Muscular and Kinematic Behavior of the Lumbar Spine During Flexion-Extension

Kaigle, Allison M.; Wessberg, Per; Hansson, Tommy

doi:10.1097/00002517-199804000-00013

Cited by 93 publications

(54 citation statements)

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“…This result agrees with the previous literature [17], which found 4 mm of anterior-posterior translation on average when considering L2-L5. The present study found 3.27 mm of anterior-posterior translation on average considering L3-S1.…”

Section: Discussionsupporting

confidence: 93%

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Quantification of continuous in vivo flexion–extension kinematics and intervertebral strains

Nagel¹,

Zitnay²,

Barocas³

et al. 2014

Eur Spine J

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Purpose Healthy subjects performed lumbar flexion and were assessed by video fluoroscopy to measure the in vivo kinematics of the lower lumbar motion segments. Methods Fifteen healthy subjects (8 male, 7 female, 28 ± 10 years) performed lumbar flexion and extension back to neutral while their vertebrae were imaged. The sagittal plane vertebral margins of L3-S1 were identified. Lumbar angle, segmental margin strains, axial displacements, anterior-posterior (A-P) translations, and segmental rotations over the course of flexion were measured. Results L4-L5 had the largest posterior margin Green strain (65 %). Each segment displayed more axial displacement than A-P translation. Peak vertebral angulation occurred at approximately 75 % of peak flexion during the extension phase. Conclusion L4-L5 exhibited the largest anterior and posterior margin strains (29 and 65 %, respectively). Strains in the disc during in vivo lumbar flexion are due to both angular rotation and linear translation.

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Section: Discussionsupporting

confidence: 93%

“…Cadaveric and in vivo experiments typically report segmental rotation [14][15][16][17][18][19][20][21][22], with a few also reporting intervertebral strains [23][24][25]. Takayanagi et al [21] took fluoroscopic video of healthy males performing flexion.…”

Section: Introductionmentioning

confidence: 99%

Quantification of continuous in vivo flexion–extension kinematics and intervertebral strains

Nagel¹,

Zitnay²,

Barocas³

et al. 2014

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…Also, certain psychological states like fear can lead to increased fusimotor drive, a phenomenon described as ''fusimotor set.'' 37 In chronic LBP, the presence of increased paraspinal electromyographic activity in full forward flexion (loss of the flexionrelaxation phenomenon 21,49 ) or even during the swing phase of walking, 3 might be related to these excitatory mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Thoracolumbar Proprioception in Individuals with and without Low Back Pain: Intratester Reliability, Clinical Applicability, and Validity

Koumantakis¹,

Winstanley²,

Oldham³

2002

J Orthop Sports Phys Ther

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Study Design: Repeated measures design of active spinal position sense in individuals with and without low back pain (LBP). Objectives: Reproducibility and validity evaluation of thoracolumbar proprioception measurement. Background: Proprioception studies in peripheral joints and the spine suggest that there may be proprioception deficits due to injury, pain, or degeneration. Kinesthetic retraining may be useful in rehabilitation of patients with LBP, but appropriate measures are required to objectively quantify spinal proprioception. Methods and Measures: Active-target reproduction in the sagittal, horizontal, and coronal planes was assessed (3 separate occasions for 18 asymptomatic volunteers and 2 occasions for 62 patients with LBP). Repositioning accuracy was expressed as absolute errors (AE) and variable errors (VE). Reliability was analyzed with intraclass correlation coefficient (ICC) and precision with standard error of measurement (SEM) and calculation of the smallest detectable difference (SDD) index. Repeated measures ANOVA and correlations were used for within-group comparisons and discriminant analysis for between-group comparisons. Results: Reproducibility was better for the asymptomatic group, with AE for flexion and rotation being the most reliable (ICC = 0.76-0.80, SEM = 0.91°-1.34°). SDDs were high for all tests, suggesting limited clinical applicability. Reproducibility for the same tests was poor-moderate (ICC = 0.31-0.64, SEM = 0.45°-3.90°) for the patient group. AE for right-side rotation could discriminate between subject groups with 83.3% specificity but only 54.8% sensitivity. Conclusions: Proprioception testing, with the methods employed, did not demonstrate good measurement properties in a sample of patients with recurrent LBP. Neither could it sufficiently discriminate between individuals with and without LBP. Possible reasons for these findings are discussed.

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“…The literature describes different methods on how to measure the lumbar range of motion (ROM). Techniques reach from an easy-to-do fingertip-to-floor distance (FTFD) test to various inclinometer methods and highly invasive measurements with pedicle screws [23,25,26]. The more practical, non-invasive and low cost tests, such as the modified Schober, are widely used in medical examinations and have received a large amount of scientific attention.…”

Section: Introductionmentioning

confidence: 99%

Do MRI findings correlate with mobility tests? An explorative analysis of the test validity with regard to structure

Quack

Schenk²,

Laeubli³

et al. 2006

Eur Spine J

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To find out whether segmental magnetic resonance imaging (MRI) findings such as intervertebral disc degeneration (DD) and facet joint osteoarthritis (FJO) are associated with motion deficiencies as seen in common mobility tests and observed range of motion (ROM). A total of 112 female subjects, nurses and office workers, with and without low back pain, were examined by clinical experts, and lumbar mobility was measured including modified Schober, fingertip-to-floor distance (FTFD) and ZEBRIS motion analysis. An MRI of the lumbar spine was made. Mobility findings were correlated with segmental morphologic changes as seen on MRI at the levels of L1-2 through L5-S1. Only a few statistically significant correlations between MRI findings and the results of the mobility tests could be found. Lateral bending was weakly and negatively correlated to DD and FJO but only on the level of L5-S1. The FTFD showed a weak positive correlation to endplate changes on the level of L4-5. When ROM is observed by clinical experts, there are several significant relationships between MRI findings and the observed motion. There is a highly significant segmental correlation between DD and disc form alteration as seen on MRI on the level of single motion segments. Pain history and current pain level did not moderate any association between MRI and mobility. There is no clear relationship between the structural changes represented by MRI and the measured mobility tests used in this study. Our findings suggest that close observation of spinal motion may provide at least equal information about the influence of spinal structures on motion than the commonly used measured mobility tests do.

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Muscular and Kinematic Behavior of the Lumbar Spine During Flexion-Extension

Cited by 93 publications

References 0 publications

Quantification of continuous in vivo flexion–extension kinematics and intervertebral strains

Quantification of continuous in vivo flexion–extension kinematics and intervertebral strains

Thoracolumbar Proprioception in Individuals with and without Low Back Pain: Intratester Reliability, Clinical Applicability, and Validity

Do MRI findings correlate with mobility tests? An explorative analysis of the test validity with regard to structure

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