Inefficient Muscular Stabilization of the Lumbar Spine Associated With Low Back Pain

Hodges, Paul W.; Richardson, Carolyn A.

doi:10.1097/00007632-199611150-00014

Cited by 1,511 publications

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“…Participants stood with feet shoulder width apart and flexed or extended their right shoulder as fast as possible in response to coloured lights [16]. Participants performed 24 repetitions of shoulder flexion and extension in random order in a rested state and following upper limb exercise involving arm crank ergometry or repetitive shoulder movement.…”

Section: Methodsmentioning

confidence: 99%

Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease

2016

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Please cite this article as: Smith MD, Chang AT, Hodges PW, Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease, Gait and Posture (2015), http://dx.doi.org/10.1016/j.gaitpost. 2015.09.004 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Abdominal muscle EMG was similar between groups, but controls had greater ES EMG during arm movements. Individuals with more severe COPD had greater OE and RA EMG both before and during arm movement compared to those with less severe COPD and controls. Following exercise, OE and ES EMG increased in people with less severe COPD.This study shows that severe COPD is associated with impaired ability to recover balance and greater trunk muscle activity during postural challenges. Augmented trunk muscle activity may limit the contribution of trunk movements to balance recovery and could contribute to increased falls risk.

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Section: Methodsmentioning

confidence: 99%

Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease

2016

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“…The rationale for the use of motor control exercises is that the deep abdominal and paraspinal muscles have a critical role in the dynamic control of the lumbar spine [17,18]. For example, delayed onset of activity of the transversus abdominis muscle (TrA) has been reported in patients with recurrent low back pain [16,17] compared to asymptomatic subjects.…”

Section: Introductionmentioning

confidence: 99%

An investigation of the reproducibility of ultrasound measures of abdominal muscle activation in patients with chronic non-specific low back pain

et al. 2009

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Ultrasound (US) measures are used by clinicians and researchers to evaluate improvements in activity of the abdominal muscles in patients with low back pain. Studies evaluating the reproducibility of these US measures provide some information; however, little is known about the reproducibility of these US measures over time in patients with low back pain. The objectives of this study were to estimate the reproducibility of ultrasound measurements of automatic activation of the lateral abdominal wall muscles using a leg force task in patients with chronic low back pain. Thirty-five participants from an existing randomised, blinded, placebo-controlled trial participated in the study. A reproducibility analysis was undertaken from all patients using data collected at baseline and after treatment. The reproducibility of measurements of thickness, muscle activation (thickness changes) and muscle improvement/deterioration after intervention (differences in thickness changes from single images made before and after treatment) was analysed. The reproducibility of static images (thickness) was excellent (ICC 2,1 = 0.97, 95% CI = 0.96-0.97, standard error of the measurement (SEM) = 0.04 cm, smallest detectable change (SDC) = 0.11 cm), the reproducibility of thickness changes was moderate (ICC 2,1 = 0.72, 95% CI 0.65-0.76, SEM = 15%, SDC 41%), while the reproducibility of differences in thickness changes from single images with statistical adjustment for duplicate measures was poor (ICC 2,1 = 0.44, 95% CI 0.33-0.58, SEM = 21%, SDC = 66.5%). Improvements in the testing protocol must be performed in order to enhance reproducibility of US as an outcome measure for abdominal muscle activation.

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“…However, changes in spinal mechanics have been reported as a common element (Panjabi, 2006). Altered spinal mechanics and LBP have been linked with atrophy (Hides et al, 2008a;Danneels et al, 2000;Hodges et al, 2006;Hodges & Richardson, 1996;Ferriera et al, 2004) and altered motor control (Hodges & Richardson, 1996) of the lumbar multifidus (LM) and transversus abdominis (TrA) muscles. Atrophy of LM and TrA has also been associated with loss of lordosis, development of back pain and spinal injury, and following periods of low activity and disuse of spinal muscles (Buckey, 2006;Hides et al, 2011;Sayson & Hargens, 2008).…”

Section: Introductionmentioning

confidence: 99%

The immediate effects of exercise using the Functional Re-adaptive Exercise Device on lumbopelvic kinematics in people with and without low back pain

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Wilkinson

et al. 2017

Musculoskeletal Science and Practice

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BackgroundDysfunction of the lumbar multifidus (LM) and transversus abdominis (TrA) muscles is associated with low back pain (LBP). The Functional Re-adaptive Exercise Device (FRED) has shown potential as a non-specific LBP intervention by automatically recruiting LM and TrA. Loss or lordosis and altered lumbopelvic positioning has also been linked to LBP and is often trained within LM and TrA interventions. The effect that FRED exercise has on lumbopelvic positioning and lumbar lordosis is unknown. ObjectivesTo assess the effect of FRED exercise on lumbopelvic kinematics and alignment to establish whether FRED exercise promotes a favourable lumbopelvic posture for training LM and TrA. DesignWithin and between-group comparison study MethodOne hundred and thirty participants, 74 experiencing LBP, had lumbopelvic kinematic data measured during over-ground walking and FRED exercise.Magnitude-based inferences were used to compare walking with FRED exercise within participants and between the asymptomatic and LBP groups, to establish the effects of FRED exercise on lumbopelvic kinematics, compared to walking, in each group. ResultsFRED exercise promotes an immediate change in anterior pelvic tilt by 8.7 degrees compared to walking in the no-LBP and LBP groups. Sagittal-plane spinal extension increased during FRED exercise at all spinal levels by 0.9 degrees in the no-LBP group, and by 1.2 degrees in the LBP group. ConclusionsFRED exercise promotes a lumbopelvic position more conducive to LM and TrA training than walking in both asymptomatic people and those with LBP. Highlights A posture conducive to LM and TrA training was promoted. The posture appears to occur automatically in people with and without LBP. Exercise on the FRED may be effective for LM and TrA training.

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Inefficient Muscular Stabilization of the Lumbar Spine Associated With Low Back Pain

Abstract: The delayed onset of contraction of transversus abdominis indicates a deficit of motor control and is hypothesized to result in inefficient muscular stabilization of the spine.

Cited by 1,511 publications

References 46 publications

Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease

Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease

An investigation of the reproducibility of ultrasound measures of abdominal muscle activation in patients with chronic non-specific low back pain

The immediate effects of exercise using the Functional Re-adaptive Exercise Device on lumbopelvic kinematics in people with and without low back pain

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