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PubMed1995

Expression of gap junction genes, connexin40 and connexin43, during fetal mouse development.

The expression patterns of the gap junction genes connexin40 and connexin43 have been analyzed during late mouse fetal development, i.e., at embryonic days 14.5 and 16.5, by in situ hybridization and immunofluorescence. Connexin40 was found in endothelial cells of vessels, cardiomyocytes and in developing myoblasts and myotubes. Expression of connexin40 in developing muscle fibers was strong in the back muscles and weaker in the muscles of the limbs. The number of labeled cells in the back muscle decreased with ongoing differentiation of myoblasts, in accordance with the idea that connexin40 is only expressed in the early stages of muscle cell differentiation. Within a muscle bundle, connexin40 expression was predominantly found at the outermost side where myoblasts fuse to multinucleated myotubes. In contrast, connexin43 exhibits a wide and complex pattern of expression in fetal mouse development. It is found in organs originating from all three germ layers, such as epidermis, heart, lung, muscle, kidney and gut. Connexin43 transcript and protein were very abundant in tissues that had been undergoing inductive interactions, e.g., the inner enamel epithelium of the teeth, the glomeruli of the kidneys and the infundibulum forming the neural part of the pituitary gland. Very high connexin43 expression was found in the embryonic meninges (dura mater) and in the fetal adrenal cortex. During keratinocyte differentiation connexin43 mRNA expression decreased, being much stronger in the stratum basale than in stratum granulosum. No obvious discrepancy between the amount of mRNA and protein of either connexin was noticed, suggesting that there is no specific translational regulation at these developmental stages.

Animals↗
PubMed2000

Histochemistry and morphology of the multifidus muscle in lumbar disc herniation: comparative study between diseased and normal sides.

STUDY DESIGN: This comparative study was conducted on 19 patients (13 men and 6 women) with lumbar disc herniation (LDH). The histologic and histochemical differences and changes in the back muscles of the diseased and normal sides were evaluated. OBJECTIVES: To determine the histologic differences in the back muscles between the diseased and normal sides in lumbar disc herniation. SUMMARY OF BACKGROUND DATA: The morphologic changes of back muscles between the diseased and normal sides in lumbar disc herniation were examined using histologic and histochemical methods. Few studies have reported the difference in these changes based on quantitative analyses. METHODS: All samples were harvested bilaterally from the multifidus muscle at the level of L4-L5 or L5-S1 in patients with lumbar disc herniation and then were examined by histologic and histochemical methods (hematoxylin-eosin, Gomori trichrome, NADH-TR, and ATPase stains). The percentage, cross-sectional area (CSA), and lesser diameter (LD) of muscle fibers were measured using computerized image analysis. The Wilcoxon, paired t, Kruskal Wallis, and Fisher tests were used for statistical analysis. RESULTS: Both Type I and II fibers in the diseased side were significantly smaller than those from the normal side. In the diseased side, the potential strength of Type II fibers was weakened. Some pathologic changes (fiber type grouping, small angulated fibers, group atrophy, moth-eaten appearance, and internal nuclei, etc.) in the diseased side were more obvious than those in the normal side. When the straight leg raising test results were abnormal, both Type I and II fibers in the diseased side were smaller than those in the normal side. The Type I fibers of the diseased side were significantly smaller when the patients had symptoms of central low back pain. The size of the Type I fibers as well as of the Type II fibers did not differ between the diseased and normal sides in patients with unilateral and bilateral low back pain. CONCLUSIONS: The present study indicated that there were differences in the characteristics of the multifidus muscle between the diseased and normal sides in patients with lumbar disc herniation. The changes in muscle characteristics primarily were related to the disc protrusion. In addition, different locations of the low back pain seemed to cause different secondary effects on the muscle characteristics.

Adult↗
PubMed1989

EMG muscle scanning: stability of hand-held surface electrodes.

Electromyographic (EMG) muscle scanning measures 2-second samples of integrated muscle action potentials from individual neck and back muscles using a hand-held scanner with post-style surface electrodes separated by a fixed distance. This "scanning" technique is widely used to expeditiously assess muscle activity in the diagnosis of musculoskeletal disorders. In order to determine if the 2-second sample is sufficiently representative of electrical activity at a specific muscle site, the stability of the signal received by the hand-held scanner was measured bilaterally at six neck and back muscle sites over 40 seconds (20 2-second integration periods) in five seated subjects. Taking the overall average EMG activity as the "true" value, the mean number of 2-second integration periods required to achieve less than 5% standard error was calculated to be 1.47 for the 60 muscles tested. Only three sites required more than five integration periods. The validity of EMG scanning as a diagnostic tool is enhanced by longer integration periods.

