A Comparison of Clinical Spinal Mobility Measures to Experimentally Derived Lumbar Spine Passive Stiffness

2020 ◽  
Vol 36 (6) ◽  
pp. 397-407
Author(s):  
Liana M. Tennant ◽  
Erika Nelson-Wong ◽  
Joshua Kuest ◽  
Gabriel Lawrence ◽  
Kristen Levesque ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Erector Spinae ◽  
Spinal Mobility ◽  
Low Back ◽  
Tissue Stiffness ◽  
Mechanical Stiffness ◽  
Intervertebral Motion ◽  
Clinical Assessments ◽  
Local Tissue ◽  
Spinal Stiffness

Spinal stiffness and mobility assessments vary between clinical and research settings, potentially hindering the understanding and treatment of low back pain. A total of 71 healthy participants were evaluated using 2 clinical assessments (posteroanterior spring and passive intervertebral motion) and 2 quantitative measures: lumped mechanical stiffness of the lumbar spine and local tissue stiffness (lumbar erector spinae and supraspinous ligament) measured via myotonometry. The authors hypothesized that clinical, mechanical, and local tissue measures would be correlated, that clinical tests would not alter mechanical stiffness, and that males would demonstrate greater lumbar stiffness than females. Clinical, lumped mechanical, and tissue stiffness were not correlated; however, gradings from the posteroanterior spring and passive intervertebral motion tests were positively correlated with each other. Clinical assessments had no effect on lumped mechanical stiffness. The males had greater lumped mechanical and lumbar erector spinae stiffness compared with the females. The lack of correlation between clinical, tissue, and lumped mechanical measures of spinal stiffness indicates that the use of the term “stiffness” by clinicians may require reevaluation; clinicians should be confident that they are not altering mechanical stiffness of the spine through segmental mobility assessments; and greater resting lumbar erector stiffness in males suggests that sex should be considered in the assessment and treatment of the low back.

Use of Kinetic and Kinematic Data to Evaluate Load Transfer as a Mechanism for Flexion Relaxation in the Lumbar Spine

2013 ◽  
Vol 135 (10) ◽  
Author(s):  
Samuel J. Howarth ◽  
Paul Mastragostino
Keyword(s):  
Lumbar Spine ◽  
Body Mass ◽  
Full Range ◽  
Added Mass ◽  
Erector Spinae ◽  
Lower Limbs ◽  
Upper Body ◽  
Low Back ◽  
Kinematic Data ◽  
Flexion Relaxation

Flexion relaxation (FR) in the low back occurs when load is transferred from the spine's extensor musculature to its passive structures. This study investigated the influence of added upper body mass on low back kinetics and kinematics at the FR onset. Sixteen participants (eight male, eight female) performed standing full forward spine flexion with 0%, 15%, and 30% of their estimated upper body mass added to their shoulders. Electromyographic data were obtained from the lumbar erector spinae. Ground reaction forces and kinematic data from the lower limbs, pelvis, and spine were recorded. Extensor reaction moments (determined using a bottom-up linked segment model) and flexion angles at the FR onset were documented along with the maximum spine flexion. The angle at the FR onset increased significantly with added mass (p < 0.05). Expressing the FR onset angle as a percent of the full range of trunk flexion motion for that condition negated any differences between the added mass conditions. These findings demonstrate that low back kinetics play a role in mediating FR in the lumbar spine.

scholarly journals Trunk muscular endurance, lumbar spine mobility and hip flexibility in sailors with and without low back pain

2020 ◽  
Vol 33 ◽  
Author(s):  
Laís Marinho de Araújo ◽  
Elisa Dell’Antonio ◽  
Marcel Hubert ◽  
Caroline Ruschel ◽  
Helio Roesler ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
National Level ◽  
Spinal Mobility ◽  
Trunk Muscles ◽  
Normative Values ◽  
Low Back ◽  
Spine Mobility ◽  
The Right

