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A neural network approach to motor-sensory relations during postural disturbance.

This study explored whether artificial neural networks (ANN) can be used to quantify the motor-sensory relationship during postural disturbance. An ANN model was constructed with seven mechanical stimuli to the visual, vestibular and somatosensory systems (i.e., head angular and linear accelerations, eye-target distance, ankle joint rotation and velocity, as well as normal and shear ground contact forces under the feet) as inputs, and electromyographic activities of tibialis anterior and gastrocnemius muscles as outputs. These inputs and outputs were directly measured during a sudden toes-up-down rotation of the supporting base in two groups of elderly subjects: people with peripheral neuropathy (NP) who have severe loss of mechanoreception in the sole of their feet and people without NP. The products of ANN weights were used in a summary statistic called the Q-value to estimate the contribution of each mechanical stimulus to sensory systems in determining each leg muscle activity. It was found that: (1) the stimuli to the vestibular system and/or ankle proprioceptors have greater contributions to leg muscle activities, especially the TA muscle, in people with NP than people without NP; (2) the stimuli to somatosensory receptors have the greatest contribution, and the stimuli to the vestibular system have the least contribution to both muscle activities in both groups. These findings are supported by previous studies and have demonstrated the potential of the Q-value concept in the ANN model in studying the motor-sensory relationship in human postural control.

Aged↗

Mechanics and control of the flat versus normal foot during the stance phase of walking.

OBJECTIVE: To compare walking stance phase rearfoot and forefoot motion, ankle joint moments and extrinsic foot muscle EMG profiles between normal and pes planus feet. DESIGN: A cross-sectional comparative study. BACKGROUND: Musculoskeletal conditions are often attributed to pes planus, in which motion is assumed to be excessive and the muscle control inadequate. However, many of the speculated differences in mechanics and control between the normal and the pes planus foot have not been quantified. METHODS: Kinematic and kinetic data were obtained from video recordings of skin surface markers and a force plate, and EMG was recorded with surface electrodes. Analysis of variance was carried out to compare the group profiles. RESULTS: In the pes planus group: the forefoot was less adducted (P < .05) at toe-off, and total transverse plane range of motion, at 8 degrees versus 10 degrees, was less (P < .01); the peak plantarflexor ankle moment at push-off was greater (P < .05); the invertor moment was greater at foot flat (P < .05); for the EMG profiles, activity early in stance, relative to the mean stance phase activity was higher (P < .01) in tibialis anterior and lower (P < .05) in the peronei, soleus and medial and lateral gastrocnemius. CONCLUSIONS: Despite reaching statistical significance, the group differences were small for the task of laboratory walking at a natural pace. The main implications of the differences were for restraint of motion. The expectations of excessive motion and muscle effort in the pes planus group were therefore not substantiated. RELEVANCE: Symptomatic pes planus subjects did not reveal the expected biomechanical differences from normal subjects. The underlying causes of symptoms were not identifiable.

Adaptation, Physiological↗

Defining phases for the sit-to-walk movement.

OBJECTIVE: To define phases of the sit-to-walk movement and test their consistency in a normal population. DESIGN: An observational study of thirteen healthy volunteers. BACKGROUND: Moving from sitting to walking is a daily activity that may present difficulty for some populations in terms of control and stability. METHODS: The movement was partitioned into phases according to changes in ground reaction forces and peak velocity of the total body centre of mass. Consistency of each phase duration was assessed. RESULTS: Four phases of sit-to-walk were defined; flexion momentum, extension, unloading and stance. ICC scores for phase duration ranged from 0.54 (extension) to 0.81 (stance). CONCLUSIONS: This is the first study to define distinct phases of the sit-to-walk movement. There was moderate to good consistency for phase duration. RELEVANCE: By defining and testing phases of the sit-to-walk movement this study enhances understanding of this everyday movement and provide a model for future research.

Activities of Daily Living↗

How postural behaviour in undisturbed upright stance can be used to assess the physical characteristics of various models of ankle orthoses.