Action Potentials↗
PubMed1997

Flexion relaxation of the hamstring muscles during lumbar-pelvic rhythm.

OBJECTIVE: This study investigated the simultaneous activity of back muscles and hamstring muscles during sagittal forward body flexion and extension in healthy persons. The study was cross-sectional. DESIGN: A descriptive study of paraspinal and hamstring muscle activity in normal persons during lumbar-pelvic rhythm. SETTING: A university hospital. PARTICIPANTS: Forty healthy volunteers (21 men, 19 women, ages 17 to 48 years), all without back pain or other pain syndromes. MAIN OUTCOME MEASURES: Surface electromyography (EMG) was used to follow activities in the back and the hamstring muscles. With movement sensors, real lumbar flexion was separated from simultaneous pelvic motion by monitoring the components of motion with a two-inclinometer method continuously from the initial upright posture into full flexion. All signals were sampled during real-time monitoring for off-line analyses. RESULTS: Back muscle activity ceased (ie, flexion relaxation [FR] occurred) at lumbar flexion with a mean of 79 degrees. Hamstring activity lasted longer and EMG activity ceased in the hamstrings when nearly full lumbar flexion (97%) was reached. After this point total flexion and pelvic flexion continued further, so that the last part of lumbar flexion and the last part of pelvic flexion happened without back muscle activity or hamstring bracing, respectively. CONCLUSIONS: FR of the back muscles during body flexion has been well established and its clinical significance in low back pain has been confirmed. In this study, it was shown for the first time that the hip extensors (ie, hamstring muscles) relax during forward flexion but with different timing. FR in hamstrings is not dependent on or coupled firmly with back muscle behavior in spinal disorders and the lumbar pelvic rhythm can be locally and only partially disturbed.

Adolescent↗
PubMed2001

Recent advances in lumbar spinal mechanics and their significance for modelling.

Mathematical models are often used to quantify the overall forces and moments acting on the lumbar spine. However, if the purpose of the research is to explain how spinal tissues can be injured, it is necessary to distribute the overall forces and moments between (and within) different spinal structures, because it is the concentration of force which causes injury, and elicits pain. This paper reviews recent experimental evidence concerning the distribution of forces and moments acting on the lumbar spine. Lordotic postures increase loading of the posterior annulus and apophyseal joints, whereas moderately flexed postures tend to equalise compressive stress across the disc, and unload the apophyseal joints. Sustained compression reduces the volume and pressure of the nucleus pulposus, while increasing compressive stresses in the annulus and neural arch. Sustained compression also reduces disc height, giving some slack to collagen fibres in the intervertebral disc and ligaments, and causing them to resist bending less. Disc degeneration has a similar effect on disc height, and stress distributions. On the other hand, discs and ligaments can be subjected to greater bending moments following a period of sustained or repetitive bending, because sustained bending impairs the normal protective reflex from the back muscles, and repetitive bending fatigues the back muscles, reducing their ability to protect the spine. Incorporating this information into mathematical models will make them better able to identify which activities are most likely to injure the lumbar spine in life.

Biomechanical Phenomena↗
PubMed2006

Sagittal spine movements of small therian mammals during asymmetrical gaits.

Mammalian locomotion is characterized by the use of asymmetrical gaits associated with extensive flexions and extensions of the body axis. Although the impact of sagittal spine movements on locomotion is well known, little information is available on the kinematics of spinal motion. Intervertebral joint movements were studied in two metatherian and three eutherian species during the gallop and halfbound using high-speed cineradiography. Fast-Fourier transformation was used to filter out high frequency digitizing errors and keep the lower frequency sinusoid oscillations that characterize the intervertebral angular movements. Independent of their regional classification as thoracic or lumbar vertebrae, 7+/-1 presacral intervertebral joints were involved in sagittal bending movements. In only one species, no more than five intervertebral joints contributed to the resulting 'pelvic movement'. In general, the trunk region involved in sagittal bending during locomotion did not correspond to the traditional subdivisions of the vertebral column (e.g. as thoracic and lumbar or pre- and postdiaphragmatic region). Therefore, these classifications do not predict the regions involved in spinal oscillations during locomotion. Independent of the gait, maximum flexion of the spine was observed in the interval between the last third of the swing phase and touch-down. This results in a retraction of the pelvis and hindlimbs before touch-down and, we hypothesize, enhances the stability of the system. Maximum extension occurred during the first third of the swing phase (i.e. after lift-off) in all species. In general, the observed timing of dorsoventral oscillations of the spine are in accordance with that observed in other mammals and with activity data of respiratory and epaxial back muscles. Although no strict craniocaudal pattern was observable, the more cranial intervertebral joints tend to flex and extend earlier than the more caudal ones. This is in accordance with the organization and the activation of the paravertebral musculature in mammals. The amplitude of intervertebral joint movements increased caudally, reaching its highest values in the presacral joint. The more intense sagittal bending movements in the caudal intervertebral joints are reflected by the muscle fiber type composition of the back muscles involved. Despite the highly similar amplitude of 'pelvic motion', touch-down and lift-off positions of the pelvis were clearly different between the species with a long, external tail and those with no external tail.

