Viscoelastic creep induced by repetitive spine flexion and its relationship to dynamic spine stability

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.     

The relationship between flexibility and EMG activity pattern of the erector spinae muscles during trunk flexion–extension

BackgroundMovements in the lumbar spine, including flexion and extension are governed by a complex neuromuscular system involving both active and passive units. Several biomechanical and clinical studies have shown the myoelectric activity reduction of the lumbar extensor muscles (flexion–relaxation phenomenon) during lumbar flexion from the upright standing posture. The relationship between flexibility and EMG activity pattern of the erector spinae during dynamic trunk flexion–extension task has not yet been completely discovered.ObjectiveThe purpose of this study was to investigate the relationship between general and lumbar spine flexibility and EMG activity pattern of the erector spinae during the trunk flexion–extension task.MethodsThirty healthy female college students were recruited in this study. General and lumbar spine flexibilities were measured by toe-touch and modified schober tests, respectively. During trunk flexion–extension, the surface electromyography (EMG) from the lumbar erector spinae muscles as well as flexion angles of the trunk, hip, lumbar spine and lumbar curvature were simultaneously recorded using a digital camera. The angle at which muscle activity diminished during flexion and initiated during extension was determined and subjected to linear regression analysis to detect the relationship between flexibility and EMG activity pattern of the erector spinae during trunk flexion–extension.ResultsDuring flexion, the erector spinae muscles in individuals with higher toe-touch scores were relaxed in larger trunk and hip angles and reactivated earlier during extension according to these angles (P < 0.001) while in individuals with higher modified schober scores this muscle group was relaxed later and reactivated sooner in accordance with lumbar angle and curvature (P < 0.05). Toe-touch test were significantly correlated with trunk and hip angles while modified schober test showed a significant correlation with lumbar angle and curvature variables.ConclusionThe findings of this study indicate that flexibility plays an important role in trunk muscular recruitment pattern and the strategy of the CNS to provide stability. The results reinforce the possible role of flexibility alterations as a contributing factor to the motor control impairments. This study also shows that flexibility changes behavior is not unique among different regions of the body.     

EMG in rotation–flexion of the torso

The objective of this study was to determine the magnitude and phasic relationship of the torso muscles in rotation–flexion of varying degree of asymmetries of the trunk. Nineteen normal young subjects (7 males and 12 females) were stabilized on a posture stabilizing platform and instructed to assume a flexed and right rotated posture. A combination 20°, 40° and 60° of rotation and 20°, 40° and 60° of flexion resulted in nine postures. These postures were assumed in a random order. The subjects were asked to exert their maximal voluntary isometric contraction (MVC) in the plane of rotation of the posture assumed for a period of 5 s. The surface EMG from the external and internal obliques, rectus abdominis, latissimus dorsi and erector spinae at the 10th thoracic and 3rd lumbar vertebral levels was recorded. The abdominal muscles had the least response at 40° of flexion, the dorsal muscles had the highest magnitude.With increasing right rotation, the left external oblique continued to decrease its activity. The ANOVA revealed that rotation and muscles had a significant main effect on normalized peak EMG (p < 0.02) in both genders. There was a significant interaction between rotation and flexion in both genders (p < 0.02) and rotation and muscle in females. The erector spinae activity was highest at 40° flexion, due to greater mechanical disadvantage and having not reached the state of flexion–relaxation. The abdominal muscle activity declined with increasing asymmetry, due to the decreasing initial muscle length. The EMG activity was significantly affected by rotation than flexion (p < 0.02).     

Trunk muscle reflexes are elicited by small continuous perturbations in healthy subjects and patients with low-back pain

Low-back pain (LBP) has been recognized as the leading cause of disability worldwide. Lumbar instability has been considered as an important mechanism of LBP and one potential contributor to lumbar stability is trunk muscle reflex activity. However, due to the differences in experimental paradigms used to quantify trunk mechanics and trunk reflexes it remains unclear as to what extent the reflex pathway contributes to overall lumbar stability. The goal of this work was to determine to what extent reflexes of various trunk muscles were elicited by the small continuous perturbations normally used to quantify trunk mechanics. Electromyographic (EMG) activity was measured bilaterally from 3 trunk extensor muscles and 3 trunk flexor muscles at four epochs: 25–50 ms, 50–75 ms, 75–100 ms and 100–125 ms following each perturbation. Reflex activity was seen in all muscles as 34 of the 48 muscle-epoch combinations showed a significant reflex response to either perturbations in the forward or backward direction. However, the reflex EMG activity did not correlate with mechanical estimates of the reflex response. Thus, even though reflexes are indeed elicited by the small perturbations used to quantify trunk mechanics, their exact contribution to overall lumbar stability remains unknown.     

