Abstract
BackgroundLow back pain is the most prevalent and disabling condition worldwide, with a high recurrence rate in the general adult population. MethodsA set of open-sourced trunk musculoskeletal models was used to investigate trunk flexion kinematics under different motor control strategies, including minimizing shearing or compressive loads at the L4/L5 or L5/S1 level. FindingsA control strategy that minimizes the load on the lower lumbar intervertebral disc can result in two kinematic patterns—the “restricted lumbar spine” and the “overflexed lumbar spine”—in performing the trunk flexion task. The “restricted” pattern can reduce the overall load on the lower lumbar levels, whereas the “overflexed” pattern can reduce the shearing force only at the L4/L5 level and increase the compressive and shearing forces at the L5/S1 level and the compressive force at the L4/L5 level. InterpretationThis study investigated the relationships between specific trunk kinematics in patients with low back pain and lumbar intervertebral loading via musculoskeletal modelling and simulation. The results provide insight into individualized treatment for patients with low back pain.
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