Animals↗
PubMed2005

Cross-sectional associations between trunk muscle composition, back pain, and physical function in the health, aging and body composition study.

BACKGROUND: Associations between trunk muscle composition and physical function have not been examined previously in older adults. We hypothesized that lower trunk muscle area and attenuation (higher fat infiltration) are associated with decreased functional capacity. METHODS: The study sample consisted of a biracial cohort of well functioning men (739) and women (788) aged 70-79 from the Pittsburgh site of the Health, Aging and Body Composition (Health ABC) study. Computed tomography was used to measure trunk muscle area (cm2) and muscle attenuation (Hounsfield Unit [HU]) of the following muscle groups: lumbar paraspinals, lateral abdominals, and rectus abdominis. An average score was calculated for both trunk area and attenuation. The Health ABC Physical Performance Battery (PPB) and its individual components (usual and narrow walk, chair stands, and standing balance) were used to measure functional capacity. RESULTS: Linear regression analyses adjusting for demographic factors, height, body fat, thigh muscle composition, disease status, and low back pain (LBP) found that average trunk muscle area was not associated with any element of functional capacity (p >.10), whereas average trunk muscle attenuation was positively associated with the Health ABC Physical Performance Battery (p <.05) and chair stands (p <.001). Participants reporting higher LBP severity during the past year had lower muscle attenuation (p <.001 for trend), but there was no difference in average trunk muscle area according to LBP status. CONCLUSIONS: Findings suggest a link between trunk muscle composition and history of LBP as well as reduced functional capacity in older adults. Improving trunk muscle quality may lead to reduced LBP severity and improved functional status.

Abdomen↗
PubMed1997

Phasic activity in the human erector spinae during repetitive hand movements.

1. Phasic activity in the human back muscle erector spinae (ES) was studied during repetitive hand movements. The hand movements were elicited voluntarily by the subject or induced passively by the experimenter through a servomotor or through cyclical electrical stimulation of muscles acting about the wrist. The aim of the study was to determine whether the rhythmical activation of ES was of supraspinal, intersegmental or segmental origin. 2. When voluntary rhythmical hand movements were performed as fast as possible, cyclical ES EMG bursts occurred at the same frequency. This frequency was significantly higher than that reached when the task was to contract the back muscles as rapidly as possible. This suggests that the ES activity during the fast hand movements was not generated by direct commands descending to the ES muscles from the motor area of the cerebral cortex responsible for voluntary back muscle activation. 3. During imposed rhythmical hand movements, ES EMG bursts remained entrained to the hand movements, even when movement frequencies far exceeded those attainable voluntarily either for the hand or the back. This showed that ES EMG responses could be evoked by the hand movements even when these were not generated by descending neural commands. Two alternative mechanisms of ES activation were considered: (a) propriospinal transmission of afferent input entering the spinal cord from the upper extremity; (b) afferent input from ES and other trunk muscles, responding to local oscillations transmitted mechanically from the hand to the lower back. 4. Activation of ES via proprioceptive signals from the forearm was unlikely since (a) simultaneous electrical stimulation of wrist extensor and wrist flexor muscles did not result in repetitive ES EMG bursting; (b) cyclical vibration of the wrist extensors did not evoke ES EMG bursting; (c) when the forearm was constrained and the hand was moved passively, the lower trunk accelerations and cyclical ES EMG both occurred at a harmonic of the hand movement frequency. 5. We conclude that the repetitive ES EMG bursting during hand movements was probably due to a local segmental reflex rather than to descending commands. Remote mechanical oscillations of the trunk caused by hand movements evidently elicited proprioceptive reflexes in ES that presumably contributed to trunk stabilization.