OBJECTIVES: To assess various ankle orthoses presenting different physical characteristics. DESIGN: The postural performance in bi-pedal stance of 14 healthy adults was assessed during four different ankle orthoses conditions. BACKGROUND: Resultant ankle stiffness is an important component in undisturbed upright postural regulation. METHODS: The centre of pressure displacements issued from the force platform were used to compute the horizontal motions of the centre of gravity, the controlled variable, and those of the difference between the centre of pressure and the vertical projection of the centre of gravity from which ankle stiffness can be estimated. Their respective contribution was assessed through a frequency analysis and a fractional Brownian motion modelling to determine their spatio-temporal linkage and their degree of control. RESULTS: Ligacast, the more rigid model, induces the larger decrease, principally in the medio-lateral direction, in both centre of pressure minus centre of gravity and centre of gravity amplitudes. Dynastab reduces only the centre of pressure minus centre of gravity motions in both medio-lateral and antero-posterior directions. Lastly, no specific effect was observed for the less rigid Ligaflex for each motion and each direction. These effects are mainly explained by a reduction in the distance covered until the corrective process is initiated, the corresponding time interval being unchanged. In addition, depending on the model, the corrective processes appear more or less controlled. CONCLUSIONS: Modulating the ankle joint stiffness by using various models of orthoses induces some contrasted behaviours, hence suggesting that postural control does not result solely from resultant ankle stiffness. RELEVANCE: This data, contributing to the understanding of orthotic devices by emphasising their benefits, allows the practitioners and physical therapists to take into account the specific effects generated by each model.

Adult↗

Responses to whole head-and-body tilts with and without passive ankle dorsiflexion in the absence of visual feedback.

OBJECTIVES: We have investigated lower limb responses in seven blindfolded healthy subjects to well controlled tilts in the standing position. Our aims were (1) to determine the effect of head acceleration magnitude on responses evoked by whole head-and-body tilts, and (2) to establish whether tilt-evoked responses are modifiable by passive ankle dorsiflexion. Whole head-and-body tilts evoked responses in the biceps femoris, medial gastrocnemius and tibialis anterior muscles. METHODS: Seven young healthy subjects stood on a spring-activated tilting apparatus and underwent sudden whole head-and-body tilts of about 15 degrees from the vertical position, with or without passive ankle dorsiflexion. Head acceleration was recorded with a linear accelerometer and ankle angular displacement with a potentiometer. Surface EMG signals were recorded in the right biceps femoris, medial gastrocnemius and tibialis anterior muscles. RESULTS: As the peak of head acceleration was increased from 0.5 g to 1.8 g, the frequency of occurrence of tilt-evoked responses increased from 7% to 60% of trials in the biceps femoris muscle during whole head-and-body tilts. In general, the more proximal muscle (biceps femoris) was activated before the more distal muscle (medial gastrocnemius) during whole head-and-body tilts, while the opposite pattern was found during tilt with dorsiflexion. CONCLUSIONS: Our results indicate that the occurrence of tilt-evoked responses increases with an increase in the amplitude of tilting acceleration. This suggests that tilt-evoked responses are dependent, at least in part, on vestibular stimulation. In addition, the spatio-temporal pattern of biceps femoris and medial gastrocnemius muscle activation was opposite during whole head-and-body tilts and tilts with dorsiflexion. This finding suggests that foot/ankle somatosensory inputs can modify tilt-evoked responses.

Adolescent↗

Cervical muscle response to right posterolateral impacts.

