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McClintock FA, Callaway AJ, Clark CJ, Williams JM. Validity and reliability of inertial measurement units used to measure motion of the lumbar spine: A systematic review of individuals with and without low back pain. Med Eng Phys 2024; 126:104146. [PMID: 38621847 DOI: 10.1016/j.medengphy.2024.104146] [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: 10/06/2023] [Revised: 12/22/2023] [Accepted: 03/09/2024] [Indexed: 04/17/2024]
Abstract
Low back pain (LBP) is a leading cause of disability, resulting in aberrant movement. This movement is difficult to measure accurately in clinical practice and gold standard methods, such as optoelectronic systems involve the use of expensive laboratory equipment. Inertial measurement units (IMU) offer an alternative method of quantifying movement that is accessible in most environments. However, there is no consensus around the validity and reliability of IMUs for quantifying lumbar spine movements compared with gold standard measures. The aim of this systematic review was to establish concurrent validity and repeated measures reliability of using IMUs for the measurement of lumbar spine movements in individuals with and without LBP. A systematic search of electronic databases, incorporating PRISMA guidelines was completed, limited to the English language. 503 studies were identified where 15 studies met the inclusion criteria. Overall, 305 individuals were included, and 109 of these individuals had LBP. Weighted synthesis of the results demonstrated root mean squared differences of <2.4° compared to the gold standard and intraclass correlations >0.84 for lumbar spine movements. IMUs offer clinicians and researchers valid and reliable measurement of motion in the lumbar spine, comparable to laboratory methods, such as optoelectronic motion capture for individuals with and without LBP.
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Affiliation(s)
- Frederick A McClintock
- Faculty of Health and Social Sciences, Bournemouth University, Fern Barrow, Poole BH12 5BB, United Kingdom.
| | - Andrew J Callaway
- Faculty of Health and Social Sciences, Bournemouth University, Fern Barrow, Poole BH12 5BB, United Kingdom
| | - Carol J Clark
- Faculty of Health and Social Sciences, Bournemouth University, Fern Barrow, Poole BH12 5BB, United Kingdom
| | - Jonathan M Williams
- Faculty of Health and Social Sciences, Bournemouth University, Fern Barrow, Poole BH12 5BB, United Kingdom
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2
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Comparison of Kinematic Movement Patterns Between 2 Subgroups of Females With Low Back Pain and Healthy Women During Sit-to-Stand and Stand-to-Sit. J Appl Biomech 2022; 38:346-354. [PMID: 36096477 DOI: 10.1123/jab.2022-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/04/2022] [Accepted: 08/06/2022] [Indexed: 11/18/2022]
Abstract
The purpose of study was to compare the kinematic patterns of the thoracic, lumbar, and pelvis segments and hip joints between 2 low back pain subgroups and healthy women during sit-to-stand and stand-to-sit. Kinematic data of 44 healthy women and 2 subgroups of females with low back pain in 2 subgroups of movement system impairment model (rotation-extension [Rot.Ext] and rotation-flexion [Rot.Flex]) were recorded. Participants performed sit-to-stand and stand-to-sit at a preferred speed. Each task was divided into a pre buttock lifted off/on (pre-BOff/n) phase and a post-BOff/n phase. The Rot.Ext subgroup showed greater range of motion in the thoracic during pre-BOff phase of sit-to-stand (P < .001) and pre-BOn phase of stand-to-sit (P = .01) compared to the other 2 groups. The Rot.Flex subgroup displayed limited left hip joint excursion during sit-to-stand pre-BOff (P = .04) and stand-to-sit post-BOn phases (P = .02). The Rot.Flex subgroup showed greater pelvis tilt excursion during sit-to-stand post-BOff (P = .04) and stand-to-sit pre-BOn (P = .01) and post-BOn phases (P = .01). In subgroups of women with chronic low back pain, there were kinematic changes in adjacent body segments/joints of lumbar spine during sit-to-stand and stand-to-sit tasks.
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Sipko T, Glibowski E. Immediate Effects of Single-Session Proprioceptive Neuromuscular Facilitation Exercises on the Sit-to-Stand Strategy in Patients With Chronic Lumbar Spinal Disc Disease: A Preliminary Study. J Manipulative Physiol Ther 2022. [DOI: 10.1016/j.jmpt.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Keller AV, Torres-Espin A, Peterson TA, Booker J, O’Neill C, Lotz JC, Bailey JF, Ferguson AR, Matthew RP. Unsupervised Machine Learning on Motion Capture Data Uncovers Movement Strategies in Low Back Pain. Front Bioeng Biotechnol 2022; 10:868684. [PMID: 35497350 PMCID: PMC9047543 DOI: 10.3389/fbioe.2022.868684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022] Open
Abstract
Chronic low back pain (LBP) is a leading cause of disability and opioid prescriptions worldwide, representing a significant medical and socioeconomic problem. Clinical heterogeneity of LBP limits accurate diagnosis and precise treatment planning, culminating in poor patient outcomes. A current priority of LBP research is the development of objective, multidimensional assessment tools that subgroup LBP patients based on neurobiological pain mechanisms, to facilitate matching patients with the optimal therapies. Using unsupervised machine learning on full body biomechanics, including kinematics, dynamics, and muscle forces, captured with a marker-less depth camera, this study identified a forward-leaning sit-to-stand strategy (STS) as a discriminating movement biomarker for LBP subjects. A forward-leaning STS strategy, as opposed to a vertical rise strategy seen in the control participants, is less efficient and results in increased spinal loads. Inefficient STS with the subsequent higher spinal loading may be a biomarker of poor motor control in LBP patients as well as a potential source of the ongoing symptomology.
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Affiliation(s)
- Anastasia V. Keller
- Brain and Spinal Injury Center (BASIC), Weill Institute for Neuroscience, Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veterans Affairs Healthcare System, San Francisco, CA, United States
| | - Abel Torres-Espin
- Brain and Spinal Injury Center (BASIC), Weill Institute for Neuroscience, Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Thomas A. Peterson
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Jacqueline Booker
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Conor O’Neill
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Jeffrey C Lotz
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Jeannie F Bailey
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Adam R. Ferguson
- Brain and Spinal Injury Center (BASIC), Weill Institute for Neuroscience, Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veterans Affairs Healthcare System, San Francisco, CA, United States
| | - Robert P. Matthew
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States
- *Correspondence: Robert P. Matthew,
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Patterson CS, Lohman E, Asavasopon S, Dudley R, Gharibvand L, Powers CM. The influence of hip flexion mobility and lumbar spine extensor strength on lumbar spine flexion during a squat lift. Musculoskelet Sci Pract 2022; 58:102501. [PMID: 35026497 DOI: 10.1016/j.msksp.2021.102501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 12/02/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]
Abstract
STUDY DESIGN Cross-sectional; Controlled laboratory study. OBJECTIVE To examine the associations among available hip flexion motion, lumbar extensor strength and peak lumbar flexion during a squat lift task. SUMMARY OF BACKGROUND DATA Lumbar spine flexion during lifting can result in increased strain on spinal structures. Although decreased available hip flexion motion and reduced strength of the lumbar extensor muscles has been proposed to contribute to greater lumbar flexion during lifting, direct relationships have not been explored. METHODS Fifty healthy young adults participated (23 males and 27 females). Strength of the lumbar extensors was measured using a motor-driven dynamometer. Available hip flexion was assessed using 3D motion capture. Peak lumbar spine flexion and hip flexion were quantified during the descent phase of the squat lifting task. RESULTS There was a significant negative association between available hip flexion and peak lumbar spine flexion during squat lifting in females (r = -0.407, p = 0.035) but not males (r = -0.341, p = 0.120). Similarly, peak lumbar spine flexion was negatively associated with lumbar extensor strength in females (r = -0.398, p = 0.040) but not males (r = -0.310, p = 0.161). During the squat lift, peak hip motion was positively associated with available hip flexion for both males and females combined (r = 0.774, p < 0.001). CONCLUSION Females with less available hip flexion and lower lumbar extensor strength exhibit greater lumbar flexion when performing a lifting task. Clinicians should be aware of the potential contributions of such impairments when instructing patients into various lifting strategies.
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Affiliation(s)
- Christopher S Patterson
- Loma Linda University Department of Physical Therapy, 24951, N. Circle Dr., A-620, Loma Linda, CA, 92350, USA; Azusa Pacific University, 901 E Alosta Ave. Azusa, CA, 91702, USA.
| | - Everett Lohman
- Loma Linda University Department of Physical Therapy, 24951, N. Circle Dr., A-620, Loma Linda, CA, 92350, USA.
| | - Skulpan Asavasopon
- University of Southern California Division of Biokinesiology and Physical Therapy, 1540 E. Alcazar St. CHP - 155, Los Angeles, CA, 90089, USA
| | - Robert Dudley
- Loma Linda University Department of Physical Therapy, 24951, N. Circle Dr., A-620, Loma Linda, CA, 92350, USA; Azusa Pacific University, 901 E Alosta Ave. Azusa, CA, 91702, USA.
| | - Lida Gharibvand
- Loma Linda University School of Allied Health Professions, 24951 N. Circle Dr., A-620, Loma Linda, CA, 92350, USA.
| | - Christopher M Powers
- University of Southern California Division of Biokinesiology and Physical Therapy, 1540 E. Alcazar St. CHP - 155, Los Angeles, CA, 90089, USA.
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Knox PJ, Pohlig RT, Pugliese JM, Coyle PC, Sions JM, Hicks GE. Aberrant Lumbopelvic Movements Predict Prospective Functional Decline in Older Adults with Chronic Low Back Pain. Arch Phys Med Rehabil 2022; 103:473-480.e1. [PMID: 34547273 PMCID: PMC8901446 DOI: 10.1016/j.apmr.2021.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate if clinically observable aberrant lumbopelvic movements are associated with physical function at 12-month follow-up in older adults with chronic low back pain (CLBP), both directly and indirectly through baseline physical function. DESIGN Secondary analysis of a yearlong prospective cohort study. SETTING Clinical Research Laboratory. PARTICIPANTS Community-dwelling older adults with CLBP (N=250). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Data from 239 participants were analyzed. Participants were screened at baseline for aberrant lumbopelvic movements during active trunk flexion; total observable aberrant movements were recorded and summed (range 0-4). Latent constructs of physical function were developed from an array of perception-based and performance-based outcome measures at baseline and 12 months, respectively. Structural Equation Modeling was used to assess the direct effect of baseline aberrant movement score on the latent construct of 12-month physical function, and its indirect effect through baseline physical function. RESULTS Aberrant movements were present in most participants (64.7%) and had a significant negative total effect on 12-month physical function (γ= -0.278, P<.001). Aberrant movement score's direct effect and indirect effect, through baseline functioning, were significantly negatively associated with physical function at 12-months, after adjusting for covariates (γ=-0.068, P=.038; γ= -0.210, P<.001, respectively). CONCLUSIONS Aberrant lumbopelvic movements are associated with decreased physical function at 12-month follow-up in older adults with CLBP, independent of baseline physical function and covariates. Future studies should evaluate if screening for aberrant movements may inform prognostic and interventional efforts in this patient population.
