Force-deformation response of the lumbar spine: a sagittal plane model of posteroanterior manipulation and mobilization

Keller, Tony S.; Colloca, Christopher J.; Béliveau, Jean Guy

doi:10.1016/s0268-0033(02)00003-7

Cited by 53 publications

(61 citation statements)

References 17 publications

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“…PA mobilisation forces at L3 with a magnitude of 100 N, as used in this study, has been found to cause segmental movement of the lumbar spine and generalised extension of the spine as far as T7 (Keller et al, 2002;Evans, 1992, 1997;Lee and Svensson, 1993;Powers et al, 2003). It has been proposed that end-range lumbar PA mobilisation may reduce paraspinal muscle activity (Zusman, 1986), however the position of 'end range' is ambiguous.…”

Section: Discussionmentioning

confidence: 73%

“…Mobilisation: In prone lie, the researcher stood on a force platform (Kistler, Winterthure) and applied a central posteroanterior mobilisation using the pisiform grip (Maitland et al, 2005) with an oscillating force from 60 N to 100 N force, a frequency of 1.2 Hz for 2 min. The sampling frequency for the force platform was set at 10 Hz, with a measuring range from 0 to 180 N. The application of 100 N force has been shown to produce spinal movement (Keller et al, 2002;Lee and Svensson, 1993;Lee and Evans, 1992). The forces applied by the therapist is estimated from the difference between the vertical ground-reaction force and the researcher's body mass, providing an indirect measure of maximum applied force, minimum applied force and frequency of oscillation.…”

Section: Experimental Conditionsmentioning

confidence: 99%

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Comparison of surface electromyographic activity of erector spinae before and after the application of central posteroanterior mobilisation on the lumbar spine

Krekoukias¹,

Petty²,

Cheek³

2009

Journal of Electromyography and Kinesiology

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Lumbar spine accessory movements, used by therapists in the treatment of patients with low back pain, is thought to decrease paravertebral muscular activity; however there is little research to support this suggestion. This study investigated the effects of lumbar spine accessory movements on surface electromyography (sEMG) activity of erector spinae.A condition randomised, placebo controlled, repeated measures design was used. sEMG measurements were recorded from 36 asymptomatic subjects following a control, placebo and central posteroanterior (PA) mobilisation to L3 each for 2 min. The therapist stood on a force platform while applying the PA mobilisation to quantify the force used. The PA mobilisation applied to each subject had a mean maximum force of 103.3 N, mean amplitude of force oscillation of 41.1 N, and a frequency of 1.2 Hz. Surface electromyographic data were recorded from the musculature adjacent to L3, L5 and T10.There were statistically significant reductions of 15.5% (95% CI: 8.0-22.5%) and 17.8% (95% CI: 12.9-22.4%) in mean sEMG values following mobilisation compared with the control and placebo, respectively.This study demonstrates that a central PA mobilisation to L3 results in a statistically significant decrease in the sEMG activity of erector spinae of an asymptomatic population.

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Section: Discussionmentioning

confidence: 73%

Section: Experimental Conditionsmentioning

confidence: 99%

Comparison of surface electromyographic activity of erector spinae before and after the application of central posteroanterior mobilisation on the lumbar spine

Krekoukias¹,

Petty²,

Cheek³

2009

Journal of Electromyography and Kinesiology

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“…Using static radiographic technology while mechanically applying a PA force at L4 in healthy male subjects, Lee and Evans 11 measured less extension at the L3-L4 and L4-L5 segments (1.2°) and more extension at the L2-L3 segment (2.4°), 2 segments cranial to the force application (target vertebra). 11 The similarity between the predicted kinematics by Keller et al 8 and the measured kinematics of Lee and Evans 11 was that force applied at 1 spinous process influenced motion at the targeted and adjacent segments. The difference between these 2 studies was that the direction of motion between the nontargeted vertebrae was reversed.…”

mentioning

confidence: 70%

“…The difference between these 2 studies was that the direction of motion between the nontargeted vertebrae was reversed. The data by Keller et al 8 and Lee and Evans 11 are surprising in light of these authors' comments suggesting that 3-point bending (a single force applied on 1 side of a beam and 2 counteracting forces on the other side acting in the opposite direction) governs the PA mobilization maneuver. If this were correct, the greatest amount of motion should have occurred at the targeted motion segment with less motion at adjacent segments.…”

mentioning

confidence: 98%

Assessment of Lumbar Spine Kinematics Using Dynamic MRI: A Proposed Mechanism of Sagittal Plane Motion Induced by Manual Posterior-to-Anterior Mobilization

