Back strength cannot be predicted accurately from anthropometric measures in subjects with and without chronic low back pain


      Objectives. (1) To develop a multiple regression equation using anthropometric measurements to predict back strength and (2) to estimate the effect of practice on the back strength results and back strength predictions.
      Design. Comparative study with repeated measures performed on three days.
      Background. The assessment of back muscle relative endurance (% maximal strength) requires the measurement of maximal back strength which is problematic with low back pain patients.
      Methods. The back strength (L5/S1 static extension moment), age and 26 anthropometric parameters were obtained from 83 male volunteers [42 healthy subjects and 41 chronic low back pain patients] aged between 20 and 60 years. A subsample of 20 healthy subjects and 20 patients were assessed through three days of testing to evaluate the variations of back strength with practice.
      Results. The final regression model (n=42 healthy subjects) explained 39% of the variance in back strength. Back strength increased with practice (Math Eq & 3) for both healthy and patients groups. However, the error of prediction of back strength derived from the regression model showed a significant improvement with practice for the patients only.
      Conclusions. Back strength cannot be predicted from simple anthropometric measures without important errors. The decrease of the error of prediction obtained for the patient group is indicative of a decreasing influence of psychological factors that are independent of motor learning because the effect of motor learning would have occurred on both groups if present.
      Relevance The prediction of back strength would be useful to determine (1) the relative force level of a given exercise or (2) the preinjury back strength. Unfortunately, anthropometric measurements are not enough good predictors of back strength.