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Affiliation(s)
- Patrick J. Knox
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Ryan T. Pohlig
- Department of Epidemiology, University of Delaware, Newark, DE.,Biostatistics Core, University of Delaware, Newark, DE
| | | | - Peter C. Coyle
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Jaclyn M. Sions
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Gregory E. Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE
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Shirouchi W, Ishii S, Yamamoto S. Effect of different seat heights on lumbar spine flexion during stand-to-sit motion. J Phys Ther Sci 2022; 34:7-12. [PMID: 35035071 PMCID: PMC8752281 DOI: 10.1589/jpts.34.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/05/2021] [Indexed: 11/25/2022] Open
Abstract
[Purpose] This study aimed to investigate the movement of the thorax, lumbar spine, and
pelvis when healthy participants sit on a chair, and to identify the kinematic
characteristics due to changes in the height of the seat. [Participants and Methods]
Twenty healthy participants (14 males, 6 females; mean age, 29 ± 5 years) were recruited
for this study. They performed stand-to-sit motion using one seat with a height of 100%
that of the lower leg length (standard) and another with a height of 60% that of the lower
leg length (lower). A three-dimensional motion analysis system and four force plates were
used to analyze each joint angle. [Results] The mean lumbar spine flexion angle was
significantly increased in the lower versus the standard seat. As a kinematic
characteristic, the pelvis tilted posteriorly while the thorax tilted anteriorly, which
increased the lumbar spine flexion angle. The pelvis was tilted posteriorly when the hip
joint flexed about 60° regardless of the seat height. [Conclusion] The lumbar spine
flexion angle increased in the lower seat stand-to-sit motion, which suggested an increase
in the load on the lumbar spine. The lumbar spine flexion angle was influenced by the
characteristic movements of the thorax and pelvis.
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Affiliation(s)
- Wakana Shirouchi
- Naruo Orthopedic Hospital: 12-24 Okada-machi, Cyuo-ku, Kumamoto city, Kumamoto 862-0958, Japan
| | - Shinichiro Ishii
- Graduate School of International University of Health and Welfare, Japan
| | - Sumiko Yamamoto
- Graduate School of International University of Health and Welfare, Japan
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Knox PJ, Simon CB, Pohlig RT, Pugliese JM, Coyle PC, Sions JM, Hicks GE. A Standardized Assessment of Movement-evoked Pain Ratings Is Associated With Functional Outcomes in Older Adults With Chronic Low Back Pain. Clin J Pain 2021; 38:241-249. [PMID: 34954729 PMCID: PMC8917081 DOI: 10.1097/ajp.0000000000001016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/06/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Despite high prevalence estimates, chronic low back pain (CLBP) remains poorly understood among older adults. Movement-evoked pain (MeP) is an understudied factor in this population that may importantly contribute to disability. This study investigated whether a novel MeP paradigm contributed to self-reported and performance-based function in older adults with CLBP. MATERIALS AND METHODS This secondary analysis includes baseline data from 230 older adults with CLBP in the context of a prospective cohort study. The Repeated Chair Rise Test, Six Minute Walk Test, and Stair Climbing Test were used to elicit pain posttest LBP ratings were aggregated to yield the MeP variable. Self-reported and performance-based function were measured by the Late Life Function and Disability Index (LLFDI) scaled function score and Timed Up-and-Go Test (TUG), respectively. Robust regression with HC3 standard errors was used to model adjusted associations between MeP and both functional outcomes; age, sex, body mass index, and pain characteristics (ie, intensity, quality, and duration) were utilized as covariates. RESULTS MeP was present in 81.3% of participants, with an average rating of 5.09 (SD=5.4). Greater aggregated posttest MeP was associated with decreased LLFDI scores (b=-0.30, t=-2.81, P=0.005) and poorer TUG performance (b=0.081, t=2.35, P=0.020), independent of covariates. LBP intensity, quality and duration were not associated with the LLFDI or TUG, (all P>0.05). DISCUSSION Aggregated posttest MeP independently contributed to worse self-reported and performance-based function among older adults with CLBP. To understand long-term consequences of MeP, future studies should examine longitudinal associations between MeP and function in this population.
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Affiliation(s)
- Patrick J. Knox
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Corey B. Simon
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC
| | - Ryan T. Pohlig
- Department of Epidemiology, University of Delaware, Newark, DE
- Biostatistics Core, University of Delaware, Newark, DE
| | | | - Peter C. Coyle
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Jaclyn M. Sions
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Gregory E. Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE
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Jones SL, Hitt JR, Henry SM. Dual goals of trunk restriction and stability are prioritized by individuals with chronic low back pain during a volitional movement. Gait Posture 2021; 90:16-22. [PMID: 34358848 PMCID: PMC8585721 DOI: 10.1016/j.gaitpost.2021.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with chronic low back pain demonstrate impaired responses to volitional and externally-generated postural perturbations that may impact stability whilst performing activities of daily living. Understanding how balance may be impaired by strategy selection is an important consideration during rehabilitation from low back pain to prevent future injurious balance loss. RESEARCH QUESTION This cross-sectional study explored the influence of an active pain episode on volitional movement patterns and stability during a sit-to-stand task in individuals with chronic low back pain compared to those with no low back pain history. METHODS Thirteen participants with low back pain who were in an active flare-up and 13 without pain sat on a height-adjusted chair and performed 5 sit-to-stand movements. Sagittal plane kinematics, kinetics, and surface electromyography were used to compute neuromuscular variables across Acceleration, Transition and Deceleration phases. Stability was assessed using times to contact of body centers of mass and pressure to base of support boundaries. Independent samples t-tests were used to examine group effects, and repeated measures analyses of variance assessed within-subjects effects across movement phases. RESULTS Individuals with low back pain tended to restrict proximal joint motions through heightened muscle activity while increasing distal joint movement and distal muscle contributions. Individuals with low back pain used a greater driving force, indicated by a longer time to contact of the center of pressure, to achieve comparable center of mass stability. Individuals with low back pain may prioritize trunk restriction and stability through the sit-to-stand movement, possibly related to fear of pain or movement. SIGNIFICANCE The tendency for individuals with active low back pain to restrict trunk movements may require additional effort to maintain stability. Further research should examine whether trunk restriction is related to pain-related fear of movement and whether additional cognitive resources are required to maintain movement stability.
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Affiliation(s)
- Stephanie L Jones
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA; Department of Exercise and Sport Studies, Smith College, Northampton, MA, USA.
| | - Juvena R Hitt
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Sharon M Henry
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
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Seerden SFL, Dankaerts W, Swinnen TW, Westhovens R, De Vlam K, Vanwanseele B. Axial Spondyloarthritis is associated with changes in lumbosacral loading during daily activities. Clin Biomech (Bristol, Avon) 2021; 85:105347. [PMID: 33905963 DOI: 10.1016/j.clinbiomech.2021.105347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is currently little insight in lumbar spine loading during activities of daily living in patients with axial spondyloarthritis. Furthermore, it is unclear how inflammation or ankylosis-related mobility limitations in patients with axial spondyloarthritis affect lumbosacral loading, and if lumbar movement profiles have an effect on lumbosacral loading as well. Therefore, the aim of this study is to get more insight in the differences in peak and cumulative lumbosacral loading in patients with axial spondyloarthritis during activities of daily living. METHODS Three-dimensional motion analysis with integrative force-plates was used to calculate peak lumbosacral moment (peak loading) and lumbosacral moment impulse (cumulative loading), of 19 patients with axial spondyloarthritis and 23 healthy controls during forward bending, sit-to-stand and two lifting tasks (symmetric/asymmetric). We compared inflammatory (n = 7) and ankylosed (n = 12) patients with axial spondyloarthritis and controls. Patients were also classified into Flexion or Lordotic profile. FINDINGS Both inflammatory and ankylosed patients generated significantly larger lumbosacral moment impulses than healthy controls in all movements, except during sit-to-stand, where the inflammatory group showed larger moment impulse than both other two groups. Patients with a Lordotic profile showed lowered peak lumbosacral moments and moment impulses compared to those with a Flexion profile. INTERPRETATION Both inflammatory and ankylosed patients experienced more cumulative loading depending on the activity. But our findings suggest that classification of patients into different movement profiles might be more interesting to clinically target specific loading adaptations related to pain and fear of movement.
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Affiliation(s)
- Stefan F L Seerden
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium.
| | - Wim Dankaerts
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium
| | - Thijs W Swinnen
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium; Division of Rheumatology, UZ Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Belgium
| | - Rene Westhovens
- Division of Rheumatology, UZ Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Belgium
| | - Kurt De Vlam
- Division of Rheumatology, UZ Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Belgium
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium
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11
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Effect of movement speed on lower and upper body biomechanics during sit-to-stand-to-sit transfers: Self-selected speed vs. fast imposed speed. Hum Mov Sci 2021; 77:102797. [PMID: 33848920 DOI: 10.1016/j.humov.2021.102797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/08/2021] [Accepted: 04/05/2021] [Indexed: 11/21/2022]
Abstract
Preferred and fast speed sit-to-stand and stand-to-sit (STS) tests are prevalent in literature, but biomechanical changes between the different speeds of STS have never been studied. Understanding differences between these STS techniques will better inform experimental design for research assessing functional ability in clinical populations. The purpose of this study was to investigate the effect of different speeds of STS transfers on lower body and trunk kinematics and kinetics in healthy adults. Nineteen healthy middle-aged and older adults participated in this study. Two different speeds of STS were tested: self-selected speed and fast speed (as quickly as possible). Ten Vicon cameras and two AMTI force platforms were used to collect three-dimensional kinematic and kinetic data. During sit-to-stand transfer, peak knee extension velocity and knee extension moment were significantly increased for the fast speed STS as compared to the preferred speed STS. During stand-to-sit transfer, peak knee extension moment and lower back moment were significantly increased while STS time was decreased for the fast speed STS as compared to the preferred speed STS. Our results indicate that the fast speed STS could be more challenging for participants compared to the preferred speed STS evidenced by greater knee and lower back joint movements. Therefore, fast STS tests should be reconsidered when testing middle-aged and older adults with chronic low back pain and knee joint problems.
