Sixteen subjects were exposed to fatiguing (vibration) and restorative (walking) interventions to assess their response to sudden loads. Unexpected loads, which people often experience, can lead to high forces in the spine and may be a cause of low irack injury. Erector spinae responses to sudden load were mediated by exposure to vibration and walking. Reaction time was affected by fatigue. Vertical vibration exposure significantly increased the muscle response time. Walking was able to ameliorate that effect. Sudden loads can exacerbate fatigue effects. Walking after driving, reduces the risk to the back due to handling unpredictable loads.

Unexpected loads, which often occur in the working environment, can lead to high forces in the spine and, thus, may be a cause of low back injury. This paper discusses the effect of "sudden load" on the erector spine reaction and amplitude. Muscle responses were mediated by several factors, including fatigue, posture, expectation and rehabilitation, in chronic low back pain patients. The subjects were fatigued by holding a 20% maximum voluntary contraction for 1 min. A functional restoration program was tested for its efficacy in reducing reaction time and EMG amplitude in chronic low back pain patients. Reaction time was longer and EMG amplitude lower in patients than in their matched controls. EMG reaction time and magnitude decreased in patients after a 2-week rehabilitation program, including specific training of coordination and posture control. The results of the modelling showed higher spinal compressive load and lower shear forces when the load was expected than when the load was unexpected. The effect of sudden loads can be exacerbated if a worker is not standing on a flat surface or is fatigued. Chronic low back pain patients have less ability to protect themselves from sudden loads, but they can be trained to improve their response by means of an appropriate rehabilitation program.

Sudden loads can exacerbate fatigue effects. Walking after driving reduces the risk to the back caused by handling unpredictable loads. Vibration exposure guidelines should be more conservative. Patients have longer response times than healthy subjects, but patients can improve their response to sudden loads via rehabilitation. Patients exhibit a flexion-extension oscillation at 5 Hz in response to a sudden load, suggesting that the 5-Hz, seated, natural frequency observed during whole-body vibration may result from neurophysiologic control limits.

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Physical therapy involves a set of factors and methods that affect the biological processes in the body. It is widely used, relatively inexpensive, non-invasive, and easy to apply. Physiotherapy is also used in the treatment of patients with carpal tunnel syndrome (CTS). This syndrome represents the most common compressive mononeuropathy of the upper limb and leads to significant disability. Hence, its successful treatment leads to significant benefits for both the patient and society. There is no established algorithm for the use of physical therapy in these patients. In this publication, we present the physiotherapeutic methods used for the treatment of CTS both before and after surgical treatment.