OBJECTIVE: To test the hypothesis that the head kinematic and the cervical muscle EMG responses to unexpected impacts of increasing low-velocity in the posterolateral direction will be greater than to expected impacts. DESIGN: Ten healthy volunteers were subjected to right posterolateral of 5.0, 8.6, 12.2, and 15.4 m/s2 acceleration in expected and unexpected conditions. BACKGROUND: The effect of a posterolateral impact on the cervical muscle responses is unknown. METHODS: Bilateral EMG of the sternocleidomastoids, trapezii, and splenii capitis were recorded and compared. The acceleration of the chair, torso, and head was recorded and compared. RESULTS: At an acceleration of 15.4 m/s2, the sternocleidomastoids generated the highest EMG in the unexpected impact conditions with lower percentages for the expected impact (50% of their maximal voluntary contraction). The splenii exhibited between 30% and 40% EMG, the trapezii generated approximately 25%. The EMG was significantly affected by the levels of acceleration (P < 0.01) for the sternocleidomastoids and splenii. The time to onset and peak EMG for all muscles progressively decreased with increasing levels of acceleration and regressed significantly on it (P < 0.01). Head accelerations were greater in the unexpected impacts (P < 0.5). CONCLUSIONS: The cervical muscles play a primary role in posture control. They may be a at risk of injury in whiplash especially in unexpected impacts. In the case of the right posterolateral impacts the sternocleidomastoids and splenii show a differentially higher response compared to the trapezii (P < 0.5). This may suggest an increased risk of injury to these muscles. RELEVANCE: The results presented contribute to an understanding of head and neck responses in posterolateral impacts.

Acceleration↗

Modifying the gain of the visual feedback affects undisturbed upright stance control.

OBJECTIVE: To assess the effects of visual feedback gain, which express the amplitudes of the displacements of the centre of pressure displayed on a computer screen. DESIGN: The controlling variable, the centre of pressure trajectories, recorded using a force platform, were decomposed into two elementary motions: (1) the horizontal displacements of the centre of gravity and (2) the vertical projection of the difference between centre of pressure and the centre of gravity. These motions were processed through frequency analysis and modelled as fractional Brownian motion to assess their spatio-temporal linkage and their degree of control. BACKGROUND: Although tests to modify the feedback gain have already been carried out, the specific effects from a biomechanical and motor control point of view need to be assessed. METHODS: Thirteen healthy adults were tested through various visual feedback gains performed in random order. RESULTS: By increasing the visual feedback gain, no difference is observed between centre of pressure and centre of gravity motions whereas a progressive diminution of centre of gravity horizontal motions is seen. This latter effect is principally explained by a reinforcement of control during corrective processes. CONCLUSIONS: When the control of centre of gravity constitutes the main flaw in undisturbed stance maintenance, the efficiency of a visual feedback rehabilitation protocol should be largely improved by using an enhanced gain.

Acceleration↗

Cervical muscle response to posterolateral impacts--effect of head rotation.

BACKGROUND: Rear impacts may be offset, and may also occur with the head rotated at impact. The purpose of this study was to determine the response of the cervical muscles to increasing low-velocity rear impacts offset by 45 degrees to the subject's right, but also with the head rotated either right or left. METHODS: Twenty healthy volunteers underwent right posterolateral impacts of 4.6, 8.0, 11.0, and 13.1 m/s2 acceleration with head turned right or left. Electromyograms of the sternocleidomastoids, trapezii, and splenii capitis were recorded, as were acceleration of the sled, torso, and head of the participant. FINDINGS: At an impact acceleration of 13.1 m/s2, with head rotated to the right, the left sternocleidomastoid and the contralateral (to rotation) trapezius and splenius capitis generated more electromyogram activity than their counterparts (P < 0.05). Following impacts with the head rotated to the right, the left sternocleidomastoid generated 67% of its maximal voluntary electromyogram, and the right sternocleidomastoid 5% of the maximal voluntary electromyogram, whereas the remaining muscles did not generate more than 31% of the maximal voluntary contraction electromyogram. In impacts with head rotated left, the right sternocleidomastoid generated 53% of its maximal voluntary electromyogram, and the left splenius capitis and left trapezius showed more electromyogram activity than their counterparts (P < 0.05). INTERPRETATION: Head rotation in a right posterolateral impact modifies the cervical response mainly by generating an asymmetry in the paired sternocleidomastoid electromyograms. This may asymmetrically affect the risk of injury to the sternocleidomastoids. An understanding of the muscular response to rear-impacts of different types and the effect of head rotation at the time of impact is relevant to understanding the mechanism of acute whiplash injury and may be helpful to develop targeted treatments and preventative measures.