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12
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Berger-Pasternak B, Brylka D, Sipko T. Lumbar Spine Kinematics in Asymptomatic People When Changing Body Position From Sitting to Standing. J Manipulative Physiol Ther 2021; 44:113-119. [PMID: 33431283 DOI: 10.1016/j.jmpt.2020.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/20/2019] [Accepted: 07/26/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the lumbar spine kinematics in 3 movement axes in asymptomatic individuals in the sit-to-stand (STS) movement performed in a habitual, flexion, or extension manner. METHODS There were 30 participants (16 women, 14 men), aged 23 to 37 years. Each participant performed an STS test. We registered the total time of the STS movement and the maximum acceleration of the lumbar spine in the vertical, anteroposterior, and mediolateral axes. The examination of the movement pattern was performed with the use of a BTS G-sensor device. RESULTS The highest movement dynamics in the lumbar spine were observed during the STS performed in a habitual manner in the 3 axes (P < .01). The lowest movement dynamics ere associated with the extension STS pattern. The flexion pattern differed from the habitual one in total performance time in both groups (P < .01). There were no significant differences in kinematic lumbar spine between sexes. CONCLUSION The kinematics of the STS movement for asymptomatic individuals were characterized by significant variability in the maximum acceleration in the 3 axes. The highest movement dynamics were observed during the STS performed in a habitual manner, and the lowest dynamics with the extension pattern of STS.
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Affiliation(s)
| | - Daria Brylka
- Physiotherapy Department, University School of Physical Education in Wrocław, Wrocław, Poland
| | - Tomasz Sipko
- Physiotherapy Department, University School of Physical Education in Wrocław, Wrocław, Poland.
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Aure O, Kvåle A. Do pain, function, range of motion, fear and distress differ according to symptom duration and work status in patients with low back pain? A cross-sectional study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1801834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Alice Kvåle
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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14
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Does manual therapy affect functional and biomechanical outcomes of a sit-to-stand task in a population with low back pain? A preliminary analysis. Chiropr Man Therap 2020; 28:5. [PMID: 31998472 PMCID: PMC6979331 DOI: 10.1186/s12998-019-0290-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 12/23/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction Manual therapy (MT) hypothetically affects discrepant neuromuscular control and movement observed in populations with low back pain (LBP). Previous studies have demonstrated the limited influence of MT on movement, predominately during range of motion (ROM) testing. It remains unclear if MT affects neuromuscular control in mobility-based activities of daily living (ADLs). The sit-to-stand (STS) task represents a commonly-performed ADL that is used in a variety of clinical settings to assess functional and biomechanical performance. Objective To determine whether MT affects functional performance and biomechanical performance during a STS task in a population with LBP. Methods Kinematic data were recorded from the pelvis and thorax of participants with LBP, using an optoelectronic motion capture system as they performed a STS task before and after MT from November 2011 to August 2014. MT for each participant consisted of two high-velocity low-amplitude spinal manipulations, as well as two grade IV mobilizations of the lumbar spine and pelvis targeted toward the third lumbar vertebra and sacroiliac joint in a side-lying position; the order of these treatments was randomized. Pelvis and thorax kinematic data were used to derive the time-varying lumbar angle in the sagittal plane for each STS trial. The difference between the maximum and minimum lumbar angles during the STS trial determined the sagittal ROM that was used as the biomechanical outcome. Time to complete each STS trial was used as a functional measure of performance. Pre-MT and post-MT values for the lumbar sagittal ROM and time to completion were statistically analysed using paired samples t-tests. Results Data were obtained from 40 participants with 35 useful datasets (NRS = 3.3 ± 1.2; 32.4 ± 9.8 years; 16 females, 19 males). After MT, lumbar sagittal ROM increased by 2.7 ± 5.5 degrees (p = 0.007). Time to complete the STS test decreased by 0.4 ± 0.4 s (p < 0.001). Discussion These findings provide preliminary evidence that MT might influence the biomechanical and functional performance of an STS task in populations with LBP. The MT intervention in this study involved a combination of spinal manipulations and mobilizations. Future work will expand upon these data as a basis for targeted investigations on the effects of either spinal manipulation and mobilization on neuromuscular control and movement in populations with LBP.
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Matthew RP, Seko S, Bailey J, Bajcsy R, Lotz J. Simple Spline Representation for Identifying Sit-to-Stand Strategies. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:4097-4103. [PMID: 31946772 DOI: 10.1109/embc.2019.8857429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Standing from a seated position is an activity of daily living and a common clinical test of strength and balance. While this action is well-studied biomechanically, there remains a need for a clear modelling method for appropriately capturing performance and discriminating between standing strategies. This paper presents a simple framework for representing the rise from a chair as a set of splines. This formulation is inherently differentiable, defines a clear start and end point of the motion, and allows for secondary analysis of dynamic and energetic effects. This method is tested on two healthy subjects performing four different standing strategies. The spline method was found to accurately capture the standing action, with mean absolute errors of 1-2 cm for joint position, and 2-3 degrees angular error across the different standing strategies. Analysis of the spline trajectories revealed strategy-specific differences in kinematic, kinetic, and dynamic bio-markers. This suggests that low order splines can be used to accurately capture variations in sit-to-stand actions.
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Hemming R, Sheeran L, van Deursen R, Sparkes V. Investigating differences in trunk muscle activity in non-specific chronic low back pain subgroups and no-low back pain controls during functional tasks: a case-control study. BMC Musculoskelet Disord 2019; 20:459. [PMID: 31638957 PMCID: PMC6805581 DOI: 10.1186/s12891-019-2843-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 09/20/2019] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Trunk muscle dysfunction is often regarded as a key feature of non-specific chronic low back pain (NSCLBP) despite being poorly understood and variable with increases, decreases and no change in muscle activity reported. Differences in thoraco-lumbar kinematics have been observed in motor control impairment NSCLBP subgroups (Flexion Pattern, Active Extension Pattern) during static postures and dynamic activities. However, potential differences in muscle activity during functional tasks has not been established in these subgroups to date. METHODS A case-control study design recruited 50 NSCLBP subjects (27 Flexion Pattern, 23 Active Extension Pattern) and 28 healthy individuals. Surface electromyography determined muscle activity during functional tasks: reaching upwards, step-down, step-up, lifting and replacing a box, stand-to-sit, sit-to-stand, bending to retrieve (and returning from retrieving) a pen from the floor. Normalised (% sub-maximal voluntary contraction) mean amplitude electromyography of bilateral musculature (transversus abdominis/internal oblique, external oblique, superficial lumbar multifidus and longissimus thoracis) was analysed using Kruskal-Wallis and post-hoc Mann-Whitney U tests. RESULTS Transversus abdominis/internal oblique activity was significantly increased in the Flexion Pattern group compared to controls during stand-to-sit (p = 0.009) on the left side only. External oblique activity was significantly greater in the Active Extension Pattern group compared to controls during box lift (p = 0.016) on the right side only. Significantly greater activity was identified in the right Superficial lumbar multifidus during step up (p = 0.029), reach up (p = 0.013) and box replace (p = 0.007) in the Active Extension Pattern group compared to controls. However left-sided superficial lumbar multifidus activity was significantly greater in the Flexion Pattern group (compared to controls) only during stand-to-sit (p = 0.009). No significant differences were observed in longissimus thoracis activity bilaterally during any task. No significant differences between NSCLBP subgroups were observed. CONCLUSIONS Muscle activity in these NSCLBP subgroups appears to be highly variable during functional tasks with no clear pattern of activity identified. The findings reflect inconsistencies and variability in trunk muscle activity previously observed in these NSCLBP subgroups. Further work evaluating ratios of muscle activity and changes in muscle activity throughout task duration is warranted.
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Affiliation(s)
- Rebecca Hemming
- Arthritis Research UK Biomechanics and Bioengineering Centre, School of Healthcare Sciences, Cardiff University, 13.20 Eastgate House, 35-43 Newport Road, Cardiff, Wales, CF24 0AB, UK.
| | - Liba Sheeran
- Arthritis Research UK Biomechanics and Bioengineering Centre, School of Healthcare Sciences, Cardiff University, 13.20 Eastgate House, 35-43 Newport Road, Cardiff, Wales, CF24 0AB, UK
| | - Robert van Deursen
- Arthritis Research UK Biomechanics and Bioengineering Centre, School of Healthcare Sciences, Cardiff University, 2F25A Cardigan House, Heath Campus, Cardiff, Wales, CF14 4XN, UK
| | - Valerie Sparkes
- Arthritis Research UK Biomechanics and Bioengineering Centre, School of Healthcare Sciences, Cardiff University, 13.20 Eastgate House, 35-43 Newport Road, Cardiff, Wales, CF24 0AB, UK
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Staartjes VE, Klukowska AM, Schröder ML. Association of maximum back and leg pain severity with objective functional impairment as assessed by five-repetition sit-to-stand testing: analysis of two prospective studies. Neurosurg Rev 2019; 43:1331-1338. [PMID: 31451936 DOI: 10.1007/s10143-019-01168-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/10/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
Abstract
The five-repetition sit-to-stand (5R-STS) test was designed to capture objective functional impairment (OFI), and provides a new adjunctive dimension in patient assessment. Its interpretability and confounders remain poorly understood. We quantify the association among maximum patient-reported back (MBP) or leg pain (MLP) and OFI as measured by the 5R-STS using data from two prospective studies. Patients performed the 5R-STS test and completed visual analogue scales (VAS) for back and leg pain severity. Maximum pain severity was defined as VAS scores of 9 or 10. The association of MBP and MLP with 5R-STS test times as well as with the presence of OFI (> 10.5 s) and severe OFI (> 22.0 s) as determined by the 5R-STS baseline severity stratification was quantified by use of crude and adjusted regression models. A total of 258 patients were included. MBP and MLP were reported by 27 (10.5%) and 76 (29.5%) patients, respectively. Rates of OFI differed among patients with (92.6%) and without (55.0%) MBP (p < 0.001), while presence of MLP did not influence OFI (61.8% vs. 57.7%, p = 0.632). Similarly, severe OFI was more common among patients with MBP (33.3% vs. 9.1%, p < 0.001), but not among patients with MLP (17.1% vs. 9.3%, p = 0.119). In the adjusted logistic analysis, the influence of MBP on OFI persisted (odds ratio [OR] 10.08, confidence interval [CI] 2.73-65.74, p = 0.003), while MLP demonstrated no association (OR 0.91, CI 0.49-1.72, p = 0.780). These associations were consistent with findings pertaining to raw 5R-STS test times and in discectomy patients alone. There is a strong association of maximum back pain severity on VAS with the degree of OFI determined by 5R-STS testing. Radiculopathy with maximally strong back pain, however, does not seem to relevantly influence 5R-STS performance.Trial registration ClinicalTrials.gov : NCT03321357 & NCT03303300.
