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1.
The local dynamic stability of trunk movements, quantified using the maximum Lyapunov exponent (λmax), can provide important information on the neuromuscular control of spine stability during movement tasks. Although previous research has displayed the promise of this technique, all studies were completed with healthy participants. Therefore the goal of this study was to compare the dynamic stability of spine kinematics and trunk muscle activations, as well as antagonistic muscle co-contraction, between athletes with and without low back pain (LBP). Twenty interuniversity varsity athletes (10 LBP, 10 healthy controls) were recruited to participate in the study. Each participant completed a repetitive trunk flexion task at 15 cycles per minute, both symmetrically and asymmetrically, while trunk kinematics and muscular activity (EMG) were monitored. The local dynamic stability of low back EMG was significantly higher (lower λmax) in healthy individuals (p=0.002), whereas the dynamic stability of kinematics, the dynamic stability of full trunk system EMG, and the amount of antagonistic co-contraction were significantly higher when moving asymmetrically (p<0.05 for all variables). Although non-significant, kinematic and trunk system EMG stability also tended to be impaired in LBP participants, whereas they also tended to co-contract their antagonist muscles more. This study provides evidence that Lyapunov analyses of kinematic and muscle activation data can provide insight into the neuromuscular control of spine stability in back pain participants. Future research will repeat these protocols in patients with higher levels of pain, with hopes of developing a tool to assess impairment and treatment effectiveness in clinical and workplace settings.  相似文献   

2.
Stability of the spinal column is critical to bear loads, allow movement, and at the same time avoid injury and pain. However, there has been a debate in recent years as to how best to define and quantify spine stability, with the outcome being that different methods are used without a clear understanding of how they relate to one another. Therefore, the goal of the present study was to directly compare lumbar spine rotational stiffness, calculated with an EMG-driven biomechanical model, to local dynamic spine stability calculated using Lyapunov analyses of kinematic data, during a series of continuous dynamic lifting challenges. Twelve healthy male subjects performed 30 repetitive lifts under three varying load and three varying rate conditions. With an increase in the load lifted (constant rate) there was a significant increase in mean, maximum, and minimum spine rotational stiffness (p<0.001) and a significant increase in local dynamic stability (p<0.05); both stability measures were moderately to strongly related to one another (r=-0.55 to -0.71). With an increase in lifting rate (constant load), there was also a significant increase in mean and maximum spine rotational stiffness (p<0.01); however, there was a non-significant decrease in the minimum rotational stiffness and a non-significant decrease in local dynamic stability (p>0.05). Weak linear relationships were found for the varying rate conditions (r=-0.02 to -0.27). The results suggest that spine rotational stiffness and local dynamic stability are closely related to one another, as they provided similar information when movement rate was controlled. However, based on the results from the changing lifting rate conditions, it is evident that both models provide unique information and that future research is required to completely understand the relationship between the two models. Using both techniques concurrently may provide the best information regarding the true effects of (in) stability under different loading and movement scenarios, and in comparing healthy and clinical populations.  相似文献   

3.
The association between low back pain and spine movement control suggests that it is important to reliably quantify movement behavior. One method to characterize spine movement behavior is to measure the local dynamic stability (LDS) of spine movement during a repetitive flexion task in which a participant is asked to touch multiple targets repetitively. Within the literature, it has been well established that an individual’s focus of attention (FOA) can modulate their neuromuscular control and affect task performance. The goal of this project was to examine the unknown effect of FOA on LDS measurements and timing error during a repetitive spine flexion task that is commonly used to assess movement control. Fourteen healthy adults (7 male) were instructed to touch two targets (shoulder height and knee height) to the beat of a metronome (4 s/cycle) for 35 consecutive cycles. They completed this task under internal (focus on trunk movement) and external (focus on targets) FOA conditions. Motion capture data of the trunk and sacrum were collected at 120 Hz. The lumbar spine angle was defined as the orientation of the trunk relative to the pelvis. The local divergence exponent (λmax) was calculated from the sum of squares of the 3-dimensional spine angle. Timing error was calculated as the time difference between target touches and metronome beats. Changing an individual’s FOA had no effect on λmax calculations or timing error. Although clear task instructions are important, it is not essential to control for FOA during this movement assessment protocol.  相似文献   