The use of intermittent trunk flexion to alleviate low back pain during prolonged standing

The current study examined of the effect of intermittent, short-term periods of full trunk flexion on the development of low back pain (LBP) during two hours of standing. Sixteen participants completed two 2-h standing protocols, separated by one week. On one day, participants stood statically for 2 h (control day); on the other day participants bent forward to full spine flexion (termed flexion trials) to elicit the flexion relaxation (FR) phenomenon for 5 s every 15 min (experimental day). The order of the control and experimental day was randomized. During both protocols, participants reported LBP using a 100 mm visual analogue scale every 15 min. During the flexion trials, lumbar spine posture, erector spinae and gluteus medius muscle activation was monitored. Ultimately, intermittent trunk flexion reduced LBP by 36% (10 mm) at the end of a 2-h period of standing. Further, erector spinae and gluteus medius muscle quietening during FR was observed in 91% and 65% of the flexion trials respectively, indicating that periods of rest did occurred possibly contributing to the reduction in LBP observed. Since flexion periods do not require any aids, they can be performed in most workplaces thereby increasing applicability.     

Altered trunk muscle coordination during rapid trunk flexion in people in remission of recurrent low back pain

People with a history of low back pain (LBP) are at high risk to encounter additional LBP episodes. During LBP remission, altered trunk muscle control has been suggested to negatively impact spinal health. As sudden LBP onset is commonly reported during trunk flexion, the aim of the current study is to investigate whether dynamic trunk muscle recruitment is altered in LBP remission. Eleven people in remission of recurrent LBP and 14 pain free controls performed cued trunk flexion during a loaded and unloaded condition. Electromyographic activity was recorded from paraspinal (lumbar and thoracic erector spinae, latissimus dorsi, deep and superficial multifidus) and abdominal muscles (obliquus internus, externus and rectus abdominis) with surface and fine-wire electrodes. LBP participants exhibited higher levels of co-contraction of flexor/extensor muscles, lower agonistic abdominal and higher antagonistic paraspinal muscle activity than controls, both when data were analyzed in grouped and individual muscle behavior. A sub-analysis in people with unilateral LBP (n = 6) pointed to opposing changes in deep and superficial multifidus in relation to the pain side. These results suggest that dynamic trunk muscle control is modified during LBP remission, and might possibly increase spinal load and result in earlier muscle fatigue due to intensified muscle usage. These negative consequences for spinal health could possibly contribute to recurrence of LBP.     

Corrective sitting strategies: An examination of muscle activity and spine loading

The purpose of this study was to quantify the load on the lumbar spine of subjects when they are asked to adjust from a slouched sitting posture into an upright posture with one of three different strategies: “free” (no instruction) and two coached patterns: “lumbopelvic” dominant and “thoracic” dominant. The activity of selected muscles and kinematic data was recorded from 20 volunteers while performing the three movement patterns to adjust sitting posture. Moments and forces at the lumbar spine were computed from an anatomically detailed model that uses kinematics and muscle activation as input variables.The lumbopelvic pattern produces less joint moment on the lumbar spine (on average 31.2 ± 3.9 N m) when compared to the thoracic pattern (43.8 ± 5.8 N m). However, the joint compression force was similar for these two patterns, but it was smaller in the free pattern, when no coaching was given (lumbopelvic: 1279 ± 112 N, thoracic: 1367 ± (125 N, free: 1181 ± 118 N). Lower thoracic erector muscle activity and higher lumbar erector activity were measured in the lumbopelvic pattern in comparison with the other two. In summary the lumbopelvic pattern strategy using predominantly the movement of anterior pelvic tilt results in smaller joint moments on the lumbar spine and also positions the lumbar spine closest to the neutral posture minimizing passive tissue stress. This may be the strategy of choice for people with low back flexion intolerance.     

