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Pearse S, Léger M, Albert WJ, Cardoso M. Active workstations: A literature review on workplace sitting. J Bodyw Mov Ther 2024; 38:406-416. [PMID: 38763586 DOI: 10.1016/j.jbmt.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/26/2023] [Accepted: 01/02/2024] [Indexed: 05/21/2024]
Abstract
The purpose of this paper is to further understand current literature on prolonged sitting, sitting posture and active sitting solutions. This paper is divided into three sections: The first section (Part I) is a comprehensive overview of the literature on how a static prolonged seated posture can affect: spinal health, trunk posture, contact pressure/discomfort development and vascular issues. The second section (Part II) reviews and qualitatively compares the four working postures recognized in ANSI/HFES 100-2007: reclined sitting, upright sitting, declined sitting and standing. The final section (Part III) is a summary of research on active chairs that revolves around the two types of movement patterns: 1- sustaining continual movement over a range of postures, occasionally reaching neutral lordosis, and 2- maintaining high frequency and duration of daily light contractile activity in the legs (or lower limbs).
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Affiliation(s)
| | - Michelle Léger
- Faculty of Kinesiology, University of New Brunswick, NB, Canada
| | - Wayne J Albert
- Faculty of Kinesiology, University of New Brunswick, NB, Canada
| | - Michelle Cardoso
- École de kinésiologie et de loisir, Université de Moncton, NB, Canada.
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Mechanisms behind the Development of Chronic Low Back Pain and Its Neurodegenerative Features. LIFE (BASEL, SWITZERLAND) 2022; 13:life13010084. [PMID: 36676033 PMCID: PMC9862392 DOI: 10.3390/life13010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/11/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
Chronic back pain is complex and there is no guarantee that treating its potential causes will cause the pain to go away. Therefore, rather than attempting to "cure" chronic pain, many clinicians, caregivers and researchers aim to help educate patients about their pain and try to help them live a better quality of life despite their condition. A systematic review has demonstrated that patient education has a large effect on pain and pain related disability when done in conjunction with treatments. Therefore, understanding and updating our current state of knowledge of the pathophysiology of back pain is important in educating patients as well as guiding the development of novel therapeutics. Growing evidence suggests that back pain causes morphological changes in the central nervous system and that these changes have significant overlap with those seen in common neurodegenerative disorders. These similarities in mechanisms may explain the associations between chronic low back pain and cognitive decline and brain fog. The neurodegenerative underpinnings of chronic low back pain demonstrate a new layer of understanding for this condition, which may help inspire new strategies in pain education and management, as well as potentially improve current treatment.
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Eraktas İ, Ayhan C, Hayran M, Soylu AR. Alterations in forearm muscle activation patterns after scapholunate interosseous ligament injury: A dynamic electromyography study. J Hand Ther 2021; 34:384-395. [PMID: 32620427 DOI: 10.1016/j.jht.2020.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/26/2020] [Accepted: 03/16/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Case control. PURPOSE OF THE STUDY This study aimed to investigate the alterations seen in the activation patterns of the forearm muscles and to demonstrate the associated functional outcomes, in patients with scapholunate interosseous ligament (SLIL) injury. METHODS The study involved 15 patients with SLIL injury (instability group) and 11 healthy participants (control group). Both groups were evaluated with regard to their pain, grip strength, and upper extremity functional level (disabilities of the arm, shoulder and hand and patient-rated wrist evaluation questionnaires), and they also underwent a dynamic electromyography analysis of their forearm muscle activity. The activation patterns of the extensor carpi ulnaris (ECU), extensor carpi radialis (ECR), flexor carpi ulnaris, and flexor carpi radialis muscles during wrist extension and flexion were recorded by means of surface electromyography. RESULTS In the instability group, the pain severity was higher and the functional level was worse than in the control group (P < .05). Furthermore, during wrist extension, the ECR activity was lower and the ECU activity was higher in the instability group than in the control group (P < .05). CONCLUSION Dynamic stabilization of the wrist, flexor carpi ulnaris, and flexor carpi radialis muscles have been shown to play an active role with ECU and ECR. Increased ECU and decreased ECR activation may pose a potential risk in terms of enhancing the scapholunate gap. We, therefore, propose that appropriate preventive neuromuscular exercise strategies implemented as part of a physiotherapy program for patients with SLIL lesions might increase the contribution of the dynamic stability effect of the relevant muscles.
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Affiliation(s)
- İrem Eraktas
- Bolu Physical Therapy and Rehabilitation Hospital, Bolu, Turkey
| | - Cigdem Ayhan
- Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Mutlu Hayran
- School of Medicine, Department of Preventive Oncology, Hacettepe University, Ankara, Turkey
| | - Abdullah Ruhi Soylu
- School of Medicine, Department of Biophysics, Hacettepe University, Ankara, Turkey
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Der Muskulatur mehr Aufmerksamkeit schenken! MANUELLE MEDIZIN 2021. [DOI: 10.1007/s00337-021-00821-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Exposure to Sustained Flexion Impacts Lumbar Extensor Spinae Muscle Fiber Orientation. J Appl Biomech 2021; 37:248-253. [PMID: 33631717 DOI: 10.1123/jab.2020-0238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/25/2020] [Accepted: 01/08/2021] [Indexed: 11/18/2022]
Abstract
The lumbar extensor spinae (LES) has an oblique orientation with respect to the compressive axis of the lumbar spine, allowing it to counteract anterior shear forces. This mechanical advantage is lost as spine flexion angle increases. The LES orientation can also alter over time as obliquity decreases with age and is associated with decreased strength and low back pain. However, it is unknown if LES orientation is impacted by recent exposures causing adaptations over shorter timescales. Hence, the effects of a 10-minute sustained spine flexion exposure on LES orientation, thickness, and activity were investigated. Three different submaximally flexed spine postures were observed before and after the exposure. At baseline, orientation (P < .001) and thickness (P = .004) decreased with increasingly flexed postures. After the exposure, obliquity further decreased at low (pairwise comparison P < .001) and moderately (pairwise comparison P = .008) flexed postures. Low back creep occurred, but LES thickness did not change, indicating that decreases in orientation were not solely due to changes in muscle length at a given posture. Activation did not change to counteract decreases in obliquity. These changes encompass a reduced ability to offset anterior shear forces, thus increasing the potential risk of anterior shear-related injury or pain after low back creep-generating exposures.
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Wilkie K, Thornton JS, Vinther A, Trease L, McDonnell SJ, Wilson F. Clinical management of acute low back pain in elite and subelite rowers: a Delphi study of experienced and expert clinicians. Br J Sports Med 2021; 55:1324-1334. [DOI: 10.1136/bjsports-2020-102520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2020] [Indexed: 01/05/2023]
Abstract
ObjectivesRowing-related low back pain (LBP) is common but published management research is lacking. This study aims to establish assessment and management behaviours and beliefs of experienced and expert clinicians when elite and subelite rowers present with an acute episode of LBP; second, to investigate how management differs for developing and masters rowers. This original research is intended to be used to develop rowing-related LBP management guidelines.MethodsA three-round Delphi survey was used. Experienced clinicians participated in an internet-based survey (round 1), answering open-ended questions about assessment and management of rowing-related LBP. Statements were generated from the survey for expert clinicians to rate (round 2) and rerate (round 3). Consensus was gained when agreement reached a mean of 7 out of 10 and disagreement was 2 SD or less.ResultsThirty-one experienced clinicians participated in round 1. Thirteen of 20 invited expert clinicians responded to round 2 (response rate 65%) and 12 of the 13 participated in round 3 (response rate 92%).One hundred and fifty-three of 215 statements (71%) relating to the management of LBP in elite and subelite rowers acquired consensus status. Four of six statements (67%) concerning developing rowers and two of four (50%) concerning masters rowers gained consensus.ConclusionIn the absence of established evidence, these consensus-derived statements are imperative to inform the development of guidelines for the assessment and management of rowing-related LBP. Findings broadly reflect adult LBP guidelines with specific differences. Future research is needed to strengthen specific recommendations and develop best practice guidelines in this athletic population.
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Nugent FJ, Vinther A, McGregor A, Thornton JS, Wilkie K, Wilson F. The relationship between rowing-related low back pain and rowing biomechanics: a systematic review. Br J Sports Med 2021; 55:bjsports-2020-102533. [PMID: 33397675 DOI: 10.1136/bjsports-2020-102533] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Low back pain (LBP) is common in rowers. Understanding rowing biomechanics may help facilitate prevention and improve rehabilitation. OBJECTIVES To define the kinematics and muscle activity of rowers and to compare with rowers with current or LBP history. DESIGN Systematic review. DATA SOURCES EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Scopus from inception to December 2019. Grey literature was searched. STUDY ELIGIBILITY CRITERIA Experimental and non-experimental designs. METHODS Primary outcomes were kinematics and muscle activity. Modified Quality Index (QI) checklist was used. RESULTS 22 studies were included (429 participants). Modified QI score had a mean of 16.7/28 points (range: 15-21). Thirteen studies investigated kinematics and nine investigated muscle activity. Rowers without LBP ('healthy') have distinct kinematics (neutral or anterior pelvic rotation at the catch, greater hip range of motion, flatter low back spinal position at the finish) and muscle activity (trunk extensor dominant with less flexor activity). Rowers with LBP had relatively greater posterior pelvic rotation at the catch, greater hip extension at the finish and less efficient trunk muscle activity. In both groups fatigue results in increased lumbar spine flexion at the catch, which is greater on the ergometer. There is insufficient evidence to recommend one ergometer type (fixed vs dynamic) over the other to avoid LBP. Trunk asymmetries are not associated with LBP in rowers. CONCLUSION Improving clinicians' and coaches' understanding of safe and effective rowing biomechanics, particularly of the spine, pelvis and hips may be an important strategy in reducing incidence and burden of LBP.
