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At least 397 records · Page 22Linked to original sources

PubMed2004

Congenitally corrected transposition: size of the pulmonary trunk and septal malalignment.

BACKGROUND: In hearts with congenitally corrected transposition of the great arteries, the atrial and ventricular septums are usually malaligned. This is associated with an abnormal location of the atrioventricular conduction system. However, well-aligned septums and normally positioned atrioventricular conduction tissues have been found in a few cases, some of which also happened to have a small or atretic pulmonary trunk. Our aim was to determine whether septal alignment could be predicted on the basis of the size of the pulmonary trunk. Potentially this could provide a guide to the disposition of the atrioventricular conduction tissues. METHODS: We examined 14 hearts. In all cases there was usual atrial arrangement. We carried out histologic examination of the sites of the atrioventricular conduction tissues in 1 heart. RESULTS: We found a statistically significant correlation between the size of the pulmonary trunk and the degree of septal malalignment. In the presence of a small or atretic pulmonary trunk, the septums were well aligned. Our histologic study of one such specimen revealed dual atrioventricular nodes connecting to a sling of conduction tissue. This suggests that presence of a postero-inferiorly situated atrioventricular conduction bundle in addition to an anteriorly located bundle may be anticipated when the septums are well aligned. CONCLUSIONS: The presence of a small or atretic pulmonary trunk in congenitally corrected transposition of the great arteries is associated with good septal alignment. This should alert the surgeon to the possibility of a slinglike arrangement of the atrioventricular conduction system.

Atrial Appendage↗

PubMed2005

Malignant fibrous histiocytoma: outcome of tumours in the head and neck compared with those in the trunk and extremities.

Malignant fibrous histiocytoma is one of the commonest soft tissue sarcomas in adults, affecting, in order of frequency, the extremities, trunk and head and neck. We treated 131 patients with malignant fibrous histiocytoma by radical, wide, or marginal resection. Their mean age was 43 years, and there were 54 in the head and neck and 77 in the trunk and extremities. The extent of clearance of the tumour, local recurrence, and 5-year survival were studied in these two groups. In the head and neck group, local recurrences developed in 86% after marginal resection, 66% after wide resection and 27% after radical resection. The comparative figures in the trunk and extremities group were 75, 71 and 18%, respectively. The overall 5-year survival was 48% in the head and neck group and 77% in the trunk and extremities group (p=0.03). Repeat operations for recurrences of tumour offered a 'cure rate' of 23% in the head and neck group and 61% in the trunk and extremities group. Inadequate resection of the sarcoma in the head and neck was associated with a high incidence of local recurrence and a poor prognosis. Therefore, we suggest that the initial operation for sarcoma in the head and neck should be as radical as possible to reduce the chance of local recurrence and to improve the outcome.

Adolescent↗

PubMed2004

Posture of the trunk in the sagittal plane is associated with gait in community-dwelling elderly population.

OBJECTIVES: The purpose of this study was to evaluate whether abnormal posture of the trunk in the sagittal plane would affect gait and functional performance in the elderly. BACKGROUND: There have been very few reports on whether posture of the trunk is related to gait and functional performance. METHODS: The study group included 237 participants with a mean age of 80.0 years (range 65-94 years). The posture of the trunk in a standing position of the sagittal plane was classified into five groups. We investigated the relationship between the trunk posture in the sagittal plane and age with gait parameters and functional performance such as timed up & go test and functional reach. RESULTS: In the elderly subjects of normal posture, there was no difference between those in the 65-79 years age group and those in the 80 years and older age group in terms of any gait parameters. Walking abilities were significantly decreased in the abnormal posture groups. Among the abnormal posture groups, elderly in the lumbar kyphosis group had walking disabilities that did not differ between age groups, whereas gait disturbance in the thoracic kyphosis group showed a positive relation with age. CONCLUSIONS: Posture of the trunk in the sagittal plane was associated not only with the distance and time parameter of gait, but also with functional performance in the elderly.

Aged↗

PubMed2004

The effects of ankle bracing on motion of the knee and the hip joint during trunk rotation tasks.