Adult↗
PubMed2003

Muscle recovery from a short fatigue test and consequence on the reliability of EMG indices of fatigue.

The purpose of the present study was to evaluate if rest intervals of 10 or 15 min allow the back muscles to recover completely, from an electromyographic (EMG) point of view, after performing a fatiguing contraction. Twelve healthy males stood in a dynamometer with the trunk in a vertical position and performed three trunk extension fatiguing trials (30 s contractions sustained at 75% of the maximal voluntary contraction) separated successively by a 15 min (between trial 1 and 2) and a 10 min (between trial 2 and 3) rest period. The EMG signals from four pairs of back muscles were collected at 2,048 Hz with active surface electrodes. Different EMG indices computed from the temporal and frequency domains of the EMG signal were considered to evaluate muscular fatigue and recovery from trial 1 to trial 2 and from trial 2 to trial 3. No significant differences (one-way ANOVAs between the three trials, alpha=0.05) were obtained for the different EMG indices computed. The percentage of variance explained by the inter-trial effect was none in most cases, corroborating that no systematic error was present between the trials and suggesting that complete muscle recovery was allowed with 10 or 15 min rest periods. These results support the use of rest periods of 10 to 15 min between multiple fatigue tests, at least for back muscles and for high intensity short duration fatigue tasks as the one used in the present study.

Adult↗
PubMed1994

Quantitative interpretation of lumbar muscle myoelectric signals during rapid cyclic attempted trunk flexions and extensions.

The quantitative relationship between lumbar myoelectric signals (MES) and rapidly varying isometric trunk muscle forces was investigated. Ten young adult males were asked to cycle harmonically between attempted trunk flexion and attempted trunk extension in an upright position at rates of 0.33, 0.67 and 1.0 Hz to peak efforts of 20, 40 and 60% of maximum voluntary exertion levels. The forces voluntarily exerted against a load cell were measured and used along with acquired kinematic data to calculate the time course of the net sagittal moment at the level of the third lumbar vertebra during task performances. A 22 muscle double linear programming biomechanical model was used to predict the lumbar trunk muscle contraction forces from the calculated moments. Rectified and bidirectionally low-pass filtered myoelectric activities were acquired at the L3 level from four abdominal muscles and four back muscles. The processed MES were found to be well correlated (r > 0.90) with predicted muscle forces when the MES were time-shifted to account for electromechanical delay as well as the dynamic phase shift between muscle electrical activity and contraction force. Mean time shifts that maximized the linear MES-force relationship ranged from 111 to 218 ms, were greater for the trunk extensors than the trunk flexors and generally exhibited lateral symmetry. The corresponding approximate phase angles averaged 20 degrees at the slowest rate and 50 degrees at the fastest rate. MES-force phase angles decreased as effort level was increased indicating that the dynamic MES-force relationship is nonlinear. These results illustrate the importance of accounting for the phase lag between muscle electrical activity and force when using MES to quantify muscle loads during rapidly varying exertions.

Abdominal Muscles↗
PubMed2001

Median frequency of the electromyographic signal: effect of time-window location on brief step contractions.

The purpose of this study was to determine, for different back muscles, if the median frequency (MF) of the electromyographic (EMG) power spectrum changes according to the position of the time window during a 5 s step contraction. Twenty males with no known back problems were standing upright in a dynamometer allowing lower limb and pelvis stabilization. Trunk extension efforts were performed by pushing on a force platform positioned at the T4 level while the extension moment at L5/S1 was displayed as visual feedback. The EMG signals from four homologous back muscles (multifidus at L5, ilicostalis lumborum at L3, and longissimus at L1 and T10) were collected using active surface electrodes during two 5 s static step contractions performed at five force levels (10, 20, 40, 60 and 80% of the maximal voluntary contraction). The root mean square (RMS) and MF values of the EMG signals corresponding to three 250 ms time windows (beginning, middle and end of each step contraction) were computed. The RMS values of several back muscles increased from the first to the third time window for contractions performed at high force levels only. However, a concomitant decrease in the MF values was observed only for the left multifidus muscle. It was concluded that muscle fatigue does not generally manifest itself during 5 s step contractions through the EMG signal. However, it is recommended to use step contractions lasting less than 5 s and to choose a time window located in the first 1-3 s to completely eliminate the possible effects of fatigue.

Adult↗
PubMed1993

Instrumental straight-leg raising: results in healthy subjects.