Acceleration↗

Changes in distal muscle timing may contribute to slowness during sit to stand in Parkinsons disease.

OBJECTIVE: To compare patterns of muscle activation in the lower extremity and subsequent forces during sit to stand in persons with Parkinsonism. BACKGROUND: There is an interruption of the tibialis anterior/soleus interaction during forward oriented movements in some subjects with Parkinsonism, including sit to stand. This task is a major determinant of independence and 44% of those with Parkinsonism report difficulty. METHODS: 41 subjects with Parkinsonism were asked to stand up from a bench. Peak acceleration and vertical ground reaction forces, the slopes to these peaks, and the timing of events were measured. Surface electrodes were placed on tibialis anterior and soleus. RESULTS: The slower group produced force at slower rate than the fast group. The slower group spent 64% of the time taken to stand to complete the flexion-momentum phase, and the fast group spent 56%. The slower group had a larger proportion of co-contraction trials than the other groups. CONCLUSIONS: Slower subjects took longer to perform the task due to a longer time for seat off. Deficits recruiting tibialis anterior may contribute to the decreased rate of production of the acceleration forces and the longer time required for seat off. Relevance Decreased rate of rise of force is used to identify fallers in the elderly and subjects with stroke. Decreased rates of force production may therefore assist in identifying those with Parkinsonism at risk of falls. Treatment strategies designed to facilitate tibialis anterior activation may improve the functional performance of this task.

Adaptation, Physiological↗

Effects of static flexion-relaxation on paraspinal reflex behavior.

BACKGROUND: Static trunk flexion working postures and disturbed trunk muscle reflexes are related to increased risk of low-back pain. Animal studies conclude that these factors may be related; passive tissue strain in spinal ligaments causes subsequent short-term changes in reflex. Although studies have documented changes in the myoelectric onset angle of flexion-relaxation following prolonged static flexion and cyclic flexion we could find no published evidence related to the human reflex response of the trunk extensor muscles following a period of static flexion-relaxation loading. METHODS: Eighteen subjects maintained static lumbar flexion for 15 min. Paraspinal muscle reflexes were elicited both before and after the flexion-relaxation protocol using pseudorandom stochastic force disturbances while recording EMG. Reflex gain was computed from the peak value of the impulse response function relating input force perturbation to EMG response using time-domain deconvolution analyses. FINDINGS: Reflexes showed a trend toward increased gain after the period of flexion-relaxation (P < 0.055) and were increased with trunk extension exertion (P < 0.021). Significant gender differences in reflex gain were observed (P < 0.01). INTERPRETATIONS: Occupational activities requiring extended periods of trunk flexion contribute to changes in reflex behavior of the paraspinal muscles. Results suggest potential mechanisms by which flexed posture work may contribute to low-back pain. Significant gender differences indicate risk analyses should consider personal factors when considering neuromuscular behavior.

Adaptation, Physiological↗

The influence of different unloading positions upon stature recovery and paraspinal muscle activity.

OBJECTIVE: To determine whether stature recovery and paraspinal muscle activity can be altered in individuals with and without chronic low-back pain by assuming different unloading positions. DESIGN: A case-control study considering the effects of unloading position on stature recovery in individuals with and without chronic low-back pain. BACKGROUND: Stature recovery has been documented to be lower in individuals with chronic low-back pain. Elevated paraspinal muscle activity subjects the spine to increased compression, which may delay stature recovery. However, the mechanism(s) causing prolonged stature recovery are yet to be explored. METHODS: Eleven chronic low-back pain participants (age 33 yr (SD 12.2), height 1.72 m (SD 0.08), body mass 75.9 kg (SD 10.7)) and eleven asymptomatic participants (age 30.5 yr (SD 9.7), height 1.75 m (SD 0.10), body mass 73.3 kg (SD 11.7)) performed a loaded walking task (10% body mass) and adopted four unloading positions on separate occasions. Measurements of stature and muscle activity were recorded during each position. FINDINGS: Individuals with chronic low-back pain exhibited higher paraspinal EMG and delayed stature recovery in all positions (P<0.05). Both groups experienced greatest stature recovery and least muscle activity during gravity inversion (P<0.05). INTERPRETATION: Elevated muscle activity was found in the chronic low-back pain group supporting the existence of this explanation for delayed stature recovery. The gravity inverted position resulted in the lowest EMG and the greatest stature recovery. Further research is required to determine whether improving stature recovery has clinical implications by reducing pain/disability.

