Spine Loading Characteristics of Patients With Low Back Pain Compared With Asymptomatic Individuals

Marras, William S.; Davis, Kermit G.; Ferguson, Sue A.; Lucas, Benjamin R.; Gupta, Purnendu

doi:10.1097/00007632-200112010-00009

Cited by 190 publications

(114 citation statements)

References 59 publications

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“…[27][28][29][30][31] Patients with low back pain also demonstrated alterations in muscular activation patterns [32][33][34] that can result in increased axial compression and shear loading on the spine. 35 It is difficult to identify the causes of these reported functional alterations, because they may also be a consequence of pain.…”

Section: In Vivo Motion and Loading Changes In Persons With Low Back mentioning

confidence: 99%

Mechanical Conditions That Accelerate Intervertebral Disc Degeneration: Overload Versus Immobilization

Stokes

Iatridis

2004

Spine

317

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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Section: In Vivo Motion and Loading Changes In Persons With Low Back mentioning

confidence: 99%

Mechanical Conditions That Accelerate Intervertebral Disc Degeneration: Overload Versus Immobilization

Stokes

Iatridis

2004

Spine

317

253

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“…Three general aspects of altered muscle recruitment patterns in people with back pain have been investigated: (1) altered muscle activation patterns, especially coactivation, in a static task such as pulling against a fixed object or slow lifting [1,3,19,20,28], (2) altered muscle reflex latency times in response to a sudden perturbation [26] or dropped weight [18,32], quick release of trunk loading [27], or moving support platform [10], (3) altered muscle activation pattern in anticipation of an unexpected or voluntary perturbation [14,25].…”

Section: Introductionmentioning

confidence: 99%

Trunk muscular activation patterns and responses to transient force perturbation in persons with self-reported low back pain

2005

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Trunk stability requires muscle stiffness associated with appropriate timing and magnitude of activation of muscles. Abnormality of muscle function has been implicated as possible cause or consequence of back pain. This experimental study compared trunk muscle activation and responses to transient force perturbations in persons with and without self-reported history of low back pain. The objective was to determine whether or not history of back pain was associated with (1) altered anticipatory preactivation of trunk muscles or altered likelihood of muscular response to a transient force perturbation and (2) altered muscle activation patterns during a ramped effort. Twenty-one subjects who reported having back pain (LBP group) and twenty-three reporting no recent back pain (NLBP group) were tested while each subject stood in an apparatus with the pelvis immobilized. They performed 'ramped-effort' tests (to a voluntary maximum effort), and force perturbation tests. Resistance was provided by a horizontal cable from the thorax to one of five anchorage points on a wall track to the subject's right at angles of 0°, 45°, 90°, 135°and 180°to the forward direction. In the perturbation tests, subjects first pulled against the cable to generate an effort nominally 15% or 30% of their maximum extension effort. The effort and the EMG activity of five right/left pairs of trunk muscles were recorded, and muscle responses were detected. In the ramped-effort tests the gradient of the EMG-effort relationship provided a measure of each muscle's activation. On average, the LBP group subjects activated their dorsal muscles more than the NLBP group subjects in a maximum effort task when the EMG values were normalized for the maximum EMG, but this finding may have resulted from lesser maximum effort generated by LBP subjects. Greater muscle preactivation was recorded in the LBP group than the NLBP group just prior to the perturbation. The likelihood of muscle responses to perturbations was not significantly different between the two groups. The findings were consistent with the hypothesis that LBP subjects employed muscle activation in a quasistatic task and preactivation prior to a perturbation in an attempt to stiffen and stabilize the trunk. However, interpretation of the findings was complicated by the fact that LBP subjects generated lesser efforts, and it was not known whether this resulted from anatomical differences (e.g., muscle atrophy) or reduced motivation (e.g., pain avoidance).

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“…One of the reasons for this may be due to greater lumbar lordosis in girls, allowing for higher mechanical advantage of the spinal erector muscles, as suggested by Tviet et al (1994) and McIntosh et al (1993). The different geometry of the female torso from the male torso (Marras et al, 2001), as well as a presence of a greater number of type I fibers in lumbar region (Mannion et al, 1997) could potentially influence spine loading. Some limitations have to be considered for interpreting the data of this study.…”

Section: Figurementioning

confidence: 99%

Do Anthropometric Measures Influence Torso Muscle Endurance Profiles of Children Aged 7 to 14?

Dejanovic¹,

Harvey²,

Andersen³

et al. 2012

APE

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The aim of this study was to investigate whether torso endurance scores were linked with anthropometric variables in children and to develop a normative scale of anthropometric measures in children in both genders for clinical assessment, rehabilitation, physical education targets and young athletic training purposes. It was hypothesized that changes in anthropometric measures through ages 7 to 14 influence endurance scores in both subsets. It was also hypothesized that boys and girls differ in the relationships between torso muscle endurance and anthropometric measures. Reduced torso muscle endurance has been identified as a potential personal risk factor for developing low back pain and decreased athletic performance. However, torso muscle endurance data in children is lacking. Further, given that endurance tests require postures where the body is supported horizontally, it makes sense that anthropometric variables would influence endurance. Isometric torso muscle endurance scores established through four tests were performed in random order by healthy children. These were correlated with anthropometric dimensions. Seven hundred and fifty-three children from one elementary school (394 boys and 359 girls) were grouped into 8 age strata (7 to 14). Each age stratum had different number of participants for boys and girls. Four tests established isometric torso muscle endurance: Biering-Sorensen test for extensor endurance, flexor endurance test and right and left side bridge tests. The mean, standard deviation of the endurance tests and anthropometric measures were determined for each gender/age strata. The Pearson product-moment correlation coefficients were determined between the anthropometric dimensions and isometric torso endurance scores for each gender/age strata. Variance in endurance scores were not well explained by anthropometric measures. Variables other than segment length and circumference influence torso endurance as children grow and develop. Given links to future back pain and athletic performance, more investigation would be justified.

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Spine Loading Characteristics of Patients With Low Back Pain Compared With Asymptomatic Individuals

Cited by 190 publications

References 59 publications

Mechanical Conditions That Accelerate Intervertebral Disc Degeneration: Overload Versus Immobilization

Mechanical Conditions That Accelerate Intervertebral Disc Degeneration: Overload Versus Immobilization

Trunk muscular activation patterns and responses to transient force perturbation in persons with self-reported low back pain

Do Anthropometric Measures Influence Torso Muscle Endurance Profiles of Children Aged 7 to 14?

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