Factors to consider in identifying critical points in lumbar spine flexion relaxation

Abstract

Flexion relaxation (FR), a myoelectric silence of extensor muscles near end range of lumbar flexion, is commonly reported as the lumbar flexion angle at the instant the extensor muscles become silent. However, lumbar flexion angle alone is insufficient to characterize mechanisms that modulate FR. As FR requires the moment generated by passive lumbar extensor tissues to equilibrate the moment due to gravity, the inter-relationships between lumbar moment, flexion angle, and myoelectrical silence will provide added information in the understanding of FR. The purpose of this study was to examine the relationship between lumbar moment and flexion angle throughout various flexion manoeuvres. It was hypothesized that lumbar moment and flexion angle would not be linearly related and would be affected by lower limb position, range of motion, and the addition of mass to the torso. Eleven participants performed four different lumbar flexion trials. Results showed that lumbar flexion was correlated with the lumbar moment (r=0.92); however an analysis of residuals found that these measures were not linearly related. The moment was, however, correlated (r=0.99) and linearly related to the sine of trunk inclination (T12 rigid body with respect to global horizontal). Future studies of FR could use trunk inclination as a simple kinematic measure to predict relative changes in lumbar moment with flexion.