Kulig¹,

Landel²,

Powers³

2004

J Orthop Sports Phys Ther

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Study Design: Descriptive study. Objective: The purpose of this study was to describe the segmental motion of the lumbar spine during a posterior-to-anterior (PA) mobilization procedure using dynamic magnetic resonance imaging and to propose a mechanism of the lumbar spine's motion as a result of a PA force to a lumbar spinous process. Background: Studies reporting kinematic descriptions of PA mobilization are in agreement that motion takes place at all lumbar vertebrae. However, these studies differ in the reported direction of motion. Methods and Measures: Twenty asymptomatic subjects (mean age ± SD, 31.1 ± 7.0 years) participated in this study. For each subject, a PA mobilization force was manually applied at each lumbar spinous process while sagittal plane magnetic resonance images were simultaneously obtained. Intervertebral motion was defined as the change in the intervertebral angle between the resting and end range vertebral positions imparted by the PA pressure. Results: PA force applied at 1 spinous process caused motion at the target vertebra and this motion was propagated caudally and cranially. Motion at the target segment was always into extension. Conclusions: A PA force applied at a single lumbar spinous process caused motion of the entire lumbar region. The magnitude and direction of intervertebral motions varied with the segment at which the PA force was applied. We postulated that the intervertebral motion induced by a PA force on a spinous process could be in part explained by the morphology of the lumbar spine.

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“…As there was a substantial force-displacement phase angle change at this frequency, 4 Hz most likely represents the natural frequency of the resting ovine lumbar spine subjected to DV forces. An increase in the natural frequency of oscillation is consistent with the increase in structural stiffness [11]. Using a simple mass-spring model, wherein the natural frequency is defined as (k/m) ½ , k is the stiffness and m the mass, the predicted frequency shift associated with the 55% average increase in stiffness observed during 20 Hz muscle stimulation is 4.98 Hz.…”

Section: Discussionmentioning

confidence: 52%

Muscular contributions to dynamic dorsoventral lumbar spine stiffness

Keller

Colloca

Harrison³

et al. 2006

Eur Spine J

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Spinal musculature plays a major role in spine stability, but its importance to spinal stiffness is poorly understood. We studied the effects of graded trunk muscle stimulation on the in vivo dynamic dorsoventral (DV) lumbar spine stiffness of 15 adolescent Merino sheep. Constant voltage supramaximal electrical stimulation was administered to the L3-L4 interspinous space of the multifidus muscles using four stimulation frequencies (2.5, 5, 10, and 20 Hz). Dynamic stiffness was quantified at rest and during muscle stimulation using a computer-controlled testing apparatus that applied variable frequency (0.46-19.7 Hz) oscillatory DV forces (13-N preload to 48-N peak) to the L3 spinous process of the prone-lying sheep. Five mechanical excitation trials were randomly performed, including four muscle stimulation trials and an unstimulated or resting trial. The secant stiffness (k y = DV force/L3 displacement, kN/m) and loss angle (phase angle, deg) were determined at 44 discrete mechanical excitation frequencies. Results indicated that the dynamic stiffness varied 3.7-fold over the range of mechanical excitation frequencies examined (minimum resting k y = 3.86 ± 0.38 N/mm at 4.0 Hz; maximum k y = 14.1 ± 9.95 N/mm at 19.7 Hz). Twenty hertz muscle stimulation resulted in a sustained supramaximal contraction that significantly (P < 0.05) increased k y up to twofold compared to rest (mechanical excitation at 3.6 Hz). Compared to rest, k y during the 20 Hz muscle stimulation was significantly increased for 34 of 44 mechanical excitation frequencies (mean increase = 55.1%, P < 0.05), but was most marked between 2.55 and 4.91 Hz (mean increase = 87.5%, P < 0.05). For lower frequency, sub-maximal muscle stimulation, there was a graded change in k y , which was significantly increased for 32/44 mechanical excitation frequencies (mean increase = 40.4%, 10 Hz stimulus), 23/44 mechanical excitation frequencies (mean increase = 10.5%, 5 Hz stimulus), and 11/44 mechanical excitation frequencies (mean increase = 4.16%, 2.5 Hz stimulus) when compared to rest. These results indicate that the dynamic mechanical behavior of the ovine spine is modulated by muscle stimulation, and suggests that muscle contraction plays an important role in stabilizing the lumbar spine.

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Force-deformation response of the lumbar spine: a sagittal plane model of posteroanterior manipulation and mobilization

Cited by 53 publications

References 17 publications

Comparison of surface electromyographic activity of erector spinae before and after the application of central posteroanterior mobilisation on the lumbar spine

Comparison of surface electromyographic activity of erector spinae before and after the application of central posteroanterior mobilisation on the lumbar spine

Assessment of Lumbar Spine Kinematics Using Dynamic MRI: A Proposed Mechanism of Sagittal Plane Motion Induced by Manual Posterior-to-Anterior Mobilization

Muscular contributions to dynamic dorsoventral lumbar spine stiffness

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