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Affiliation(s)
- Victor E Staartjes
- Department of Neurosurgery, Bergman Clinics, Naarden, Rijksweg 69, 1411 GE, Naarden, The Netherlands. .,Amsterdam UMC, Vrije Universiteit Amsterdam, Neurosurgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands. .,Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Anita M Klukowska
- Department of Neurosurgery, Bergman Clinics, Naarden, Rijksweg 69, 1411 GE, Naarden, The Netherlands.,School of Medicine, University of Nottingham, Nottingham, UK
| | - Marc L Schröder
- Department of Neurosurgery, Bergman Clinics, Naarden, Rijksweg 69, 1411 GE, Naarden, The Netherlands
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Bailey JF, Matthew RP, Seko S, Curran P, Chu L, Berven SH, Deviren V, Burch S, Lotz JC. ISSLS PRIZE IN BIOENGINEERING SCIENCE 2019: biomechanical changes in dynamic sagittal balance and lower limb compensatory strategies following realignment surgery in adult spinal deformity patients. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:905-913. [PMID: 30826876 PMCID: PMC6536471 DOI: 10.1007/s00586-019-05925-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 02/08/2023]
Abstract
STUDY DESIGN A longitudinal cohort study. OBJECTIVE To define a set of objective biomechanical metrics that are representative of adult spinal deformity (ASD) post-surgical outcomes and that may forecast post-surgical mechanical complications. Current outcomes for ASD surgical planning and post-surgical assessment are limited to static radiographic alignment and patient-reported questionnaires. Little is known about the compensatory biomechanical strategies for stabilizing sagittal balance during functional movements in ASD patients. METHODS We collected in-clinic motion data from 15 ASD patients and 10 controls during an unassisted sit-to-stand (STS) functional maneuver. Joint motions were measured using noninvasive 3D depth mapping sensor technology. Mathematical methods were used to attain high-fidelity joint-position tracking for biomechanical modeling. This approach provided reliable measurements for biomechanical behaviors at the spine, hip, and knee. These included peak sagittal vertical axis (SVA) over the course of the STS, as well as forces and muscular moments at various joints. We compared changes in dynamic sagittal balance (DSB) metrics between pre- and post-surgery and then separately compared pre- and post-surgical data to controls. RESULTS Standard radiographic and patient-reported outcomes significantly improved following realignment surgery. From the DSB biomechanical metrics, peak SVA and biomechanical loads and muscular forces on the lower lumbar spine significantly reduced following surgery (- 19 to - 30%, all p < 0.05). In addition, as SVA improved, hip moments decreased (- 28 to - 65%, all p < 0.05) and knee moments increased (+ 7 to + 28%, p < 0.05), indicating changes in lower limb compensatory strategies. After surgery, DSB data approached values from the controls, with some post-surgical metrics becoming statistically equivalent to controls. CONCLUSIONS Longitudinal changes in DSB following successful multi-level spinal realignment indicate reduced forces on the lower lumbar spine along with altered lower limb dynamics matching that of controls. Inadequate improvement in DSB may indicate increased risk of post-surgical mechanical failure. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Jeannie F Bailey
- Department of Orthopaedic Surgery, University of California, San Francisco, USA
| | - Robert P Matthew
- Department of Electrical Engineering and Computer Science, University of California, Berkeley, USA
| | - Sarah Seko
- Department of Electrical Engineering and Computer Science, University of California, Berkeley, USA
| | - Patrick Curran
- Department of Orthopaedic Surgery, University of California, San Francisco, USA
| | - Leslie Chu
- Department of Orthopaedic Surgery, University of California, San Francisco, USA
| | - Sigurd H Berven
- Department of Orthopaedic Surgery, University of California, San Francisco, USA
| | - Vedat Deviren
- Department of Orthopaedic Surgery, University of California, San Francisco, USA
| | - Shane Burch
- Department of Orthopaedic Surgery, University of California, San Francisco, USA
| | - Jeffrey C Lotz
- Department of Orthopaedic Surgery, University of California, San Francisco, USA.
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Shojaei I, Hendershot BD, Acasio JC, Dearth CL, Ballard M, Bazrgari B. Trunk muscle forces and spinal loads in persons with unilateral transfemoral amputation during sit-to-stand and stand-to-sit activities. Clin Biomech (Bristol, Avon) 2019; 63:95-103. [PMID: 30851567 PMCID: PMC6503321 DOI: 10.1016/j.clinbiomech.2019.02.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 02/13/2019] [Accepted: 02/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Alterations and asymmetries in trunk motions during activities of daily living, involving lower extremities, are suggested to cause higher spinal loads in persons with unilateral lower limb amputation. Given the repetitive nature of most activities of daily living, knowledge of the amount of increase in spinal loads is important for designing interventions aimed at prevention of secondary low back pain due to potential fatigue failure of spinal tissues. The objective of this study was to determine differences in trunk muscle forces and spinal loads between persons with and without lower limb amputation when performing sit-to-stand and stand-to-sit tasks. METHODS Kinematics of the pelvis and thorax, obtained from ten males with unilateral transfemoral lower limb amputation and 10 male uninjured controls when performing sit-to-stand and stand-to-sit activities, were used within a non-linear finite element model of the spine to estimate trunk muscle forces and resultant spinal loads. FINDINGS The peak compression force, medio-lateral (only during stand-to-sit), and antero-posterior shear forces were respectively 348 N, 269 N, and 217 N larger in person with vs. without amputation. Persons with amputation also experienced on average 171 N and 53 N larger mean compression force and medio-lateral shear force, respectively. INTERPRETATION While spinal loads were larger in persons with amputation, these loads were generally smaller than the reported threshold for spinal tissue injury. However, a rather small increase in spinal loads during common activities of daily living like walking, sit-to-stand, and stand-to-sit may nevertheless impose a significant risk of fatigue failure for spinal tissues due to the repetitive nature of these activities.
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Affiliation(s)
- Iman Shojaei
- Department of Biomedical Engineering, F. Joseph Halcomb III, M.D. University of Kentucky, Lexington, KY 40506, USA
| | - Brad D. Hendershot
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA,Department of Rehabilitation, Research and Development Section, Walter Reed National Military Medical Center, Bethesda, MD, USA,Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Julian C. Acasio
- Department of Rehabilitation, Research and Development Section, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Christopher L. Dearth
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA,Department of Rehabilitation, Research and Development Section, Walter Reed National Military Medical Center, Bethesda, MD, USA,Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Matthew Ballard
- Department of Biomedical Engineering, F. Joseph Halcomb III, M.D. University of Kentucky, Lexington, KY 40506, USA
| | - Babak Bazrgari
- Department of Biomedical Engineering, F. Joseph Halcomb III, M.D. University of Kentucky, Lexington, KY 40506, USA
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Can objective functional impairment in lumbar degenerative disease be reliably assessed at home using the five-repetition sit-to-stand test? A prospective study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:665-673. [DOI: 10.1007/s00586-019-05897-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/17/2019] [Indexed: 10/27/2022]
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Hines MG, Tillin NA, Luo J, Lee RYW. Passive elastic contribution of hip extensors to joint moments during walking in people with low back pain. Clin Biomech (Bristol, Avon) 2018; 60:134-140. [PMID: 30355537 DOI: 10.1016/j.clinbiomech.2018.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 05/21/2018] [Accepted: 10/10/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND It has been found that alterations in passive muscle properties may be associated with low back pain, and these may be responsible for the altered gait parameters often observed in subjects with back pain. The purpose of the present study was to assess total hip and passive hip extensor moments in people with or without low back pain during the hip flexion component of walking. METHODS 52 subjects volunteered for this study (low back pain group, n = 25 (male n = 13, female n = 12), control group, n = 27 (male n = 15, female n = 12)). Passive hip moments were calculated using an adapted force transducer during supine testing. A biomechanical model and predictive equation were used to calculate passive hip moments during walking. Total hip moments were calculated with the use of a 9 camera, 3-D motion-capture system. FINDINGS Independent samples t-tests demonstrated no significant differences between groups for gait parameters or hip or knee angles. Results of the ANOVAs demonstrated significant differences in passive hip flexor moments during the second half of hip flexion (P < 0.05).There were also significant differences in hip power and work done during peaks of power absorption and the second peak of power generation (P < 0.05). INTERPRETATION The present data demonstrates that subjects with low back pain have altered passive hip extensor and total power and work done during walking compared with healthy controls. Biomechanical models should include individual measurements of passive joint moments.
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Affiliation(s)
- Mark G Hines
- London South Bank University, School of Applied Sciences, 103 Borough Road, London SE1 0AA, UK; British College of Osteopathic Medicine, 3 Sumpter Close, London NW3 5HR, UK.
| | - Neale A Tillin
- University of Roehampton, School of Life Sciences, Whiteland's College, Holybourne Avenue, London SW15 4JD, UK
| | - Jin Luo
- London South Bank University, School of Applied Sciences, 103 Borough Road, London SE1 0AA, UK
| | - Raymond Y W Lee
- University of Portsmouth, Faculty of Technology, Winston Churchill Avenue, Portsmouth PO1 2UP, UK
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Diebo BG, Shah NV, Pivec R, Naziri Q, Patel A, Post NH, Assi A, Godwin EM, Lafage V, Schwab FJ, Paulino CB. From Static Spinal Alignment to Dynamic Body Balance: Utilizing Motion Analysis in Spinal Deformity Surgery. JBJS Rev 2018; 6:e3. [DOI: 10.2106/jbjs.rvw.17.00189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Papi E, Bull AM, McGregor AH. Is there evidence to use kinematic/kinetic measures clinically in low back pain patients? A systematic review. Clin Biomech (Bristol, Avon) 2018; 55:53-64. [PMID: 29684790 PMCID: PMC6161016 DOI: 10.1016/j.clinbiomech.2018.04.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 03/06/2018] [Accepted: 04/10/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Currently, there is a widespread reliance on self-reported questionnaires to assess low back pain patients. However, it has been suggested that objective measures of low back pain patients' functional status should be used to aid clinical assessment. The aim of this study is to systematically review which kinematic /kinetic parameters have been used to assess low back pain patients against healthy controls and to propose clinical kinematic/kinetic measures. METHODS PubMed, Embase and Scopus databases were searched for relevant studies. Reference lists of selected studies and hand searches were performed. Studies had to compare people with and without non-specific low back pain while performing functional tasks and report body segment/joint kinematic and/or kinetic data. Two reviewers independently identified relevant papers. FINDINGS Sixty-two studies were included. Common biases identified were lack of assessor blinding and sample size calculation, use of samples of convenience, and poor experimental protocol standardization. Studies had small sample sizes. Range of motion maneuvers were the main task performed (33/62). Kinematic/kinetic data of different individual or combination of body segments/joints were reported among the studies, commonest was to assess the hip joint and lumbar segment motion (13/62). Only one study described full body movement. The most commonly reported outcome was range of motion. Statistically significant differences between controls and low back pain groups were reported for different outcomes among the studies. Moreover, when the same outcome was reported disagreements were noted. INTERPRETATION The literature to date offers limited and inconsistent evidence of kinematic/kinetic measures in low back pain patients that could be used clinically.