4.
Repetitive trunk flexion elicits passive tissue creep, which has been hypothesized to compromise spine stability. The current investigation determined if increased spine flexion angle at the onset of flexion relaxation (FR) in the lumbar extensor musculature was associated with altered dynamic stability of spine kinematics. Twelve male participants performed 125 consecutive cycles of full forward trunk flexion. Spine kinematics and lumbar erector spinae (LES) electromyographic (EMG) activity were obtained throughout the repetitive trunk flexion trial. Dynamic stability was evaluated with maximum finite-time Lyapunov exponents over five sequential blocks of 25 cycles. Spine flexion angle at FR onset, and peak LES EMG activity were determined at baseline and every 25th cycle. Spine flexion angle at FR increased on average by 1.7° after baseline with significant increases of 1.7° and 2.4° at the 50th and 100th cycles. Maximum finite-time Lyapunov exponents demonstrated a transient, non-statistically significant, increase between cycles 26 and 50 followed by a recovery to baseline over the remainder of the repetitive trunk flexion cycles. Recovery of dynamic stability may be the consequence of increased active spine stiffness demonstrated by the non-significant increase in peak LES EMG that occurred as the repetitive trunk flexion progressed.  相似文献   

5.
Activity of the abdominal muscles during symmetric lifting has been a consistent finding in many studies. It has been hypothesized that this antagonistic coactivation increases trunk stiffness to provide stability to the spine. To test this, we investigated whether abdominal activity in lifting is increased in response to destabilizing conditions.

Ten healthy male subjects lifted 35 l containers containing 15 l of water (unstable condition), or ice (stable condition). 3D-kinematics, ground reaction forces, and EMG of selected trunk muscles were recorded. Euler angles of the thorax relative to the pelvis were determined. Inverse dynamics was used to calculate moments about L5S1. Averaged normalized abdominal EMG activity was calculated to express coactivation and an EMG-driven trunk muscle model was used to estimate the flexor moment produced by these muscles and to estimate the L5S1 compression force.

Abdominal coactivation was significantly higher when lifting the unstable load. This coincided with significant increases in estimated moments produced by the antagonist muscles and in estimated compression forces on the L5S1 disc, except at the instant of the peak moment about L5S1. The lifting style was not affected by load instability as evidenced by the absence of effects on moments about L5S1 and angles of the thorax relative to the pelvis. The data support the interpretation of abdominal cocontraction during lifting as subserving spinal stability. An alternative function of the increased trunk stiffness due to cocontraction might be to achieve more precise control over the trajectory of lifted weight in order to avoid sloshing of the water mass in the box and the consequent perturbations.  相似文献   


6.
Torso muscles contribute both intrinsic and reflexive stiffness to the spine; recent modeling studies indicate that intrinsic stiffness alone is sometimes insufficient to maintain stability in dynamic situations. The purpose of this study was to experimentally test this idea by limiting muscular reflexive responses to sudden trunk perturbations. Nine healthy males lay on a near-frictionless apparatus and were subjected to quick trunk releases from the neutral position into flexion or right-side lateral bend. Different magnitudes of moment release were accomplished by having participants contract their musculature to create a range of moment levels. EMG was recorded from 12 torso muscles and three-dimensional lumbar spine rotations were monitored. A second-order linear model of the trunk was employed to estimate trunk stiffness and damping during each quick release. Participants displayed very limited reflex responses to the quick load release paradigms, and consequently underwent substantial trunk displacements (>50% flexion range of motion and >70% lateral bend range of motion in the maximum moment trials). Trunk stiffness increased significantly with significant increases in muscle activation, but was still unable to prevent the largest trunk displacements in the absence of reflexes. Thus, it was concluded that the intrinsic stiffness of the trunk was insufficient to adequately prevent the spine from undergoing potentially harmful rotational displacements. Voluntary muscular responses were more apparent than reflexive responses, but occurred too late and of too low magnitude to sufficiently make up for the limited reflexes.  相似文献   