The instrumental performance of Lasègue's test (instrumental straight-leg raising) provides information about the extensibility, elasticity, and electrical activity of hamstrings and back muscles and about pelvic rotation. Because relevant data on these variables are not known in literature, instrumental straight-leg raising was performed in healthy subjects. Using the toe-touch test, three groups of eight subjects were selected: a flexible group, able to touch the ground with their hands flat, a medium group, able to touch the ground with their finger tips, and a stiff group, not able to touch the ground at all. Measurements showed a considerable difference in the extensibility of the hamstrings between the groups with only a slight difference in the extensibility of the back muscles. They also showed clear differences in elasticity of the hamstrings and the back muscles in the subjects within the groups. Between the groups, however, muscle elasticity was not systematically different. Electromyogram activity was most often present in the subjects of the stiff group, predominantly in the hamstrings. It began only after the leg had been raised to a considerable extent, showed a gradual increase with leg raise, and never reached a high level.

Back↗
PubMed2002

Air-righting responses to chronic hindlimb suspension and ambulation recovery in adult rats.

Laouris et al. (1990) reported that the development of air-righting in growing new-born rats was clearly suppressed when their neck and/or back rotations were prevented. Thus, it is suggested that the neck and back muscles play an important role for a quick righting in response to drop from supine position. Further, we reported that an inhibiton of posture adjustment in response to head-down drop from a height of approximately 30 cm following chronic hindlimb suspension of adult rats was accompanied by a decrease of electromyogram (EMG) activity in both neck and back muscles (Kawano et al., 2002). However, it is still unclear how the air-righting performance is influenced by hindlimb suspension in adult rats. Thus, the effects of chronic hindlimb suspension of adult rats on the patterns and time of air-righting and role of neck and back muscles in the air-righting were investigated in the current study.

Animals↗
PubMed1988

Modulation of natural killer cell activity in peripheral blood by physical exercise.

The present study was designed to examine the effect of physical exercise on human natural killer (NK) cells. Six healthy volunteers underwent two different acute physical exercise tests with an interval of at least 1 week: (1) 60 min bicycle exercise at 80% of maximal oxygen uptake (VO2max) and (2) 60 min back-muscle training at up to 29% of VO2max; blood samples were collected before and during the last few minutes of exercise, as well as 2 h and 24 h afterwards. The NK cell activity (lysis/fixed number of mononuclear cells) increased during bicycle exercise, dropped to a minimum 2 h later and returned to pre-exercise levels within 24 h. Back-muscle exercise did not significantly influence NK cell activity. Plasma levels of adrenaline, noradrenaline, and cortisol were elevated during bicycling, but not during back-muscle exercise, indicating that exercise intensity is a determinant of NK cell activity. During bicycle exercise the NK cell subset (CD16- cells) of mononuclear cells increased significantly. Furthermore an improved interleukin 2 (IL-2) boosting of the NK cell activity was found during work as compared to IFN-alpha and indomethacin-enhanced NK cell activity. These results indicate that NK cells with a high IL-2 response capacity are recruited to the peripheral blood during exercise. The decreased NK cell activity demonstrated 2 h after work was probably not due to fluctuations in size of the NK cell pool, since the proportion of CD16+ cells was normal. The finding that indomethacin fully restored the suppressed NK cell activity in vitro and the demonstration of a twofold increase in monocyte (CD20+ cells) proportions 2 h after work, strongly indicate that prostaglandins released by monocytes during the heavy physical exercise are responsible for the down-regulation of the NK cells.

Adult↗
PubMed2001

Influence of the 5-HT(2C) receptor antagonist SB242,084 on behaviour produced by the 5-HT(2) agonist Ro60-0175 and the indirect 5-HT agonist dexfenfluramine.

