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Title: Individuals with and without low back pain use different motor control strategies to achieve spinal stiffness during the prone instability test
Authors: Won Sung
Gregory E. Hicks
David Ebaugh
Susan S. Smith
Scott Stackhouse
Peemongkon Wattananon
Sheri P. Silfies
University of Delaware
University of New England, USA
University of South Carolina
Drexel University
Mahidol University
Good Shepherd Penn Partners-Penn Therapy and Fitness
Keywords: Health Professions
Issue Date: 1-Jan-2019
Citation: Journal of Orthopaedic and Sports Physical Therapy. Vol.49, No.12 (2019), 899-907
Abstract: Copyright © 2019 Journal of Orthopaedic & Sports Physical Therapy®. BACKGROUND: The prone instability test is used to identify individuals with low back pain (LBP) who would benefit from trunk stabilization exercises. Although activity from muscles during the leg-raising portion of the prone instability test theoretically enhances spinal stiffness and reduces pain, evidence for this is lacking. OBJECTIVES: To compare and contrast (1) pain and stiffness changes between prone instability testing positions, and (2) muscle activation patterns during the prone instability test leg raise in individuals with and without LBP. METHODS: Participants with (n = 10) and without (n = 10) LBP participated in this laboratory case-control study. Spinal stiffness was measured using a beam-bending model and 3-D kinematic data. Stiffness changes were compared across the test positions and between groups. Surface electromyographic data were collected on trunk and limb musculature. Principal-component analysis was used to extract muscle synergies. RESULTS: Spinal stiffness increased across testing positions in all participants (P<.05). Participants with LBP experienced reduced pain during the test (P<.001). No between-group difference was found in spinal stiffness during leg raising during the test (P>.05). Participants without LBP used 3 muscle synergies during the leg raise and participants with LBP used 2 muscle synergies. CONCLUSION: Spinal stiffness increased in all participants; however, participants without LBP demonstrated a muscle synergy pattern where each synergy was associated with a distinct function of the prone instability test. Participants with LBP used a more global stabilization pattern, which may reflect a maladaptive method of enhancing spinal stability.
ISSN: 01906011
Appears in Collections:Scopus 2019

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