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Affiliation(s)
- Frank James Nugent
- Physical Education and Sport Sciences Department, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Alison McGregor
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Jane S Thornton
- Western Centre for Public Health and Family Medicine, University of Western Ontario, London, Ontario, Canada
| | - Kellie Wilkie
- Bodysystem Physiotherapy, Hobart, Tasmania, Australia
| | - Fiona Wilson
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Romero-Franco N, Párraga-Montilla JA, Molina-Flores EM, Jiménez-Reyes P. Effects of Combining Running and Practical Duration Stretching on Proprioceptive Skills of National Sprinters. J Strength Cond Res 2020; 34:1158-1165. [PMID: 29864052 DOI: 10.1519/jsc.0000000000002620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Romero-Franco, N, Párraga-Montilla, JA, Molina-Flores, EM, and Jiménez-Reyes, P. Effects of combining running and practical duration stretching on proprioceptive skills of national sprinters. J Strength Cond Res 34(4): 1158-1165, 2020-Practical duration stretching after aerobic activities is a recommended component of the first part of warm-up because of its effects on performance. However, its effects on proprioceptive skills are unknown. This study aimed to analyze the effects of running and practical duration static stretching (SS) and dynamic stretching (DS) on postural balance and the joint position sense (JPS) of national sprinters. Thirty-two national sprinters were randomly classified into a SS group (n = 11), DS group (n = 11), or control group (n = 10). Static stretching performed 5 minutes of running and short-duration (20 seconds) static stretches; DS performed 5 minutes of running and short-duration dynamic (20 seconds) stretches; and the control group performed 5 minutes of running. Before and after the intervention, unipedal static postural balance and knee JPS were evaluated. Static stretching exhibited a more centralized center of pressure in the medial-lateral plane for unipedal static postural balance in right-leg support after stretching (p = 0.005, d = 1.24), whereas DS showed values further from the center after stretching for the same unipedal support compared with baseline (p = 0.042, d = 0.49), and the control group remained stable (p > 0.05). Joint position sense did not show significant differences in any group (p > 0.05). In conclusion, combining running and practical duration SS may be beneficial for right-leg postural stabilization, whereas DS may be partly and slightly deleterious. Both SS and DS combined with running and running alone have neutral effects on knee JPS. Sports professionals should consider running and practical duration SS as part of the warm-up of sprinters to partly improve unipedal static postural balance.
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Affiliation(s)
- Natalia Romero-Franco
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Spain
| | | | | | - Pedro Jiménez-Reyes
- Physical Activity and Sports Science Department, Catholic University of San Antonio of Murcia, Murcia, Spain
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Abstract
STUDY DESIGN This article comprises a review of the literature. OBJECTIVE The purpose of this study was to elucidate the different types of structural failures exhibited in intervertebral discs (IVDs), summarize their potential causes with respect to mechanical loading conditions and the consequences on cell homeostasis and biomechanics. SUMMARY OF BACKGROUND DATA Many studies have been performed to gain insight into how discogenic back pain progresses in humans both in vitro and in vivo as well as in animal disc models. However, there is a major need to summarize the common factors which initiate the structural failures observed in IVDs and the typical biomechanical changes. This work could help in developing mechanisms aiming to restore the biochemical and biomechanical balance of IVDs. METHODS The different types of structural failures encountered in IVDs were reviewed from published literature. The types of mechanical loading causing these injuries and their physiological and biomechanical consequences were then summarized and linked to ongoing research in this area. RESULTS The most prominent structural failures associated with IVDs are annulus tears, disc prolapse, endplate damage, disc narrowing, radial bulging, and osteophyte formation in the vertebrae. IVDs were found to be vulnerable to compression, flexion, axial rotation, and complex loading mechanisms through single impact, cyclical, and continuous loading. However, chronic loadings had a more damaging impact on the spine. Significant consequences include imbalance of metabolic enzymes and growth factors, alteration in stress profiles of IVDs and a decrease in mechanical stiffness resulting in impaired biomechanics of the spine. CONCLUSION The mode of loading has an important impact on the severity and nature of failures seen in IVDs and the resulting consequences to biomechanics. However, further research is necessary to better understand to the mechanisms that link injury to degeneration and regeneration of IVD tissues. LEVEL OF EVIDENCE 3.
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Habitual Cervical Posture in Women With Episodic Cervicogenic Headache Versus Asymptomatic Controls. J Manipulative Physiol Ther 2020; 43:171-178. [DOI: 10.1016/j.jmpt.2018.11.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 07/06/2018] [Accepted: 11/02/2018] [Indexed: 12/13/2022]
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Sainz de Baranda P, Cejudo A, Moreno-Alcaraz VJ, Martinez-Romero MT, Aparicio-Sarmiento A, Santonja-Medina F. Sagittal spinal morphotype assessment in 8 to 15 years old Inline Hockey players. PeerJ 2020; 8:e8229. [PMID: 31915572 PMCID: PMC6942677 DOI: 10.7717/peerj.8229] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/18/2019] [Indexed: 11/20/2022] Open
Abstract
Background Physiological sagittal spinal curvatures play an important role in health and performance in sports. For that reason, several scientific studies have assessed spinal morphology in young athletes. However, to our knowledge, no study has assessed the implications of Inline Hockey (IH) practice on sagittal integrative spinal morphotype in adolescent players. Objectives The aims of the present study were to describe habitual sagittal spinal posture in young federated IH players and its relationship with training load and to determine the sagittal integrative spinal morphotype in these players. Methods An observational analysis was developed to describe the sagittal spinal morphotype in young federated IH players. A total of 74 IH players from the Technification Plan organized by the Skating Federation of the Valencian Community (aged from 8 to 15 years) participated in the study. Thoracic and lumbar curvatures of the spine were measured in a relaxed standing position (SP), in a slump sitting position (SSP) and in maximum flexion of the trunk (MFT) to determine the "Sagittal Integrative Morphotype" of all players. An unilevel inclinometer was used to quantify the sagittal spinal curvatures. The Hip Joint Angle test was used to quantify the Lumbo-Horizontal angle in flexion (L-H fx) of all participants with a goniometer. Results When thoracic curvature was analyzed according to normality references, it was found that 64.9% of IH players had thoracic hyperkyphosis in a SSP, while 60.8% and 74.3% of players were classified as normal in a SP and in MFT, respectively. As for the lumbar curve, 89.2% in a SP and 55.4% in MFT were normal, whereas 68.9% of IH players presented lumbar hyperkyphosis in a SSP. Regarding the "Sagittal Integrative Morphotype," only 17.6% of players were classified as "Normal" in the three measured positions for the thoracic curve, while 37.8% had "Thoracic Hyperkyphosis" and 41.8% presented "Functional Thoracic Hyperkyphosis." As for the "Sagittal Integrative Lumbar Morphotype," only 23% of athletes had a normal curve in the three positions, whereas 66.2% presented "Functional Lumbar Hyperkyphosis." When the L-H fx was evaluated, the results showed that only 16.2% of the athletes were classified as normal. Conclusions Federative IH practice seems to cause specific adaptations in spinal sagittal morphotype. Taking into account the "Sagittal Integrative Morphotype" only 17.6% IH players presented "Normal Morphotype" with a normal thoracic kyphosis in the three measured positions, while only 23% IH players presented "Normal Morphotype" with a normal lumbar curvature in the three assessed positions. Furthermore, only 16.2% of IH players showed normal pelvic tilt. Exercise programs to prevent or rehabilitate these imbalances in young IH players are needed.
