Lumbar Spine Motion Research Articles

Effects of pregnancy on lumbar motion patterns and muscle responses

BACKGROUND CONTEXTThe kinematics of the lumbar region and the activation patterns of the erector spinae muscle have been associated with the genesis of low back pain, which is one of the most common complications associated with pregnancy. Despite the high prevalence of pregnancy-related low back pain, the biomechanical adaptations of the lumbar region during pregnancy remain unknown. PURPOSEThis study analyzes lumbar spine motion and the activation pattern of the lumbar erector spinae muscle in healthy pregnant women. STUDY DESIGNA case-control study. PATIENT SAMPLEThe study involved 34 nulliparous women (control group) and 34 pregnant women in the third trimester (week 36 ± 1). OUTCOME MEASURESWe recorded the parameters of angular displacement of the lumbar spine in the sagittal plane during trunk flexion-extension, and the EMG activity of the erector spinae muscles during flexion, extension, eccentric and concentric contractions, and the myolectrical silence. METHODSThe participants performed several series of trunk flexion-extension movements, which were repeated 2 months postpartum. The position of the lumbar spine was recorded using an electromagnetic motion capture system. EMG activity was recorded by a surface EMG system and expressed as a percentage of a submaximal reference contraction. RESULTSAntepartum measurements showed a decrease (relative to control and postpartum measurements) in lumbar maximum flexion (52.5 ± 10.5° vs 57.3 ± 7.7° and 58.7 ± 8.6°; p < .01), the percentage of lumbar flexion during forward bending (56.4 ± 5.6% vs 59.4 ± 6.8% and 59.7 ± 5.6%; p < .01), and the time keeping maximum levels of lumbar flexion (35.7 ± 6.7% vs 43.8 ± 5.3% and 50.1 ± 3.7%; p < .01). Higher levels of erector spinae activation were observed in pregnant women during forward bending (10.1 ± 4.8% vs 6.3 ± 2.4% and 6.6 ± 2.7%; p < .01) and eccentric contraction (12.1 ± 5.2% vs 9.4 ± 3.1% and 9.1 ± 2.9%; p < .01), as well as a shortened erector spinae myoelectric silence during flexion. ConclusionsPregnant women show adaptations in their patterns of lumbar motion and erector spinae activity during trunk flexion-extension. These changes could be associated with the genesis of pregnancy-related low back pain, by means of biomechanical protection mechanisms against the increase on abdominal mass and ligamentous laxity.

Tactile cues can change movement: An example using tape to redistribute flexion from the lumbar spine to the hips and knees during lifting

Given the appropriate cues, kinematic factors associated with low back injury risk and pain, such as spine flexion, can be avoided. Recent research has demonstrated the potential for tactile sensory information to change movement. In this study an athletic strapping tape was applied bilaterally along the lumbar extensor muscles to provide continuous tactile feedback information during a repeated lifting and lowering task. The presence of the tape resulted in a statistically significant reduction in lumbar spine flexion when compared to a baseline condition in which no tape was present. This reduction was further increased with the explicit instruction to pay attention to the sensations elicited by the tape. In both cases, the reduction in lumbar spine flexion was compensated for by increases in hip and knee flexion. When the tape was then removed and participants were instructed to continue lifting as if it was still present, the reduction in lumbar flexion and increases in hip and knee flexion were retained. Thus this study provides evidence that tactile cues can provide vital feedback information that can cue human lumbar spine movement to reduce kinematic factors associated with injury risk and pain.

