Advertisement

Flexion–relaxation response to static lumbar flexion in males and females

  • Moshe Solomonow
    Correspondence
    Corresponding author
    Affiliations
    Occupational Medicine Research Center, Bioengineering Laboratory, Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, 2025 Gravier Street, Suite 400, New Orleans, LA 70112, USA
    Search for articles by this author
  • Richard V. Baratta
    Affiliations
    Occupational Medicine Research Center, Bioengineering Laboratory, Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, 2025 Gravier Street, Suite 400, New Orleans, LA 70112, USA
    Search for articles by this author
  • Anthony Banks
    Affiliations
    Occupational Medicine Research Center, Bioengineering Laboratory, Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, 2025 Gravier Street, Suite 400, New Orleans, LA 70112, USA
    Search for articles by this author
  • Curt Freudenberger
    Affiliations
    Occupational Medicine Research Center, Bioengineering Laboratory, Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, 2025 Gravier Street, Suite 400, New Orleans, LA 70112, USA
    Search for articles by this author
  • Bing He Zhou
    Affiliations
    Occupational Medicine Research Center, Bioengineering Laboratory, Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, 2025 Gravier Street, Suite 400, New Orleans, LA 70112, USA
    Search for articles by this author

      Abstract

      Objective. To determine if creep developed in the lumbar viscoelastic tissues during a period of static flexion elicited changes in the muscular responses of the flexion–relaxation phenomenon.
      Background. Static lumbar flexion is a risk factor in workers, yet the physiological biomechanical and histological processes active in the evolution of the consequent low back disorder were not demonstrated experimentally. Controlled animal studies show that static lumbar flexion develops creep in the associated viscoelastic tissues and elicits spasms and modification of muscle function. Such neuromuscular changes are to be investigated in this study while assessing normal human subjects via the flexion–relaxation phenomenon.
      Methods. Male and female subject groups performed three bouts of lumbar flexion–extension before and after a 10 min period of static lumbar flexion. The surface electromyographic from the erector spinae muscles as well as flexion angle were recorded. The angle in which electromyographic diminished during flexion and initiated during extension was determined and subjected to anova with repeated measures to determine any significant changes in the flexion–relaxation response.
      Results. The erector spinae were active through a significantly larger angle during flexion and initiated activity significantly earlier during extension after static flexion. Females demonstrated more pronounced changes than males. EMG amplitude did not change significantly. Spasms were recorded in more than half of the subjects during the static flexion period.
      Conclusions. Creep developed during a short static lumbar flexion elicited significant changes in the muscular activity pattern of the flexion–relaxation phenomenon. The muscles seem to compensate for the loss of tension in the lumbar viscoelastic tissues, while spasms suggest that some micro-damage was incurred to the viscoelastic tissues.
      Relevance Static lumbar flexion is shown experimentally as an activity that constitutes an occupational risk factor for the development of low back disorder.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Biomechanics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Adams M.
        • Dolan P.
        • Hutton W.
        Diurnal variations in the stresses on the lumbar spine.
        Spine. 1987; 12: 130-137
        • Adams M.A.
        • Dolan P.
        Time dependent changes in the lumbar spine’s resistance to bending.
        Clin. Biomech. 1996; 11: 194-200
        • Ahern D.K.
        • Hannon D.J.
        • Goreczny A.J.
        • Follick M.J.
        • Parziale J.R.
        Correlation of chronic low back pain behavior and muscle function examination of the flexion–relaxation response.
        Spine. 1990; 15: 92-95
        • Ahern D.K.
        • Follick M.J.
        • Council J.R.
        • Laser-Wolston N.
        • Litchman H.
        Comparison of lumbar paravertebral EMG patterns in chronic low back pain patients and non-patient controls.
        Pain. 1988; 34: 153-160
        • Carpenter J.
        • Flangan C.
        • Thomopoulos S.
        • Yian E.
        • Soslowsky L.
        The effect of overuse combined with intrinsic and extrinsic alterations in an animal model of rotator cuff tendinosis.
        Am. J. Sports Med. 1998; 26: 801-807
        • Chu D.
        • LeBlanc R.
        • D’Ambrosia P.
        • D’Ambrosia R.
        • Baratta R.V.
        • Solomonow M.
        Neuromuscular disorder in response to anterior cruciate ligament creep.
        Clin. Biomech. 2003; 18: 222-230
        • Dolan P.
        • Mannion A.
        Passive tissues help the back muscles to generate extensor moments during lifting.
        J. Biomech. 1994; 27: 1077-1085
      1. Fick, R., 1911. Handbuck der Anatomie und Mechanik der Gelenke. Jena, vol III