Effects of stance width on postural movement pattern and anticipatory postural control associated with unilateral arm abduction

We investigated the effects of stance width on postural movement pattern and activation timing of postural muscles during unilateral arm abduction. Thirty-two healthy subjects abducted the right arm at their own timing. Stance width was 0, 9, 18 or 27 cm. Movement angles of leg lateral inclination and trunk lateral flexion to the leg in the frontal plane were analyzed. Based on movement angles at 0 cm width, subjects were classified into three groups: contralateral whole body leaning (CWBLg); ipsilateral trunk flexion (ITFg); and contralateral trunk flexion (CTFg). A high correlation between the movement angles was obtained at 0 cm width (r = 0.82). With increasing stance width, postural movement pattern in the ITFg shifted to patterns characterized by lateral flexion of the trunk toward the side opposite to arm movement, and movement angle of leg-inclination in ITFg and CWBLg decreased. At 0 cm width, left gluteus medius and tensor fascia latae were activated significantly about 40 ms ahead of the right middle deltoid in CWBLg and CTFg, but not in ITFg. However, preceding activation became prominent (about 20 ms) in ITFg for wide stances. Moreover, bilateral activation of the tensor fascia latae was observed in CTFg for all widths.     

Anticipatory postural adjustments to arm movement reveal complex control of paraspinal muscles in the thorax

Anatomical and empirical data suggest that deep and superficial muscles may have different functions for thoracic spine control. This study investigated thoracic paraspinal muscle activity during anticipatory postural adjustments associated with arm movement. Electromyographic (EMG) recordings were made from the right deep (multifidus/rotatores) and superficial (longissimus) muscles at T5, T8, and T11 levels using fine-wire electrodes. Ten healthy participants performed fast unilateral and bilateral flexion and extension arm movements in response to a light. EMG amplitude was measured during 25 ms epochs for 150 ms before and 400 ms after deltoid EMG onset. During arm flexion movements, multifidus and longissimus had two bursts of activity, one burst prior to deltoid and a late burst. With arm extension both muscles were active in a single burst after deltoid onset. There was differential activity with respect to direction of trunk rotation induced by arm movement. Right longissimus was most active with left arm movements and right multifidus was most active with right arm movements. All levels of the thorax responded similarly. We suggest that although thoracic multifidus and longissimus function similarly to control sagittal plane perturbations, these muscles are differentially active with rotational forces on the trunk.     

Standardized activities of daily living in presence of sub-acute low-back pain: A pilot study

The aim of this pilot study was to investigate how sub-acute low-back pain (LBP) patients differed with respect to control in movements and muscle activation during standardized tasks representing daily living activities, and explore relationships between cognition and measured motor performance. Linear and nonlinear parameters were computed from kinetics, kinematics and muscle activity recorded for 12 sub-acute patients and 12 healthy matched controls during trunk flexion, sit-to-stand from a chair and lifting a box. Cognitive variables were collected to explore relationships with biomechanical parameters. For trunk flexion, left external abdominal oblique muscle activity level was lower for patients compared with controls (p < 0.05), whereas sample entropy (complexity) was higher (p < 0.05). Normalized mutual information was lower for patients compared with controls for left and right erector spinae (p < 0.05). Level of activity of left external abdominal oblique correlated negatively with cognitive ignoring and positively with catastrophizing (p ? 0.05), and catastrophizing also correlated positively with functional connectivity of abdominal muscles (p < 0.05). Signs of reorganization in muscle activation pointed towards different synergistic actions in trunk muscles in sub-acute LBP patients compared with controls. The interplay with maladaptive cognition suggested that in the subacute stage of LBP, both biomechanical and cognitive factors should be taken into account.     

Effect of changes in orientation and position of external loads on trunk muscle activity and kinematics in upright standing