Virtual immersive gaming to optimize recovery (VIGOR) in low back pain: A phase II randomized controlled trial

The virtual immersive gaming to optimize recovery (VIGOR) study is a randomized controlled trial of the effects of virtual reality games to encourage lumbar spine flexion among individuals with chronic low back pain and fear of movement. Whereas traditional graded activity or graded exposure therapies for chronic low back pain have high attrition and poor long-term efficacy, we believe that virtual reality games have distinct advantages that can enhance adherence and clinical outcomes. First, they are engaging and enjoyable activities that can distract from pain and fear of harm. In addition, because they gradually reinforce increases in lumbar spine flexion to achieve game objectives, continued engagement over time is expected to promote recovery through restoration of normal spinal motion. The study design includes two treatment groups which differ in the amount of lumbar flexion required to achieve the game objectives. All participants will play the games for nine weeks, and pre-treatment to 1-week post-treatment changes in pain and disability will serve as the co-primary clinical outcomes. In addition, changes in lumbar flexion and expectations of pain/harm will be examined as potential treatment outcome mediators. Maintenance of treatment outcomes will also be assessed for up to 48-weeks post-treatment. In brief, we hypothesize that the virtual reality games will reduce pain and disability by promoting spinal motion and allowing participants to develop an implicit understanding that they are capable of engaging in significant lumbar spine motion in their daily lives without a risk of injury to their back.

The Effects Of Core Muscle Training Combined With Lower Limbs Strengthening On Physical Fitness Of community Elderly

According to the long-term care service planning proposed by the Ministry of Health and Welfare in Taiwan, 80% of the aging population requiring long-term care service would also require community-based or home-base care. The strength of lower limbs and core muscle plays important role in prevention against fall behavior, especially for the community elderly. PURPOSE: To evaluate the physical fitness of the elderly in local community care-concern center in Taiwan, a four-month course of regular core muscle training and lower limbs strengthening was conducted. METHODS: Four elderly (Age: 66±1.6 years of age; Body height: 156.7±6.6 cm, Body weight: 62.5±13.7 kg) without any severe illness were included in this study. The training of core muscle training and lower limbs strengthening last for four months with 3 sessions per week, 60 min per session, and an intensity of 5-6 on the Ratings of Perceived Exertion scale. Physical fitness was evaluated one week before and after the intervention. Data of multiple variables were collected by using questionnaire and examination on functional fitness including grip, two-min step test, back scratch test, and 8-foot up-and-go test. The ranges of motion and isometric strength of lumbar spine and knee were measured by the microFET3. Descriptive statistics, independent sample t-test, and paired-samples t test were used to evaluate the effects of the intervention. RESULTS: The results showed significant improvement after the 4-month course in back scratch test, 2-min step test, chair sit-and reach test, and isometric strength of lumbar spine and knee (p < 0.05). Among the other tests, no significant differences were observed. CONCLUSION: Core muscle training combined with lower limbs strengthening for community elderly can improve physical fitness and isometric strength of low back and knee.

Biomechanics changes of lumbar spine caused by foraminotomy via percutaneous transforaminal endoscopic lumbar discectomy

