Intra-abdominal pressure increases stiffness of the lumbar spine

Hodges, Paul W.; Eriksson, A. E. M.; Shirley, Debra; Gandevia, Simon C.

doi:10.1016/j.jbiomech.2004.08.016

Cited by 304 publications

(212 citation statements)

References 33 publications

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“…11,19,20 Although we did not measure intra-abdominal pressure directly, we suspect that in the patient group, abnormal position and recruitment of the diaphragm resulted in subsequent reduced intra-abdominal pressure conducive to low back pain. 18 These findings are consistent with the hypothesis that abnormal postural activation of the diaphragm may serve as 1 underlying mechanism of chronic low back pain. 9 Finally, during LE flexion, total diaphragm excursions and maximum inspiratory pressure were significantly correlated in the patient group, whereas the parallel correlation in the control group was practically zero.…”

Section: Discussionsupporting

confidence: 87%

“…The diaphragm is the muscle that contributes the intra-abdominal pressure modulation and plays an important role in spinal stability. 7,16,18,27,31 Insufficient function and poor coordination of postural, or stabilizing, muscles are considered to be important etiological factors in spinal disorders associated with low back pain, such as deformational spondyloarthrosis (with or without spinal disc herniation), spinal disc protrusion, and/or spondylolisthesis. 5,12,21,25 However, a study designed specifically to test the dynamics of the diaphragm in chronic spinal disorders is lacking.…”

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confidence: 99%

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Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain

Kolář¹,

Šulc²,

Kynčl³

et al. 2012

J Orthop Sports Phys Ther

149

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FIGURE 2. (A) Subtracted image of the diaphragm excursions in the most caudal (inspiratory) and cranial (expiratory) diaphragm positions during tidal breathing in a healthy control. (B) A subtracted image of the diaphragm excursions in the most caudal (inspiratory) and cranial (expiratory) diaphragm positions during tidal breathing in a patient with chronic low back pain. (C) Schematic description of 3 diaphragmatic points (B, C, and D) used for diaphragm excursion calculations. The following 6 distances (in mm) were obtained by measuring the distance between the horizontal baseline in both expiratory and inspiratory diaphragm positions. Diaphragm excursion points: B1 to D1 were derived from the inspiratory diaphragm positions obtained from MRI images; B2 to D2 were derived from expiratory diaphragm positions obtained from respective MRI images. The inspiratory diaphragm position is designated by points B1, C1, and D1. The expiratory diaphragm position is designated by points B2, C2, and D2. Total diaphragm excursion is designated by the distance from the lower to the upper curve along points B1 to B2, C1 to C2, and D1 to D2. Adapted from Kolar et al.

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain

Kolář¹,

Šulc²,

Kynčl³

et al. 2012

J Orthop Sports Phys Ther

149

View full text Add to dashboard Cite

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“…The spines and associated ligamentous structures substantially constrain the birth canal dimensions, but they provide support for the abdominal and pelvic organs and contribute to sagittal stabilization of the sacrum (62)(63)(64). Intraabdominal hydrostatic pressure reaches high peak values during walking and running (65), and although that pressure positively influences the stability of the lumbar spine, it results in high strains in the pelvic floor (66). Pelvic floor strains thus might represent a limiting factor of birth canal dimensions, and this hypothesis receives support from the observation that wider dimensions correlate with a higher prevalence of pelvic floor disorders (67).…”

Section: Discussionmentioning

confidence: 99%

Developmental evidence for obstetric adaptation of the human female pelvis

Huseynov

Zollikofer

Coudyzer

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

160

143

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The bony pelvis of adult humans exhibits marked sexual dimorphism, which is traditionally interpreted in the framework of the "obstetrical dilemma" hypothesis: Giving birth to large-brained/ large-bodied babies requires a wide pelvis, whereas efficient bipedal locomotion requires a narrow pelvis. This hypothesis has been challenged recently on biomechanical, metabolic, and biocultural grounds, so that it remains unclear which factors are responsible for sex-specific differences in adult pelvic morphology. Here we address this issue from a developmental perspective. We use methods of biomedical imaging and geometric morphometrics to analyze changes in pelvic morphology from late fetal stages to adulthood in a knownage/known-sex forensic/clinical sample. Results show that, until puberty, female and male pelves exhibit only moderate sexual dimorphism and follow largely similar developmental trajectories. With the onset of puberty, however, the female trajectory diverges substantially from the common course, resulting in rapid expansion of obstetrically relevant pelvic dimensions up to the age of 25-30 y. From 40 y onward females resume a mode of pelvic development similar to males, resulting in significant reduction of obstetric dimensions. This complex developmental trajectory is likely linked to the pubertal rise and premenopausal fall of estradiol levels and results in the obstetrically most adequate pelvic morphology during the time of maximum female fertility. The evidence that hormones mediate female pelvic development and morphology supports the view that solutions of the obstetrical dilemma depend not only on selection and adaptation but also on developmental plasticity as a response to ecological/nutritional factors during a female's lifetime.pelvis | development | evolution | obstetrical dilemma | sex steroids

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“…The diaphragm cannot move the trunk voluntary, but its contraction contributes to trunk (spinal) stability via an increase of pressure in the abdominal cavity. This dual function of the diaphragm (ventilation and posture) is performed simultaneously [27][28][29].…”

Section: Postural Functionmentioning

confidence: 99%

Network of Breathing. Multifunctional Role of the Diaphragm: A Review

Kocjan

Adamek

Gzik-Zroska

et al. 2017

Advances in Respiratory Medicine

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The diaphragm is the primary muscle involved in active inspiration and serves also as an important anatomical landmark that separates the thoracic and abdominal cavity. However, the diaphragm muscle like other structures and organs in the human body has more than one function, and displays many anatomic links throughout the body, thereby forming a 'network of breathing'. Besides respiratory function, it is important for postural control as it stabilises the lumbar spine during loading tasks. It also plays a vital role in the vascular and lymphatic systems, as well as, is greatly involved in gastroesophageal functions such as swallowing, vomiting, and contributing to the gastroesophageal reflux barrier. In this paper we set out in detail the anatomy and embryology of the diaphragm and attempt to show it serves as both: an important exchange point of information, originating in different areas of the body, and a source of information in itself. The study also discusses all of its functions related to breathing.

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Intra-abdominal pressure increases stiffness of the lumbar spine

Cited by 304 publications

References 33 publications

Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain

Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain

Developmental evidence for obstetric adaptation of the human female pelvis

Network of Breathing. Multifunctional Role of the Diaphragm: A Review

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