Abstract Introduction: Low back pain is one of the most common injuries in sailors. Findings in the literature indicate that poor trunk endurance, flexibility and muscle strength are common in individuals with low back pain (LBP). Objective: Analyze trunk muscle endurance, lumbar spine mobility and hip flexibility in windsurfers with and without low back pain. Method: Sailors of both sexes with at least three years’ experience in the sport answered the Nordic Musculoskeletal Questionnaire and were submitted to Schober’s test, the passive straight leg raise (PSLR), the modified Thomas test, and isometric endurance assessment of the flexor, extensor and lateral flexor muscles of the torso. The sailors were divided into two groups (with and without LBP) and compared using the Student’s t-test or Mann Whitney U test. Results: Participants were 22 national-level sailors, 11 with low back pain (LBP) and 11 without (NLBP). The LBP group obtained longer holding times for the trunk extensors (p=0.028) and a greater difference in endurance between the right and left sides for lateral trunk muscles (p=0.030). Both groups obtained results below normative values in most of the tests performed. Conclusion: Sailors with low back pain exhibited greater trunk extensor endurance and a larger imbalance between lateral trunk muscles when compared to those with no LBP. Spinal mobility and hip flexibility were similar between groups.

scholarly journals Self-reports vs. physical measures of spinal stiffness

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9598
Author(s):  
Jonas Nielsen ◽  
Casper Glissmann Nim ◽  
Søren O’Neill ◽  
Eleanor Boyle ◽  
Jan Hartvigsen ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Spinal Manipulation ◽  
Self Report ◽  
Objective Measures ◽  
Low Back ◽  
Cut Points ◽  
Spinal Stiffness ◽  
Objectively Measured

Background Objectively measured reduction in lumbar posterior-to-anterior (PA) stiffness is associated with pain relief in some, but not all persons with low back pain. Unfortunately, these measurements can be time consuming to perform. In comparison, the Lumbar Spine Instability Questionnaire (LSIQ) is intended to measure spinal instability and the Lumbar Spine Disability Index (LSDI) is created for self-reporting functional disability due to increased spinal stiffness. Given the above, the aim of this study is to compare measures of the LSIQ and LSDI with objective measures of lumbar PA stiffness as measured by a mechanical device, Vertetrack (VT), in patients with persistent non-specific low back pain (nsLBP). Methods Twenty-nine patients with nsLBP completed the LSIQ and LSDI at baseline and after two weeks. On these same occasions, PA spinal stiffness was measured using the VT. Between measurements, patients received four sessions of spinal manipulation. The resulting data was analyzed to determine the correlation between the self-report and objective measures of stiffness at both time points. Further, the patients were categorized into responders and non-responders based on pre-established cut points depending on values from the VT and compared those to self-report measures in order to determine whether the LSIQ and the LSDI were sensitive to change. Results Twenty-nine participants completed the study. Measures from the LSIQ and LSDI correlated poorly with objectively measured lumbar PA stiffness at baseline and also with the change scores. The change in objectively measured lumbar PA stiffness following spinal manipulation did not differ between those who improved, and those who did not improve according to the pre-specified cut-points. Finally, a reduction in lumbar PA stiffness following intervention was not associated with improvement in LSIQ and LSDI outcomes. Conclusions The current data indicate that the LSIQ and LSDI questionnaires do not correlate with measures obtained objectively by VT. Our results suggest that these objective and self- reported measures represent different domains and as such, cannot stand in place of one another.

Biomechanical and Electromyographic Comparisons of Isometric Trunk Flexor Endurance Test Postures: Prone Plank Versus V-Sit

2015 ◽  
Vol 31 (6) ◽  
pp. 469-475
Author(s):  
Lindsay L. Musalem ◽  
Tatjana Stankovic ◽  
Drazen Glisic ◽  
Gillian E. Cook ◽  
Tyson A.C. Beach
Keyword(s):  
Lumbar Spine ◽  
Latissimus Dorsi ◽  
Body Position ◽  
Reaction Force ◽  
Rectus Abdominis ◽  
Erector Spinae ◽  
Endurance Capacity ◽  
Low Back ◽  
Endurance Test ◽  
Force Data

The objective of this study was to investigate why holding times on 2 different tests of isometric trunk flexor endurance capacity (prone plank and v-sit) are weakly correlated. Body position and ground reaction force data from 10 men and 10 women were used to conduct static biomechanical analyses of both test postures, and bilateral activations of the rectus abdominis, internal and external obliques, latissimus dorsi, and lumbar and thoracic erector spinae were measured in a second sample of 15 men and 15 women while holding the test postures. No between-posture differences in net low back flexor moments were found (P = .111), but the lumbar spine was 28° more flexed in the v-sit than in the plank (P < .001). No between-posture differences were detected in the rectus abdominis (P = .397), external obliques (P = .204), internal obliques (P = .226), or lumbar erector spinae (P = .116) activation levels, but those of the thoracic erector spinae (P = .0253) and latissimus dorsi (P < .001) were greater in the plank than in the v-sit. Altogether, the findings suggest that differences between plank and v-sit holding times are most likely related to between-test differences in lumbar spine postures and shoulder demands.