Objective: To analyze the biomechanics changes of lumbar spine caused by foraminotomy via percutaneous transforaminal endoscopic lumbar discectomy using the finite element method. Methods: Three healthy adult males (aged 35.6 to 42.3 years) without spinal diseases were enrolled in this study and 3D-CT scans were carried out to obtain the parameters of lumbar spine. Mimics software was applied to build a 3D finite element model of lumbar spine. Graded resections (1/4, 2/4, 3/4 and 4/4) of the left superior articular process of L(5) were done via percutaneous transforaminal endoscopic lumbar discectomy. Then, the pressure of the L(4/5) right facets, the pressure of the L(4/5) intervertebral disc and the motion of lumbar spine were recorded after simulating the normal flexion and extension, lateral flexion and rotation of the lumbar spine model during different resections. The data were compared among groups with analysis of variance. Results: Comparing with the normal group, after 1/4 resection of the left superior articular process of L(5), the pressure of the L(4/5) right facets showed significant differences during left lateral flexion and rotation of lumbar spine (q=8.823, 8.248, both P<0.05); and the pressure of L(4/5) intervertebral disc also changed significantly during extension and right rotation of lumbar spine (q=6.918, 6.438, both P<0.05); the motion of lumbar spine showed obvious differences during right lateral flexion and rotation (q=6.845, 7.772, 13.58, all P<0.05). Comparing with the normal group, after 2/4 resection of the left superior articular process of L(5), the pressure of the L(4/5) right facets presented significant differences during all conditions (q=5.670-17.830, all P<0.05); the pressure of L(4/5) intervertebral disc changed significantly during flexion, extension, lateral flexion and right rotation (q=5.260, 17.150, 5.727, 8.890, 15.660, all P<0.05); the motion of lumbar spine also existed differences during extension, lateral flexion and rotation (q=9.106, 5.431, 12.060, 11.160, 17.260, all P<0.05). However, after 3/4 resections, the pressure of the L(4/5) right facets, the pressure of the L(4/5) intervertebral disc and the motion of lumbar spine presented differences during all conditions when compared with those in normal group (q=6.303-25.48, all P<0.05). After 4/4 resections, the pressure of the L(4/5) right facets and the pressure of the L(4/5) intervertebral disc and the motion of lumbar spine showed significant differences during all conditions when compared with those in normal group (q=8.065-45.70, all P<0.05). Conclusions: The biomechanics and the stability of lumbar spine changed partly after 1/4 resection of the superior articular process and obviously after more than 2/4 is resected. The superior articular process should be paid more attention during foraminotomy via percutaneous transforaminal endoscopic lumbar discectomy.

A comparative analysis of lumbar spine mechanics during barbell- and crate-lifting: implications for occupational lifting task assessments

Purpose. To compare the effects of object handled and handgrip used on lumbar spine motion and loading during occupational lifting task simulations. Methods. Eight male and eight female volunteers performed barbell and crate lifts with a pronated (barbell) and a neutral (crate) handgrip. The mass of barbells/crates lifted was identical across the objects and fixed at 11.6 and 9.3 kg for men and women, respectively. The initial heights of barbells/crates were individualized to mid-shank level. Body segment kinematics and foot–ground reaction kinetics were collected, and then input into an electromyography-assisted dynamic biomechanical model to quantify lumbar spine motion and loading. Results. Lumbar compression and net lumbosacral moment magnitudes were 416 N and 17 Nm lower when lifting a barbell than when lifting a crate (p < 0.001), respectively. There were no between-condition differences in lumbar flexion displacements (p > 0.392) or flexion/extension velocities (p > 0.085). Conclusions. Crate- and barbell-lifting tasks can be used interchangeably if assessing lifting mechanics based on peak spine motion variables. If assessments are based on the spine loading responses to task demands, however, then crate- and barbell-lifting tasks cannot be used interchangeably.

The natural evolution of postoperative distal adding-on in adolescent idiopathic scoliosis

