Lumbar Intervertebral Motion in Healthy Male Participants: Protocol for a Motion Analysis During Flexion and Extension Cinematographic Recordings

Caelers, Inge; Boselie, Toon; Rijkers, Kim; Hemert, Wouter L.W. van; Bie, Robert de; Santbrink, Henk van

doi:10.2196/14741

Cited by 3 publications

(2 citation statements)

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“…The study protocol was published [ 19 ]. After approval, this study included men, aged between 18 and 25 years, with a BMI <25 kg/m 2 , with no medical history of spine problems, and able to perform maximum lumbar flexion and extension without complaints.…”

Section: Methodsmentioning

confidence: 99%

The Variability of Lumbar Sequential Motion Patterns: Observational Study

Caelers¹,

Boselie²,

Hemert³

et al. 2023

JMIR Biomed Eng

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Background Physiological motion of the lumbar spine is a topic of interest for musculoskeletal health care professionals since abnormal motion is believed to be related to lumbar complaints. Many researchers have described ranges of motion for the lumbar spine, but only few have mentioned specific motion patterns of each individual segment during flexion and extension, mostly comprising the sequence of segmental initiation in sagittal rotation. However, an adequate definition of physiological motion is still lacking. For the lower cervical spine, a consistent pattern of segmental contributions in a flexion-extension movement in young healthy individuals was described, resulting in a definition of physiological motion of the cervical spine. Objective This study aimed to define the lumbar spines’ physiological motion pattern by determining the sequence of segmental contribution in sagittal rotation of each vertebra during maximum flexion and extension in healthy male participants. Methods Cinematographic recordings were performed twice in 11 healthy male participants, aged 18-25 years, without a history of spine problems, with a 2-week interval (time point T1 and T2). Image recognition software was used to identify specific patterns in the sequence of segmental contributions per individual by plotting segmental rotation of each individual segment against the cumulative rotation of segments L1 to S1. Intraindividual variability was determined by testing T1 against T2. Intraclass correlation coefficients were tested by reevaluation of 30 intervertebral sequences by a second researcher. Results No consistent pattern was found when studying the graphs of the cinematographic recordings during flexion. A much more consistent pattern was found during extension, especially in the last phase. It consisted of a peak in rotation in L3L4, followed by a peak in L2L3, and finally, in L1L2. This pattern was present in 71% (15/21) of all recordings; 64% (7/11) of the participants had a consistent pattern at both time points. Sequence of segmental contribution was less consistent in the lumbar spine than the cervical spine, possibly caused by differences in facet orientation, intervertebral discs, overprojection of the pelvis, and muscle recruitment. Conclusions In 64% (7/11) of the recordings, a consistent motion pattern was found in the upper lumbar spine during the last phase of extension in asymptomatic young male participants. Physiological motion of the lumbar spine is a broad concept, influenced by multiple factors, which cannot be captured in a firm definition yet. Trial Registration ClinicalTrials.gov NCT03737227; https://clinicaltrials.gov/ct2/show/NCT03737227 International Registered Report Identifier (IRRID) RR2-10.2196/14741

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Section: Methodsmentioning

confidence: 99%

The Variability of Lumbar Sequential Motion Patterns: Observational Study

Caelers¹,

Boselie²,

Hemert³

et al. 2023

JMIR Biomed Eng

Self Cite

View full text Add to dashboard Cite

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“… 32 The ‘three-joint complex’ is crucial for enabling spinal motions, including rotation, flexion and extension. 33 …”

Section: Introductionmentioning

confidence: 99%

Low back pain and osteoarthritis pain: a perspective of estrogen

et al. 2023

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Low back pain (LBP) is the world’s leading cause of disability and is increasing in prevalence more rapidly than any other pain condition. Intervertebral disc (IVD) degeneration and facet joint osteoarthritis (FJOA) are two common causes of LBP, and both occur more frequently in elderly women than in other populations. Moreover, osteoarthritis (OA) and OA pain, regardless of the joint, are experienced by up to twice as many women as men, and this difference is amplified during menopause. Changes in estrogen may be an important contributor to these pain states. Receptors for estrogen have been found within IVD tissue and nearby joints, highlighting the potential roles of estrogen within and surrounding the IVDs and joints. In addition, estrogen supplementation has been shown to be effective at ameliorating IVD degeneration and OA progression, indicating its potential use as a therapeutic agent for people with LBP and OA pain. This review comprehensively examines the relationship between estrogen and these pain conditions by summarizing recent preclinical and clinical findings. The potential molecular mechanisms by which estrogen may relieve LBP associated with IVD degeneration and FJOA and OA pain are discussed.

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The Variability of Lumbar Sequential Motion Patterns: Observational Study (Preprint)

Caelers¹,

Boselie²,

Hemert³

et al. 2022

Preprint

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BACKGROUND Physiological motion of the lumbar spine is a topic of interest for musculoskeletal health care professionals since abnormal motion is believed to be related to lumbar complaints. Many researchers have described ranges of motion for the lumbar spine, but only few have mentioned specific motion patterns of each individual segment during flexion and extension, mostly comprising the sequence of segmental initiation in sagittal rotation. However, an adequate definition of physiological motion is still lacking. For the lower cervical spine, a consistent pattern of segmental contributions in a flexion-extension movement in young healthy individuals was described, resulting in a definition of physiological motion of the cervical spine. OBJECTIVE This study aimed to define the lumbar spines’ physiological motion pattern by determining the sequence of segmental contribution in sagittal rotation of each vertebra during maximum flexion and extension in healthy male participants. METHODS Cinematographic recordings were performed twice in 11 healthy male participants, aged 18-25 years, without a history of spine problems, with a 2-week interval (time point T1 and T2). Image recognition software was used to identify specific patterns in the sequence of segmental contributions per individual by plotting segmental rotation of each individual segment against the cumulative rotation of segments L1 to S1. Intraindividual variability was determined by testing T1 against T2. Intraclass correlation coefficients were tested by reevaluation of 30 intervertebral sequences by a second researcher. RESULTS No consistent pattern was found when studying the graphs of the cinematographic recordings during flexion. A much more consistent pattern was found during extension, especially in the last phase. It consisted of a peak in rotation in L3L4, followed by a peak in L2L3, and finally, in L1L2. This pattern was present in 71% (15/21) of all recordings; 64% (7/11) of the participants had a consistent pattern at both time points. Sequence of segmental contribution was less consistent in the lumbar spine than the cervical spine, possibly caused by differences in facet orientation, intervertebral discs, overprojection of the pelvis, and muscle recruitment. CONCLUSIONS In 64% (7/11) of the recordings, a consistent motion pattern was found in the upper lumbar spine during the last phase of extension in asymptomatic young male participants. Physiological motion of the lumbar spine is a broad concept, influenced by multiple factors, which cannot be captured in a firm definition yet. CLINICALTRIAL ClinicalTrials.gov NCT03737227; https://clinicaltrials.gov/ct2/show/NCT03737227 INTERNATIONAL REGISTERED REPORT RR2-10.2196/14741

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Lumbar Intervertebral Motion in Healthy Male Participants: Protocol for a Motion Analysis During Flexion and Extension Cinematographic Recordings

Cited by 3 publications

References 24 publications

The Variability of Lumbar Sequential Motion Patterns: Observational Study

The Variability of Lumbar Sequential Motion Patterns: Observational Study

Low back pain and osteoarthritis pain: a perspective of estrogen

The Variability of Lumbar Sequential Motion Patterns: Observational Study (Preprint)

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