Forces at different heights and orientations are often carried by hands while performing occupational tasks. Trunk muscle activity and spinal loads are likely dependent on not only moments but also the orientation and height of these forces. Here, we measured trunk kinematics and select superficial muscle activity of 12 asymptomatic subjects while supporting forces in hands in upright standing. Magnitude of forces in 5 orientations (−25°, 0°, 25°, 50° and 90°) and 2 heights (20 cm and 40 cm) were adjusted to generate flexion moments of 15, 30 and 45 N m at the L5-S1 disc centre. External forces were of much greater magnitude when applied at lower elevation or oriented upward at 25°. Spinal kinematics remained nearly unchanged in various tasks.Changes in orientation and elevation of external forces substantially influenced the recorded EMG, despite similar trunk posture and identical moments at the L5-S1. Greater EMG activity was overall recorded under larger forces albeit constant moment. Increases in the external moment at the L5-S1 substantially increased EMG in extensor muscles (p < 0.001) but had little effect on abdominals; e.g., mean longissimus EMG for all orientations increased by 38% and 75% as the moment level altered from 15 N m to 30 N m and to 45 N m while that in the rectus abdominus increased only by 2% and 4%, respectively. Under 45 N m moment and as the load orientation altered from 90° to 50°, 25°, 0° and −25°, mean EMG dropped by 3%, 12%, 12% and 1% in back muscles and by 17%, 17%, 19% and 13% in abdominals, respectively. As the load elevation increased from 20 cm to 40 cm, mean EMG under maximum moment decreased by 21% in back muscles and by 17% in abdominals.Due to the lack of EMG recording of deep lumbar muscles, changes in relative shear/compression components and different net moments at cranial discs despite identical moments at the caudal L5-S1 disc, complementary model studies are essential for a better comprehension of neuromuscular strategies in response to alterations in load height and orientation.     

Validity of trunk extensor and flexor torque measurements using isokinetic dynamometry

This study aimed to evaluate the validity and test–retest reliability of trunk muscle strength testing performed with a latest-generation isokinetic dynamometer. Eccentric, isometric, and concentric peak torque of the trunk flexor and extensor muscles was measured in 15 healthy subjects. Muscle cross sectional area (CSA) and surface electromyographic (EMG) activity were respectively correlated to peak torque and submaximal isometric torque for erector spinae and rectus abdominis muscles. Reliability of peak torque measurements was determined during test and retest sessions. Significant correlations were consistently observed between muscle CSA and peak torque for all contraction types (r = 0.74−0.85; P < 0.001) and between EMG activity and submaximal isometric torque (r ⩾ 0.99; P < 0.05), for both extensor and flexor muscles. Intraclass correlation coefficients were comprised between 0.87 and 0.95, and standard errors of measurement were lower than 9% for all contraction modes. The mean difference in peak torque between test and retest ranged from −3.7% to 3.7% with no significant mean directional bias. Overall, our findings establish the validity of torque measurements using the tested trunk module. Also considering the excellent test–retest reliability of peak torque measurements, we conclude that this latest-generation isokinetic dynamometer could be used with confidence to evaluate trunk muscle function for clinical or athletic purposes.     

Does prolonged seated deskwork alter the lumbar flexion relaxation phenomenon?

Sustained maximum lumbar spine flexion can increase the angle at which the low back flexion relaxation phenomenon (FRP) is observed. This adaptation has been hypothesized to have implications for the control of lumbar spine stability and increase the potential for low back injury. The objective of this study was to investigate if similar changes in the FRP would occur from sub-maximal spine flexion induced by an extended continuous duration of seated office deskwork. Twenty-three participants (12 male and 11 female) performed three bouts of full forward spine flexion interspersed with two 1-h periods of seated deskwork. Lumbar spine angular kinematics and electromyographic activity from the lumbar erector spinae were obtained throughout all trials. The angles at which myoelectric silence occurred (FRP onset) were documented. Lumbar flexion at FRP onset increased by 1.3 ± 1.5° after 1-h of sitting (p < 0.05) with no further increase after 2-h. However, when the angle at the FRP onset was normalized to the total range of flexion, there was no difference in the FRP onset. These results suggest that the seated posture may induce residual deformation in the viscoelastic passive tissues of the low back; this could increase the challenge of controlling spine motion and reduce the load-bearing capacity of the lumbar spine system during activities performed following extended bouts of sitting.     

The role of trunk muscles in sitting balance control in people with low back pain

The purpose of this study was to examine the muscular activities and kinetics of the trunk during unstable sitting in healthy and LBP subjects. Thirty-one healthy subjects and twenty-three LBP subjects were recruited. They were sat on a custom-made chair mounted on a force plate. Each subject was asked to regain balance after the chair was tilted backward at 20°, and then released. The motions of the trunk and trunk muscle activity were examined. The internal muscle moment and power at the hip and lumbar spine joints were calculated using the force plate and motion data. No significant differences were found in muscle moment and power between healthy and LBP subjects (p > 0.05). The duration of contraction of various trunk muscles and co-contraction were significantly longer in the LBP subjects (p < 0.05) when compared to healthy subjects, and the reaction times of the muscles were also significantly reduced in LBP subjects (p < 0.05). LBP subjects altered their muscle strategies to maintain balance during unstable sitting, but these active mechanisms appear to be effective as trunk balance was not compromised and the internal moment pattern remained similar. The changes in muscle strategies may be the causes of LBP or the result of LBP with an attempt to protect the spine.     