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Affiliation(s)
- Pilar Sainz de Baranda
- Department of Physical Activity and Sport/Faculty of Sport Sciences/Campus of Excellence Mare Nostrum, Universidad de Murcia, Murcia, Spain
| | - Antonio Cejudo
- Department of Physical Activity and Sport/Faculty of Sport Sciences/Campus of Excellence Mare Nostrum, Universidad de Murcia, Murcia, Spain
| | - Victor Jesus Moreno-Alcaraz
- Department of Physical Activity and Sport/Faculty of Sport Sciences/Campus of Excellence Mare Nostrum, Universidad de Murcia, Murcia, Spain
| | - Maria Teresa Martinez-Romero
- Department of Physical Activity and Sport/Faculty of Sport Sciences/Campus of Excellence Mare Nostrum, Universidad de Murcia, Murcia, Spain
| | - Alba Aparicio-Sarmiento
- Department of Physical Activity and Sport/Faculty of Sport Sciences/Campus of Excellence Mare Nostrum, Universidad de Murcia, Murcia, Spain
| | - Fernando Santonja-Medina
- Department of Surgery, Pediatrics, Obstetrics and Gynecology, "Virgen de la Arrixaca" University Hospital/Faculty of Medicine/Campus of Excellence Mare Nostrum, Universidad de Murcia, Murcia, Spain
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Owlia M, Kamachi M, Dutta T. Reducing lumbar spine flexion using real-time biofeedback during patient handling tasks. Work 2020; 66:41-51. [PMID: 32417812 PMCID: PMC7369082 DOI: 10.3233/wor-203149] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/06/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Patient handling activities require caregivers to adopt postures that increase the risk of back injury. Training programs relying primarily on didactic methods have been shown to be ineffective at reducing this risk. The use of real-time biofeedback has potential as an alternative training method. OBJECTIVE To investigate the effect of real-time biofeedback on time spent by caregivers in end-range lumbar spine flexion. METHODS Novice participants were divided into intervention (n = 10) and control (n = 10) groups and were asked to perform a set of simulated care activities eight times on two consecutive days. Individuals in the intervention group watched a training video on safer movement strategies and received real-time auditory feedback from a wearable device (PostureCoach) in four training trials whenever their lumbar spine flexion exceeded a threshold (70% of maximum flexion). Changes in end-range lumbar spine flexion were compared between groups and across trials. RESULTS Participants in the intervention group saw reductions in end-range lumbar spine flexion during the simulated patient handling tasks at the end of the training compared to their baseline trials while there was no change for the control group. CONCLUSIONS The training program including PostureCoach has the potential to help caregivers learn to use safer postures that reduce the risk of back injury.
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Affiliation(s)
- Mohammadhasan Owlia
- Toronto Rehabilitation Institute, University Health Network, ON, Canada
- Department of Mechanical and Industrial Engineering, University of Toronto, ON, Canada
| | - Megan Kamachi
- Toronto Rehabilitation Institute, University Health Network, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, ON, Canada
| | - Tilak Dutta
- Toronto Rehabilitation Institute, University Health Network, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, ON, Canada
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Biviá-Roig G, Lisón JF, Sánchez-Zuriaga D. Effects of pregnancy on lumbar motion patterns and muscle responses. Spine J 2019; 19:364-371. [PMID: 30144534 DOI: 10.1016/j.spinee.2018.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/10/2018] [Accepted: 08/15/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The kinematics of the lumbar region and the activation patterns of the erector spinae muscle have been associated with the genesis of low back pain, which is one of the most common complications associated with pregnancy. Despite the high prevalence of pregnancy-related low back pain, the biomechanical adaptations of the lumbar region during pregnancy remain unknown. PURPOSE This study analyzes lumbar spine motion and the activation pattern of the lumbar erector spinae muscle in healthy pregnant women. STUDY DESIGN A case-control study. PATIENT SAMPLE The study involved 34 nulliparous women (control group) and 34 pregnant women in the third trimester (week 36 ± 1). OUTCOME MEASURES We recorded the parameters of angular displacement of the lumbar spine in the sagittal plane during trunk flexion-extension, and the EMG activity of the erector spinae muscles during flexion, extension, eccentric and concentric contractions, and the myolectrical silence. METHODS The participants performed several series of trunk flexion-extension movements, which were repeated 2 months postpartum. The position of the lumbar spine was recorded using an electromagnetic motion capture system. EMG activity was recorded by a surface EMG system and expressed as a percentage of a submaximal reference contraction. RESULTS Antepartum measurements showed a decrease (relative to control and postpartum measurements) in lumbar maximum flexion (52.5 ± 10.5° vs 57.3 ± 7.7° and 58.7 ± 8.6°; p < .01), the percentage of lumbar flexion during forward bending (56.4 ± 5.6% vs 59.4 ± 6.8% and 59.7 ± 5.6%; p < .01), and the time keeping maximum levels of lumbar flexion (35.7 ± 6.7% vs 43.8 ± 5.3% and 50.1 ± 3.7%; p < .01). Higher levels of erector spinae activation were observed in pregnant women during forward bending (10.1 ± 4.8% vs 6.3 ± 2.4% and 6.6 ± 2.7%; p < .01) and eccentric contraction (12.1 ± 5.2% vs 9.4 ± 3.1% and 9.1 ± 2.9%; p < .01), as well as a shortened erector spinae myoelectric silence during flexion. CONCLUSIONS Pregnant women show adaptations in their patterns of lumbar motion and erector spinae activity during trunk flexion-extension. These changes could be associated with the genesis of pregnancy-related low back pain, by means of biomechanical protection mechanisms against the increase on abdominal mass and ligamentous laxity.
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Affiliation(s)
- Gemma Biviá-Roig
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Ramón y Cajal s/n, Alfara del Patriarca, 46115 Valencia, Spain
| | - Juan Francisco Lisón
- Department of Medicine, Faculty of Health Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Ramón y Cajal s/n, Alfara del Patriarca, 46115 Valencia, Spain
| | - Daniel Sánchez-Zuriaga
- Department of Anatomy and Human Embryology, Facultat de Medicina i Odontologia, Universitat de València, Av Blasco Ibáñez, 15, 46010 València, Spain.
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Abstract
This paper offers a mechanistic account of back pain which attempts to incorporate all of the most important recent advances in spinal research. Anatomical and pain-provocation studies show that severe and chronic back pain most often originates in the lumbar intervertebral discs, the apophyseal joints, and the sacroiliac joints. Psychosocial factors influence many aspects of back pain behaviour but they are not important determinants of who will experience back pain in the first place. Back pain is closely (but not invariably) associated with structural pathology such as intervertebral disc prolapse and endplate fractures, although age-related biochemical changes such as those revealed by a ‘dark disc’ on MRI have little clinical relevance. All features of structural pathology (including disc prolapse) can be re-created in cadaveric specimens by severe or repetitive mechanical loading, with a combination of bending and compression being particularly harmful to the spine. Structural disruption alters the mechanical environment of disc cells in a manner that leads to cell-mediated degenerative changes, and animal experiments confirm that surgical disruption of a disc is followed by widespread disc degeneration. Some people are more vulnerable to spinal degeneration than others, largely because of their genetic inheritance. Age-related biochemical changes and loading history can also affect tissue vulnerability. Finally the concept of ‘functional pathology’ is introduced, according to which, back pain can arise because postural habits generate painful stress concentrations within innervated tissues, even though the stresses are not high enough to cause physical disruption.
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Gagnon D, Plamondon A, Larivière C. A comparison of lumbar spine and muscle loading between male and female workers during box transfers. J Biomech 2018; 81:76-85. [PMID: 30286979 DOI: 10.1016/j.jbiomech.2018.09.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/14/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
There is a clear relationship between lumbar spine loading and back musculoskeletal disorders in manual materials handling. The incidence of back disorders is greater in women than men, and for similar work demands females are functioning closer to their physiological limit. It is crucial to study loading on the spine musculoskeletal system with actual handlers, including females, to better understand the risk of back disorders. Extrapolation from biomechanical studies conducted on unexperienced subjects (mainly males) might not be applicable to actual female workers. For male workers, expertise changes the lumbar spine flexion, passive spine resistance, and active/passive muscle forces. However, experienced females select similar postures to those of novices when spine loading is critical. This study proposes that the techniques adopted by male experts, male novices, and females (with considerable experience but not categorized as experts) impact their lumbar spine musculoskeletal systems differently. Spinal loads, muscle forces, and passive resistance (muscle and ligamentous spine) were predicted by a multi-joint EMG-assisted optimization musculoskeletal model of the lumbar spine. Expert males flexed their lumbar spine less (avg. 21.9° vs 30.3-31.7°) and showed decreased passive internal moments (muscle avg. 8.9% vs 15.9-16.0%; spine avg. 4.7% vs 7.1-7.8%) and increased active internal moments (avg. 72.9% vs 62.0-63.9%), thus producing a different impact on their lumbar spine musculoskeletal systems. Experienced females sustained the highest relative spine loads (compression avg. 7.3 N/BW vs 6.2-6.4 N/BW; shear avg. 2.3 N/BW vs 1.7-1.8 N/BW) in addition to passive muscle and ligamentous spine resistance similar to novices. Combined with smaller body size, less strength, and the sequential lifting technique used by females, this could potentially mean greater risk of back injury. Workers should be trained early to limit excessive and repetitive stretching of their lumbar spine passive tissues.