7.
Greater hamstring musculotendinous stiffness is associated with lesser ACL loading mechanisms. Stiffness is enhanced via training, but previous investigations evaluated tendon rather than musculotendinous stiffness, and none involved the hamstrings. We evaluated the effects of isometric and isotonic training on hamstring stiffness and ACL loading mechanisms. Thirty-six healthy volunteers were randomly assigned to isometric, isotonic, and control groups. Isometric and isotonic groups completed 6 weeks of training designed to enhance hamstring stiffness. Stiffness, anterior tibial translation, and landing biomechanics were measured prior to and following the interventions. Hamstring stiffness increased significantly with isometric training (15.7%; p = 0.006), but not in the isotonic (13.5%; p = 0.089) or control (0.4%; p = 0.942) groups. ACL loading mechanisms changed in manners consistent with lesser loading, but these changes were not statistically significant. These findings suggest that isometric training may be an important addition to ACL injury prevention programs. The lack of significant changes in ACL loading mechanisms and effects of isotonic training were likely due to the small sample sizes per group and limited intervention duration. Future research using larger sample sizes and longer interventions is necessary to determine the effects of enhancing hamstring stiffness on ACL loading and injury risk.  相似文献   

8.
With mechanical loading as the main risk factor for LBP, exoskeletons (EXO) are designed to reduce the load on the back by taking over part of the moment normally generated by back muscles. The present study investigated the effect of an active exoskeleton, controlled using three different control modes (INCLINATION, EMG & HYBRID), on spinal compression forces during lifting with various techniques.Ten healthy male subjects lifted a 15 kg box, with three lifting techniques (free, squat & stoop), each of which was performed four times, once without EXO and once each with the three different control modes. Using inverse dynamics, we calculated L5/S1 joint moments. Subsequently, we estimated spine forces using an EMG-assisted trunk model.Peak compression forces substantially decreased by 17.8% when wearing the EXO compared to NO EXO. However, this reduction was partly, by about one third, attributable to a reduction of 25% in peak lifting speed when wearing the EXO. While subtle differences in back load patterns were seen between the three control modes, no differences in peak compression forces were found. In part, this may be related to limitations in the torque generating capacity of the EXO. Therefore, with the current limitations of the motors it was impossible to determine which of the control modes was best. Despite these limitations, the EXO still reduced both peak and cumulative compression forces by about 18%.  相似文献   

9.
This study investigated the effects of age on upper erector spinae (UES), lower erector spinae (LES) and lower body (gluteus maximus; biceps femoris; and vastus lateralis) muscle activity during a repetitive lifting task. Twenty-four participants were assigned to two age groups: ‘younger’ (n = 12; mean age ± SD = 24.6 ± 3.6 yrs) and ‘older’ (n = 12; mean age = 46.5 ± 3.0 yrs). Participants lifted and lowered a box (13 kg) repetitively at a frequency of 10 lifts per minute for a maximum of 20 min. EMG signals were collected every minute and normalised to a maximum voluntary isometric contraction. A submaximal endurance test of UES and LES was used to assess fatigue. Older participants showed higher levels of UES and LES muscle activity (approximately 12–13%) throughout the task, but less fatigue compared to the younger group post-task completion. When lifting, lower-limb muscle activity was generally higher in older adults, although temporal changes were similar. While increased paraspinal muscle activity may increase the risk of back injury in older workers when repetitive lifting, younger workers may be more susceptible to fatigue-related effects. Education and training in manual materials handling should consider age-related differences when developing training programmes.  相似文献   

10.
There is a clear relationship between lumbar spine loading and back musculoskeletal disorders in manual materials handling. The incidence of back disorders is greater in women than men, and for similar work demands females are functioning closer to their physiological limit. It is crucial to study loading on the spine musculoskeletal system with actual handlers, including females, to better understand the risk of back disorders. Extrapolation from biomechanical studies conducted on unexperienced subjects (mainly males) might not be applicable to actual female workers. For male workers, expertise changes the lumbar spine flexion, passive spine resistance, and active/passive muscle forces. However, experienced females select similar postures to those of novices when spine loading is critical. This study proposes that the techniques adopted by male experts, male novices, and females (with considerable experience but not categorized as experts) impact their lumbar spine musculoskeletal systems differently. Spinal loads, muscle forces, and passive resistance (muscle and ligamentous spine) were predicted by a multi-joint EMG-assisted optimization musculoskeletal model of the lumbar spine. Expert males flexed their lumbar spine less (avg. 21.9° vs 30.3–31.7°) and showed decreased passive internal moments (muscle avg. 8.9% vs 15.9–16.0%; spine avg. 4.7% vs 7.1–7.8%) and increased active internal moments (avg. 72.9% vs 62.0–63.9%), thus producing a different impact on their lumbar spine musculoskeletal systems. Experienced females sustained the highest relative spine loads (compression avg. 7.3 N/BW vs 6.2–6.4 N/BW; shear avg. 2.3 N/BW vs 1.7–1.8 N/BW) in addition to passive muscle and ligamentous spine resistance similar to novices. Combined with smaller body size, less strength, and the sequential lifting technique used by females, this could potentially mean greater risk of back injury. Workers should be trained early to limit excessive and repetitive stretching of their lumbar spine passive tissues.  相似文献   