Objective To analyze the clinical value of transforaminal endoscopic minimally invasive surgery for the treatment of recurrent lumbar disc herniation. Methods Strictly included in the criteria, 47 patients diagnosed with recurrent lumbar disc herniation who was treated unsuccessfully with conservative treatment were selected from our department from May 2011 to December 2015.There were 31 males and 16 females, with an average age of 43.45 ±3.37 years old (29-62 years old). There were L3,4 section in 4 cases, L4,5 section in 32 cases, and L 5S1 section in 11 cases. The interval between the first operation and the reoperation was between 10 and 185 months, with an average of 49 months. In the first operation, there were 11 cases of posterior intervertebral disc endoscopy (MED) surgery, and 36 cases of decompression of vertebral disc nucleus pulposus surgery. Take a prone position under local anesthesia percutaneous puncture intervertebral foramen in the endoscopic minimally invasive surgery, intraoperative decompression of vertebral canal and nerve root canal, removal of intervertebral disc nucleus pulposus tissue, explore and release nerve root. The Oswestry disability index (ODI), visual analogue scale (VAS) and improved Macnab standard were used to assess the efficacy of the operation. Operation segments intervertebral height change, lumbar power X-ray slice of intervertebral Angle was measured according to preoperative and last follow-up of lumbar lateral X-ray observation, and lumbar spine motion (the range of motion, ROM) was calculated. Results All cases were successfully performed, no open surgery, and all cases were followed up. The average surgical blood volume was 10.3± 2.7 ml, the operation time was 63.5±11.6 min, no nerve root injury, dural injury, cerebrospinal fluid leakage, muscle strength decline, secondary obstruction, lumbar instability or other serious complications occurred. The follow-up time was from 18 to 52 months, with an average of 35.5±5.1 months. The preoperative ODI 51.35±15.29 decreased to 3.31±2.17 at the last postoperative follow-up, the preoperative VAS score 8.11±1.05 decreased to (1.03± 0.81) at the last postoperative follow-up, and the difference was statistically significant (P 0.05), the motion of operation segmental lumbar (the range of motion, ROM) had no significant difference (P > 0.05). Conclusion Under the premise of strict control of surgical indications, the clinical efficacy of minimally invasive surgery for the treatment of recurrent lumbar disc herniation is reliable. The transforaminal approach does not affect the stability of the spine. The operation has the advantages of small trauma, fewer complications, and is safe and effective. Key words: Lumbar vertebrae; Intervertebral disc displacement; Recurrence; Endoscopy; Treatment outcome; Surgical procedures, minimally invasive

Shock attenuation in the human lumbar spine during walking and running.

During locomotion, each step generates a shock wave that travels through the body toward the head. Without mechanisms for attenuation, repeated shocks can lead to pathology. Shock attenuation (SA) in the lower limb has been well studied, but little is known about how posture affects SA in the spine. To test the hypothesis that lumbar lordosis (LL) contributes to SA, 27 adults (14 male, 13 female) walked and ran on a treadmill. Two lightweight, tri-axial accelerometers were affixed to the skin overlying T12/L1 and L5/S1. Sagittal plane accelerations were analyzed using power spectral density analysis, and lumbar SA was assessed within the impact-related frequency range. 3D kinematics quantified dynamic and resting LL. To examine the effects of intervertebral discs on spinal SA, supine MRI scans were used to measure disc morphology. The results showed no association between LL and SA during walking, but LL correlated with SA during running (P<0.01, R2=0.30), resulting in as much as 64% reduction in shock signal power among individuals with the highest LL. Patterns of lumbar spinal motion partially explain differences in SA: larger amplitudes of LL angular displacement and slower angular displacement velocity during running were associated with greater lumbar SA (P=0.008, R2=0.41). Intervertebral discs were associated with greater SA during running (P=0.02, R2=0.22) but, after controlling for disc thickness, LL remained strongly associated with SA (P=0.001, R2=0.44). These findings support the hypothesis that LL plays an important role in attenuating impact shocks transmitted through the human spine during high-impact, dynamic activities such as running.

Recognition of Chronic Low Back Pain During Lumbar Spine Movements Based on Surface Electromyography Signals

Chronic low back pain (CLBP) is a common musculoskeletal disorder and a major source of disability in adults. The assessment of lumbar muscle functioning has proven as an appropriate approach for early identification of CLBP when significant pathological signs and symptoms are absent. Thus, earlier therapy or rehabilitation can be administered to prevent further deterioration, such as spinal stenosis or disk herniation. In this paper, surface electromyography (sEMG) signal analysis was explored for the recognition of low back pain in subjects with non-specific symptoms; 88 CLBP subjects and a control group of 83 subjects were recruited for sEMG data acquisition. Subjects were asked to perform four specific movements, namely forward bending, backward bending, right lateral flexion, and left lateral flexion. While performing each movement, sEMG signals from three pairs of lumbar muscles were captured, and 31 features from both the time and frequency domains were extracted from the signal. Finally, the main feature group and four subsets, derived from it, were explored. The suggested method allowed to achieve CLBP recognition accuracy of 98.04% based on subset C for forward bending, followed by 96.15% based on subset E for right lateral flexion, 93.33% based on subset E for left lateral flexion, and 91.30% based on subset B for backward bending. A combination of support vector machine classifiers and optimal feature selection allowed for improved classification performance. The main aim of this paper is to recognize CLBP in subjects with non-specific pathology during the four types of movement. The major steps carried out to achieve this are pre-processing, feature selection, and classification of the sEMG signals acquired from 171 subjects. Results suggest CLBP recognition based on sEMG as a promising alternative to the conventional methods. Therefore, this paper could inspire the design of appropriate programs that can ensure effective rehabilitation of CLBP patients.