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Affiliation(s)
- Denis Gagnon
- Faculté des sciences de l'activité physique, Université de Sherbrooke, Sherbrooke, Québec, Canada.
| | - André Plamondon
- Institut de recherche Robert Sauvé en santé et en sécurité du travail, Montréal, Québec, Canada
| | - Christian Larivière
- Institut de recherche Robert Sauvé en santé et en sécurité du travail, Montréal, Québec, Canada
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Abboud J, Daneau C, Nougarou F, Dugas C, Descarreaux M. Motor adaptations to trunk perturbation: effects of experimental back pain and spinal tissue creep. J Neurophysiol 2018; 120:1591-1601. [PMID: 29975166 DOI: 10.1152/jn.00207.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In complex anatomical systems, such as the trunk, motor control theories suggest that many motor solutions can be implemented to achieve a similar goal. Although reflex mechanisms act as a stabilizer of the spine, how the central nervous system uses trunk redundancy to adapt neuromuscular responses under the influence of external perturbations, such as experimental pain or spinal tissue creep, is still unclear. The aim of this study was to identify and characterize trunk neuromuscular adaptations in response to unexpected trunk perturbations under the influence of spinal tissue creep and experimental back pain. Healthy participants experienced a repetition of sudden external trunk perturbations in two protocols: 1) 15 perturbations before and after a spinal tissue creep protocol and 2) 15 perturbations with and without experimental back pain. Trunk neuromuscular adaptations were measured by using high-density electromyography to record erector spinae muscle activity recruitment patterns and a motion analysis system. Muscle activity reflex attenuation was found across unexpected trunk perturbation trials under the influence of creep and pain. A similar area of muscle activity distribution was observed with or without back pain as well as before and after creep. No change of trunk kinematics was observed. We conclude that although under normal circumstances muscle activity adaptation occurs throughout the same perturbations, a reset of the adaptation process is present when experiencing a new perturbation such as experimental pain or creep. However, participants are still able to attenuate reflex responses under these conditions by using variable recruitment patterns of back muscles. NEW & NOTEWORTHY The present study characterizes, for the first time, trunk motor adaptations with high-density surface electromyography when the spinal system is challenged by a series of unexpected perturbations. We propose that the central nervous system is able to adapt neuromuscular responses by using a variable recruitment pattern of back muscles to maximize the motor performance, even under the influence of pain or when the passive structures of the spine are altered.
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Affiliation(s)
- Jacques Abboud
- Department of Anatomy, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
| | - Catherine Daneau
- Department of Human Kinetics, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
| | - François Nougarou
- Department of Electrical Engineering, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
| | - Claude Dugas
- Department of Human Kinetics, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières , Trois-Rivières, Quebec , Canada
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Ayhan C, Tanrıkulu S, Leblebicioglu G. Scapholunate interosseous ligament dysfunction as a source of elbow pain syndromes: Possible mechanisms and implications for hand surgeons and therapists. Med Hypotheses 2018; 110:125-131. [PMID: 29317055 DOI: 10.1016/j.mehy.2017.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 11/02/2017] [Accepted: 12/03/2017] [Indexed: 12/01/2022]
Abstract
Elbow pain syndromes are common upper extremity musculoskeletal disorders, and they are usually associated with repetitive occupational exposure. Ligaments are often one of the sources of musculoskeletal disorders because of their mechanical and neurological properties. The wrist ligaments are some of the ligaments most vulnerable to occupational exposure. Since most occupational tasks require wrist extension for handling tools and loading, the scapholunate interosseous ligament (SLIL) bears greater strain during loading, which results in creep deformation and hysteresis. Ligamentous creep may result in diminished ability to detect signal changes during joint movements, which impairs neuromuscular control established by ligamentomuscular reflex arcs elicited from mechanoreceptors in the ligaments. Changes in muscle activation patterns of forearm muscles due to diminished ligamentomuscular reflexes may initiate a positive feedback loop, leading to musculoskeletal pain syndromes. The relationship between elbow pain syndromes and SLIL injury will be presented through two hypotheses and relevant pain mechanisms: 1. Repetitive tasks may cause creep deformation of the SLIL, which then impairs ligamentomuscular reflexes, leading to elbow pain disorders. 2. Lateral epicondylalgia may increase the risk of SLIL injury through the compensation of the lower extensor carpi radialis muscle activity by higher extensor carpi ulnaris muscle activity, which may alter carpal kinematics, leading to SLIL degeneration over time. The differential diagnosis is usually complicated in musculoskeletal pain disorders. The failure of treatment methods is one of the issues of concern for many researchers. A key element in developing treatment strategies is to understand the source of the disorder and the nature of the injury. We proposed that the differential diagnosis include SLIL injuries when describing elbow pain syndromes, particularly, lateral epicondylalgia.
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Affiliation(s)
- Cigdem Ayhan
- Hacettepe University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Ankara, Turkey.
| | - Seval Tanrıkulu
- Koc University, Faculty of Medicine, Orthopedics and Traumatology Department, Hand Surgery Unit, İstanbul, Turkey
| | - Gursel Leblebicioglu
- Hacettepe University, Faculty of Medicine, Orthopaedics and Traumatology Department, Hand Surgery Unit, Ankara, Turkey
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Abboud J, Rousseau B, Descarreaux M. Trunk proprioception adaptations to creep deformation. Eur J Appl Physiol 2017; 118:133-142. [DOI: 10.1007/s00421-017-3754-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 10/31/2017] [Indexed: 11/28/2022]
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Abboud J, Lardon A, Boivin F, Dugas C, Descarreaux M. Effects of Muscle Fatigue, Creep, and Musculoskeletal Pain on Neuromuscular Responses to Unexpected Perturbation of the Trunk: A Systematic Review. Front Hum Neurosci 2017; 10:667. [PMID: 28101013 PMCID: PMC5209383 DOI: 10.3389/fnhum.2016.00667] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 12/15/2016] [Indexed: 12/22/2022] Open
Abstract
Introduction: Trunk neuromuscular responses have been shown to adapt under the influence of muscle fatigue, as well as spinal tissue creep or even with the presence of low back pain (LBP). Despite a large number of studies exploring how these external perturbations affect the spinal stability, characteristics of such adaptations remains unclear. Aim: The purpose of this systematic review was to assess the quality of evidence of studies investigating trunk neuromuscular responses to unexpected trunk perturbation. More specifically, the targeted neuromuscular responses were trunk muscle activity reflex and trunk kinematics under the influence of muscle fatigue, spinal creep, and musculoskeletal pain. Methods: A research of the literature was conducted in Pubmed, Embase, and Sport-Discus databases using terms related to trunk neuromuscular reflex responses, measured by electromyography (baseline activity, reflex latency, and reflex amplitude) and/or trunk kinematic, in context of unexpected external perturbation. Moreover, independent variables must be either trunk muscle fatigue or spinal tissue creep or LBP. All included articles were scored for their electromyography methodology based on the “Surface Electromyography for the Non-Invasive Assessment of Muscles (SENIAM)” and the “International Society of Electrophysiology and Kinesiology (ISEK)” recommendations whereas overall quality of articles was scored using a specific quality checklist modified from the Quality Index. Meta-analysis was performed on reflex latency variable. Results: A final set of 29 articles underwent quality assessments. The mean quality score was 79%. No effect of muscle fatigue on erector spinae reflex latency following an unexpected perturbation, nor any other distinctive effects was found for back muscle fatigue and reflex parameters. As for spinal tissue creep effects, no alteration was found for any of the trunk reflex variables. Finally, the meta-analysis revealed an increased erector spinae reflex latency in patients with chronic LBP in comparison with healthy controls following an unexpected trunk perturbation. Conclusion: The literature provides some evidence with regard to trunk adaptions in a context of spinal instability. However, most of the evidence was inconclusive due to a high methodological heterogeneity between the studies.
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Affiliation(s)
- Jacques Abboud
- Département D'anatomie, Université du Québec à Trois-Rivières Trois-Rivières, QC, Canada
| | - Arnaud Lardon
- Pôle Recherche Clinique Chiropratique, Institut Franco-Européen de ChiropraxieIvry-Sur-Seine, France; Département des Sciences de L'activité Physique, Université du Québec à Trois-RivièresTrois-Rivières, QC, Canada
| | - Frédéric Boivin
- Département des Sciences de L'activité Physique, Université du Québec à Trois-Rivières Trois-Rivières, QC, Canada
| | - Claude Dugas
- Département des Sciences de L'activité Physique, Université du Québec à Trois-Rivières Trois-Rivières, QC, Canada
| | - Martin Descarreaux
- Département des Sciences de L'activité Physique, Université du Québec à Trois-Rivières Trois-Rivières, QC, Canada
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Miller BJ, Fathallah FA. The Effects of a Stooped Work Task on the Muscle Activity and Kinematics of the Lower Back. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/154193120605001306] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Working in a stooped posture is an important risk factor for low back disorders (LBDs) that requires special focus. Spinal flexion increases the loading on the passive tissues of the lumbar spine compared to neutral postures, yet sustained or repeated flexion reduces the load bearing capability of these tissues. The objective of this study is to assess the effect of performing a stooped work task on the passive tissues of the low back. Passive tissue response is assessed by measuring trunk sagittal range of motion and the occurrence of the flexion-relaxation (F-R) phenomenon at specific times during the work period. Fourteen subjects (10 female and 4 male) were instrumented with a portable data collection system while performing the stooped work task of fresh-market tomato harvest for one hour in the morning and one hour in the afternoon. Results indicate significant changes in the trunk and lumbar sagittal range of motion and F-R after only 11 minutes of stooped work, with few changes for durations up to 55 minutes of work. The potential benefits of short, frequent rest breaks on recovery of passive tissue response are also demonstrated. The data collection device developed for this study allows for further investigation of the effects of stooped work on the lower back, which could lead to improved interventions to reduce LBD risk.