Influence of prolonged bed-rest on spectral and temporal electromyographic motor control characteristics of the superficial lumbo-pelvic musculature

Little is known about the motor control of the lumbo-pelvic musculature in microgravity and its simulation (bed-rest). Analysis of spectral and temporal electromyographic variables can provide information on motor control relevant for normal function. This study examined the effect of 56-days of bed-rest with 1-year follow-up in 10 male subjects on the median frequency and the activation timing in surface electromyographic recordings from five superficial lumbo-pelvic muscles during a repetitive knee movement task. Trunk fat mass (from whole body-composition measurements) and movement accuracy as possible explanatory factors were included. Increased median frequency was observed in the lumbar erector spinae starting late in bed-rest, but this was not seen in its synergist, the thoracic erector spinae (p < .0001). These changes persisted up to 1-year after bed-rest and were independent of changes in body-composition or movement accuracy. Analysis suggested decreases of median frequency (p < .0001) in the abdominal and gluteal muscles to result from increased (p < .01) trunk fat levels during and after bed-rest. No changes in lumbo-pelvic muscle activation timing were seen. The results suggest that bed-rest particularly affects the shorter lumbar erector spinae and that the temporal sequencing of superficial lumbo-pelvic muscle activation is relatively robust.     

Mechanical demands on the lower back in patients with non-chronic low back pain during a symmetric lowering and lifting task

There is limited information in the literature related to the lower back loading in patients with LBP, particularly those with non-chronic LBP. Toward addressing such a research gap, a case-control study was conducted to explore the differences in lower back mechanical loads between a group of females (n = 19) with non-chronic, non-specific LBP and a group of asymptomatic females (n = 19). The differences in lower back mechanical loads were determined when participants completed one symmetric lowering and lifting of a 4.5 kg load at their preferred cadence. The axial, shearing, and moment components of task demand at the time of peak moment component as well as measures of peak trunk kinematics were analyzed. Patient vs. asymptomatic group performed the task with smaller peak thoracic rotation and peak lumbar flexion. While no differences in the moment component of task demand on the lower back between the patients and controls were found, the shearing (40–50 age group) and axial components of task demand were, respectively, larger and smaller in patients vs. controls. Whether alterations in lower back loads in patients with non-chronic LBP are in response to pain or preceded the pain, the long-term exposure to abnormal lower back mechanics may adversely affect spinal structure and increase the likelihood of further injury or pain. Therefore, the underlying reason(s) as well as the potential consequence(s) of such altered lower back mechanics in patients with non-chronic LBP should to be further investigated.     

Alternating activation is related to fatigue in lumbar muscles during sustained sitting

The aim of this study was to investigate the relation between variability in muscle activity and fatigue during a sustained low level contraction in the lumbar muscles. Twenty-five healthy participants (13 men 12 women) performed a 30 min sitting task with 5 degrees inclination of the trunk. Surface electromyographic (EMG) signals were recorded bilaterally from the lumbar muscles with 2 high density surface EMG grids of 9 × 14 electrodes. Median frequency (MDF) decrease, amplitude (RMS) increase and the rating of perceived exertion (RPE) were used as fatigue indices. Alternating activation and spatial and temporal variability were computed and relations with the fatigue indices were explored. During sitting, the mono- and bipolar RMS slightly increased while the MDF remained unchanged indicating no systematic muscle fatigue, although the average RPE increased from 6 to 13 on a scale ranging between 6 and 20. Higher frequency of alternating activation between the left and right side was associated with increased RPE (p = 0.03) and decreased MDF (p = 0.05). A tendency in the same direction was seen between increased spatial and temporal variation within the grids and increased RPE and decreased MDF. Present findings provide evidence for a relationship between variability in muscle activity and fatigue.     