Effect of arm swinging on lumbar spine and hip joint forces

During level walking, arm swing plays a key role in improving dynamic stability. In vivo investigations with a telemeterized vertebral body replacement showed that spinal loads can be affected by differences in arm positions during sitting and standing. However, little is known about how arm swing could influence the lumbar spine and hip joint forces and motions during walking. The present study aims to provide better understanding of the contribution of the upper limbs to human gait, investigating ranges of motion and joint reaction forces.A three-dimensional motion analysis was carried out via a motion capturing system on six healthy males and five patients with hip instrumented implant. Each subject performed walking with different arm swing amplitudes (small, normal, and large) and arm positions (bound to the body, and folded across the chest). The motion data were imported in a commercial musculoskeletal analysis software for kinematic and inverse dynamic investigation.The range of motion of the thorax with respect to the pelvis and of the pelvis with respect to the ground in the transversal plane were significantly associated with arm position and swing amplitude during gait. The hip external-internal rotation range of motion statistically varied only for non-dominant limb. Unlike hip joint reaction forces, predicted peak spinal loads at T12-L1 and L5-S1 showed significant differences at approximately the time of contralateral toe off and contralateral heel strike.Therefore, arm position and swing amplitude have a relevant effect on kinematic variables and spinal loads, but not on hip loads during walking.

Differences in lumbar spine and lower extremity kinematics in people with and without low back pain during a step-up task: a cross-sectional study

BackgroundLow back pain (LBP) affects more than one third of the population at any given time, and chronic LBP is responsible for increased medical costs, functional limitations and decreased quality of life. A clear etiology is often difficult to identify, but aberrant posture and movement are considered contributing factors to chronic LBP that are addressed during physiotherapy intervention. Information about aberrant movement during functional activities in people with LBP can help inform more effective interventions. The purpose of this study was to determine if there are differences in lumbar spine and lower extremity kinematics in people with and without LBP during a step-up task.MethodsA convenience sample of 37 participants included 19 with LBP and 18 without a history of LBP. All participants were between the ages of 18 and 65, and controls were matched to participants with LBP based on age, gender and BMI. A motion capture system was used to record spine and lower extremity kinematics during the step-up task. ANOVA tests were used to determine differences in three-dimensional kinematics between groups.ResultsParticipants with LBP displayed less lower lumbar motion in the sagittal plane (P = 0.001), more knee motion in the coronal plane (P = 0.001), and more lower extremity motion in the axial plane (P = 0.002) than controls.ConclusionsPeople with LBP display less lower lumbar spine motion in the sagittal plane and more out-of-plane lower extremity motion. Clinically, the step-up task can be used to identify these aberrant movements to develop more focused functional interventions for patients with LBP.Trial registrationNot applicable.