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Affiliation(s)
- Brandon J. Miller
- Occupational Biomechanics Laboratory Department of Biological and Agricultural Engineering University of California, Davis, California
| | - Fadi A. Fathallah
- Occupational Biomechanics Laboratory Department of Biological and Agricultural Engineering University of California, Davis, California
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Wei Y, Shan X. Muscular Activation Pattern of Bilateral Extensors Response to Asymmetric Hand Lifting During Trunk Flexion-extension Performance. J Mot Behav 2016; 49:422-428. [PMID: 27740907 DOI: 10.1080/00222895.2016.1219312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The authors' purpose was to test the effect of asymmetric hand lifting on muscular activation patterns of 3 bilateral extensors. Eighteen male university students without back pain were volunteered. Each performed flexion-extension randomly with conditions of right lifting, left lifting, and nonlifting. Surface electromyography from bilateral thoracic, lumbar erector spinae, and hamstring was recorded. The cross-correlation and relative intensity in paired muscles of bilateral extensors was calculated in flexion as well as extension period. The results showed that the cross-correlation coefficient was decreased and the phase lag as well as the relative intensity of bilateral extensors was increased significantly in thoracic level. The phase lag as well as the relative intensity of bilateral extensors was increased significantly in lumbar level. It was concluded that asymmetric lifting has a significant effect on muscular activation of bilateral extensors in thorax level, which causes the ipsilateral extensor to activate larger and longer. Asymmetric lifting also has some effect on muscular activation of bilateral extensors in lumbar level but with less extent than in thorax level, which causes contralateral extensor to activate larger and longer. Asymmetric lifting seems to have no significant effect on muscular activation of bilateral hamstring.
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Affiliation(s)
- Ying Wei
- a College of Physical Education, Shandong Normal University , Jinan , China
| | - Xinhai Shan
- a College of Physical Education, Shandong Normal University , Jinan , China
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22
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Thornton JS, Vinther A, Wilson F, Lebrun CM, Wilkinson M, Di Ciacca SR, Orlando K, Smoljanovic T. Rowing Injuries: An Updated Review. Sports Med 2016; 47:641-661. [DOI: 10.1007/s40279-016-0613-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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23
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Gagnon D, Plamondon A, Larivière C. A biomechanical comparison between expert and novice manual materials handlers using a multi-joint EMG-assisted optimization musculoskeletal model of the lumbar spine. J Biomech 2016; 49:2938-2945. [PMID: 27469898 DOI: 10.1016/j.jbiomech.2016.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 07/05/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
Abstract
Expertise is a key factor modulating the risk of low back disorders (LBD). Through years of practice in the workplace, the typical expert acquires high level specific skills and maintains a clean record of work-related injuries. Ergonomic observations of manual materials handling (MMH) tasks show that expert techniques differ from those of novices, leading to the idea that expert techniques are safer. Biomechanical studies of MMH tasks performed by experts/novices report mixed results for kinematic/kinetic variables, evoking potential internal effect of expertise. In the context of series of box transfers simulated by actual workers, detailed internal loads predicted by a multiple-joint EMG-assisted optimization lumbar spine model are compared between experts and novices. The results confirmed that the distribution of internal moments are modulated by worker expertise. Experts flexed less their lumbar spine and exerted more active muscle forces while novices relied more on passive resistance of the muscles and ligamentous spine. More specifically for novices, the passive contributions came from global extensor muscles, selected local extensor muscles, and passive structures of the lumbar spine (ligaments and discs). The distinctive distribution of internal forces was not concomitant with a similar effect on joint forces, these forces being dependent on external loading which was equivalent between experts and novices. From a safety standpoint, the present results suggest that experts were more efficient than novices in partitioning internal moment contributions to balance net (external) loading. Thus, safer handling practices might be seen as a result of experts׳ experience.
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Affiliation(s)
- Denis Gagnon
- Faculté des sciences de l׳activité physique, Université de Sherbrooke, Sherbrooke, Québec, Canada.
| | - André Plamondon
- Institut de recherche Robert Sauvé en santé et en sécurité du travail, Montréal, Québec, Canada
| | - Christian Larivière
- Institut de recherche Robert Sauvé en santé et en sécurité du travail, Montréal, Québec, Canada
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24
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Lumbopelvic flexibility modulates neuromuscular responses during trunk flexion–extension. J Electromyogr Kinesiol 2016; 28:152-7. [DOI: 10.1016/j.jelekin.2016.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/16/2016] [Accepted: 04/18/2016] [Indexed: 11/22/2022] Open
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25
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Sukadarin EH, Deros BM, Ghani JA, Mohd Nawi NS, Ismail AR. Postural assessment in pen-and-paper-based observational methods and their associated health effects: a review. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2016; 22:389-98. [DOI: 10.1080/10803548.2016.1156924] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Baeske R. Mobilisation with movement: a step towards understanding the importance of peripheral mechanoreceptors. PHYSICAL THERAPY REVIEWS 2016. [DOI: 10.1080/10833196.2015.1121014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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27
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Abboud J, Nougarou F, Descarreaux M. Muscle Activity Adaptations to Spinal Tissue Creep in the Presence of Muscle Fatigue. PLoS One 2016; 11:e0149076. [PMID: 26866911 PMCID: PMC4750977 DOI: 10.1371/journal.pone.0149076] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/26/2016] [Indexed: 12/02/2022] Open
Abstract
Aim The aim of this study was to identify adaptations in muscle activity distribution to spinal tissue creep in presence of muscle fatigue. Methods Twenty-three healthy participants performed a fatigue task before and after 30 minutes of passive spinal tissue deformation in flexion. Right and left erector spinae activity was recorded using large-arrays surface electromyography (EMG). To characterize muscle activity distribution, dispersion was used. During the fatigue task, EMG amplitude root mean square (RMS), median frequency and dispersion in x- and y-axis were compared before and after spinal creep. Results Important fatigue-related changes in EMG median frequency were observed during muscle fatigue. Median frequency values showed a significant main creep effect, with lower median frequency values on the left side under the creep condition (p≤0.0001). A significant main creep effect on RMS values was also observed as RMS values were higher after creep deformation on the right side (p = 0.014); a similar tendency, although not significant, was observed on the left side (p = 0.06). A significant creep effects for x-axis dispersion values was observed, with higher dispersion values following the deformation protocol on the left side (p≤0.001). Regarding y-axis dispersion values, a significant creep x fatigue interaction effect was observed on the left side (p = 0.016); a similar tendency, although not significant, was observed on the right side (p = 0.08). Conclusion Combined muscle fatigue and creep deformation of spinal tissues led to changes in muscle activity amplitude, frequency domain and distribution.
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Affiliation(s)
- Jacques Abboud
- Département d’Anatomie, Université du Québec à Trois-Rivières, Québec, Canada
- * E-mail:
| | - François Nougarou
- Département de Génie Électrique, Université du Québec à Trois-Rivières, Québec, Canada
| | - Martin Descarreaux
- Département des Sciences de l’Activité Physique, Université du Québec à Trois-Rivières, Québec, Canada
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28
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Riley AE, Craig TD, Sharma NK, Billinger SA, Wilson SE. Novice lifters exhibit a more kyphotic lifting posture than experienced lifters in straight-leg lifting. J Biomech 2015; 48:1693-9. [PMID: 26077846 DOI: 10.1016/j.jbiomech.2015.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 05/20/2015] [Accepted: 05/24/2015] [Indexed: 10/23/2022]
Abstract
As torso flexion and repetitive lifting are known risk factors for low back pain and injury, it is important to investigate lifting techniques that might reduce injury during repetitive lifting. By normalizing lumbar posture to a subject's range of motion (ROM), as a function of torso flexion, this research examined when subjects approached their range of motion limits during dynamic lifting tasks. For this study, it was hypothesized that experienced lifters would maintain a more neutral lumbar angle relative to their range of motion, while novice lifters would approach the limits of their lumbar ROM during the extension phase of a straight-leg lift. The results show a statistically significant difference in lifting patterns for these two groups supporting this hypothesis. The novice group maintained a much more kyphotic lumbar angle for both the flexion (74% of the lumbar angle ROM) and extension phases (86% of the lumbar angle ROM) of the lifting cycle, while the experienced group retained a more neutral curvature throughout the entire lifting cycle (37% of lumbar angle ROM in flexion and 48% of lumbar angle ROM in extension). By approaching the limits of their range of motion, the novice lifters could be at greater risk of injury by placing greater loads on the supporting soft tissues of the spine. Future research should examine whether training subjects to assume more neutral postures during lifting could indeed lower injury risks.
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Affiliation(s)
- A E Riley
- Department of Mechanical Engineering, University of Kansas, Lawrence, KS, United States
| | - T D Craig
- Department of Mechanical Engineering, University of Kansas, Lawrence, KS, United States
| | - N K Sharma
- Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS, United States
| | - S A Billinger
- Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS, United States
| | - S E Wilson
- Department of Mechanical Engineering, University of Kansas, Lawrence, KS, United States.
