Effects of Volitional Spine Stabilization and Lower Extremity Fatigue on Trunk Control During Landing in Individuals With Recurrent Low Back Pain

2016 ◽  
Vol 46 (2) ◽  
pp. 71-78 ◽  
Author(s):  
Ram Haddas ◽  
Steven F. Sawyer ◽  
Phillip S. Sizer ◽  
Toby Brooks ◽  
Ming-Chien Chyu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lower Extremity ◽  
Low Back ◽  
Trunk Control ◽  
Spine Stabilization ◽  
Recurrent Low Back Pain

scholarly journals Individuals with recurrent low back pain exhibit further altered trunk control in remission than when in pain

2020 ◽  
Author(s):  
Hai-Jung Steffi Shih ◽  
Linda Van Dillen ◽  
Jason Kutch ◽  
Kornelia Kulig
Keyword(s):  
Young Adults ◽  
Low Back Pain ◽  
Back Pain ◽  
Control Strategy ◽  
Frontal Plane ◽  
Low Back ◽  
Trunk Control ◽  
Co Activation ◽  
Symptom Remission ◽  
Recurrent Low Back Pain

AbstractBackgroundMovement alterations due to low back pain (LBP) could lead to long-term adverse consequences if they do not resolve after symptom subsides. This study aims to determine if altered trunk control associated with recurrent low back pain persists beyond symptom duration.MethodsTwenty young adults with recurrent low back pain were tested once during an LBP episode and once in symptom remission, and twenty matched back-healthy participants served as controls. Participants walked on a treadmill with five prescribed step widths. Motion capture and surface electromyography were used to record frontal plane trunk kinematics and muscle activation. Thorax-pelvis coordination was calculated using vector coding technique, and bilateral longissimus activation and co-activation were analyzed.FindingsYoung adults with recurrent LBP exhibited a “looser” trunk control strategy in the frontal plane during gait that was persistent regardless of pain status across multiple step widths compared to back-healthy controls. This was demonstrated by a greater pelvis-only, less thorax-only coordination pattern, and decreased bilateral longissimus co-activation in individuals with recurrent LBP than controls. The looser trunk control strategy was further amplified when individuals with recurrent LBP were in symptom remission and exhibited greater trunk excursion and reduced in-phase coordination.InterpretationThe amplification of aberrant movement during symptom remission may suggest that movement patterns or anatomical factors existing prior to the tested painful episode underlie the altered trunk control in individuals with recurrent LBP. The symptom remission period of recurrent LBP patients may be a critical window into clinical evaluation and treatment.

scholarly journals Effects of Volitional Spine Stabilization on Trunk Control During Asymmetric Lifting Task in Patients With Recurrent Low Back Pain

2019 ◽  
Vol 10 (8) ◽  
pp. 1006-1014 ◽  
Author(s):  
Ram Haddas ◽  
Yigal Samocha ◽  
James Yang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Muscle Activity ◽  
Healthy Controls ◽  
Low Back ◽  
Care Providers ◽  
Trunk Control ◽  
Hip Abduction ◽  
Asymmetric Lifting ◽  
Recurrent Low Back Pain

Study Design: Prospective, concurrent-cohort study. Objectives: To determine the effects of volitional preemptive abdominal contraction (VPAC) on trunk control during an asymmetric lift in patients with recurrent low back pain (rLBP) and compare with matched controls. Methods: Thirty-two rLBP patients and 37 healthy controls performed asymmetric lifting with and without VPAC. Trunk, pelvis, and hip biomechanical along with neuromuscular activity parameters were obtained using 3-dimensional motion capture and electromyography system. Hypotheses were tested using analysis of variance. Results: The VPAC resulted in significantly reduced muscle activity across all trunk extensor muscles in both groups (M ± SD, 6.4% ± 8.2% of maximum contraction; P ≤ .005), and reduced trunk side flexion (1.4° ± 5.1° smaller; P ≤ .005) and hip abduction (8.1° ± 21.1° smaller; P ≤ .003). rLBP patients exhibited reduced muscle activity in external oblique (12.3% ± 5.5% of maximum contraction; P ≤ .012), as well as decreased hip flexion (4.7°, P ≤ .008) and hip abduction (5.2°, P ≤ .001) at the final position of lifting in comparison with healthy controls. Conclusions: The results of this study defend the recommendation that the use of a VPAC increase spine stability during an asymmetrical loading task. Our results provide an indication that a VPAC strategy that is achieved during an asymmetric lifting decreases exposure for lumbar spine injury and instability. Spine care providers and ergonomists can use this information when designing neuromuscular control training programs, both for healthy individuals aimed at prevention of injury, as well as those with a history of rLBP, aimed at full functional recovery and protection from future injury.

scholarly journals Jogging Kinematics After Lumbar Paraspinal Muscle Fatigue

2009 ◽  
Vol 44 (5) ◽  
pp. 475-481 ◽  
Author(s):  
Joseph M. Hart ◽  
D. Casey Kerrigan ◽  
Julie M. Fritz ◽  
Christopher D. Ingersoll
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Lower Extremity ◽  
Healthy Controls ◽  
Low Back ◽  
Trunk Flexion ◽  
History Of ◽  
Lumbar Extension ◽  
Recurrent Low Back Pain

Abstract Context: Isolated lumbar paraspinal muscle fatigue causes lower extremity and postural control deficits. Objective: To describe the change in body position during gait after fatiguing lumbar extension exercises in persons with recurrent episodes of low back pain compared with healthy controls. Design: Case-control study. Setting: Motion analysis laboratory. Patients or Other Participants: Twenty-five recreationally active participants with a history of recurrent episodes of low back pain, matched by sex, height, and mass with 25 healthy controls. Intervention(s): We measured 3-dimensional lower extremity and trunk kinematics before and after fatiguing isometric lumbar paraspinal exercise. Main Outcome Measure(s): Measurements were taken while participants jogged on a custom-built treadmill surrounded by a 10-camera motion analysis system. Results: Group-by-time interactions were observed for lumbar lordosis and trunk angles (P < .05). A reduced lumbar spine extension angle was noted, reflecting a loss of lordosis and an increase in trunk flexion angle, indicating increased forward trunk lean, in healthy controls after fatiguing lumbar extension exercise. In contrast, persons with a history of recurrent low back pain exhibited a slight increase in spine extension, indicating a slightly more lordotic position of the lumbar spine, and a decrease in trunk flexion angles after fatiguing exercise. Regardless of group, participants experienced, on average, greater peak hip extension after lumbar paraspinal fatigue. Conclusions: Small differences in response may represent a necessary adaptation used by persons with recurrent low back pain to preserve gait function by stabilizing the spine and preventing inappropriate trunk and lumbar spine positioning.

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