Ro60-0175 has been described as a selective agonist at the 5-HT(2C) receptor, yet it has only 10- fold higher affinity at the 5-HT(2C) compared to the 5-HT(2A) subtype, and equivalent affinity for the 5-HT(2B) receptor. The selective 5-HT(2C) receptor antagonist SB242,084 (0.5 mg kg(-1) i.p.), blocked the hypoactivity and penile grooming induced by Ro60-0175 (1 mg kg(-1) s.c.). The combination of SB242,084 (0.5 mg kg(-1) i.p.) and Ro60-0175 (3 - 10 mg kg(-1)) produced a completely different pattern of behaviours including wet-dog shakes, hyperactivity and back muscle contractions. These latter effects were blocked by the selective 5-HT(2A) receptor antagonist MDL100,907 (0.5 mg kg(-1) i.p.), but not the 5-HT(2B) receptor antagonist SB215,505 (3 mg kg(-1) p.o.). The indirect 5-HT releaser/reuptake inhibitor dexfenfluramine (1 - 10 mg kg(-1) i.p.) produced a mild increase in locomotor activity, penile grooming, and occasional back muscle contractions and wet-dog shakes. Pre-treatment with SB242,084 (0.5 mg kg(-1)), blocked the incidence of penile grooming, and markedly potentiated both the dexfenfluramine-induced hyperactivity, the incidence of back muscle contractions, and to a lesser extent wet-dog shakes. Some toxicity was also evident in animals treated with dexfenfluramine (10 mg kg(-1))/SB242,084 (0.5 mg kg(-1)), but not in any other treatment groups. The hyperactivity and toxicity produced by the dexfenfluramine (10 mg kg(-1))/SB242,084 (0.5 mg kg(-1)) combination was replicated in a further study, and hyperthermia was also recorded. Both hyperthermia and toxicity were blocked by MDL100,907 (0.5 mg kg(-1)) but not SB215,505 (3 mg kg(-1)). An attenuation of the hyperlocomotor response was also observed following MDL100,907. These findings suggest that 5-HT(2C) receptor activation can inhibit the expression of behaviours mediated through other 5-HT receptor subtypes.

Aminopyridines↗
PubMed2000

Can exercise therapy improve the outcome of microdiscectomy?

STUDY DESIGN: A prospective randomized controlled trial of exercise therapy in patients who underwent microdiscectomy for prolapsed lumbar intervertebral disc. Results of a pilot study are presented. OBJECTIVE: To determine the effects of a postoperative exercise program on pain, disability, psychological status, and spinal function. SUMMARY OF BACKGROUND DATA: Microdiscectomy is often used successfully to treat prolapsed lumbar intervertebral disc. However, some patients do not have a good outcome and many continue to have low back pain. The reasons for this are unclear but impairment of back muscle function due to months of inactivity before surgery may be a contributing factor. A postoperative exercise program may improve outcome in such patients. METHODS: Twenty patients who underwent lumbar microdiscectomy were randomized into EXERCISE and CONTROL groups. After surgery, all patients received normal postoperative care that included advice from a physiotherapist about exercise and a return to normal activities. Six weeks after surgery, patients in the EXERCISE group undertook a 4-week exercise program that concentrated on improving strength and endurance of the back and abdominal muscles and mobility of the spine and hips. Assessments of spinal function were performed in all patients during the week before surgery and at 6, 10, 26, and 52 weeks after. The assessment included measures of posture, hip and lumbar mobility, back muscle endurance capacity and electromyographic measures of back muscle fatigue. On each occasion, patients completed questionnaires inquiring about pain, disability and psychological status. RESULTS: Surgery improved pain, disability, back muscle endurance capacity and hip and lumbar mobility in both groups of patients. After the exercise program, the EXERCISE group showed further improvements in these measures and also in electromyographic measures of back muscle fatigability. All these improvements were maintained 12 months after surgery. The only further improvement showed by the CONTROL group between 6 and 52 weeks was an increase in back muscle endurance capacity. CONCLUSION: A 4-week postoperative exercise program can improve pain, disability, and spinal function inpatients who undergo microdiscectomy. [Key words: electromyogram median frequency, exercise therapy, intervertebral disc prolapse, microdiscectomy, randomized controlled trial, spinal function.

Adolescent↗
PubMed1993

The effects of flexion on the geometry and actions of the lumbar erector spinae.

A modeling study was undertaken to determine the effects of flexion on the forces exerted by the lumbar back muscles. Twenty-nine fascicles of the lumbar multifidus and erector spinae were plotted onto tracings of radiographs of nine normal volunteers in the flexion position. Moment arms and force vectors of each fascicle were calculated. The model revealed that moment arms decreased slightly in length resulting in no more than an 18% decrease in maximum extensor moments exerted across the lumbar spine. Compression loads were not significantly different from those generated in the upright posture. However, there were major changes in shear forces, in particular a reversal from a net anterior to a net posterior shear force at the L5/S1 segment. Flexion causes substantial elongation of the back muscles, which must therefore reduce their maximum active tension. However, if increases in passive tension are considered it emerges that the compression forces and moments exerted by the back muscles in full flexion are not significantly different from those produced in the upright posture.

Adult↗