Adaptation, Physiological↗

Evaluation of segmental postural characteristics during quiet standing in control and Idiopathic Scoliosis patients.

BACKGROUND: The complex skeletal deformations that accompany Idioapthic Scoliosis pose a challenge to the clinician to non-invasively discriminate Idiopathic Scoliosis patients from children with no pathology. Therefore, the focus of this study is to non-invasively evaluate the position and amplitude of displacement of the pelvis, shoulders and thorax during quiet standing of Idiopathic Scoliosis patients and control subjects. METHODS: The quiet standing posture of 18 healthy adolescent females and 22 Idiopathic Scoliosis subjects was evaluated using an Optotrak 3020 position sensor over a period of 120 s, with 4 repeat trials. Outcome measures included the mean position, root mean square amplitude and range over the duration of 120 s trials for both linear and angular measures of the pelvis, thorax and shoulders. Appropriate sample times were chosen and evaluated for stability over the 120 s period, and between trial reliability was evaluated. FINDINGS: There was a significant difference between groups for the mean position of the shoulder blade rotation in reference to the base of support and to the pelvis. The Idiopathic Scoliosis patients had a significantly larger root mean square amplitude of anterior-posterior displacement of the T1 and S1 spinous processes in reference to the base of support. There was no difference between the sample durations to estimate the mean position of the body segments, however the root mean square increased significantly. INTERPRETATION: This study demonstrates that postural abnormalities are evident during quiet standing in Idiopathic Scoliosis patients.

Child↗

Head and neck position sense in whiplash patients and healthy individuals and the effect of the cranio-cervical flexion action.

BACKGROUND: Whiplash may damage structures within the neck that can affect position sense. Deep neck flexor muscle retraining may improve position sense. The current study compared range of motion and position sense in whiplash and control subjects and investigated the effects of a muscle training session on position sense. METHODS: Twenty-three subjects with whiplash were compared with a matched control group. Range of motion and neck position sense measures were recorded using the 3-Space Fastrak. Measures of function were also assessed in the whiplash group. Subjects were then randomised into experimental and control groups and the former group received a training session to activate the deep neck flexor and scapular stabilising muscles (the cranio-cervical flexion action) during head and neck movements. After training, position sense measures were re-evaluated. FINDINGS: Results showed significant reductions (P < 0.05) in active range of motion in the whiplash group when compared to the healthy group. No significant differences (P > 0.05) between whiplash and healthy groups in position matching accuracy were observed. Functional outcome scores indicated the whiplash group to be mildly disabled. No effect on error scores was observed when position-matching tasks were performed with and without the cranio-cervical flexion action. Correlations between functional measures or range of motion, and position sense were not significant. INTERPRETATION: There was no evidence of position sense impairment in the mildly disabled whiplash subjects. The performance of the cranio-cervical flexion action had no effect on position sense, and hence clinical improvements observed from using this action may be more associated with mechanical stabilisation.

Adult↗

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↗

Intramuscular hemodynamics in bilateral erector spinae muscles in symmetrical and asymmetrical postures with and without loading.