BACKGROUND: The use of prophylactic ankle braces is common during athletic activities since the ankle is one of the most commonly injured joints. Past studies have focused on the effects of ankle braces on ankle movement restriction, preventing injuries, proprioception, balance and athletic performance. However, the influence of ankle restriction on other joints has not been studied. The constraint of ankle movement may lead to an increased loading on the knee joint, which could be a potential risk of knee injuries during athletic activities. The primary goal of the current study was to determine quantitatively the effect of an ankle brace on the knee axial rotation during two different trunk turning tasks. METHODS: Ten healthy subjects performed trunk turning movements while standing on one leg: turning sideways to catch a ball and turning sideways to touch a target with the shoulder. The tasks were performed with and without an ankle brace worn on the supporting leg. The trunk axial rotation in reference to the floor and three dimensional joint angular motions of the ankle, knee and hip were determined. FINDINGS: The use of an ankle brace resulted in reduced trunk axial rotation during the ball catching tasks, and increased knee axial rotation during the target touching tasks. INTERPRETATION: The results of this study showed that the effect of the ankle brace on the knee axial rotation depended on the context of the tasks performed. Under situations that required forceful trunk turning movement while standing on a single leg, the ankle braces may cause an increase in the knee axial rotation indicating higher risk of knee injury.

Abdomen↗

PubMed2005

Co-contraction recruitment and spinal load during isometric trunk flexion and extension.

BACKGROUND: Pushing and pulling tasks account for 20% of occupational low-back injury claims. Primary torso muscle groups recruited during pushing tasks include rectus abdominis and the external obliques. However, analyses suggest that antagonistic co-contraction of the paraspinal muscles is necessary to stabilize the spine during flexion exertions. The study quantified co-contraction and spinal load differences during isometric flexion and extension exertions. The goal was to provide insight into the mechanisms requiring greater co-contraction during trunk flexion exertions compared to extension exertions. METHODS: Electromyographic (EMG) signals were recorded from the trunk muscles of healthy volunteers during isometric trunk flexion and extension exertions. A biomechanical model was implemented to estimate total muscle force from the measured EMG and trunk moment data. A similar model estimated the muscle forces necessary to achieve equilibrium while minimizing the sum of squared muscle forces. The difference in these forces represented co-contraction. Spinal load attributed to co-contraction was computed. RESULTS: Average co-contraction during flexion exertions was approximately twice the value of co-contraction during extension, i.e. 28% and 13% of total muscle forces respectively. Co-contraction accounted for up to 47% of the total spinal load during flexion exertions. Consequently, spinal compression during the flexion tasks was nearly 50% greater than during extension exertions despite similar levels of trunk moment. INTERPRETATION: Co-contraction must be considered when evaluating spinal load during pushing exertions. Results underscore the need to consider neuromuscular control of spinal stability when evaluating the biomechanical risks.

Adult↗

PubMed2006

Effects of different levels of torso coactivation on trunk muscular and kinematic responses to posteriorly applied sudden loads.

BACKGROUND: Studies examining rapid spine loading have documented the influence of steady-state trunk preloads, and the resulting levels of trunk muscle preactivation, on the control of spine stability. However, the effects of different levels of muscle coactivation, and resulting spine loads, on the response to a perturbation of the externally unloaded trunk are unclear. METHODS: Fourteen male subjects coactivated the abdominal muscles at four different levels (approximately 0%, 10%, 20% and 30% of the maximal voluntary contraction) monitored by an electromyography biofeedback system while semi-seated in a neutral lumbar spine position. They were loaded posteriorly in two directions (0 degrees and 30 degrees from the sagittal plane) and with two different loads (6.80 and 9.07 kg). Force perturbation, spine displacement and electromyography activity were measured, and torso compression and stability were modeled. FINDINGS: Abdominal coactivation significantly increased spine stability and reduced the movement of the lumbar spine after perturbation, but at the cost of increasing spinal compression. Preactivation also reduced the frequency and magnitude, and delayed the onset of muscle reactions, mainly for the back muscles and the internal oblique. The higher magnitude load and the load applied in an oblique direction both showed more potentially hazardous effects on the trunk. INTERPRETATION: Torso coactivation increases spinal stiffness and stability and reduces the necessity for sophisticated muscle responses to perturbation. Although further investigation is needed, it appears there is an asymptotic function between coactivation and both stiffness and stability. There also appears to be more hazard when buttressing twisting components of a sudden load compared to sagittal components. Patients with trunk instability and intolerance to spine compression may benefit from low to moderate levels of coactivation.

Abdominal Muscles↗

PubMed2004

Sapheno-femoral junction reflux in patients with a normal saphenous trunk.

