Effects of Gender and Recurrent Low Back Pain on Lifting Style

Abstract

Abstract. Objective: The purpose of this study was to examine the influence of gender and existing, recurrent low back pain (rLBP) on lower extremity and trunk mechanics, as well as neuromuscular control, during a lift task. Design: A multivariate design was used to examine the effects of gender and group on biomechanical and neuromuscular control variables in randomized symmetric and asymmetric lifting. Methods: 68 Males and females with rLBP and healthy performed symmetric and asymmetric weighted box lifting trials to a 1 meter height table. Results: Lifting style was different between gender and between the rLBP versus healthy groups during a 1m box lifting. A significant two-way interaction effect between gender and group was observed for multifidus muscle activity and knee rotation in asymmetric lifting. Several gender and group main effects were observed in pelvis obliquity, trunk flexion and side flexion, knee abduction angles in symmetric lifting; and in pelvis obliquity and rotation, trunk flexion and side flexion, hip abduction, knee abduction angles, external oblique and internal oblique muscles activity in asymmetric lifting. Conclusions: Females and individuals with rLBP appear to use different lifting styles that emphasize movement at the pelvis accompanied by poor kinematic control features at the hip, trunk and knee. Clinicians should be mindful of these changes when developing prevention and rehabilitation programs aimed at improving trunk control in preparation for lifting tasks during domestic and occupational activities.

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

“…Recurrent LBP patients have diminished trunk 49 and lower extremity strength, flexibility, and range of motion, 22 , 39 , 50 as well as altered neuromuscular control. 22 , 39 , 51 These patients presented with reduced activity in the EO and GM and increased activity in Mf in both initial and final position of lifting in comparison to healthy control. Laird et al 49 reviewed 43 studies on the lumbopelvic kinematics in LBP patients and found that these patients have reduced lumbar range of motion, move more slowly, and have reduced proprioception compared with people without LBP.…”

“…Lifting technique was based on the discretion of the individual and the subject’s box weight was determined by their maximum psychophysically acceptable weight ( Table 1 ). 21 , 22 Participants performed 3 weighted box (0.65 m long, 0.35 m wide, and 0.15 m high) lifting trials with VPAC and 3 trials without VPAC to a 1 m high table in right side directions ( Figures 1 and 2 ). The VPAC condition was presented in random order.…”

“…31 All too often, vocational lifting is asymmetric, 15,32 which is associated with decreased trunk strength, a reduction in the maximum acceptable weight of the lift, and more complex trunk motion. 15,22,32 Normal lumbar spinal segments in individuals without LBP appear to be tolerant of a 700-and1000-N shear force during repetitive versus occasional shear exposures, respectively. 14 However, repeated lifting in a slouched posture increases those shear forces during manually demanding activities, especially when the patient has a history of LBP.…”

“… 21 Often, patients are required to manage materials while performing lifting tasks in restricted areas in various body positions. 21 - 24 Such common lifting scenarios are encountered repeatedly in healthcare, 25 , 26 farm animal management, 27 physically heavy and monotonous work, 28 and performing arts. 29 A typically slouched posture during lifting sequences is often accentuated when returning to an upright position with the load, 30 which increases the compressive forces between the lumbar vertebrae.…”

A Novel Method for Calculation of Knee Deformation Angles in Clinical and Sport Biomechanics

“…(Di Stasi, Myer, Hewett, 2013;Griffin, Agel, Albohm, 2000) Additional evidence suggests that when the knee is flexed less than 40° represents the most unprotected range for ACL tears as consistently reported in cadaveric (Kanamori, Woo, Ma, 2000;Markolf, O'Neil, Jackson, 2004), in vivo (Heijne, Fleming, Renstrom, 2004;Pedowitz, O'Connor, Akeson, 2003) and computer simulation (Pandy, Shelburne, 1997;Pflum, Shelburne, & Torry, 2004) studies of ACL strain or force. Biomechanical analyses seek to improve understanding of the mechanisms of knee injury and to find ways to reduce knee injury incidence (Di Stasi et al, 2013;Haddas, James, Hooper, 2015;Haddas, Yang, Sizer, 2015;Jung et al, 2013;Liu-Barba, Hull, Howell, 2007;Patzkowski et al, 2012). These biomechanical studies usually include analysis of knee joint deformation, where joint architecture immutably constrains and guides movement outcomes (Liu-Barba et al, 2007;Wilson, Feikes, Zavatsky, O'Connor, 2000).…”