 32-- ♀♀, > 50 , > 50 y.oy.o..
Severe vertebral Severe vertebral osteophytosisosteophytosis in in
the thoracic vertebra (T2the thoracic vertebra (T2--T10)T10)
RESULTS: DJD vertebrae
DISCUSSION
Age proved to be a contributing factor to increased MSM scores, with a
greater age-related increase in females.
However, other factors associated with the activity and with subHowever, other factors associated with the activity and with subsistence sistence
strategies may well have affected the pattern and distribution ostrategies may well have affected the pattern and distribution of bone f bone
lesions:lesions:
Fishing/RowingFishing/Rowing –– symmetrical lesions at the site of insertion of symmetrical lesions at the site of insertion of
costoclavicularcostoclavicular ligament, ligament, ““kayakerkayaker’’s clavicles clavicle””. Positive correlation . Positive correlation
between some insertions sites from the upper limb. DJD in between some insertions sites from the upper limb. DJD in
acromioclavicularacromioclavicular joints. joints.
Boat manufacture/Shipping goodsBoat manufacture/Shipping goods –– severe DJD in hand joints. severe DJD in hand joints.
Vertebral Vertebral osteophytosisosteophytosis and and peripherialperipherial osteoathritisosteoathritis in the cervical in the cervical
vertebra. vertebra.
CONCLUSION
““ ((……) Familiarized With Hard Work Since Young Ages () Familiarized With Hard Work Since Young Ages (……))
(Oliveira (Oliveira inin Godinho, 1947: 23)Godinho, 1947: 23)
Subjected to repetitive biomechanical stressSubjected to repetitive biomechanical stress
Importance of Importance of ethohistoricalethohistorical data to biological data to biological
interpretationinterpretation
Possible correlation with some Possible correlation with some ConstânciaConstância’’ss
subsistence activitiessubsistence activities
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