OBJECTIVE: To determine the patterns and clinical importance of saphenofemoral junction (SFJ) reflux in patients with chronic venous disease (CVD) and a normal great saphenous vein (GSV) trunk. METHODS: Fifteen hundred consecutive patients were examined using duplex ultrasound (DU) in three centres. Patients with reflux involving the SFJ and/or its tributaries only were included and its prevalence and patterns were studied. Patients with GSV trunk reflux or in any other veins were excluded. The SFJ diameter was categorised as normal, dilated or varicose. The results of surgery were evaluated by DU in 42 patients 1 year after the procedure. RESULTS: SFJ area incompetence with a competent GSV trunk occurred in 8.8% of limbs. It was significantly more common in CEAP class 2, 13.6% compared to class 3, 8.2% (p=0.03), class 1, 2.7%, class 4, 4.4% and classes 5 and 6 together, 1.5% (p<0.001 for all). The SFJ had a normal diameter in 21%, dilated in 62% and varicose in 17%. Reflux was seen in 39% of limbs with a normal SFJ diameter, in 85% of those with a dilated SFJ and in all varicose SFJs. Of the 42 operated limbs, 27 had ligation and division of the SFJ and tributary phlebectomies. Fifteen had tributary phlebectomies only, leaving the SFJ intact. At one-year follow-up, SFJ area reflux was found in six limbs (14.3%), involving the SFJ alone in 1, a main tributary in 1 and 4 small tributaries. No reflux was found in the GSV trunk. All but two of the 42 patients were satisfied with the results. CONCLUSIONS: SFJ reflux with tributary involvement and sparing of the GSV trunk occurs in 8.8% of CVD patients. Such reflux is found in the entire spectrum of CVD, but it is more common in class 2. Local surgery with or without SFJ ligation has very good results at 1 year. DU scanning prior to treatment is important in all patients so that the intact GSV can be spared.

Dilatation, Pathologic↗

PubMed2006

How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait.

In healthy walking, the timing between trunk and pelvic rotations, as well as erector spinae (ES) activity varies systematically with walking velocity, whereas a comparable velocity-dependent adaptation of trunk-pelvis coordination is often reduced or absent in persons with low back pain (LBP). Based on the hypothesis that trunk-pelvis coordination is linked to overall gait stability, persons with LBP can be expected to have difficulties in dealing with perturbations. We examined the ability of 12 persons with LBP and 12 controls to adapt trunk and pelvis rotations and ES activity to sudden changes in velocity. 3D angular movements of thoracic, lumbar, and pelvic segments and surface EMG were recorded during treadmill walking at six different velocities, which increased or decreased unexpectedly. Relative phases of segmental rotations were determined and (in-)variant properties of kinematics and ES activity were studied using principal component analysis. Compared to healthy controls, persons with LBP exhibited a reduced ability to adapt trunk-pelvis coordination and ES muscle activity to changes in velocity. Altered coordination and muscular control may reflect an attempt to stabilise the spine and prevent the occurrence of unexpected perturbations. The assessment of gait patterns in terms of coordination may help clinicians to quantify movement impairments and may suggest interventions aimed at facilitating the emergence of desired coordination patterns.

Acceleration↗

PubMed2005

Aging affects coordination of rapid head motions with trunk and pelvis movements during standing and walking.

The head, containing the gravity sensors (vestibular system) and the visual system, must be stabilized in space to provide a steady reference. During walking, the head also needs to be free to move to allow scanning of surrounding objects and steering of locomotion. With aging, deteriorations in motor and sensory systems and their integration are commonly observed. Nevertheless, the strategies used by elderly subjects to complete challenging tasks that require precise sensorimotor integration, such as turning the head rapidly during gait, is not known. The objective of this study was to determine the effects of aging on the movement coordination of the head, trunk and pelvis when executing a rapid head motion in response to a visual signal. Elderly and young subjects turned their head rapidly (up, down, left, right or none) in response to a visual signal, during standing and walking. The 3-D positions of head, trunk and pelvis were recorded and analyzed. All subjects, young and old, successfully performed the task during both standing and walking without any loss of balance. Postural stability was maintained as large head motions were accompanied by relatively small trunk and pelvis movements. Horizontal plane movements associated with right and left head turns were significantly larger than sagittal plane movements associated with head up and down motions. Head motions were significantly slower and smaller in elderly subjects, and resulted in disrupted horizontal plane trunk-pelvis coordination during walking. We conclude that head, trunk and pelvis movements are coordinated in a task-dependent manner such that their movement amplitudes induced by rapid voluntary head motions are larger in walking than in standing. This task-dependent movement coordination is affected by aging.