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


        • Allen G.M.
        • Gandevia S.C.
        • McKenzie D.K.
        Reliability of measurements of muscle strength and voluntary activation using twitch interpolation.
        Muscle Nerve. 1995; 18: 593-600
        • Callaghan M.J.
        • McCarthy C.J.
        • Al Omar A.
        • Oldham J.A.
        The reproducibility of multi-joint isokinetic and isometric assessments in a healthy and patient population.
        Clin. Biomech. 2000; 15: 678-683
        • Clarke H.H.
        Relationship of strength and anthropometric measures to physical performances involving the trunk and legs.
        Res. Q. 1957; 28: 223-232
        • De Luca C.J.
        Use of the surface EMG signal for performance evaluation of back muscles.
        Muscle Nerve. 1993; 16: 210-216
        • Durnin J.V.G.A.
        • Womersley J.
        Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years.
        Br. J. Nut. 1974; 32: 77-97
        • Estlander A.M.
        • Vanharanta H.
        • Moneta G.B.
        • Kaivanto K.
        Anthropometric variables, self-efficacy beliefs, and pain and disability ratings on the isokinetic performance of low back pain patients.
        Spine. 1994; 19: 941-947
        • Fairbank J.C.T.
        • Couper J.
        • Davies J.
        • O’Brien J.
        The Oswestry low back pain disability questionnaire.
        Physiotherapy. 1980; 66: 271-273
        • Flores L.
        • Gatchel R.J.
        • Polatin P.B.
        Objectivation of functional improvement after nonoperative care.
        Spine. 1997; 22: 1622-1633
        • Garrow J.S.
        • Webster J.
        Quetelet’s index (W/H2) as a measure of fatness.
        Int. J. Obesity. 1985; 9: 147-153
        • Gomez T.
        • Beach G.
        • Cooke C.
        • Hrudey W.
        • Goyert P.
        Normative database for trunk range of motion, strength, velocity, and endurance with the Isostation B-200 lumbar dynamometer.
        Spine. 1991; 16: 15-21
        • Graves J.E.
        • Pollock M.L.
        • Carpenter D.M.
        • et al.
        Quantitative assessment of full range-of-motion isometric lumbar extension strength.
        Spine. 1990; 15: 289-294
        • Gross M.T.
        • Dailey E.S.
        • Dalton M.D.
        • et al.
        Relationship between lifting capacity and anthropometric measures.
        JOSPT. 2000; 30: 237-247
        • Hides J.A.
        • Stokes M.J.
        • Saide M.
        • Jull G.A.
        • Cooper D.H.
        Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain.
        Spine. 1994; 19: 165-172
        • Hirsch G.
        • Beach G.
        • Cooke C.
        • Menard M.
        • Locke S.
        Relationship between performance on lumbar dynamometry and Waddell score in a population with low-back pain.
        Spine. 1991; 16: 1039-1043
        • Hortobagyi T.
        • Katch F.I.
        • Katch V.L.
        • LaChance P.F.
        • Behnke A.R.
        Relationships of body size, segmental dimensions, and ponderal equivalents to muscular strength in high-strength and low-strength subjects.
        Int. J. Sports Med. 1990; 11: 349-356
        • Jerome J.A.
        • Hunter K.
        • Gordon P.
        • Mckay N.
        A new robust index for measuring isokinetic trunk flexion and extension. Outcome from a regional study.
        Spine. 1991; 16: 804-808
        • Katch F.I.
        • Behnke A.R.
        • Katch V.L.
        The Ponderal Somatogram: evaluation of body size and shape from anthropometric girths and stature.
        Hum. Biol. 1987; 59: 439-458
        • Keller A.
        • Johansen J.G.
        • Hellesnes J.
        • Brox J.I.
        Predictors of isokinetic back muscle strength in patients with low back pain.
        Spine. 1999; 24: 275-280
        • Larivière C.
        • Arsenault A.B.
        • Gravel D.
        • Gagnon D.
        • Loisel P.
        Evaluation of measurement strategies to increase the reliability of EMG indices to assess back muscle fatigue and recovery.
        J. Electromyogr. Kinesiol. 2002; 12: 135-146
        • Lariviere C.
        • Gagnon D.
        • Gravel D.
        • et al.
        A triaxial dynamometer to monitor lateral bending and axial rotation moments during static trunk extension efforts.
        Clin. Biomech. 2001; 16: 80-83
        • Laubach L.L.
        • McConville J.T.
        Muscle strength, flexibility, and body size of adult males.
        Res. Q. 1966; 37: 384-392
        • Laubach L.L.
        • McConville J.T.
        The relationship of strength to body size and typology.
        Med. Sci. Sports. 1969; 1: 189-194
        • Lean M.E.J.
        • Han T.S.
        • Deurenberg P.
        Predicting body composition by densitometry from simple anthropometric measurements.
        Am. J. Clin. Nut. 1996; 63: 4-14
        • Malchaire J.B.
        • Masset D.F.
        Isometric and dynamic performances of the trunk and associated factors.
        Spine. 1995; 20: 1649-1656
        • Mannion A.F.
        • Adams M.A.
        • Cooper R.G.
        • Dolan P.
        Prediction of maximal back muscle strength from indices of body mass and fat-free body mass.
        Rheumatology. 1999; 38: 652-655
        • Mannion A.F.
        • Kaser L.
        • Weber E.
        • Rhyner A.
        • Dvorak J.
        • Muntener M.
        Influence of age and duration of symptoms on fibre type distribution and size of the back muscles in chronic low back pain patients.
        Eur. Spine J. 2000; 9: 273-281
        • Marras W.S.
        • Davis K.G.
        A non-MVC normalization technique for the trunk musculature: Part 1. Method development.
        J. Electromyogr. Kinesiol. 2001; 11: 1-9
        • Mayhew J.L.
        • Piper F.C.
        • Ware J.S.
        Anthropometric correlates with strength performance among resistance trained athletes.
        J. Sports Med. Phys. Fit. 1993; 33: 159-165
        • Menard M.R.
        • Cooke C.
        • Locke S.R.
        • Beach G.N.
        • Butler T.B.
        Pattern of performance in workers with low back pain during comprehensive motor performance evaluation.
        Spine. 1994; 19: 1359-1366
        • Mital A.
        • Ayoub M.M.
        Modeling of isometric strength and lifting capacity.
        Hum. Factors. 1980; 22: 285-290
        • Mooney V.
        • Gulick J.
        • Perlman M.
        • et al.
        Relationships between myoelectric activity, strength, and MRI of lumbar extensor muscles in back pain patients and normal subjects.
        J. Spinal Disord. 1997; 10: 348-356
        • Moritani T.
        • DeVries H.A.
        Neural factors versus hypertrophy in the time course of muscle strength gain.
        Am. J. Phys. Med. 1979; 58: 115-130
        • Oddsson L.I.E.
        • Giphart J.E.
        • Buijs R.J.C.
        • Roy S.H.
        • Taylor H.P.
        • DeLuca C.J.
        Development of new protocols and analysis procedures for the assessment of LBP by surface EMG techniques.
        J. Rehabil. Res. Dev. 1997; 34: 415-426
        • Sale D.G.
        • MacDougall J.D.
        • Upton A.R.M.
        • McComas A.J.
        Effect of strength training upon motoneuron excitability in man.
        Med. Sci. Sports Exerc. 1983; 15: 57-62
        • Simonsen J.C.
        Coefficient of variation as a measure of subject effort.
        Arch. Phys. Med. Rehabil. 1995; 76: 516-520
        • Spitzer W.O.
        • Leblanc F.E.
        • Dupuis M.
        Scientific approach to the assessment and management of activity-related spinal disorders.
        Spine. 1987; 12: S1-S59
        • Stokes I.A.F.
        • Rush S.
        • Moffroid M.
        • Johnson G.B.
        • Haugh L.D.
        Trunk extensor EMG––torque relationship.
        Spine. 1987; 12: 770-776
        • Stokes M.
        • Young A.
        The contribution of reflex inhibition to arthrogenous muscle weakness.
        Clin. Sci. 1984; 67: 7-14
        • Thorsen M.A.
        Body structure and design: factors in the motor performance of college women.
        Res. Q. 1964; 35: 420-432
        • Vlaeyen J.W.S.
        • Kole-Snijders A.M.J.
        • Boeren R.G.B.
        • van Eek H.
        Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance.
        Pain. 1995; 62: 363-372
        • Waddell G.
        • Newton M.
        • Henderson I.
        • Somerville D.
        • Main C.J.
        A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability.
        Pain. 1993; 52: 157-168