Changes in the mechanical properties of the trunk in low back pain may be associated with recurrence

Hodges, Paul, van den Hoorn, Wolbert, Dawson, Anna and Cholewicki, Jacek (2009) Changes in the mechanical properties of the trunk in low back pain may be associated with recurrence. Journal of Biomechanics, 42 1: 61-66. doi:10.1016/j.jbiomech.2008.10.001

Author Hodges, Paul
van den Hoorn, Wolbert
Dawson, Anna
Cholewicki, Jacek
Title Changes in the mechanical properties of the trunk in low back pain may be associated with recurrence
Journal name Journal of Biomechanics   Check publisher's open access policy
ISSN 0021-9290
Publication date 2009-01-05
Year available 2008
Sub-type Article (original research)
DOI 10.1016/j.jbiomech.2008.10.001
Volume 42
Issue 1
Start page 61
End page 66
Total pages 6
Place of publication United Kingdom
Publisher Pergamon Press
Collection year 2009
Language eng
Subject C1
920201 Allied Health Therapies (excl. Mental Health Services)
110317 Physiotherapy
110601 Biomechanics
1106 Human Movement and Sports Science
110321 Rehabilitation and Therapy (excl. Physiotherapy)
Abstract Exercise is one of the few effective treatments for LBP. Although exercise is often based on the premise of reduced spinal stiffness, trunk muscle adaptation may increase stiffness. This study developed and validated a method to assess trunk stiffness and damping, and tested these parameters in 14 people with recurring LBP and 17 pain-free individuals. Effective trunk stiffness, mass and damping were estimated with the trunk modeled as a linear second-order system following trunk perturbation. Equal weights (12–15% body weight) were attached to the front and back of the trunk via pulleys such that the trunk could move freely and no muscle activity was required to hold the weights. The trunk was perturbed by the unexpected release of one of the weights. Trunk kinematics and cable force were used to estimate system properties. Reliability was assessed in 10 subjects. Trunk stiffness was greater in recurrent LBP patients (forward perturbation only), but damping was lower (both directions) than healthy controls. Estimates were reliable and validated by accurately estimated mass. Contrary to clinical belief, trunk stiffness was increased, not reduced, in recurrent LBP, most likely due to augmented trunk muscle activity and changes in reflex control of trunk muscles. Although increased stiffness may aid in the protection of spinal structures, this may have long-term consequences for spinal health and LBP recurrence due to compromised trunk dynamics (decreased damping).
Keyword Spine stability
Recurrent low back pain
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Health and Rehabilitation Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 81 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 10 Mar 2009, 13:29:42 EST