11.
The effects of external resistance on the recruitment of trunk muscles in sagittal movements and the coactivation mechanism to maintain spinal stability were investigated using a simple computational model of iso-resistive spine sagittal movements. Neural excitation of muscles was attained based on inverse dynamics approach along with a stability-based optimisation. The trunk flexion and extension movements between 60° flexion and the upright posture against various resistance levels were simulated. Incorporation of the stability constraint in the optimisation algorithm required higher antagonistic activities for all resistance levels mostly close to the upright position. Extension movements showed higher coactivation with higher resistance, whereas flexion movements demonstrated lower coactivation indicating a greater stability demand in backward extension movements against higher resistance at the neighbourhood of the upright posture. Optimal extension profiles based on minimum jerk, work and power had distinct kinematics profiles which led to recruitment patterns with different timing and amplitude of activation.  相似文献   

12.
During range of motion (max-ROM) tests performed on an isokinetic dynamometer, the mechanical delay between the button press (by the participant to signal their max-ROM) and the stopping of joint rotation resulting from system inertia induces errors in both max-ROM and maximum passive joint moment. The present study aimed to quantify these errors by comparing data when max-ROM was obtained from the joint position data, as usual (max-ROMPOS), to data where max-ROM was defined as the first point of dynamometer arm deceleration (max-ROMACC). Fifteen participants performed isokinetic ankle joint max-ROM tests at 5, 30 and 60° s−1. Max-ROM, peak passive joint moment, end-range musculo-articular (MAC) stiffness and area under the joint moment-position curve were calculated. Greater max-ROM was observed in max-ROMPOS than max-ROMACC (P < 0.01) at 5 (0.2 ± 0.15%), 30 (1.8 ± 1.0%) and 60° s−1 (5.9 ± 2.3%), with the greatest error at the fastest velocity. Peak passive moment was greater and end-range MAC stiffness lower in max-ROMPOS than in max-ROMACC only at 60° s−1 (P < 0.01), whilst greater elastic energy storage was found at all velocities. Max-ROM and peak passive moment are affected by the delay between button press and eventual stopping of joint rotation in an angular velocity-dependent manner. This affects other variables calculated from the data. When high data accuracy is required, especially at fast joint rotation velocities (≥30° s−1), max-ROM (and associated measures calculated from joint moment data) should be taken at the point of first change in acceleration rather than at the dynamometer’s ultimate joint position.  相似文献   