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Gsell KY, Beaudette SM, Graham RB, Brown SHM. The effect of different ranges of motion on local dynamic stability of the elbow during unloaded repetitive flexion-extension movements. Hum Mov Sci 2015; 42:193-202. [PMID: 26048713 DOI: 10.1016/j.humov.2015.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 04/29/2015] [Accepted: 05/25/2015] [Indexed: 11/28/2022]
Abstract
Local dynamic stability (LDS) of movement is controlled primarily by active muscles, and is known to be influenced by factors such as movement speed and inertial load. Other factors such as muscle length, the length of the target trajectory, and the resistance of passive tissues through ranges of motion (ROM) may also influence LDS. This study was designed to examine the effect of ROM, which impacts each of the aforementioned factors, on LDS of the elbow. 16 participants performed 30 unloaded, repetitive, flexion-extension movements of the elbow with varying (1) angular displacement magnitudes: 40° and 80°; (2) locations of ROM: mid-range, flexion end-range, extension end-range; and (3) rotated positions of the forearm: pronated and supinated. LDS was calculated using a finite time Lyapunov analysis of angular elbow flexion-extension kinematic data. EMG-based muscle activation and co-contraction data were also examined for possible mechanisms of stabilization. Results showed no changes in LDS with any movement condition; however, there were significant effects on muscle activation with ROM location and forearm rotated position. This suggests that a consistent level of LDS of the elbow through varying ROMs is maintained, at least in part, by the active control of the elbow flexor and extensor muscles.
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Affiliation(s)
- Kelsey Y Gsell
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Shawn M Beaudette
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Ryan B Graham
- School of Physical & Health Education, Nipissing University, North Bay, ON P1B 8L7, Canada
| | - Stephen H M Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada.
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30
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Stegemöller EL, Roper J, Hass CJ, Kennedy DJ. Changes in gait kinematics and lower back muscle activity post-radiofrequency denervation of the zygapophysial joint: a case study. Spine J 2015; 15:e21-7. [PMID: 24120824 DOI: 10.1016/j.spinee.2013.06.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2011] [Revised: 05/02/2013] [Accepted: 06/18/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Using diagnostic anesthetic blocks, the lumbar zygapophysial (facet) joint has been shown to be the primary cause of pain in approximately 15% of patients with chronic low back pain. Radiofrequency neurotomy (RFN) of the lumbar medial branch innervating the zygapophysial joint has been shown to provide a significant decrease in pain in patients selected by dual comparative anesthetic blocks, but quantitative improvements in mobility have not been fully elucidated. A theoretical concern with RFN is that the multifidus muscle, a stabilizing paraspinal muscle, is also denervated during this procedure, which may have adverse effects on mobility and spine stability. PURPOSE The purpose of this study was to examine gait kinematics and muscle activity of the low back during treadmill walking both before and after RFN. STUDY DESIGN Case study. PATIENT SAMPLE One 33-year-old female, with 15 years of chronic left low back pain and a diagnosis of L4/L5 lumbar zygapophysial joint pain by dual comparative anesthetic blocks was studied. OUTCOME MEASURES Self-reported measures of perceived pain and effort; in addition to physiologic measures of heart rate, gait kinematics and surface electromyography (EMG) activity of the multifidus and erector spinae muscles were collected before and after the procedure. METHODS The participant walked for 15 consecutive minutes on a treadmill. The first and last 5-minute intervals were at a self-selected pace, and the middle 5-minute interval was at a 50% increase of the self-selected pace. Gait kinematics and lumbar paraspinal surface EMG activity were recorded during the last minute of each walking interval. Heart rate, perceived effort, and perceived pain were also collected at the end of each walking interval. Data were collected both 7 and 1 days before RFN, and on the following days post-RFN: 0, 8, 14, 28, and 58. RESULTS Perceived effort did not change despite an increase in treadmill speed and heart rate. Pain decreased by 60% in the first two weeks and by 92% by 4 weeks post-RFN. There were also gradual positive changes in gait kinematics across all post-sessions and an immediate and sustained decrease in surface EMG activity over the left multifidus and erector spinae muscles following RFN. CONCLUSIONS The results of this pilot study are the first to show quantitative positive changes in gait and muscle activity post-RFN, suggesting that the relationship between this procedure and mobility warrant further investigation.
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Affiliation(s)
- Elizabeth L Stegemöller
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL 32611-8205, USA
| | - Jaimie Roper
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL 32611-8205, USA
| | - Chris J Hass
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL 32611-8205, USA
| | - David J Kennedy
- Department of Orthopaedics, Divisions of Spine and Rehabilitation Medicine, Stanford University, 450 Broadway St Pavilion C, MC 6342, Redwood City, CA 94063, USA.
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Mawston GA, G. Boocock M. Lumbar posture biomechanics and its influence on the functional anatomy of the erector spinae and multifidus. PHYSICAL THERAPY REVIEWS 2015. [DOI: 10.1179/1743288x15y.0000000014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Ng L, Cañeiro JP, Campbell A, Smith A, Burnett A, O'Sullivan P. Cognitive functional approach to manage low back pain in male adolescent rowers: a randomised controlled trial. Br J Sports Med 2015; 49:1125-31. [DOI: 10.1136/bjsports-2014-093984] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2015] [Indexed: 11/04/2022]
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Maaswinkel E, van Drunen P, Veeger DJHEJ, van Dieën JH. Effects of vision and lumbar posture on trunk neuromuscular control. J Biomech 2014; 48:298-303. [PMID: 25498916 DOI: 10.1016/j.jbiomech.2014.11.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/17/2014] [Accepted: 11/21/2014] [Indexed: 10/24/2022]
Abstract
The goal of this study was to determine the effects of vision and lumbar posture on trunk neuromuscular control. Torso perturbations were applied with a pushing device while the subjects were restrained at the pelvis in a kneeling-seated position. Torso kinematics and the muscle activity of the lumbar part of the M. Longissimus were recorded for 14 healthy subjects. Four conditions were included: a flexion, extension and neutral lumbar posture with eyes closed and the neutral posture with eyes open. Frequency response functions of the admittance and reflexes showed that there was no significant difference between the eyes open and eyes closed conditions, thereby confirming that vision does not play a role in the stabilization of the trunk during small-amplitude trunk perturbations. In contrast, manipulating posture did lead to significant differences. In particular, the flexed condition led to a lower admittance and lower reflex contribution compared to the neutral condition. Furthermore, the muscle pre-activation (prior to the onset of the perturbation) was significantly lower in the flexed posture compared to neutral. This confirms that flexing the lumbar spine increases the passive tissue stiffness and decreases the contribution of reflex activity to trunk control.
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Affiliation(s)
- Erwin Maaswinkel
- MOVE Research Institute Amsterdam, Faculty of Human Movement Science, VU University Amsterdam, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands
| | - Paul van Drunen
- BioMechanical Engineering Department, Faculty of Mechanical Engineering, Delft University of Technology, Mekelweg 4, 2628 CD Delft, The Netherlands
| | - Dirk-Jan H E J Veeger
- MOVE Research Institute Amsterdam, Faculty of Human Movement Science, VU University Amsterdam, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands
| | - Jaap H van Dieën
- MOVE Research Institute Amsterdam, Faculty of Human Movement Science, VU University Amsterdam, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands.
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34
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Villumsen M, Samani A, Jørgensen MB, Gupta N, Madeleine P, Holtermann A. Are forward bending of the trunk and low back pain associated among Danish blue-collar workers? A cross-sectional field study based on objective measures. ERGONOMICS 2014; 58:246-258. [PMID: 25374330 DOI: 10.1080/00140139.2014.969783] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this cross-sectional study was to investigate the association between the duration of objectively measured forward bending of the trunk and low back pain (LBP) intensity among 198 Danish blue-collar workers (male = 115; female = 83). The duration of forward bending of ≥ 30°, ≥ 60° and ≥ 90° was divided into high (the highest tertile) and low-moderate (the remaining tertiles) categories. High (>5) and low ( ≤ 5) pain intensities were categorised from a self-reported 0-9 scale. Results of multi-adjusted logistic regressions indicated no significant positive associations between forward bending and LBP intensity. On the contrary, higher duration of forward bending of ≥ 30° was associated with lower LBP intensity during all day (OR = 0.40; 95% CI, 0.15-1.02; p = 0.05) and work (OR = 0.44; 95% CI, 0.17-1.15; p = 0.09). This indication of a negative association may be explained by fear-avoidance behaviour of the blue-collar worker, job crafting or healthy worker effect.