Adult↗

PubMed2004

Is the trunk movement more perturbed after an asymmetric than after a symmetric perturbation during lifting?

Low back injury is associated with sudden movements and loading. Trunk motion after sudden loading depends on the stability of the spine prior to loading and on the trunk muscle activity in response to the loading. Both factors are not axis-symmetric. Therefore, it was hypothesized that the effects on trunk dynamics would be larger after an asymmetric than after a symmetric perturbation. Ten subjects lifted a crate in which, prior to lifting, a mass was displaced to the front or to the side without the subjects being aware of this. Crate and subject movements, crate reaction forces and muscle activity were recorded. From this, the stability prior to the perturbation was estimated, and the trunk angular kinematics and moments at the lumbo-sacral joint were calculated. Both perturbations only minimally affected the trunk kinematics, although the stability of the spine prior to the lifting movement was higher in the sagittal plane than in the frontal plane. In both conditions the stability appeared to be sufficient to absorb the applied perturbation.

Adult↗

PubMed2006

Model and in vivo studies on human trunk load partitioning and stability in isometric forward flexions.

To resolve the trunk redundancy to determine muscle forces, spinal loads, and stability margin in isometric forward flexion tasks, combined in vivo-numerical model studies was undertaken. It was hypothesized that the passive resistance of both the ligamentous spine and the trunk musculature plays a crucial role in equilibrium and stability of the system. Fifteen healthy males performed free isometric trunk flexions of approximately 40 degrees and approximately 65 degrees +/- loads in hands while kinematics by skin markers and EMG activity of trunk muscles by surface electrodes were measured. A novel kinematics-based approach along with a nonlinear finite element model were iteratively used to calculate muscle forces and internal loads under prescribed measured postures and loads considered in vivo. Stability margin was investigated using nonlinear, linear buckling, and perturbation analyses under various postures, loads and alterations in ligamentous stiffness. Flexion postures significantly increased activity in extensor muscles when compared with standing postures while no significant change was detected in between flexed postures. Compression at the L5-S1 substantially increased from 570 and 771 N in upright posture, respectively, for +/-180 N, to 1912 and 3308 N at approximately 40 degrees flexion, and furthermore to 2332 and 3850 N at approximately 65 degrees flexion. Passive ligamentous/muscle components resisted up to 77% of the net moment. In flexion postures, the spinal stability substantially improved due both to greater passive stiffness and extensor muscle activities so that, under 180 N, no muscle stiffness was required to maintain stability. The co-activity of abdominal muscles and the muscle stiffness were of lesser concern to maintain stability in forward flexion tasks as compared with upright tasks. An injury to the passive system, on one hand, required a substantial compensatory increase in active muscle forces which further increased passive loads and, hence, the risk of injury and fatigue. On the other hand, it deteriorated the system stability which in turn could require greater additional muscle activation. This chain of events would place the entire trunk active-passive system at higher risks of injury, fatigue and instability.

Abdomen↗

PubMed2006

Trunk muscle activation patterns during walking at different speeds.

Investigations of trunk muscle activation during gait are rare in the literature. As yet, the small body of literature on trunk muscle activation during gait does not include any systematic study on the influence of walking speed. Therefore, the aim of this study was to analyze trunk muscle activation patterns at different walking speeds. Fifteen healthy men were investigated during walking on a treadmill at speeds of 2, 3, 4, 5 and 6 km/h. Five trunk muscles were investigated using surface EMG (SEMG). Data were time normalized according to stride time and grand averaged SEMG curves were calculated. From these data stride characteristics were extracted: mean SEMG amplitude, minimum SEMG level and the variation coefficient (VC) over the stride period. With increasing walking speed, muscle activation patterns remained similar in terms of phase dependent activation during stride, but mean amplitudes increased generally. Phasic activation, indicated by VC, increased also, but remained almost unchanged for the back muscles (lumbar multifidus and erector spinae) between 4 and 6 km/h. During stride, minimum amplitude reached a minimum at 4 km/h for the back muscles, but for internal oblique muscle it decreased continuously from 2 to 6 km/h. Cumulative sidewise activation of all investigated muscles reached maximum amplitudes during the contralateral heel strike and propulsion phases. The observed changes argue for a speed dependent modulation of activation of trunk muscles within the investigated range of walking speeds prior to strictly maintaining certain activation characteristics for all walking speeds.