Effect of different inner core diameters on structural strength of cannulated pedicle screws under various lumbar spine movements

BackgroundCurrently, cannulated pedicle screws have been widely used in minimal invasive or navigation techniques. However, the stress distribution and the strength of different core diameters of cannulated screw are not clear. This study aimed to investigate the mechanical strength of cannulated screws with different inner core diameter under various lumbar spine movements using finite element analysis.ResultsThe results showed that the von-Mises stress of a cannulated screw was larger than that of a solid screw in all loading conditions, especially above 2 mm in cannulated core diameter. In lateral bending, extension, and flexion, the maximum von-Mises stress was found approximate to the proximal thread for all types of screws. In rotation condition, the maximum von-Mises stress was located at the middle of the screw. Additionally, the difference in stiffness of instrumented levels was not significant among four screws under the same loading condition.ConclusionCannulated screws could provide enough stability for the vertebral body fusion comparing to solid screws. The diameter of cannulated core is suggested not to exceed 2.0 mm.

Analysis of the relationship between the facet fluid sign and lumbar spine motion of degenerative spondylolytic segment using Kinematic MRI

PurposeTo investigate the relationship between the facet fluid sign (FFS) and kinematics of affected lumbar segment in patients with low-grade, single-level lumbar degenerative spondylolisthesis using kinematic magnetic resonance imaging (kMRI).Materials and methods Ninety-two patients diagnosed with low-grade (Grade 1 or 2), single level lumbar degenerative spondylolisthesis L3 to S1. Angular and translational motion, whole lumbar motion, slip percentage, and facet angle were measured. Disc degeneration and degrees of osteoarthritis were graded, facet effusion was evaluated and classified as Positive or Negative FFS (PosFFS or NegFFS).Results There were significant differences in the facet degeneration, translational motion, percentage of total angular motion, and flexion-extension slip difference between the PosFFS and NegFFS group. 28.3% of the patients in PosFFS group had anterolisthesis in flexion, but not extension.There was a significant difference in the incidence of FFS between the dynamic and static spondylolisthesis (75% vs 35%, p < 0.001). If FFS was present on kMRI, a positive predictive value for dynamic spondylolisthesis was 75.6%. with the sensitivity and specificity of 0.75 and 0.65 for posFFS to diagnose dynamic DS. The likelihood ratio for dynamic slips in the presence of FFS was 2.1, and the likelihood ratio for static slips in the presence of FFS was 1.1.Conclusion Facet fluid sign was present in weight-bearing neutral position, and the presence of FFS in kMRI increased the probability of having dynamic spondylolisthesis.

Atlantoaxial instability: An exceptional complication of ankylosing spondylitis

BackgroundAtlantoaxial instability (AAI) and more rarely odontoid pannus formation, similar to the one observed in Rheumatoid Arthritis, are seldom reported in ankylosing spondylitis (AS). We report a new case of a patient with AS with a pannus in the atlanto-axial region and cervical C1-C2 instability. Case presentationThe patient, now aged 41, was diagnosed with AS in 2010. She was put on different non steroidal anti inflammatory treatments with persistent spinal pain. She was referred to our department in 2015 with severe cervical pain and stiffness since 3months. On examination, the patient had severely limited cervical spine movements. Lumbar spine movements were moderately affected. There was no neurological deficit. Her Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was 4.9/10 and Bath Ankylosing Spondylitis Functional Index (BASFI) was 5/10. Plain Radiographs of the pelvis showed bilateral grade 4 sacroilitis and bilateral coxitis. Dorsal and lumbar spine plain radiographs showed squaring of vertebral bodies. Cervical spine radiographs showed an increased atlanto-axial distance. Spinal MRI confirmed the atlantoaxial subluxation with an anterior distance of 8mm, with marked intraspinal pannus formation and synovitis around the odontoid peg. Synovial thickening exerted an anterior mark on the bulbo-medullary junction with no evidence of oedema signs. Posterior zygapophysial ankylosis involving all cervical levels was also observed. The patient had a cervical collar with anti-tumor necrosis factor-α (cerolizumab-pegol) prescription with favorable outcome. ConclusionOdontoid pannus formation is rare in AS. Clinical and radiological follow-up are important to assess the impact on the cervical spine.