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Affiliation(s)
- Enrica Papi
- Department of Surgery and Cancer, Imperial College London, London, UK,Department of Bioengineering, Imperial College London, London, UK,Corresponding author at: Department of Surgery and Cancer, Imperial College London, Room 7L16, Floor 7, Laboratory Block, Charing Cross Hospital, London, W6 8RF, UK.
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Zawadka M, Skublewska-Paszkowska M, Gawda P, Lukasik E, Smolka J, Jablonski M. What factors can affect lumbopelvic flexion-extension motion in the sagittal plane?: A literature review. Hum Mov Sci 2018; 58:205-218. [DOI: 10.1016/j.humov.2018.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 10/17/2022]
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Pranata A, Perraton L, El-Ansary D, Clark R, Mentiplay B, Fortin K, Long B, Brandham R, Bryant A. Trunk and lower limb coordination during lifting in people with and without chronic low back pain. J Biomech 2018; 71:257-263. [DOI: 10.1016/j.jbiomech.2018.02.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 01/20/2018] [Accepted: 02/11/2018] [Indexed: 10/18/2022]
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Suzuki H, Endo K, Sawaji Y, Matsuoka Y, Nishimura H, Takamatsu T, Murata K, Seki T, Konishi T, Aihara T, Yamamoto K. Radiographic Assessment of Spinopelvic Sagittal Alignment from Sitting to Standing Position. Spine Surg Relat Res 2018; 2:290-293. [PMID: 31435536 PMCID: PMC6690107 DOI: 10.22603/ssrr.2017-0074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 12/21/2017] [Indexed: 11/05/2022] Open
Abstract
Introduction Most people in modern societies spend the majority of their time sitting. However, sagittal spinal alignment is usually analyzed in the standing position. For understanding the symptoms associated with postural changes, this alignment is better to be analyzed in various positions. The purpose of this study was to investigate lumbo-pelvic relationships between standing up and sitting (sit-to-stand) motion. Methods The study subjects were 25 healthy young adult volunteers without any spinal symptoms. The following parameters were measured, namely, intervertebral range of motion (IV ROM), lumbar lordotic angle (L1L5), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI), on lateral whole-spine radiographs while sitting upright, sitting anterior flexed (anteflexed), standing anteflexed, and standing upright. Results The measurements of spinopelvic parameters during sit-to-stand motion (sitting upright, sitting anteflexed, standing anteflexed, standing upright, respectively) were as follows: L1L5 (7.9, −4.4, 3.1, 31.9) and PT (31.5, 26.5, 11.9, 7.7). Regarding IV ROM, the lumbar segmental ROM after seat-off was wider than before seat-off (sitting anteflexed). In particular, the L4-L5 segments had a wide ROM from standing anteflexed to standing upright. Conclusions The pelvis was retroverted in the sitting upright position and gradually anteverted during sit-to-stand motion. Lumbar lordosis decreased in the sitting upright position, temporarily decreased further (sitting anteflexed), and then increased in the standing position (standing anteflexed and standing upright). The mechanical loads on lumbosacral segments were greater after seat-off due to the reverse movement between upper lumbar and pelvic segments.
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Affiliation(s)
- Hidekazu Suzuki
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kenji Endo
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Yasunobu Sawaji
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Yuji Matsuoka
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hirosuke Nishimura
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Taichiro Takamatsu
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kazuma Murata
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takeshi Seki
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takamitsu Konishi
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takato Aihara
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kengo Yamamoto
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
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Actis JA, Nolasco LA, Gates DH, Silverman AK. Lumbar loads and trunk kinematics in people with a transtibial amputation during sit-to-stand. J Biomech 2018; 69:1-9. [DOI: 10.1016/j.jbiomech.2017.12.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 12/20/2017] [Accepted: 12/28/2017] [Indexed: 11/16/2022]
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Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain. J Electromyogr Kinesiol 2018; 39:35-41. [PMID: 29413451 DOI: 10.1016/j.jelekin.2018.01.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/05/2018] [Accepted: 01/17/2018] [Indexed: 11/21/2022] Open
Abstract
The objectives of this study were to investigate whether excessive feet pronation alters the joints' kinematics, kinetics and the activity of involved muscles during gait in low back pain patients. METHODS The lower limb joints' motion, moment and power, as well as the activity of involved muscles during walking were measured in a control group, and two experimental groups including a group with excessive feet pronation only, and another group of low back pain patients with excessive feet pronation. RESULTS In both experimental groups, ankle inversion, knee flexion and internal rotation, hip internal rotation, plantar flexors' moment, hip flexors' moment, and peak positive ankle power were lower than those in control group (p < .05). Besides, in patients, higher activity of gastrocnemius medialis, gluteus medius, erector spinae, and internal oblique muscles, and lower negative power at the ankle and peak positive power at the knee were observed (p < .05). In conclusion, pronated feet with low back pain was associated with less ankle inversion and knee flexion, higher knee and hip internal rotation, higher muscle activity, less energy absorption at the ankle, and reduced positive power at the knee. This study reveals that strengthening of the muscles especially knee extensors are of great importance in low back pain patients with feet pronation.
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Sung PS, Danial P. Gender difference of shoulder-pelvic kinematic integration for trunk rotation directions in healthy older adults. Clin Biomech (Bristol, Avon) 2017; 50:56-62. [PMID: 28987872 DOI: 10.1016/j.clinbiomech.2017.09.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/18/2017] [Accepted: 09/24/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The trunk coordination pattern has been extensively studied, and there is a higher pain prevalence and asymmetry in female older adults. However, there is a lack of investigation of different directions of trunk rotation and asymmetrical compensatory strategies of motor control between genders. The purpose of this study was to investigate shoulder and pelvic ranges of motion (ROM) as well as relative phases (RP) for the different directions of trunk rotation between genders in healthy older adults. METHODS There were 62 right hand dominant older adults in this study (31 female subjects (68.4 [5.62]years) and 31 male subjects (68.7 [5.68]years)). The participants performed trunk axial rotation from the left to the right direction (RP1) and then returned to the left side (RP2), three times repeatedly in standing. The measurements included shoulder and pelvic ROM, RP1, and RP2. The RP was defined as the average absolute relative phase, which was the difference between the phase angle of the shoulder and the phase angle of the pelvis during trunk rotation. FINDINGS The female group demonstrated significantly greater pelvic rotation compared to the male group (98.64 [24.67] vs. 86.96 [18.97]; t=2.09, p=0.04) during trunk rotation. The pelvic ROM demonstrated a significant positive correlation with shoulder ROM in both genders; however, the RP was negatively correlated with the pelvis. For pelvic rotation, the male group demonstrated a negative correlation with RP1 (r=-0.68, p<0.01) and RP2 (r=-0.60, p<0.01) while the female group demonstrated a negative correlation with RP2 (r=-0.53, p<0.01). The ageing factor demonstrated negative correlations with ROM for the shoulder and pelvis in both genders. INTERPRETATION Although no gender difference was indicated on the direction of RP, the pelvic ROM was significantly lesser in the male group. The male group demonstrated lesser pelvic rotation in both directions of rotation; however, the female group showed lesser pelvic rotation in RP2. The male group demonstrated stiffened pelvic rotation and greater shoulder rotation in both directions while the female group demonstrated pelvic stiffness only in the direction from right to left rotation. Clinicians need to consider this directional asymmetry of trunk rotation to enhance integrated shoulder-pelvic coordination in female older adults. MINI ABSTRACT A coordinative pattern of different directions of trunk rotation was investigated in healthy older adults. The pelvic range of motion was lesser in the male group compared with the female group. The female group demonstrated pelvic stiffness only in the direction from right to left rotation, while the male group demonstrated pelvic stiffness in both directions. Clinicians need to understand the gender difference of directional coordination as integrated coordination in female older adults.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy, Central Michigan University, Health Professions Building 1220, Mt. Pleasant, MI 48859, United States.
| | - Pamela Danial
- Department of Physical Therapy, Central Michigan University, Health Professions Building 1220, Mt. Pleasant, MI 48859, United States
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Asavasopon S. Chronification of low back pain: getting to the spine of the problem. Braz J Phys Ther 2017; 22:1-6. [PMID: 29229288 PMCID: PMC5816080 DOI: 10.1016/j.bjpt.2017.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/14/2017] [Accepted: 11/20/2017] [Indexed: 11/18/2022] Open
Affiliation(s)
- Skulpan Asavasopon
- Loma Linda University, School of Allied Health Professions, Department of Physical Therapy, Loma Linda, United States; University of Southern California, Division of Biokinesiology & Physical Therapy, Los Angeles, United States
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Kuai S, Liao Z, Zhou W, Guan X, Ji R, Zhang R, Guo D, Liu W. The Effect of Lumbar Disc Herniation on Musculoskeletal Loadings in the Spinal Region During Level Walking and Stair Climbing. Med Sci Monit 2017; 23:3869-3877. [PMID: 28796755 PMCID: PMC5562184 DOI: 10.12659/msm.903349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background People with low back pain (LBP) alter their motion patterns during level walking and stair climbing due to pain or fear. However, the alternations of load sharing during the two activities are largely unknown. The objective of this study was to investigate the effect of LBP caused by lumbar disc herniation (LDH) on the muscle activities of 17 main trunk muscle groups and the intradiscal forces acting on the five lumbar discs. Material/Methods Twenty-six healthy adults and seven LDH patients were recruited to perform level walking and stair climbing in the Gait Analysis Laboratory. Eight optical markers were placed on the bony landmarks of the spinous process and pelvis, and the coordinates of these markers were captured during the two activities using motion capture system. The coordinates of the captured markers were applied to developed musculoskeletal model to calculate the kinetic variables. Results LDH patients demonstrated higher muscle activities in most trunk muscle groups during both level walking and stair climbing. There were decreases in anteroposterior shear forces on the discs in the pathological region and increases in the compressive forces on all the lumbar discs during level walking. The symmetry of mediolateral shear forces was worse in LDH patients than healthy adults during stair climbing. Conclusions LDH patients exhibited different kinetic alternations during level walking and stair climbing. However, both adaptive strategies added extra burdens to the trunk system and further increased the risk for development of LDH.