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Affiliation(s)
- Morten Villumsen
- a Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology , Aalborg University , Aalborg, Fredrik Bajers Vej 7, DK-9220 Aalborg , Denmark
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35
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Park KN, Oh JS. Influence of thoracic flexion syndrome on proprioception in the thoracic spine. J Phys Ther Sci 2014; 26:1549-50. [PMID: 25364109 PMCID: PMC4210394 DOI: 10.1589/jpts.26.1549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 04/10/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study was performed to determine the difference in thoracic repositioning sense in young people with and without thoracic flexion syndrome (TFS) in target positions of half extension. [Subjects] People with TFS (n = 15; 7 men and 8 women) and people without TFS (n = 15; 7 men and 8 women) were recruited from three universities. Subjects were guided into a sitting extension target posture and were asked to move from a neutral position (2 s) to an extension target position (2 s); 10 trials were performed. [Results] People with TFS showed a significantly higher thoracic repositioning error in the extension target position than people without TFS. [Conclusion] People with TFS show a higher thoracic spine repositioning error in extension than people without TFS. A rehabilitation program to treat TFS should be implemented for individuals with decreased position sense of the thoracic spine.
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Affiliation(s)
- Kyue-Nam Park
- Department of Physical Therapy, Jeonju University, Republic
of Korea
| | - Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical
Science and Engineering, Inje University, Republic of Korea
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36
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Cheng X, Zhang T, Shan X, Wang J. Effect of posterior cruciate ligament creep on muscular co-activation around knee: A pilot study. J Electromyogr Kinesiol 2014; 24:271-6. [DOI: 10.1016/j.jelekin.2014.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 12/15/2013] [Accepted: 01/15/2014] [Indexed: 10/25/2022] Open
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37
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Olson MW. Comparison of trunk muscle reflex activation patterns between active and passive trunk flexion-extension loading conditions. Hum Mov Sci 2014; 34:12-27. [PMID: 24690742 DOI: 10.1016/j.humov.2014.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 03/01/2014] [Accepted: 03/07/2014] [Indexed: 11/30/2022]
Abstract
The aim of the present study was to determine the effects of trunk flexion-extension loading on the neuromuscular reflexive latencies and amplitude responses of the trunk musculature. Eighteen male and female subjects (18-27yrs) participated in active and passive trunk flexion extension, performed ∼7days apart. Subjects performed 60 trunk flexion-extension repetitions. Surface electromyography (EMG) was collected bilaterally from paraspinal and abdominal muscles. In the active condition, subjects volitionally moved their trunks, while in the passive condition the dynamometer controlled the movements. The trunk was perturbed before and immediately after 30 repetitions. Latency of muscle onset, latency of first peak, latency of maximum peak, and peak EMG amplitude were evaluated. No differences between conditions, sides, or perturbation session were apparent. Overall latencies were shorter in females (p<.05) and abdominal muscles compared to paraspinals (p<.05). Thoracic paraspinal muscle amplitudes were greater than all other muscles (p<.05). Based upon the present results, the neuromuscular system engages trunk flexor muscles prior to the paraspinals in order to provide possible stabilization of the trunk when flexor moments are generated. Overall, the results indicate no difference in response of the neuromuscular system to active or passive repetitive loading.
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Affiliation(s)
- Michael W Olson
- Southern Illinois University, Department of Kinesiology, 1075 S. Normal Avenue, Carbondale, IL 62901, United States.
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38
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Rosner AL, Conable KM, Edelmann T. Influence of foot orthotics upon duration of effects of spinal manipulation in chronic back pain patients: a randomized clinical trial. J Manipulative Physiol Ther 2014; 37:124-40. [PMID: 24412249 DOI: 10.1016/j.jmpt.2013.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 10/30/2013] [Accepted: 11/01/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of 4 weeks of custom foot orthotics on pain, disability, recurrence of spinal fixation, and muscle dysfunction in adult low back pain patients receiving limited chiropractic care. METHODS Adult volunteers with low back pain of greater than or equal to 1 month's duration were randomized to receive custom orthotics (group A) or a flat insole sham (group B) with limited chiropractic care in 5 visits over 4 weeks. Primary outcome measures are as follows: Quadruple Numerical Pain Rating Scale (for back), the Roland-Morris Disability Questionnaire, the number of muscles grade 4 or lower on manual muscle testing, and the number of spinal fixations detected by motion palpation and vertebral challenge at intake (B1), 2 weeks later before treatment began and orthotic use was initiated (B2) and before each subsequent treatment at approximately days 3, 10, 17, and 24 after B2. Secondary outcome measures are correlations of all primary outcomes. RESULTS Both groups improved on all Numerical Pain Rating Scale, Roland-Morris Disability Questionnaire, and the number of muscles from intake (B1) to final visit. Only group B yielded significant improvements in the number of spinal fixations. No outcome measures showed statistical difference between groups at any time point; however, those who wore custom orthotics longer each day showed trends toward greater improvements in some outcome measures. CONCLUSIONS Both groups improved with chiropractic care including spinal manipulation; however, there were no statistical differences shown between sham and custom orthotic groups. Future studies should formally measure the time that orthotics or shams are worn in a weight-bearing capacity each day.
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Affiliation(s)
- Anthony L Rosner
- Research Director, International College of Applied Kinesiology, Shawnee Mission, KS.
| | - Katharine M Conable
- Associate Professor, Chiropractic Division, Logan University/College of Chiropractic, Chesterfield, MO
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Eungpinichpong W, Buttagat V, Areeudomwong P, Pramodhyakul N, Swangnetr M, Kaber D, Puntumetakul R. Effects of restrictive clothing on lumbar range of motion and trunk muscle activity in young adult worker manual material handling. APPLIED ERGONOMICS 2013; 44:1024-1032. [PMID: 23642759 DOI: 10.1016/j.apergo.2013.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 12/27/2012] [Accepted: 04/02/2013] [Indexed: 06/02/2023]
Abstract
The objective of this study was to examine the effect of wearing restrictive trousers on lumbar spine movement, trunk muscle activity and low back discomfort (LBD) in simulations of manual material handling (MMH) tasks. Twenty-eight young adults participated in the study performing box lifting, liquid container handling while squatting, and forward reaching while sitting on a task chair when wearing tight pants (sizes too small for the wearer) vs. fit pants (correct size according to anthropometry). Each task was repeated three times and video recordings were used as a basis for measuring lumbar range of motion (LRoM). The response was normalized in terms on baseline hip mobility. Trunk muscle activity of rectus abdominis (RA) and erector spinae (ES) muscles were also measured in each trial and normalized. At the close of each trial, participants rated LBD using a visual analog scale. Results revealed significant effects of both pants and task types on the normalized LRoM, trunk muscle activity and subjective ratings of LBD. The LRoM was higher and trunk muscle (ES) activity was lower for participants when wearing tight pants, as compared to fit pants. Discomfort ratings were significantly higher for tight pants than fit. These results provide guidance for recommendations on work clothing fit in specific types of MMH activities in order to reduce the potential of low-back pain among younger workers in industrial companies.
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Affiliation(s)
- Wichai Eungpinichpong
- Division of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
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40
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Viscoelastic creep induced by repetitive spine flexion and its relationship to dynamic spine stability. J Electromyogr Kinesiol 2013; 23:794-800. [DOI: 10.1016/j.jelekin.2013.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 03/22/2013] [Accepted: 04/03/2013] [Indexed: 11/17/2022] Open
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41
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Muslim K, Bazrgari B, Hendershot B, Toosizadeh N, Nussbaum MA, Madigan ML. Disturbance and recovery of trunk mechanical and neuromuscular behaviors following repeated static trunk flexion: influences of duration and duty cycle on creep-induced effects. APPLIED ERGONOMICS 2013; 44:643-651. [PMID: 23332771 DOI: 10.1016/j.apergo.2012.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 12/21/2012] [Accepted: 12/28/2012] [Indexed: 06/01/2023]
Abstract
Occupations involving frequent trunk flexion are associated with a higher incidence of low back pain. To investigate the effects of repeated static flexion on trunk behaviors, 12 participants completed six combinations of three static flexion durations (1, 2, and 4 min), and two flexion duty cycles (33% and 50%). Trunk mechanical and neuromuscular behaviors were obtained pre- and post-exposure and during recovery using sudden perturbations. A longer duration of static flexion and a higher duty cycle increased the magnitude of decrements in intrinsic stiffness. Increasing duty cycle caused larger decreases in reflexive muscle responses, and females had substantially larger decreases in reflexive responses following exposure. Patterns of recovery for intrinsic trunk stiffness and reflexive responses were consistent across conditions and genders, and none of these measures returned to pre-exposure values after 20 min of recovery. Reflexive responses may not provide a compensatory mechanism to offset decreases in intrinsic trunk stiffness following repetitive static trunk flexion. A prolonged recovery duration may lead to trunk instability and a higher risk of low back injury.