Severe low back pain with mild leg symptoms due to lumbar spine stenosis

2021 ◽  
pp. 1-4
Author(s):  
Ryo Kanematsu ◽  
Junya Hanakita ◽  
Toshiyuki Takahashi ◽  
Manabu Minami ◽  
Kazuhiro Miyasaka ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Low Back

scholarly journals Preoperative Fluoroscopically Guided Regional Erector Spinae Plane Blocks Reduce Opioid Use, Increase Mobilization, and Reduce Length of Stay Following Lumbar Spine Fusion

2021 ◽  
pp. 219256822110107
Author(s):  
Robert J. Owen ◽  
Noah Quinlan ◽  
Addisyn Poduska ◽  
William Ryan Spiker ◽  
Nicholas T. Spina ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Length Of Stay ◽  
Lumbar Fusion ◽  
Spine Fusion ◽  
Erector Spinae ◽  
Control Group ◽  
Block Group ◽  
Opioid Use ◽  
Lumbar Spine Fusion ◽  
Delivery Technique

Study Design: Retrospective review. Objective: To determine the effectiveness of erector spinae plane (ESP) blocks at improving perioperative pain control and function following lumbar spine fusions. Methods: A retrospective analysis was performed on patients undergoing < 3 level posterolateral lumbar fusions. Data was stratified into a control group and a block group. We collected postop MED (morphine equivalent dosages), physical therapy ambulation, and length of stay. PROMIS pain interference (PI) and physical function (PF) scores, ODI, and VAS were collected preop and at the first postop visit. Chi-square and student’s t-test ( P = .05) were used for analysis. We also validated a novel fluoroscopic technique for ESP block delivery. Results: There were 37 in the block group and 39 in the control group. There was no difference in preoperative opioid use ( P = .22). On postop day 1, MED was reduced in the block group (32 vs 51, P < .05), and more patients in the block group did not utilize any opioids (22% vs 5%, P < .05). The block group ambulated further on postop day 1 (312 ft vs 204 ft, P < .05), and had reduced length of stay (2.4 vs 3.2 days, P < .05). The block group showed better PROMIS PI scores postoperatively (58 vs 63, P < .05). The novel delivery technique was validated and successful in targeting the correct level and plane. Conclusions: ESP blocks significantly reduced postop opioid use following lumbar fusion. Block patients ambulated further with PT, had reduced length of stay, and had improved PROMIS PI postoperatively. Validation of the block demonstrated the effectiveness of a novel fluoroscopic delivery technique. ESP blocks represent an underutilized method of reducing opioid consumption, improving postoperative mobilization and reducing length of stay following lumbar spine fusion.

scholarly journals Development of a trunk motor paradigm for use in neuroimaging

2020 ◽  
Vol 11 (1) ◽  
pp. 193-200
Author(s):  
Elizabeth Saunders ◽  
Brian C. Clark ◽  
Leatha A. Clark ◽  
Dustin R. Grooms
Keyword(s):  
Motor Control ◽  
Maximum Voluntary Contraction ◽  
Voluntary Contraction ◽  
Erector Spinae ◽  
Head Motion ◽  
Low Back ◽  
Cyclic Contraction ◽  
Cyclic Contractions ◽  
Measurement Units ◽  
Healthy Participants

AbstractThe purpose of this study was to quantify head motion between isometric erector spinae (ES) contraction strategies, paradigms, and intensities in the development of a neuroimaging protocol for the study of neural activity associated with trunk motor control in individuals with low back pain. Ten healthy participants completed two contraction strategies; (1) a supine upper spine (US) press and (2) a supine lower extremity (LE) press. Each contraction strategy was performed at electromyographic (EMG) contraction intensities of 30, 40, 50, and 60% of an individually determined maximum voluntary contraction (MVC) (±10% range for each respective intensity) with real-time, EMG biofeedback. A cyclic contraction paradigm was performed at 30% of MVC with US and LE contraction strategies. Inertial measurement units (IMUs) quantified head motion to determine the viability of each paradigm for neuroimaging. US vs LE hold contractions induced no differences in head motion. Hold contractions elicited significantly less head motion relative to cyclic contractions. Contraction intensity increased head motion in a linear fashion with 30% MVC having the least head motion and 60% the highest. The LE hold contraction strategy, below 50% MVC, was found to be the most viable trunk motor control neuroimaging paradigm.

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