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Affiliation(s)
- Shengzheng Kuai
- Department of Mechanical Engineering, Tsinghua University, Beijing, China (mainland).,Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen, Guangdong, China (mainland)
| | - Zhenhua Liao
- Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen, Guangdong, China (mainland)
| | - Wenyu Zhou
- Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China (mainland)
| | - Xinyu Guan
- Department of Mechanical Engineering, Tsinghua University, Beijing, China (mainland)
| | - Run Ji
- Institute of Biomechanics, National Research Center for Rehabilitation Technical Aids, Beijing, China (mainland)
| | - Rui Zhang
- Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China (mainland)
| | - Daiqi Guo
- Department of Orthopedics, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China (mainland)
| | - Weiqiang Liu
- Department of Mechanical Engineering, Tsinghua University, Beijing, China (mainland).,Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen, Guangdong, China (mainland)
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Bazrgari B, Xia T. Application of advanced biomechanical methods in studying low back pain - recent development in estimation of lower back loads and large-array surface electromyography and findings. J Pain Res 2017; 10:1677-1685. [PMID: 28761372 PMCID: PMC5522670 DOI: 10.2147/jpr.s139185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Low back pain (LBP) is a major public health problem and the leading disabling musculoskeletal disorder globally. A number of biomechanical methods using kinematic, kinetic and/or neuromuscular approaches have been used to study LBP. In this narrative review, we report recent developments in two biomechanical methods: estimation of lower back loads and large-array surface electromyography (LA-SEMG) and the findings associated with LBP. The ability to estimate lower back loads is very important for the prevention and the management of work-related low back injuries based on the mechanical loading model as one category of LBP classification. The methods used for estimation of lower back loads vary from simple rigid link-segment models to sophisticated, optimization-based finite element models. In general, reviewed reports of differences in mechanical loads experienced in lower back tissues between patients with LBP and asymptomatic individuals are not consistent. Such lack of consistency is primarily due to differences in activities under which lower back mechanical loads were investigated as well as heterogeneity of patient populations. The ability to examine trunk neuromuscular behavior is particularly relevant to the motor control model, another category of LBP classification. LA-SEMG not only is noninvasive but also provides spatial resolution within and across muscle groups. Studies using LA-SEMG showed that healthy individuals exhibit highly organized, symmetric back muscle activity patterns, suggesting an orderly recruitment of muscle fibers. In contrast, back muscle activity patterns in LBP patients are asymmetric or multifocal, suggesting lack of orderly muscle recruitment. LA-SEMG was also shown capable of capturing unique back muscle response to manual therapy. In conclusion, estimation of low back load and LA-SEMG techniques demonstrated promising potentials for understanding LBP and treatment effects. Future studies are warranted to fully establish clinical validity of these two biomechanical methods.
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Affiliation(s)
- Babak Bazrgari
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, Lexington, KY
| | - Ting Xia
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
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Shojaei I, Salt EG, Hooker Q, Bazrgari B. Mechanical demands on the lower back in patients with non-chronic low back pain during a symmetric lowering and lifting task. J Biomech 2017; 70:255-261. [PMID: 28712541 DOI: 10.1016/j.jbiomech.2017.06.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/12/2017] [Accepted: 06/20/2017] [Indexed: 12/19/2022]
Abstract
There is limited information in the literature related to the lower back loading in patients with LBP, particularly those with non-chronic LBP. Toward addressing such a research gap, a case-control study was conducted to explore the differences in lower back mechanical loads between a group of females (n=19) with non-chronic, non-specific LBP and a group of asymptomatic females (n=19). The differences in lower back mechanical loads were determined when participants completed one symmetric lowering and lifting of a 4.5kg load at their preferred cadence. The axial, shearing, and moment components of task demand at the time of peak moment component as well as measures of peak trunk kinematics were analyzed. Patient vs. asymptomatic group performed the task with smaller peak thoracic rotation and peak lumbar flexion. While no differences in the moment component of task demand on the lower back between the patients and controls were found, the shearing (40-50 age group) and axial components of task demand were, respectively, larger and smaller in patients vs. CONTROLS Whether alterations in lower back loads in patients with non-chronic LBP are in response to pain or preceded the pain, the long-term exposure to abnormal lower back mechanics may adversely affect spinal structure and increase the likelihood of further injury or pain. Therefore, the underlying reason(s) as well as the potential consequence(s) of such altered lower back mechanics in patients with non-chronic LBP should to be further investigated.
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Affiliation(s)
- Iman Shojaei
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Elizabeth G Salt
- College of Nursing, University of Kentucky, Lexington, KY 40506, USA
| | - Quenten Hooker
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA
| | - Babak Bazrgari
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA.
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Chronic low back pain patients walk with locally altered spinal kinematics. J Biomech 2017; 60:211-218. [DOI: 10.1016/j.jbiomech.2017.06.042] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/22/2017] [Accepted: 06/25/2017] [Indexed: 11/23/2022]
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The Effect of Lumbar Disc Herniation on Spine Loading Characteristics during Trunk Flexion and Two Types of Picking Up Activities. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:6294503. [PMID: 29065628 PMCID: PMC5485332 DOI: 10.1155/2017/6294503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/16/2017] [Accepted: 04/26/2017] [Indexed: 11/18/2022]
Abstract
The main purpose of this study was to investigate the compensatory response of the muscle activities of seventeen major muscle groups in the spinal region, intradiscal forces of the five lumbar motion segment units (MSUs), and facet forces acting on the ten lumbar facet joints in patients with lumbar disc herniation (LDH). Twenty-six healthy adults and seven LDH patients performed trunk flexion, ipsilateral picking up, and contralateral picking up in sequence. Eight optical markers were placed on the landmarks of the pelvis and spinal process. The coordinates of these markers were captured to drive a musculoskeletal model to calculate the muscle activities, intradiscal forces, and facet forces. The muscle activities of the majority of the seventeen major muscle groups were found increases in LDH patients. In addition, the LDH patients displayed larger compressive forces and anteroposterior forces on all the five lumbar MSUs and more lumbar facet inventions on most facet joints. These findings suggest that the LDH patients demonstrate compensatory increases in the most trunk muscle activities and all spinal loads. These negative compensatory responses increase the risk of the aggravation of disc herniation. Therefore, treatment should intervene as earlier as possible for the severe LDH patients.
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Sung PS, Maxwell MJ. Kinematic chain reactions on trunk and dynamic postural steadiness in subjects with recurrent low back pain. J Biomech 2017. [PMID: 28645455 DOI: 10.1016/j.jbiomech.2017.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although subjects with recurrent low back pain (LBP) demonstrate altered trunk control, the kinematic and kinetic responses of the trunk have not been carefully investigated. This study was conducted to compare the standing time, spine range of motion (ROM), and dynamic postural steadiness index (DPSI) based on visual condition between subjects with and without recurrent LBP during upright one leg standing. Sixty-three individuals participated in the study, including 34 control subjects and 29 subjects with recurrent LBP. The DPSI was a composite of the medio-lateral (MLSI), anterior-posterior (APSI), and vertical steadiness indices (VSI) on a force platform. The control group demonstrated longer standing time (s) during the eyes-open condition than the LBP group (26.82±6.03 vs. 19.87±9.36; t=2.96, p=0.01). Regarding spine ROM, visual condition was significantly different between groups (F=7.09, p=0.01) and demonstrated interactions with spine region and group (F=5.53, p=0.02). For the kinetic measures, there was a significant interaction between visual conditions and indices (F=25.30, p=0.001). In the LBP group, the DPSI was significantly correlated with the MLSI (r=0.59, p=0.002), APSI (r=0.44, p=0.03), and VSI (r=0.98, p=0.01) in the eyes-closed condition. Overall, the results of this study indicated that the LBP group decreased thorax and lumbar spine rotations during the eyes-closed condition. The LBP group also demonstrated positive correlations with the kinetic indices, enhancing dynamic postural steadiness in the eyes-closed condition in order to possibly avoid pain or further injury. This dynamic postural steadiness strategy is necessary to improve kinetic and kinematic chain reactions in the LBP group. This compensatory pattern supports the development of optimal postural correction strategies to prevent LBP recurrence and might represent a chain reaction to protect trunk control without visual input.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy, Central Michigan University, United States.
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Abstract
BACKGROUND Degenerative flat back (DFB) is characterized by sagittal imbalance resulting from the loss of lumbar lordosis (LL). Extensive degeneration and weakness of lumbar paraspinal extensor muscle (PSE) are thought to be the main cause of DFB. This study is to evaluate correlation between preoperative PSE conditions and angular severity of DFB and to evaluate correlation between preoperative PSE conditions and degree of improvement of DFB obtained by corrective surgery. MATERIALS AND METHODS Forty five patients with DFB who took magnetic resonance image (MRI) preoperatively and conducted simple radiography and three-dimensional gait analysis before and 6 months after corrective surgery were included. To determine the severity of PSE atrophy, the ratio between cross-sectional area of PSE and disc was calculated from L1-L2 to L4-L5 on MRI. To assess the degree of fat infiltration, the signal intensity of PSE was measured. Static parameters of spinopelvic segment were measured by simple radiography. Dynamic parameters of spinopelvic and lower limb joints were obtained by three-dimensional gait analysis. RESULTS In static parameters, thoracic angle was correlated with atrophy and fat infiltration of upper PSE. Thoracic angle was less improved after surgery, as atrophy of upper PSE was more severe. In dynamic parameters, thoracic angle showed correlation with upper PSE conditions, whereas lumbar angle had correlation with middle to lower PSE conditions. While thoracic kyphosis was less improved after surgery, as atrophy of upper PSE was more severe, LL was less improved, as atrophy and fat infiltration of PSE from L1-L2 to L4-L5 were more severe. CONCLUSIONS Severity of atrophy or fat infiltration of PSE showed correlation with degree of angular deformity in patients with DFB and with less improvement after corrective surgery. Dynamic parameters showed more prominent correlation with PSE conditions than static parameters and also showed segmental specificity between PSE and angular deformity.