Differences in lumbar spine and lower extremity kinematics during a step down functional task in people with and people without low back pain

BackgroundWhen functional movements are impaired in people with low back pain, they may be a contributing factor to chronicity and recurrence. The purpose of the current study was to examine lumbar spine, pelvis, and lower extremity kinematics during a step down functional task between people with and without a history of low back pain. MethodsA 3-dimensional motion capture system was used to analyze kinematics during a step down task. Total excursion of the lumbar spine, pelvis, and lower extremity segments in each plane were calculated from the start to end of the task. Separate analysis of variance tests (α=0.05) were conducted to determine the effect of independent variables of group and plane on lumbar spine, pelvis, and lower extremity kinematics. An exploratory analysis was conducted to examine kinematic differences among movement-based low back pain subgroups. FindingsSubjects with low back pain displayed less lumbar spine movement than controls across all three planes of movement (P-values=0.001–0.043). This group difference was most pronounced in the sagittal plane. For the lower extremity, subjects with low back pain displayed more frontal and axial plane knee movement than controls (P-values=0.001). There were no significant differences in kinematics among movement-based low back pain subgroups. InterpretationPeople with low back pain displayed less lumbar region movement in the sagittal plane and more off-plane knee movements than the control group during a step down task. Clinicians can use this information when assessing lumbar spine and lower extremity movement during functional tasks, with the goal of developing movement-based interventions.

Movement-Related Urinary Urgency: A Theoretical Framework and Retrospective, Cross-sectional Study

Objectives: Objectives of this report are to (1) describe a theoretical framework for symptom monitoring of urgency during standard movement testing, (2) report the prevalence of movement diagnoses, and (3) demonstrate the relationship between movement diagnoses and pelvic floor muscle diagnoses in individuals with urgency. Background: Urinary urgency is a complex condition that causes economic and psychological burden. The relationship between movements and postures of the spine, hip, and urinary urgency symptoms has not well researched. Combining current understandings of neurological control of urgency and standard procedures utilized during movement examination, we report on a subgroup of individuals who have movement-related urgency. Methods: A retrospective chart review was performed to identify patients with urinary urgency. Movement diagnoses of hip or spine were then identified, as well as the typical pelvic floor muscle diagnoses. Results: A total of 225 patients, mean age 49.7 years, were identified with urinary urgency symptoms. Of this cohort, 48% of patients received a hip or spine movement diagnosis. Lumbar spine movement diagnoses were the most prevalent (31%), 13.7% of all patients were given thoracic movement diagnoses, and 11.1% of patients were given hip movement diagnoses. Conclusion: The prevalence of spine or hip movement diagnoses in patients with urinary urgency was high (48.0%). A significant relationship was found between the presence of spine/hip movement diagnoses and pelvic floor muscle diagnoses (χ2 [1, N = 225] = 42.27, P = .000). Standard evaluation for patients with urinary urgency should include movement testing of spine and hip, with symptom monitoring of urinary urgency during examination.

Analysis of 3D multi-segment lumbar spine motion during gait and prone hip extension

Modeling the lumbar spine as a single rigid segment does not consider the relative contribution of regional or segmental motion that may occur during a task. The current study used a multi-segment model to measure three-dimensional (3D) upper and lower lumbar spine motion during walking and prone hip extension (PHE). The degree of segmental redundancy during these movements was assessed by calculating the cross-correlation of the segmental angle time series (R0) and the correlation of the segmental ranges of motion (RROM). All correlation coefficients (R0, RROM) were interpreted as follows: very strong (0.80–1.00), strong (0.60–0.79), moderate (0.40–0.59), weak (0.20–0.39), and very weak (0.00–0.19). Strong/very strong positive R0 were demonstrated between the two segments in all three planes during PHE and in the transverse plane during walking. Weak/moderate R0 were demonstrated in the sagittal and frontal planes during walking. Strong/very strong positive RROM were demonstrated in the transverse plane during PHE, and moderate positive RROM was demonstrated in the sagittal plane during walking. Non-significant RROM were demonstrated for all other planes and movements. These results suggest the motion patterns of the upper and lower lumbar regions during walking and PHE are sufficiently distinct to warrant the use a multi-segment model for these movements. It also appears that the degree of redundancy between the upper and lower lumbar regions may be task-dependent.

