Sensory-motor control of the lower back: implications for rehabilitation

Ebenbichler, Gerold; Oddsson, Lars; Kollmitzer, Josef; Erim, Zeynep

doi:10.1097/00005768-200111000-00014

Cited by 185 publications

(98 citation statements)

References 94 publications

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“…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. It appears that respiratory muscles other than the diaphragm were more consistently recruited during TB when lower extremities were engaged in order to compensate for the relatively limited movement of the diaphragm, whereas the diaphragm was more central to breathing in healthy subjects.…”

Section: Discussionmentioning

confidence: 82%

mentioning

confidence: 99%

“…9 Trunk stabilization and postural trunk control may play an important role in the etiology of low back pain. 9 In turn, the function of the diaphragm may affect how the trunk is stabilized, especially during postural activity. 11,15,22 Various studies have shown that the pelvic girdle and lumbar spine are reflexively stabilized and braced prior to the initiation of extremity movements.…”

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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

142

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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: Discussionmentioning

confidence: 82%

mentioning

confidence: 99%

mentioning

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

142

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“…Despite evidence that anticipatory and automatic postural coordination is altered with LBP, it is still not clear how differences in muscle activation relate to LBP and what are the implications for LBP intervention [6]. Currently, it is not known whether abnormal muscle function can cause or contribute to LBP.…”

Section: Discussionmentioning

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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“…Body composition changes is one of the factors that can cause back pain in middle age, and aging, including increased body fat mass, especially in the abdominal region, and muscle weakness in the central regions of the body. With an increase in abdominal obesity, a compensating curve is created in the lumbar curvature, and increase in the upper body weight causes also a lot of pressure on the intervertebral discs, which causes back pain as well (Ebenbichler, Oddsson, Kollmitzer, & Erim, 2001). Due to the increase in the arches of the lumbar region, the center of gravity shifts forward which results in disturbance of the postural control and increased risk of falling, and ultimately mobility reduction in later periods (Wright & Perricelli, 2008).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Pilates Exercises on Motor Control of Inactive Middle-Aged Women

Seghatoleslami¹,

Afif²,

Irandoust³

et al. 2018

Sleep Hypn

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Inactive lifestyle and its degrading consequences such as increased body fat mass, muscle atrophy and physical functioning problems are among factors affecting the motorcontrol in adulthood. Therefore, the aim of study was to investigate the effect of Pilates exercise on motor control indexes of inactive middle-aged women.Method: This was a semi experimental study with pretest and post test design performed on 43 inactive females with mean age of 44.4±5.1 yearswith low activity, body percent fat above 35%, WHR> 0.95. They were assigned into two experimental (n=22) and control (n=21) groups. The pilates group did their exercise for 4 months, three weeks a week while the control group did their daily routines. Allbody composition variables were measured by body composition analyzer and functional tests were measured by speed and balance tests. Independent and dependent t-test was used to analyze the data. Results: The results suggested that dynamic balance and walking speed were improved significantly and those effective factors on motor control such as obesity variables,including body mass index (BMI), waist hip ratio (WHR), percent body fat (PBF), visceral fat (VF) (respectively, p=0.003; p=0.001; p=0.004) were also improved. Walking speed and balance were the other parameters affecting the motor control of aged women (respectively, p=0.001; p=003). Conclusion: It seems that pillates exercise may improve walking speed, balance and also lead to a better bodycomposition. Therefore, having such an exercise program can be effective in motor controland its major consequences for gait and postural control of elderly people.

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Sensory-motor control of the lower back: implications for rehabilitation

Cited by 185 publications

References 94 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

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

The Impact of Pilates Exercises on Motor Control of Inactive Middle-Aged Women

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