PLAD (personal lift assistive device) stiffness affects the lumbar flexion/extension moment and the posterior chain EMG during symmetrical lifting tasks

The PLAD (personal lift assistive device) was designed to reduce the lumbar moment during lifting and bending tasks via elastic elements. This investigation examined the effects of modulating the elastic stiffness. Thirteen men completed 90 lifts (15 kg) using 6 different PLAD stiffnesses in stoop, squat and freestyle lifting postures. The activity of 8 muscles were recorded (latissimus dorsi, thoracic and lumbar erector spinae, rectus abdominis, external oblique, gluteus maximus, biceps femoris and rectus femoris), 3D electromagnetic sensors tracked the motion of each segment and strain gauges measured the elastic tension. EMG data were rectified, filtered, normalized and integrated as a percentage of the lifting task. The highest PLAD tension elicited the greatest reduction in erector spinae activity (mean of thoracic and lumbar) in comparison to the no-PLAD condition for the stoop (37%), squat (38%), and freestyle (37%) lifts, while prompting comparable reductions in gluteus maximums and biceps femoris activity. The highest PLAD stiffness also elicited the greatest reduction in the integrated L4/L5 flexion moment for the stoop (19.0%), squat (18.4%) and freestyle (17.4%) lifts without changing peak lumbar flexion. Each increase in PLAD stiffness further reduced the muscle activity of the posterior chain and the dynamic lumbar moment.     

Obesity and spinal loads; a combined MR imaging and subject-specific modeling investigation

Epidemiological studies have identified obesity as a possible risk factor for low back disorders. Biomechanical models can help test such hypothesis and shed light on the mechanism involved. A novel subject-specific musculoskeletal-modelling approach is introduced to estimate spinal loads during static activities in five healthy obese (BMI > 30 kg/m²) and five normal-weight (20 < BMI < 25 kg/m²) individuals. Subjects underwent T1 through S1 MR imaging thereby measuring cross-sectional-area (CSA) and moment arms of trunk muscles together with mass and center of mass (CoM) of T1-L5 segments. MR-based subject-specific models estimated spinal loads using a kinematics/optimization-driven approach. Average CSAs of muscles, moment arms of abdominal muscles, mass and sagittal moment arm of CoM of T1-L5 segments were larger in obese individuals (p < 0.05 except for the moment arm of CoMs) but moment arms of their back muscles were similar to those of normal-weight individuals (p > 0.05). Heavier subjects did not necessarily have larger muscle moment arms (e.g., they were larger in 64 kg (BMI = 20.7 kg/m²) subject than 78 kg (BMI = 24.6 kg/m²) subject) or greater T1-L5 trunk weight (e.g., the 97 kg (BMI = 31 kg/m²) subject had similar trunk weight as 109 kg (BMI = 33.3 kg/m²) subject). Obese individuals had in average greater spinal loads than normal-weight ones but heavier subjects did not necessarily have greater spinal loads (117 kg (BMI = 40.0 kg/m²) subject had rather similar L5-S1 compression as 105 kg (BMI = 34.7 kg/m²) subject). Predicted L4-L5 intradiscal pressures for the normal-weight subjects ranged close to the measured values (R² = 0.85–0.92). Obese individuals did not necessarily have greater IDPs than normal-weight ones.     

Influence of back muscle fatigue on lumbar reflex adaptation during sudden external force perturbations

There is still conflicting evidence about the influence of fatigue on trunk reflex activity. The aim of this study was to measure response latency and amplitude changes of lumbar and abdominal muscles after heavy external force perturbation applied to the trunk in the sagittal plane before and after back muscle fatigue, in expected and unexpected conditions. Ten healthy subjects in a semi-seated position, torso upright in a specific apparatus performed an intermittent back muscle fatigue protocol. EMG reflex activity of erector spinae (ES) and external oblique muscles were recorded in unexpected and in expected (self pre-activation) conditions. After fatigue, the normalized reflex amplitude of ES increased in expected and unexpected conditions (P < 0.05) while ES response latency was slightly decreased. Reflexes latencies for ES were systematically shorter (P < 0.05) of 25% in expected compared to unexpected conditions. These findings suggest that a large external force perturbation would elicit higher paraspinal magnitude responses and possible earlier activation in order to compensate the loss of muscular force after fatigue. Because of the seated position the postural adjustments were probably not triggered and thus explain the lack of abdominal activation. The self-anticipated pre-activation in order to counteract perturbations was not affected by fatigue illustrating the natural muscular activation to maintain trunk stability.