Differences in kinematics of the lumbar spine and lower extremities between people with and without low back pain during the down phase of a pick up task, an observational study

BackgroundLimited research exists on lumbar spine and lower extremity movement during functional tasks in people with and without low back pain (LBP). ObjectiveTo determine differences in lumbar spine and lower extremity kinematics in people with and without LBP during the down phase of a pick up task. DesignCross-sectional, observational study. Method35 people (14 M, 21 F, 26.9 ± 10.9 years, 24.8 ± 3.2 kg/m2); 18 with and 17 without LBP were matched based on age, gender and BMI. Kinematics of the lumbar spine and lower extremities were measured using 3D motion capture, while subjects picked up an object off the floor. People with LBP were examined and assigned to movement-based LBP subgroups. Repeated measures ANOVA tests were conducted to determine the effect of group and region on lumbar spine and lower extremity kinematics. A secondary analysis was conducted to examine the effect of LBP subgroup on lumbar spine kinematics. ResultsCompared to controls, subjects with LBP displayed greater upper and less lower lumbar flexion (P < 0.05), and more lumbar flexion during the first 25% of the pick up task (P < 0.01). There were no group differences in frontal or axial plane lumbar spine kinematics. Subjects with LBP displayed more frontal plane movement at the knee than control subjects (P < 0.01). There were no significant effects of movement-based LBP subgroup on kinematics (P > 0.05). ConclusionsWhen evaluating movement during a functional task, the clinician should consider regional differences in the lumbar spine, pattern of movement, and lower extremity movement.

Reliability and Validity of I Handy Android Application on Measurement of Lumbar Spine Movement in Patients with Low Back Pain

Purpose: The purpose of this study was to investigate the reliability and concurrent validity of active spinal mobility measurements using a gravity-based bubble inclinometer and an android application. Objective: This study was to examine the utility of an android application as a measurement tool in measurement of lumbar range of motion in low back pain patient Methods: It is a descriptive study design with a sample size of 30 patients. Results: Interclass correlation coefficients were used to analyze the ability of Samsung tab 2 and I handy application for measuring lumbar ROM in LBP patients. Conclusion: The I handy application has good Intra and inter-tester reliability and it can be used to measure the lumbar spine range of motion.

Reproducibility of a new signal processing technique to assess joint sway during standing

Postural control strategies can be investigated by kinematic analysis of joint movements. However, current research is focussing mainly on the analysis of centre of pressure excursion and lacks consensus on how to assess joint movement during postural control tasks. This study introduces a new signal processing technique to comprehensively quantify joint sway during standing and evaluates its reproducibility. Fifteen patients with non-specific low back pain and ten asymptomatic participants performed three repetitions of a 60-second standing task on foam surface. This procedure was repeated on a second day. Lumbar spine movement was recorded using an inertial measurement system. The signal was temporally divided into six sections. Two outcome variables (mean absolute sway and sways per second) were calculated for each section. The reproducibility of single and averaged measurements was quantified with linear mixed-effects models and the generalizability theory. A single measurement of ten seconds duration revealed reliability coefficients of .75 for mean absolute sway and .76 for sways per second. Averaging a measurement of 40 seconds duration on two different days revealed reliability coefficients higher than .90 for both outcome variables. The outcome variables’ reliability compares favourably to previously published results using different signal processing techniques or centre of pressure excursion. The introduced signal processing technique with two outcome variables to quantify joint sway during standing proved to be a highly reliable method. Since different populations, tasks or measurement tools could influence reproducibility, further investigation in other settings is still necessary. Nevertheless, the presented method has been shown to be highly promising.