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Affiliation(s)
- Jung Hwan Lee
- Department of Physical Medicine and Rehabilitation, Wooridul Spine Hospital, Seoul, Korea,Address for correspondence: Dr. Jung Hwan Lee, Department of Physical Medicine and Rehabilitation, Wooridul Spine Hospital, 46-17 Chungdam-Dong, Gangnam-Gu, Seoul, Korea. E-mail:
| | - Sang-Ho Lee
- Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea
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Sung PS, Danial P, Lee DC. Comparison of the different kinematic patterns during lateral bending between subjects with and without recurrent low back pain. Clin Biomech (Bristol, Avon) 2016; 38:50-5. [PMID: 27569600 DOI: 10.1016/j.clinbiomech.2016.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/04/2016] [Accepted: 08/15/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lateral bending is a prerequisite for various functional activities of daily life, which require combined three-dimensional motion. Even though a number of studies have evaluated spinal kinematic changes during lateral bending, the literature reveals a lack of data based on limb dominance. The purpose of this study was to compare kinematic angular displacement of the spinal regions for dominant and non-dominant lateral bending in subjects with and without recurrent low back pain. METHODS Forty-four right hand dominant individuals with recurrent low back pain (43.1 [17.4] years) and without low back pain (39.7 [18.7] years) participated in this study. All participants were asked to perform trunk lateral bending to the dominant and non-dominant sides with a bar, three times repeatedly. The outcome measures included three-dimensional angular displacements for the three regions of the spine (upper thorax, lower thorax, and lumbar spine). FINDINGS Lumbar rotation (degrees) increased to the dominant side in the low back pain group (9.29 [1.06]) compared to the control group (6.20 [1.02]) with increased rotation in the upper thorax as well (t=-2.09, p=0.04). However, the upper thorax rotation increased in the low back pain group to the non-dominant side (t=2.08, p=0.03) and to the dominant side (t=-2.35, p=0.02). There was a group interaction with planes (F=5.82, p=0.02) during lateral bending. INTERPRETATION Although lower thorax motion was not different between groups, increased lumbar spine and upper thorax rotations to the dominant side in the low back pain group were evident during lateral bending. This directional asymmetry should be carefully monitored to understand increased lumbar rotation to the dominant side in subjects with recurrent low back pain. The interactions between group and plane explain compensation strategies through increased lumbar rotation to the dominant side with decreased lateral bending of the upper thorax in subjects with recurrent low back pain.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy, Central Michigan University, United States.
| | - Pamela Danial
- Department of Physical Therapy, Central Michigan University, United States
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Lee JH, Lee SH. Static and Dynamic Parameters in Patients With Degenerative Flat Back and Change After Corrective Fusion Surgery. Ann Rehabil Med 2016; 40:682-91. [PMID: 27606275 PMCID: PMC5012980 DOI: 10.5535/arm.2016.40.4.682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 01/15/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate characteristics of static and dynamic parameters in patients with degenerative flat back (DFB) and to compare degree of their improvement between successful and unsuccessful surgical outcome groups. METHODS Forty-seven patients with DFB were included who took whole spine X-ray and three-dimensional motion analysis before and 6 months after corrective surgery. Forty-four subjects were selected as a control group. As static parameters, thoracic kyphosis (TK), thoracolumbar junction (TLJ), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured. As dynamic parameters, maximal and minimal angle of pelvic tilt, lower limb joints, and thoracic and lumbar vertebrae column (dynamic TK and LL) in sagittal plane were obtained. RESULTS The DFB group showed smaller TK and larger LL, pelvic posterior tilt, hip flexion, knee flexion, and ankle dorsiflexion than the control group. Most of these parameters were significantly corrected by fusion surgery. Dynamic spinal parameters correlated with static spinal parameters. The successful group obtained significant improvement in maximal and minimal dynamic LL than the unsuccessful group. CONCLUSION The DFB group showed characteristic lower limb and spinal angles in dynamic and static parameters. Correlation between static and dynamic parameters was found in spinal segment. Dynamic LL was good predictor of successful surgical outcomes.
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Affiliation(s)
- Jung Hwan Lee
- Department of Medicine and Rehabilitation, Wooridul Spine Hospital, Seoul, Korea
| | - Sang-Ho Lee
- Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea
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Multi-segment analysis of spinal kinematics during sit-to-stand in patients with chronic low back pain. J Biomech 2016; 49:2060-2067. [DOI: 10.1016/j.jbiomech.2016.05.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 05/06/2016] [Accepted: 05/15/2016] [Indexed: 11/23/2022]
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Farahpour N, Jafarnezhad A, Damavandi M, Bakhtiari A, Allard P. Gait ground reaction force characteristics of low back pain patients with pronated foot and able-bodied individuals with and without foot pronation. J Biomech 2016; 49:1705-1710. [PMID: 27086117 DOI: 10.1016/j.jbiomech.2016.03.056] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 03/25/2016] [Accepted: 03/29/2016] [Indexed: 10/22/2022]
Abstract
UNLABELLED The link between gait parameters and foot abnormalities in association with low back pain is not well understood. The objective of this study was to investigate the effects of excessive foot pronation as well as the association of LBP with excessive foot pronation on the GRF components during shod walking. METHODS Forty-five subjects were equally divided into a control group, a group of subjects with pronated feet only, and another group with pronated feet and LBP. Ground reaction forces were analyzed during shod walking. RESULTS Foot pronation without low back pain was associated with increased lateral-medial ground reaction force, impulse, and time to peak of all reaction forces in heel contact phase (p<0.03). In low back pain patients with pronated foot, greater vertical reaction forces (p=0.001) and loading rate, and time to peak on propulsion force were observed compared to pronated foot without low back pain group. Impulse in posterior-anterior reaction force was smaller in the able-bodied group with normal foot than in the other groups (p<0.05). Positive peak of free moments of the LBP group was significantly greater than that in other groups (p<0.05). In conclusion, foot pronation alone was not associated with elevated vertical ground reaction forces. While, low back pain patients with foot pronation displayed higher vertical ground reaction force as well as higher loading rate. Present results reveal that gait ground reaction force components in low back pain patients with pronated foot may have clinical values on the prognosis and rehabilitation of mechanical LBP patients.
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Affiliation(s)
- Nader Farahpour
- Sport Biomechanics Department, Bu-Ali Sina University, Hamedan, Iran.
| | | | - Mohsen Damavandi
- Faculty of Physical Education and Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran.
| | | | - Paul Allard
- Department of Kinesiology, University of Montreal, Montreal, QC, Canada.
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Sipko T, Glibowski E, Barczyk-Pawelec K, Kuczyński M. The Effect of Chronic Pain Intensity on Sit-to-Stand Strategy in Patients With Herniated Lumbar Disks. J Manipulative Physiol Ther 2016; 39:169-75. [DOI: 10.1016/j.jmpt.2016.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 01/07/2016] [Accepted: 01/18/2016] [Indexed: 11/25/2022]
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Welch N, Moran K, Antony J, Richter C, Marshall B, Coyle J, Falvey E, Franklyn-Miller A. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med 2015; 1:e000050. [PMID: 27900136 PMCID: PMC5117021 DOI: 10.1136/bmjsem-2015-000050] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 01/30/2023] Open
Abstract
Background Low back pain is one of the most prevalent musculoskeletal conditions in the world. Many exercise treatment options exist but few interventions have utilised free-weight resistance training. To investigate the effects of a free-weight-based resistance training intervention on pain and lumbar fat infiltration in those with chronic low back pain. Methods Thirty participants entered the study, 11 females (age=39.6±12.4 years, height=164 cm±5.3 cm, body mass=70.9±8.2 kg,) and 19 males (age=39.7±9.7 years, height=179±5.9 cm, body mass=86.6±15.9 kg). A 16-week, progressive, free-weight-based resistance training intervention was used. Participants completed three training sessions per week. Participants completed a Visual Analogue Pain Scale, Oswestry Disability Index and Euro-Qol V2 quality of life measure at baseline and every 4 weeks throughout the study. Three-dimensional kinematic and kinetic measures were used for biomechanical analysis of a bodyweight squat movement. Maximum strength was measured using an isometric mid-thigh pull, and lumbar paraspinal endurance was measured using a Biering-Sorensen test. Lumbar paraspinal fat infiltration was measured preintervention and postintervention using MRIs. Results Postintervention pain, disability and quality of life were all significantly improved. In addition, there was a significant reduction in fat infiltration at the L3L4 and L4L5 levels and increase in lumbar extension time to exhaustion of 18%. Conclusions A free-weight-based resistance training intervention can be successfully utilised to improve pain, disability and quality of life in those with low back pain.
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Affiliation(s)
- Neil Welch
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
- INSIGHT Research Centre, Dublin City University, Dublin, Ireland
- Sports Surgery Clinic, Santry Demesne, Dublin 9, Ireland
| | - Kieran Moran
- INSIGHT Research Centre, Dublin City University, Dublin, Ireland
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Joseph Antony
- INSIGHT Research Centre, Dublin City University, Dublin, Ireland
| | - Chris Richter
- INSIGHT Research Centre, Dublin City University, Dublin, Ireland
| | - Brendan Marshall
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Joe Coyle
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
| | - Eanna Falvey
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
- Department of Medicine, University College Cork, Cork, Ireland
| | - Andrew Franklyn-Miller
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
- Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Victoria, Australia
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44
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Sung PS, Leininger PM. A kinematic and kinetic analysis of spinal region in subjects with and without recurrent low back pain during one leg standing. Clin Biomech (Bristol, Avon) 2015; 30:696-702. [PMID: 26021880 DOI: 10.1016/j.clinbiomech.2015.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate the relationship between normalized kinematic and kinetic stability indices for spinal regions with eyes-open and eyes-closed conditions during non-dominant leg standing between subjects with recurrent low back pain and control subjects. METHODS The kinematic stability index for the spinal regions (core spine model, lumbar spine, lower and upper thorax) and the kinetic stability index from force plate were measured. All participants were asked to maintain non-dominant leg standing with the dominant hip and knee flexed approximately 90 degrees for 25 seconds. Forty-two participants enrolled in the study, including 22 subjects with low back pain (12 male, 10 female) and 20 control subjects (12 male, 8 female). FINDINGS For the kinematic index for stability, the visual condition (F=30.06, p=0.0001) and spinal region (F=10.82, p=0.002) were statistically significant. The post hoc test results indicated a significant difference in the lumbar spine compared with the upper and lower thorax and the core spine model. The kinetic stability (average [standard deviation]) during the eyes-closed condition significantly decreased in the low back pain group (t=-3.24, p=0.002). INTERPRETATION The subjects with recurrent low back pain demonstrated higher lumbar spine stability in eyes-open condition. This higher stability of the lumbar spine might be due to a possible pain avoiding strategy from the standing limb. The low back pain group also significantly decreased kinetic stability during the eyes-closed condition. Clinicians need to consider both kinetic and kinematic indices while considering visual condition for lumbar spine stability in subjects with recurrent low back pain.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy, The University of Scranton, Scranton, PA 18510, United States.