BACKGROUND: Although attention has been paid to the relationship between the changes in blood circulation in erector spinae muscles and back pain, little is known about their hemodynamics in several various comparable postures with and without loading. Studies on hemodynamics of erector spinae muscles using near-infrared spectroscopy have been performed on subjects and patients mainly in forward flexion positions. METHODS: Two near-infrared spectroscopes were used to measure oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin in bilateral erector spinae muscles at L2-3 in subjects in 9 postures, and holding no load, 10 kg or 20 kg in maximum flexed and lateral bending. Those three values in each posture and loading condition were expressed as a percentage of their corresponding values obtained in the standing upright position, and designated and statistically analyzed as %Oxy-Hb, %Deoxy-Hb and %Total-Hb, respectively. FINDINGS: %Total-Hb and %Oxy-Hb in maximum flexion were the most decreased. In maximum lateral bending, %Oxy-Hb only in the contralateral erector spinae muscles was decreased. When the load was 20 kg, the decreases in %Oxy-Hb were the largest in maximum flexion and lateral bendings. INTERPRETATION: Using two near-infrared spectroscopes allowed us to measure simultaneously the hemodynamics of bilateral muscles. They demonstrated different responses in each side. Asymmetrical posture and loading were accompanied by asymmetrical changes of the bilateral erector spinae muscles. Stretched muscle had less blood volume and oxygenation, both of which decreased with increasing load. These results showed that these postures and conditions might lead to fatigue of the ES muscles.

Adult↗

Sitting on a chair or an exercise ball: various perspectives to guide decision making.

BACKGROUND: Prolonged sitting is recognized as a risk factor for the reporting of low back troubles. Despite the use of exercise balls in replacement of the office chair, little quantitative evidence exists to support this practice and hence motivated this research. Given the potential for several biological effects and mechanisms this study was approached with several layers of instrumentation to quantify differences in muscle activation, spine posture, spine compression and stability while sitting on an exercise ball versus a stable seat surface. Also, differences in the pressure distribution at the seat-user interface were quantified for the different seat surfaces to provide an objective perspective on the mechanism influencing perceived comfort levels. METHODS: Eight male subjects volunteered to sit for 30 min on an exercise ball and on a wooden stool. Muscle activity and spine position were used to model spine load and stability. An additional seven sat on an exercise ball and chair to examine pressure distribution over the contact area. FINDINGS: There was no difference in muscle activation profiles of each of the 14 muscles between sitting on the stool and ball. Calculated stability and compression values showed sitting on the ball made no difference in mean response values. The contact area of the seat-user interface was greatest on the exercise ball. INTERPRETATION: The results of this study suggest that prolonged sitting on a dynamic, unstable seat surface does not significantly affect the magnitudes of muscle activation, spine posture, spine loads or overall spine stability. Sitting on a ball appears to spread out the contact area possibly resulting in uncomfortable soft tissue compression perhaps explaining the reported discomfort.

Adult↗

Force-plate based computation of ankle and hip strategies from double-inverted pendulum model.

BACKGROUND: Using statistical characteristics of the centre of pressure displacement or of the ground reaction forces, it is difficult to have quantitative evaluation of the equilibrium strategy employed (ankle or hip). The purpose of this study is to validate a new force-plate based approach that allows to evaluate postural strategies employed through a method based on a double-inverted pendulum model. METHODS: This method allows to compute ankle and hip joint motion only from force plate data and relies on inverse kinematics with the centre of mass considered as the end effector. Furthermore, an index, depending on the covariance between hip and ankle angles, is proposed to quantify the strategy used. To validate the method and the strategy index, we compare the results of our computation to an optical stereophotogrammetry measurement of the angles considered as reference value. FINDINGS: The experiments demonstrate that our method provides acceptable results. The root mean square error between computed and measured hip and ankle angles stands between 4.5 x 10(-3)degrees for ankle angle in static condition and 1.1 x 10(-1) degrees for hip angle in hip forced condition. INTERPRETATION: The main interest of our method for clinicians is that it allows to retrieve the ankle and hip angles only using a simple and widespread device, the force-plate. Moreover, it proposes a new postural index that can be also be computed without videographic systems.

Adult↗

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↗