Abstract
A comprehensive assessment of trunk function, including the lumbar extensor muscles, appears to be important in various conditions affecting axial musculature. This pilot cross-sectional observational study aimed to define a battery of tests that comprehensively assess trunk muscle function (strength and muscular endurance). Sixty subjects without low back pain (LBP) underwent measurement of isometric lower back extensor strength using a hand-held dynamometer (HHD) in three positions; measurement of respiratory muscle strength; and Biering-Sørensen, prone-plank, and side-bridge tests. The repeatability, short-term and long-term reliability using the HHD device in different postural positions was confirmed. The greatest isometric lower back extensor strength was generated in the sitting position by male subjects. Time of effort in the Biering-Sørensen test was longer in women and older subgroups than in men and younger individuals, although this was not the case for the other two muscular endurance tests. This pilot monitoring of trunk muscle strength and endurance in healthy volunteers may lead to a better understanding of trunk muscle function. Based on this methodological background, the authors aim to use the defined battery of tests in their further studies in a group of patients with LBP and certain neuromuscular diseases to verify its usefulness in clinical practice.
Highlights
The lumbar extensor muscles, the lumbar paraspinal muscles, comprise two main groups: the transversospinalis group, including the multifidus muscle, and more laterally, the erector spinae muscles, which consist of the longissimus and iliocostalis muscles [1,2]
The highest values of isometric lower back extensor strength were measured in t sitting position, followed by those measured standing, while the lowest values were me to use pelvic fixation [12] and, at the same time, a semi-sitting position with a hip flexion angle of 40–60◦, since this position appears to increase the specificity of back extensor action and reduce hip extensor activity [12,23]
All the tests are easy to perform in everyday clinical practice, are reasonable in terms of time and cost, and, at the same time, are reliable and valid
Summary
The lumbar extensor muscles, the lumbar paraspinal muscles, comprise two main groups: the transversospinalis group, including the multifidus muscle, and more laterally, the erector spinae muscles, which consist of the longissimus and iliocostalis muscles [1,2]. The lumbar extensor muscular system, more precisely the lumbar multifidus muscle and the erector spinae muscle, plays an essential role in stabilizing the lumbar spine and initiating and controlling all movements in the lumbar vertebral column [3,4]. By controlling these movements, the lumbar extensors stabilize and protect the underlying osteoligamentous spinal structures from potentially harmful stresses that might otherwise be experienced as a result of movements made beyond their optimal functional range and/or over protracted periods [5]. Prospective studies suggest lumbar extensor deconditioning may be a common risk factor predicting acute low back injury and low back pain (LBP) [11,12]
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