| | - Peter M Leininger
- Department of Physical Therapy, The University of Scranton, Scranton, PA 18510, United States
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45
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Alqhtani RS, Jones MD, Theobald PS, Williams JM. Correlation of lumbar-hip kinematics between trunk flexion and other functional tasks. J Manipulative Physiol Ther 2015; 38:442-7. [PMID: 26099204 DOI: 10.1016/j.jmpt.2015.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 11/26/2014] [Accepted: 05/08/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The purpose of this study was to explore the relationship between the kinematic profiles of flexion of the upper lumbar and lower lumbar (LL) spine and hip and 3 sagittally dominant functional tasks (lifting, stand-to-sit, and sit-to-stand). METHODS Fifty-three participants were recruited for this study. Four sensors were attached to the skin over the S1, L3, T12, and lateral thigh. Relative angles between adjacent sensors were used to quantify the motion for the hip, LL, and upper lumbar spine. Pearson correlation coefficients were used to explore the relationship between the movements and more functional tasks. One-way analysis of variance was used to determine the significance of differences between the variables. RESULTS Flexion resulted in a greater or similar range of motion (ROM) to the other tasks investigated for both spinal regions but less ROM for the hip. Strong correlations for ROM are reported between forward flexion tasks and lifting for the LL spine (r = 0.83) and all regions during stand-to-sit and sit-to-stand (r = 0.70-0.73). No tasks were strongly correlated for velocity (r = 0.03-0.55). CONCLUSION Strong correlations were only evident for the LL spine ROM between lifting and flexion; all other tasks afforded moderate or weak correlations. This study suggests that sagittal tasks use different lumbar-hip kinematics and place different demands on the lumbar spine and hip.
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Affiliation(s)
- Raee S Alqhtani
- Student, Institute of Medical Engineering & Medical Physics, Cardiff School of Engineering, Cardiff University, Cardiff, UK; Physiotherapy Specialist, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
| | - Michael D Jones
- Senior Lecturer, Cardiff University, Institute of Medical Engineering & Medical Physics, Cardiff School of Engineering, Cardiff University, Cardiff, UK
| | - Peter S Theobald
- Lecturer, Cardiff University, Institute of Medical Engineering & Medical Physics, Cardiff School of Engineering, Cardiff University, Cardiff, UK
| | - Jonathan M Williams
- Senior Lecturer, Faculty of Health and Social Sciences, Bournemouth University, Dorset, UK
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Wang TY, Pao JL, Yang RS, Jang JSR, Hsu WL. The adaptive changes in muscle coordination following lumbar spinal fusion. Hum Mov Sci 2015; 40:284-97. [DOI: 10.1016/j.humov.2015.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 12/03/2014] [Accepted: 01/05/2015] [Indexed: 10/24/2022]
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47
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Pijnenburg M, Brumagne S, Caeyenberghs K, Janssens L, Goossens N, Marinazzo D, Swinnen SP, Claeys K, Siugzdaite R. Resting-State Functional Connectivity of the Sensorimotor Network in Individuals with Nonspecific Low Back Pain and the Association with the Sit-to-Stand-to-Sit Task. Brain Connect 2015; 5:303-11. [PMID: 25557846 DOI: 10.1089/brain.2014.0309] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Individuals with nonspecific low back pain (NSLBP) show a decreased sit-to-stand-to-sit (STSTS) performance. This dynamic sensorimotor task requires integration of sensory and motor information in the brain. Therefore, a better understanding of the underlying central mechanisms of impaired sensorimotor performance and the presence of NSLBP is needed. The aims of this study were to characterize differences in sensorimotor functional connectivity in individuals with NSLBP and to investigate whether the patterns of sensorimotor functional connectivity underlie the impaired STSTS performance. Seventeen individuals with NSLBP and 17 healthy controls were instructed to perform five consecutive STSTS movements as fast as possible. Based on the center of pressure displacement, the total duration of the STSTS task was determined. In addition, resting-state functional connectivity images were acquired and analyzed on a multivariate level using both functional connectivity density mapping and independent component analysis. Individuals with NSLBP needed significantly more time to perform the STSTS task compared to healthy controls. In addition, decreased resting-state functional connectivity of brain areas related to the integration of sensory and/or motor information was shown in the individuals with NSLBP. Moreover, the decreased functional connectivity at rest of the left precentral gyrus and lobule IV and V of the left cerebellum was associated with a longer duration of the STSTS task in both individuals with NSLBP and healthy controls. In summary, individuals with NSLBP showed a reorganization of the sensorimotor network at rest, and the functional connectivity of specific sensorimotor areas was associated with the performance of a dynamic sensorimotor task.
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Affiliation(s)
- Madelon Pijnenburg
- 1 Department of Rehabilitation Sciences, KU Leuven-University of Leuven , Leuven, Belgium
| | - Simon Brumagne
- 1 Department of Rehabilitation Sciences, KU Leuven-University of Leuven , Leuven, Belgium
| | - Karen Caeyenberghs
- 2 Department of Physical Therapy and Motor Rehabilitation, University of Ghent , Ghent, Belgium .,3 Department of Movement and Sports Sciences, University of Ghent , Ghent, Belgium
| | - Lotte Janssens
- 1 Department of Rehabilitation Sciences, KU Leuven-University of Leuven , Leuven, Belgium
| | - Nina Goossens
- 1 Department of Rehabilitation Sciences, KU Leuven-University of Leuven , Leuven, Belgium
| | | | - Stephan P Swinnen
- 5 Department of Kinesiology, KU Leuven-University of Leuven , Leuven, Belgium
| | - Kurt Claeys
- 6 Department of Rehabilitation Sciences, KU Leuven-University of Leuven , Leuven, Belgium
| | - Roma Siugzdaite
- 4 Department of Data Analysis, University of Ghent , Ghent, Belgium
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48
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The role of trunk muscles in sitting balance control in people with low back pain. J Electromyogr Kinesiol 2014; 24:947-53. [PMID: 25287529 DOI: 10.1016/j.jelekin.2014.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 09/03/2014] [Accepted: 09/16/2014] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to examine the muscular activities and kinetics of the trunk during unstable sitting in healthy and LBP subjects. Thirty-one healthy subjects and twenty-three LBP subjects were recruited. They were sat on a custom-made chair mounted on a force plate. Each subject was asked to regain balance after the chair was tilted backward at 20°, and then released. The motions of the trunk and trunk muscle activity were examined. The internal muscle moment and power at the hip and lumbar spine joints were calculated using the force plate and motion data. No significant differences were found in muscle moment and power between healthy and LBP subjects (p>0.05). The duration of contraction of various trunk muscles and co-contraction were significantly longer in the LBP subjects (p<0.05) when compared to healthy subjects, and the reaction times of the muscles were also significantly reduced in LBP subjects (p<0.05). LBP subjects altered their muscle strategies to maintain balance during unstable sitting, but these active mechanisms appear to be effective as trunk balance was not compromised and the internal moment pattern remained similar. The changes in muscle strategies may be the causes of LBP or the result of LBP with an attempt to protect the spine.
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49
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Williams JM, Haq I, Lee RY. An experimental study investigating the effect of pain relief from oral analgesia on lumbar range of motion, velocity, acceleration and movement irregularity. BMC Musculoskelet Disord 2014; 15:304. [PMID: 25228332 PMCID: PMC4171543 DOI: 10.1186/1471-2474-15-304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 09/11/2014] [Indexed: 11/11/2022] Open
Abstract
Background Movement alterations are often reported in individuals with back pain. However the mechanisms behind these movement alterations are not well understood. A commonly cited mechanism is pain. The aim of this study was to investigate the effect of pain reduction, from oral analgesia, on lumbar kinematics in individuals with acute and chronic low back pain. Methods A prospective, cross-sectional, experimental repeated-measures design was used. Twenty acute and 20 chronic individuals with low back pain were recruited from General Practitioner and self-referrals to therapy departments for low back pain. Participants complained of movement evoked low back pain. Inertial sensors were attached to the sacrum and lumbar spine and used to measure kinematics. Kinematic variables measured were range of motion, angular velocity and angular acceleration as well as a determining movement irregularity (a measure of deviation from smooth motion). Kinematics were investigated before and after administration of oral analgesia to instigate pain reduction. Results Pain was significantly reduced following oral analgesia. There were no significant effects on the kinematic variables before and after pain reduction from oral analgesia. There was no interaction between the variables group (acute and chronic) and time (pre and post pain reduction). Conclusion The results demonstrate that pain reduction did not alter lumbar range of motion, angular velocity, angular acceleration or movement irregularity questioning the role of pain in lumbar kinematics. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-304) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jonathan M Williams
- Bournemouth University, School of Health and Social Care, Royal London House, Christchurch Road, Bournemouth, Dorset BH1 3LT, UK.
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50
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Blache Y, Pairot de Fontenay B, Monteil K. The effects of seat height and foot placement on lumbar spine load during sit-to-stand tasks. ERGONOMICS 2014; 57:1687-1695. [PMID: 25174255 DOI: 10.1080/00140139.2014.948495] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to determine the influence of seat height and foot position in the sagittal plane on L5-S1 joint load. Fourteen healthy male adults stood up from a chair with three different seat heights and positions of the feet in the sagittal plane. L5-S1 net joint torque, mechanical work, range of motion and electromyographic activity of the erector spinae muscle were measured. L5-S1 net joint work increased by about 50% from high to low seat position. The mean and peak L5-S1 net joint torques increased about 30% from foot-back to foot-neutral position. These results were reinforced by a greater integrated electromyography signal from the erector spinae from high to low seat position and from foot-back to foot-neutral position. A high chair and placement of the feet behind the knees may be advisable to lessen lumbar load during sit-to-stand movements.
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Affiliation(s)
- Y Blache
- a Centre de Recherche et d'Innovation sur le Sport , Université Claude Bernard , Lyon , France
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