Impairment Evaluation Based on Spinal Range of Motion in Normal Subjects

Lowery, Wylie D.; Horn, T; Boden, Scott D.; Wiesel, Sam W.

doi:10.1097/00002517-199212000-00003

Cited by 34 publications

(12 citation statements)

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“…1,14,55,58,64 An effect of sex has already been observed in frontal and sagittal planes, 10,29,30,54 but not in axial rotation. 57,65 Coupled motions also showed a tendency, although not significant, to decrease with age in the 3 planes. It is unclear whether these coupled motions have clinical significance, particularly in the sagittal plane.…”

Section: Discussionmentioning

confidence: 75%

Cervical Range of Motion and Cephalic Kinesthesis

Demaille-Wlodyka¹,

Chiquet²,

Lavaste³

et al. 2007

Spine

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Section: Discussionmentioning

confidence: 75%

Cervical Range of Motion and Cephalic Kinesthesis

Demaille-Wlodyka¹,

Chiquet²,

Lavaste³

et al. 2007

Spine

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“…However, many asymptomatic individuals also have a small in vivo range of spinal motion in the range considered to represent spinal impairment. 50 Trunk flexibility (i.e., voluntary range of motion) is apparently not predictive of subsequent back pain. 51 …”

Section: Motion Segmentsmentioning

confidence: 99%

Mechanical Conditions That Accelerate Intervertebral Disc Degeneration: Overload Versus Immobilization

Stokes

Iatridis

2004

Spine

318

253

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Study Design. A review of the literature on macromechanical factors that accelerate disc degeneration with particular focus on distinguishing the roles of immobilization and overloading.Objective. This review examines evidence from the literature in the areas of biomechanics, epidemiology, animal models, and intervertebral disc physiology. The purpose is to examine: 1) what are the degenerationrelated alterations in structural, material, and failure properties in the disc; and 2) evidence in the literature for causal relationships between mechanical loading and alterations in those structural and material properties that constitute disc degeneration.Summary of Background Data. It is widely assumed that the mechanical environment of the intervertebral disc at least in part determines its rate of degeneration. However, there are two plausible and contrasting theories as to the mechanical conditions that promote degeneration: 1) mechanical overload; and 2) reduced motion and loading.Results. There are a greater number of studies addressing the "wear and tear" theory than the immobilization theory. Evidence is accumulating to support the notion that there is a "safe window" of tissue mechanical conditions in which the discs remain healthy.Conclusions. It is concluded that probably any abnormal loading conditions (including overload and immobilization) can produce tissue trauma and/or adaptive changes that may result in disc degeneration. Adverse mechanical conditions can be due to external forces, or may result from impaired neuromuscular control of the paraspinal and abdominal muscles. Future studies will need to evaluate additional unquantified interactions between biomechanics and factors such as genetics and behavioral responses to pain and disability.

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“…21 Furthermore, normal, asymptomatic individuals have been classified inappropriately as having an impairment simply on the basis of ROM. 11 This challenges the system used to determine disability determination for purposes of compensation because disability is defined as a diminished capacity for everyday activities and gainful employment resulting from an impairment. 20 This problem currently is pervasive.…”

mentioning

confidence: 99%

“…4 Therefore, it seems inappropriate to use a mean value, as suggested by the AMA. Second, LROM is influenced by factors such as age, gender, and time of day, 7,11,18 and the AMA guidelines do not take these factors into consideration when classifying impairment. Finally, hypermobility also may need to be considered when impairment is rated.…”

mentioning

confidence: 99%