Abdominal Muscles↗

PubMed2004

Radiotherapy-induced supra-aortic trunk disease: early and long-term results of surgical and endovascular reconstruction.

PURPOSE: Few articles have dealt specifically with management of radiotherapy-induced supra-aortic trunk disease. We investigated the results of surgical and endovascular treatment of these lesions, and present our findings in a large series of patients. METHODS: The study was conducted at 11 centers. Over 10 years 64 patients with radiotherapy-induced supra-aortic trunk disease underwent surgical or endovascular treatment. Data were collected retrospectively in a consecutive cohort of patients, and were analyzed with the Kaplan-Meier method. RESULTS: Mean patient age was 64.4 years. The indications for radiotherapy included breast cancer (30%), head and neck malignancies (50%), and lymphomas (19%). The mean interval between irradiation and arterial revascularization was 15.2 years. Thirteen of the 64 patients (20%) had asymptomatic disease, and 51 patients (80%) had symptomatic disease. Ninety-two stenotic or occlusive lesions were observed, which involved the common carotid artery (n = 62), the subclavian artery (n = 26), or the innominate artery (n = 4). Twenty-three patients (36%) had multiple supra-aortic trunk lesions, but only 8 patients underwent reconstruction of multiple supra-aortic trunks. Five patients (8%) underwent sternotomy for revascularization from the ascending aorta. Forty-seven patients required revascularization of a common carotid artery; procedures included bypass grafting (n = 30), angioplasty with stent placement (n = 13), carotid-carotid transposition (n = 2), and endarterectomy (n = 2). Fifteen patients underwent restoration of a subclavian artery. One patient died on postoperative day 5, of stroke after early occlusion of an intercarotid crossover bypass graft. Mean follow-up was 37 months (range, 2-120 months). Ten late deaths occurred during follow-up. The probability of survival at 4 years was 78.1% +/- 8.6%. During follow-up, 6 patients had stroke, 4 bypass occlusions occurred and 3 stenoses occurred in the revascularized arteries. At 4 years the probability of freedom from stroke was 85% +/- 8.8%. At 4 years the primary patency rate was 79.3% +/- 8.5% and the secondary patency rate was 87.9% +/- 7.2%. CONCLUSIONS: In light of the context, the results of arterial revascularization to treat radiation-induced arterial lesions of the supra-aortic trunk are satisfactory.

Adult↗

PubMed2006

Postural control of the trunk during unstable sitting in Parkinson's disease.

Postural instability and falls, both common in Parkinson's disease (PD), have been related to altered trunk control. In this study, we investigated dynamic trunk control with subjects balancing on a seat mounted on a hemisphere, for up to 15s in five trials. We compared eight PD patients with a fall-history, eight without a fall-history, and eight matched healthy subjects. The number of trials completed without balance loss and the time to balance loss were significantly lower in PD patients as compared to healthy controls, whereas the PD patients with a fall-history did not perform significantly less than the patients without a fall-history. Multivariate analysis of variance showed significant effects of group on movements of the center of pressure (CoP) under the seat with the largest amplitudes among the PD fallers and the smallest amplitudes among the healthy controls. Univariate analyses revealed that this effect was mainly based on a significantly larger root mean square CoP displacement in the medio-lateral direction, with significant post hoc differences between all three groups. Trunk angular deviations were significantly smaller among PD patients than controls. Finally, both CoP movements and trunk movements had a significantly lower frequency content and were thus slower in PD patients than in controls, except for anterior-posterior CoP movements. The results show that trunk control is affected in PD and suggest that these changes may be related to postural instability and fall risk.

Accidental Falls↗

PubMed1997

Extension of the "elephant trunk" technique in complex aortic pathology: the "bidirectional" option.

BACKGROUND: The "elephant trunk" technique, using a free-floating vascular prosthesis, was originally described to facilitate a subsequent operation on the downstream aorta. We developed an additional refinement of this technique, called the "bidirectional elephant trunk." This option may represent an interesting tool in more complex aortic operations, especially when the descending aorta has to be replaced first in patients with concomitant pathology of the ascending aorta or of the aortic arch. METHODS: The initial operation is performed through a left thoracotomy. The proximal elephant trunk is created by invaginating the future aortic arch graft into the descending aortic graft. The proximal anastomosis between the doubled graft and the proximal descending aorta is performed first. During construction of the distal anastomosis, a distal elephant trunk may be inserted likewise. If the aortic arch and ascending aorta have to be replaced later, this second step is performed through a median sternotomy. The free-floating arch graft is pulled out of the proximal descending aorta with a nerve hook, unfolded, and used for total arch replacement. RESULTS: This technique was used successfully in 3 patients without mortality. No major complications were observed excepted persistent hoarseness in a patient with preoperative paresis of the recurrent nerve. No perfusion problems due to the unfolding of the free-floating graft occurred during the second operation. CONCLUSIONS: The bidirectional elephant trunk technique is an interesting option that may be suitable for patients presenting with a complex pathology of the whole thoracic aorta when the descending segment has to be replaced first.