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Affiliation(s)
- Khoirul Muslim
- Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
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42
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Persons with unilateral lower-limb amputation have altered and asymmetric trunk mechanical and neuromuscular behaviors estimated using multidirectional trunk perturbations. J Biomech 2013; 46:1907-12. [PMID: 23726183 DOI: 10.1016/j.jbiomech.2013.04.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/17/2013] [Accepted: 04/20/2013] [Indexed: 11/20/2022]
Abstract
Among persons with unilateral lower-limb amputation (LLA), proximal compensations and preferential use of the sound limb during gait and movement may lead to chronic alterations and/or asymmetries in trunk mechanical and neuromuscular behaviors. Trunk stiffness, the magnitude and timing of maximum reflex force, and EMG reflex delays of superficial trunk muscles, were estimated here using multidirectional (anteriorly- and laterally-directed) position-controlled horizontal trunk perturbations (±5mm, applied at T8) with the pelvis immobilized. Alterations and asymmetries in these trunk behaviors were quantified and compared among eight males with unilateral LLA, and eight male non-amputation controls. During anteriorly-directed perturbations, trunk stiffness and maximum reflex force were 24% and 23% lower, respectively, among participants with LLA compared to non-amputation controls, and the timing of maximum reflex force was 8% later. During lateral perturbations, trunk stiffness and maximum reflex force were also significantly lower among participants with LLA, by 22% and 27%, respectively. Bilateral asymmetries were present in trunk stiffness and the timing of maximum reflex force among persons with LLA. Specifically, trunk stiffness was 20% lower and timing of maximum reflex force was 9% later during perturbations involving spinal tissues and muscles ipsilateral to the side of amputation. Reduced and asymmetric trunk mechanical and neuromuscular behaviors may suggest a condition of reduced trunk stability among individuals with LLA, which could be due to repeated exposure to altered and asymmetric gait and movement and/or compensatory muscle recruitment in response to lost or altered musculature subsequent to LLA.
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43
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Toosizadeh N, Bazrgari B, Hendershot B, Muslim K, Nussbaum MA, Madigan ML. Disturbance and recovery of trunk mechanical and neuromuscular behaviours following repetitive lifting: influences of flexion angle and lift rate on creep-induced effects. ERGONOMICS 2013; 56:954-963. [PMID: 23586596 DOI: 10.1080/00140139.2013.785601] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
UNLABELLED Repetitive lifting is associated with an increased risk of occupational low back disorders, yet potential adverse effects of such exposure on trunk mechanical and neuromuscular behaviours were not well described. Here, 12 participants, gender balanced, completed 40 min of repetitive lifting in all combinations of three flexion angles (33, 66, and 100% of each participant's full flexion angle) and two lift rates (2 and 4 lifts/min). Trunk behaviours were obtained pre- and post-exposure and during recovery using sudden perturbations. Intrinsic trunk stiffness and reflexive responses were compromised after lifting exposures, with larger decreases in stiffness and reflexive force caused by larger flexion angles, which also delayed reflexive responses. Consistent effects of lift rate were not found. Except for reflex delay no measures returned to pre-exposure values after 20 min of recovery. Simultaneous changes in both trunk stiffness and neuromuscular behaviours may impose an increased risk of trunk instability and low back injury. PRACTITIONER SUMMARY An elevated risk of low back disorders is attributed to repetitive lifting. Here, the effects of flexion angle and lift rate on trunk mechanical and neuromuscular behaviours were investigated. Increasing flexion angle had adverse effects on these outcomes, although lift rate had inconsistent effects and recovery time was more than 20 min.
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Affiliation(s)
- Nima Toosizadeh
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
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44
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Gender Differences in Trunk and Pelvic Kinematics During Prolonged Ergometer Rowing in Adolescents. J Appl Biomech 2013; 29:180-7. [DOI: 10.1123/jab.29.2.180] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The trunk and pelvis kinematics of 20 healthy male and female adolescent rowers were recorded during an ergometer trial using an electromagnetic tracking system (Fastrak). The kinematics of each drive phase were collected during the 1st and 20th minute, respectively. The mean and range of the kinematics, stroke rate and stroke length were compared between genders and over time. Male rowers postured their pelvis with more posterior tilt and their thoracic spine in more flexion than female rowers (P< .05). Both genders postured their pelvis in more posterior pelvic rotation and upper trunk in more flexion over time. Male rowers were found to have a significantly shorter drive phase than female rowers (P= .001). Differences in trunk and pelvic kinematics between adolescent male and female rowers suggest potentially various mechanisms for biomechanical stress. Assessment and training of rowers should take gender differences into consideration.
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45
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Mörl F, Bradl I. Lumbar posture and muscular activity while sitting during office work. J Electromyogr Kinesiol 2013; 23:362-8. [DOI: 10.1016/j.jelekin.2012.10.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 09/11/2012] [Accepted: 10/02/2012] [Indexed: 11/28/2022] Open
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Howarth SJ, Glisic D, Lee JGB, Beach TAC. Does prolonged seated deskwork alter the lumbar flexion relaxation phenomenon? J Electromyogr Kinesiol 2013; 23:587-93. [PMID: 23380695 DOI: 10.1016/j.jelekin.2013.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 01/10/2013] [Accepted: 01/10/2013] [Indexed: 11/28/2022] Open
Abstract
Sustained maximum lumbar spine flexion can increase the angle at which the low back flexion relaxation phenomenon (FRP) is observed. This adaptation has been hypothesized to have implications for the control of lumbar spine stability and increase the potential for low back injury. The objective of this study was to investigate if similar changes in the FRP would occur from sub-maximal spine flexion induced by an extended continuous duration of seated office deskwork. Twenty-three participants (12 male and 11 female) performed three bouts of full forward spine flexion interspersed with two 1-h periods of seated deskwork. Lumbar spine angular kinematics and electromyographic activity from the lumbar erector spinae were obtained throughout all trials. The angles at which myoelectric silence occurred (FRP onset) were documented. Lumbar flexion at FRP onset increased by 1.3±1.5° after 1-h of sitting (p<0.05) with no further increase after 2-h. However, when the angle at the FRP onset was normalized to the total range of flexion, there was no difference in the FRP onset. These results suggest that the seated posture may induce residual deformation in the viscoelastic passive tissues of the low back; this could increase the challenge of controlling spine motion and reduce the load-bearing capacity of the lumbar spine system during activities performed following extended bouts of sitting.
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Affiliation(s)
- Samuel J Howarth
- Department of Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada M2H 3J1.
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47
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EMG activation of trunk and upper limb muscles following experimentally-induced overpronation and oversupination of the feet in quiet standing. Gait Posture 2013; 37:190-4. [PMID: 22940541 DOI: 10.1016/j.gaitpost.2012.06.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 06/14/2012] [Accepted: 06/30/2012] [Indexed: 02/02/2023]
Abstract
Kinematic studies have shown that experimentally-induced overpronation or oversupination of the subtalar joint may alter the position of the legs, hips and pelvis and consequently the trunk and upper limb. The purpose of the present study was to examine whether such foot deformity affects the activity of muscles that act on the trunk and upper limb. Twenty-eight healthy individuals (11 males and 17 females) 21.4±1.9 years of age without skeletal deformity, leg length discrepancy (LLD), overpronated or oversupinated feet or excessive lateral pelvic inclination volunteered for the study. Bilateral EMG recordings of the latissimus dorsi, pectoralis major and rectus abdominis were undertaken for 30-s with each subject in the relaxed standing position and at 5° and 10° bilateral or unilateral overpronation or oversupination of the foot on the dominant side using wooden wedge-shape blocks. The recorded EMG activity was normalised based on the EMG activity produced by the muscles under investigation during maximum isometric voluntary contraction. The findings of the present study revealed that neither bilateral nor unilateral overpronation/oversupination of the feet induced a significant alteration of the EMG activity of the latissimus dorsi, pectoralis major and rectus abdominis on either the dominant or non-dominant side. These findings suggest that in the absence of other major structural deformity bilateral or unilateral foot overpronation or oversupination does not affect the EMG activity of muscles that act on the trunk and upper limb in quiet standing.
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48
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Ulrey BL, Fathallah FA. Effect of a personal weight transfer device on muscle activities and joint flexions in the stooped posture. J Electromyogr Kinesiol 2013; 23:195-205. [DOI: 10.1016/j.jelekin.2012.08.014] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 08/19/2012] [Accepted: 08/23/2012] [Indexed: 11/30/2022] Open
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49
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Nelson AG, Kokkonen J, Arnall DA, Li L. Acute Stretching Increases Postural Stability in Nonbalance Trained Individuals. J Strength Cond Res 2012; 26:3095-100. [DOI: 10.1519/jsc.0b013e3182430185] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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50
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Trunk muscle reflex amplitudes increased in patients with subacute, recurrent LBP treated with a 10-week stabilization exercise program. Motor Control 2012; 17:1-17. [PMID: 22964879 DOI: 10.1123/mcj.17.1.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Altered trunk muscle reflexes have been observed in patients with low back pain (LBP). Altered reflexes may contribute to impaired postural control, and possibly recurrence of LBP. Specific stabilization exercise (SSE) programs have been shown to decrease the risk of LBP recurrence in a select group of patients with acute, first episode LBP. It is not known if trunk muscle reflex responses improve with resolution of subacute, recurrent LBP when treated with a SSE program. A perturbation test was used to compare trunk muscle reflexes in patients with subacute, recurrent LBP, before and after 10 weeks of a SSE program and a group of matched control subjects (CNTL). The LBP group pre therapy had delayed trunk muscle reflexes compared with the CNTL group. Post therapy reflex latencies remained delayed, but amplitudes increased. Increased reflex amplitudes could limit excessive movement of the spine when perturbed; potentially helping prevent recurrence.
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