13.
We checked on the supposition that the magnitude of postural reactions to an unexpected postural disturbance in upright stance in humans can be determined to a considerable extent by the level of background stiffness in the ankle joints. For this purpose, we estimated changes in the joint stiffness under different conditions of visual control; these values were estimated within the period of background body oscillations (i.e., before the beginning of a compensatory motor reaction) and compared with those in the course of postural reactions evoked by vibrational stimulation of the ankle (shin) muscles. Experiments were carried where the subjects stood with open and closed eyes (OE and CE, respectively) and while standing wearing spectacles with frosted glass passing only diffuse light (DL). In the course of the tests, the subjects stood in the usual comfortable vertical position (hereafter, standard stance) or in the same position but with the possibility to lightly touch an immobile object by a finger (stance with additional support). Such technique was used to weaken the effects of CE and DL on background sways of the body and to lead these sways close to the level typical of OE conditions. The joint stiffness was estimated using an approach based on frequency filtration of oscillations of the center of pressure of the feet (CPF) that allowed us to select signals proportional to displacements of the total center of gravity (CG) of the body and to calculate the difference between oscillations of the CPF and CG (a CPF-CG variable). The CPF-CG variable is proportional to the horizontal acceleration of the CG and, therefore, can be used for estimation of the changes in stiffness in the ankle joints. Under conditions of standard stance, the usual conditions rather similarly influenced both variables (CG and CPF-CG) in the course of both background body oscillations and a postural response. The examined variables were the greatest under CE conditions, decreased under conditions of perception of DL, and became smallest with OE. At standing with additional support, the dependence of the examined variables on visual conditions disappeared within the period of background body oscillations (before the beginning of postural reactions). In this case, the magnitude of oscillations of the CPF-CG variable under CE and DL conditions decreased to the level observed at standing under OE conditions. The magnitude of CG displacements induced by vibrational stimulations of the muscles remained, nevertheless, clearly dependent on visual conditions (the same regularities were observed as in the case of standing with no additional support). Thus, our findings demonstrate that the correlation between the characteristics of postural reactions in the upright stance and the level of ankle joint stiffness is not single-valued. Neirofiziologiya/Neurophysiology, Vol. 39, No. 2, pp. 146–153, March–April, 2007.  相似文献   

14.
Female athletes are more prone to anterior cruciate ligament (ACL) injury. A neuromuscular imbalance called leg dominance may provide a biomechanical explanation. Therefore, the purpose of this study was to compare the side-to-side lower limb differences in movement patterns, muscle forces and ACL forces during a single-leg drop-landing task from two different heights. We hypothesized that there will be significant differences in lower limb movement patterns (kinematics), muscle forces and ACL loading between the dominant and non-dominant limbs. Further, we hypothesized that significant differences between limbs will be present when participants land from a greater drop-landing height. Eight recreational female participants performed dominant and non-dominant single-leg drop landings from 30 to 60 cm. OpenSim software was used to develop participant-specific musculoskeletal models and to calculate muscle forces. We also predicted ACL loading using our previously established method. There were no significant differences between dominant and non-dominant leg landing except in ankle dorsiflexion and GMED muscle forces at peak GRF. Landing from a greater height resulted in significant differences among most kinetics and kinematics variables and ACL forces. Minimal differences in lower-limb muscle forces and ACL loading between the dominant and non-dominant legs during single-leg landing may suggest similar risk of injury across limbs in this cohort. Further research is required to confirm whether limb dominance may play an important role in the higher incidence of ACL injury in female athletes with larger and sport-specific cohorts.  相似文献   

15.
16.
Abnormal muscle stiffness is a potential complication after injury and identifying interventions that modify muscle stiffness may be useful to promote recovery. The purpose of this study was to identify the short-term effects of dry needling (DN) on resting and contracted gastrocnemius muscle stiffness and strength of the triceps surae in individuals with latent myofascial trigger points (MTrPs). In this randomized controlled trial, 52 individuals received two DN treatment sessions to latent MTrPs and 50 individuals received two sham needling sessions. Resting and contracted muscle stiffness were assessed both at the treatment site and a standardized central site in the medial gastrocnemius head immediately post-treatment and one week after the last session. There were significant group by time interactions for resting muscle stiffness at the site of the MTrP (p = .03), but not at the central site (p = .29). Post-needling between group comparison indicated that the DN group had significantly lower resting muscle stiffness at the site of the MTrP than the sham group after adjusting for baseline differences. There were no significant between group differences in contracted muscle stiffness or muscle strength. Identifying strategies that can reduce aberrant muscle stiffness may help to guide management of individuals with neuromuscular pain-related conditions.Level of evidence: Therapy, level 2.  相似文献   