        • Fisher A.
        • Chang C.
        Electromyographic evidence of paraspinal muscle spasms during sleep in patients with low back pain.
        Clin. J. Pain. 1985; 1: 147-154
        • Frank C.
        • Amiel D.
        • Woo S.
        • Akeson W.
        Normal ligament properties and ligament healing.
        Clin. Orthop. Rel. Res. 1985; 196: 15-25
        • Golding J.S.R.
        Electromyography of the erector spinae in low back pain.
        Postgraduate Med. J. 1952; 28: 401-406
        • Haig A.
        • Wiesman G.
        • Haugh L.
        • Pope M.
        • Grobler L.
        Prospective evidence for change in paraspinal muscle activity after herniated nucleus pulposus.
        Spine. 1993; 18: 926-930
        • Hedman T.
        • Fernie G.
        In vivo measurements of lumbar spinal creep in two seated postures.
        Spine. 1995; 20: 178-183
        • Hoyt W.
        • Hunt H.
        • DePauw M.
        EMG assessment of chronic low back pain syndrome.
        J. Am. Osteopath. Assoc. 1981; 80: 728-730
        • Jackson M.
        • Solomonow M.
        • Zhou B.
        • Baratta R.V.
        • Harris M.
        Multifidus EMG and tension relaxation recovery after prolonged static lumbar flexion.
        Spine. 2001; 26: 715-723
        • Kumar S.
        Theories of musculoskeletal injury causation.
        Ergonomics. 2001; 44: 17-47
        • McGill S.M.
        • Kippers V.
        Transfer of loads between lumbar tissues during the flexion–relaxation phenomenon.
        Spine. 1994; 19: 2190-2196
        • McGill S.
        • Brown S.
        Creep response of the lumbar spine to prolonged full flexion.
        Clin. Biomech. 1992; 7: 43-46
        • Miller D.
        Comparison of EMG activity in the lumbar paraspinal muscles of subjects with and without chronic low back pain.
        Phys. Therapy. 1985; 65: 1347-1354
        • Pedersen H.
        • Blunk C.
        • Gardner G.
        The anatomy of lumbosacral posterior rami and meningeal branches of spinal nerves.
        J. Bone Joint Surg. A. 1956; 38: 377-391
        • Roland M.
        A critical review of the evidence for a pain–spasm–pain cycle in spinal disorders.
        Clin. Biomech. 1986; 1: 102-109
        • Shirado O.
        • Ito T.
        • Kaneda K.
        • Strax T.E.
        Flexion–relaxation phenomenon in the backmuscles. A comparative study between healthy subjects and patients with chronic low back pain.
        Amer. J. Phys. Med. Rehab. 1995; 74: 139-144
        • Shivonen T.
        • Partanen J.
        • Hanninen O.
        • Soimakallio S.
        Electric behavior of low back muscles during lumbar pelvic rhythm in low back pain and healthy controls.
        Arch. Phys. Med. Rehab. 1991; 71: 1080-1087
      2. Solomonow, M., Hatipkarasulu, S., Zhou, B., et al., in press. Biomechanics and electromyography of a common idiopathic low back disorder. Spine

        • Soslowsky L.
        • Thomopoulos S.
        • Tun S.
        • Flanagan C.
        • Keefer C.
        • Mastaw J.
        • Carpenter J.
        Overuse activity injury in supraspinatus tendon in an animal model.
        Shoulder Elbow Surg. 2000; 9: 79-84
      3. Survey of Occupational Injuries and Illnesses, National Institute of Occupational Safety and Health. 1999, Washington, DC

        • Towmey L.
        • Taylor J.
        Flexion creep deformation and hysterisis in the lumbar vertebral column.
        Spine. 1982; 7: 116-122
        • Williams M.
        • Solomonow M.
        • Zhou B.
        • Baratta R.
        • Harris M.
        Multifidus spasms elicited by prolonged lumbar flexion.
        Spine. 2000; 22: 2916-2924
      4. Workplace Injuries and Illnesses. Bureau of Labor Statistics, US Dept. of Labor, Report USDL-95-508, 1995, Washington, DC