Anastomosis, Surgical↗

PubMed2001

Muscle activity and range of motion during active trunk rotation in a sitting posture.

Twisted trunk postures during tractor driving are associated with low-back pain. The purposes of this study were to quantify the muscle activity as a function of twisting angle, to quantify the range of motion (ROM) during active trunk rotation and to determine whether there were any differences between tractor drivers and office workers and between twisting direction for these variables. The subjects performed exertions in a seated position, twisting from the neutral position to the end of the ROM. The results showed that external oblique and erector spinae had significantly different activation patterns depending on twisting direction. For the contralateral external oblique and the ipsilateral erector spinae, the muscle effort required to twist the trunk was low up to about 20 degrees twisting angle, then the muscle effort needed to twist the trunk increased progressively. No significant differences due to occupation or twisting direction were found. The result implies that work in twisted trunk postures might be a risk factor for low-back pain.

Adult↗

PubMed1995

Electromyographic analysis of four techniques for isometric trunk muscle exercises.

Posture to avoid hyperextension of the lumbar spine during isometric trunk muscle exercises has been widely recommended. However, there are no common standards for cervical and pelvic alignment during exercises. To investigate the effects of four different techniques regarding cervical and pelvic alignment, electromyographic (EMG) and radiological studies were performed on 30 healthy subjects. The four different postures were: (1) maximally extended neck, (2) neutral neck, (3) maximally flexed neck, and (4) maximally flexed neck with pelvic stabilization through muscle contraction. During flexion exercises, the largest increase in EMG activity in the abdominal muscles was observed with the flexed neck with pelvic stabilization (p < .01). During extensor exercises, the largest increase in EMG activity in the erector spinae was also obtained in the same position (p < .01). An increase of EMG activity in antagonist muscles (eg, erector spinae on flexion, and rectus and oblique muscles on extension) was also greatest with the flexed neck and pelvic stabilization. From the radiographic study, degrees of lumbar lordosis were least with the flexed neck and pelvic stabilization (p < .01). This study showed that neck and pelvic alignment can influence the EMG activity of trunk flexors and extensors during isometric trunk exercises. For isometric trunk muscle exercises, a maximum flexed neck with pelvic stabilization through muscle contraction seems to be the most optimal posture for decreasing the lumbar lordosis and for activating trunk flexors and extensors most effectively.

Abdominal Muscles↗

PubMed2000

The effect of load on the coordination of the trunk for subjects with and without chronic low back pain during flexion-extension and lateral bending tasks.

OBJECTIVE: To evaluate if patients move their trunk sections differently than normal subjects and to determine if these differences increase when lifting a load. DESIGN: Comparative study using a repeated measures design. BACKGROUND: Many studies demonstrate a modification of the lumbar-pelvic rhythm for chronic low back pain patients but the large variability of the results impair the discrimination power. It was hypothesized that the lifting of a load would magnify the manifestation of lumbar impairments. METHODS: Fifteen chronic low back pain patients and 18 normal subjects performed maximal flexion-extension and lateral bending of the trunk with and without a 12 kg load. The pelvic, lumbar and thoracic motions were measured with a motion analysis system. RESULTS: During flexion-extension tasks, a significant decrease in lumbar flexion and increase in thoracic flexion were observed for the patients. The load effect was significant for all trunk sections but did not allow a better discrimination between groups. CONCLUSIONS: Lifting a 12 kg load during flexion-extension of the trunk did confirm alteration in trunk section coordination but did not help to better discriminate patients from normal subjects. However, it was demonstrated for the first time that chronic low back pain patients compensate for a loss of lumbar flexion by increasing their thoracic flexion. RELEVANCE: The lumbar-pelvic rhythm is routinely used to evaluate low back impairments. The use of kinematic measures enhance the objectivity of the examination but the large variability of the results impair the discrimination power. Lifting a load during such an evaluation might magnify the low back impairments and increase the discrimination power of this measure.

Adult↗