17.
Anterior cruciate ligament (ACL) injury is one of the most common serious lower-extremity injuries experienced by athletes participating in field and court sports and often occurs during a sudden change in direction or pivot. Both lateral trunk positioning during cutting and peak external knee abduction moments have been associated with ACL injury risk, though it is not known how core muscle activation influences these variables. In this study, the association between core muscle pre-activation and trunk position as well as the association between core muscle pre-activation and peak knee abduction moment during an unanticipated run-to-cut maneuver were investigated in 46 uninjured individuals. Average co-contraction indices and percent differences between muscle pairs were calculated prior to initial contact for internal obliques, external obliques, and L5 extensors using surface electromyography. Outside tilt of the trunk was defined as positive when the trunk was angled away from the cutting direction. No significant associations were found between pre-activations of core muscles and outside tilt of the trunk. Greater average co-contraction index of the L5 extensors was associated with greater peak knee abduction moment (p=0.0107). Increased co-contraction of the L5 extensors before foot contact could influence peak knee abduction moment by stiffening the spine, limiting sagittal plane trunk flexion (a motion pattern previously linked to ACL injury risk) and upper body kinetic energy absorption by the core during weight acceptance.  相似文献   

18.
Ankle osteoarthritis is a debilitating condition affecting about 1% of the population with approximately 50,000 new instances annually. One treatment is total ankle arthroplasty (TAA), however, its effects on balance are not well understood. This study analyzed balance over a two-year period following TAA. 408 subjects (177 left, 231 right ankles) diagnosed with end-stage ankle osteoarthritis performed quiet standing trials while center of pressure (COP) data were collected. Data were compared across three time points (pre-op, 1-year, and 2-years post-op) and between surgical and non-surgical limbs using a linear mixed model with significance set at P = 0.05. COP excursions in the feet-together condition were not significantly different between limbs after 2 years in anteroposterior or mediolateral directions (P = 0.06, 0.08) after being significantly different between limbs in the anteroposterior (P = 0.014) and mediolateral direction (P < 0.001) pre-op. The vertical ground reaction force significantly decreased across time in the non-surgical limb, while reciprocally increasing in the surgical limb (P < 0.001). After 2 years, no significant difference in vertical ground reaction force between limbs existed (P = 0.20). Limb asymmetry indices decreased at each time point in both conditions (all P < 0.001) and were not significantly different from zero after 2 years in the feet-together condition (P = 0.290). In conclusion, surgical limb balance improved compared to pre-op, resulting in increased symmetry between limbs after 2 years. Vertical ground reaction forces on both limbs converge and limb asymmetry indices approach zero two years post-op. Differences in the COP excursion-loading symmetry relationship between limbs could be useful for identifying instability in other pathologies.  相似文献   

19.
The effects of external resistance on the recruitment of trunk muscles in sagittal movements and the coactivation mechanism to maintain spinal stability were investigated using a simple computational model of iso-resistive spine sagittal movements. Neural excitation of muscles was attained based on inverse dynamics approach along with a stability-based optimisation. The trunk flexion and extension movements between 60° flexion and the upright posture against various resistance levels were simulated. Incorporation of the stability constraint in the optimisation algorithm required higher antagonistic activities for all resistance levels mostly close to the upright position. Extension movements showed higher coactivation with higher resistance, whereas flexion movements demonstrated lower coactivation indicating a greater stability demand in backward extension movements against higher resistance at the neighbourhood of the upright posture. Optimal extension profiles based on minimum jerk, work and power had distinct kinematics profiles which led to recruitment patterns with different timing and amplitude of activation.  相似文献   

20.
Textured insoles may enhance sensory input on the plantar surfaces of the feet, thereby influencing neuromuscular function. The aim of this study was to investigate whether textured surfaces alter postural stability and lower limb muscle activity during quiet bipedal standing balance with eyes open. Anterior–posterior (AP) and mediolateral (ML) sway variables and the intensity of electromyographic (EMG) activity in eight dominant lower limb muscles were collected synchronously over 30 s in 24 young adults under three randomised conditions: control surface (C), texture 1 (T1) and texture 2 (T2). Repeated measures ANOVA showed that the textured surfaces did not significantly affect AP or ML postural sway in comparison to the control condition (p > 0.05). Neither did the textured surfaces significantly alter EMG activity in the lower limbs (p > 0.05). Under the specific conditions of this study, texture did not affect either postural sway or lower limb muscle activity in static bipedal standing. The results of this study point to three areas of further work including the effect of textured surfaces on postural stability and lower limb muscle activity: (i) in young healthy adults under more vigorous dynamic balance tests, (ii) post-fatigue, and (iii) in older adults presenting age-related deterioration.  相似文献   

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