Sharon Henry

University of Vermont | UVM · Department of Rehabilitation and Movement Science

Background: Despite the extensive evidence supporting physical activity (PA) for managing chronic low back pain (CLBP), little is known about PA prescription by physical therapists treating patients with CLBP. Objective: 1) Explore how PA prescriptions provided by outpatient physical therapists treating patients with CLBP align with PA guideline...

Patients with chronic low back pain (CLBP) exhibit remodelling of the lumbar soft tissues such as muscle fatty infiltrations (MFI) and fibrosis of the lumbar multifidus (LuM) muscles, thickness changes of the thoracolumbar fascia (TLF) and perimuscular connective tissues (PMCT) surrounding the abdominal lateral wall muscles. Rehabilitative ultrasou...

Low back pain (LBP) remains one of the most common and incapacitating health conditions worldwide. Clinical guidelines recommend exercise programs after the acute phase, but clinical effects are modest when assessed at a population level. Research needs to determine who is likely to benefit from specific exercise interventions, based on clinical pr...

Background Individuals with chronic low back pain demonstrate impaired responses to volitional and externally-generated postural perturbations that may impact stability whilst performing activities of daily living. Understanding how balance may be impaired by strategy selection is an important consideration during rehabilitation from low back pain...

Recently remodeling of lumbar soft tissues has received increased research attention. However, the major determinants that influence remodeling need to be elucidated in order to understand the impact of different rehabilitation modalities on tissue remodeling. The main aim of this study was to explore the between‐subject variance of different measu...

Introduction With low back pain (LBP), remodelling of the lumbar soft tissues involves both trunk muscles and neighbouring passive connective tissues. The aim of the present study was to compare three quantitative measures of these tissues, using ultrasound imaging (USI), among healthy controls and individuals with LBP. Methods USI measures from 3...

The aim of this study was to test whether determinants associated with lumbar stability can predict performance during unstable sitting (trunk postural control - TPC). If confirmed, unstable sitting could be viewed as a proxy measure for these determinants. Wobbling chair motion was measured in 58 subjects with an inertial sensor, and six outcomes...

Background/purpose: Endurance sports, including cross-country skiing, require long hours of repetitive training potentially increasing the chance of injury, yet injury incidence and risk factors for adult cross-country skiers remain relatively unexplored. Data for elite adult north American competitive cross-country skiers is unexplored. A 12 mont...

Background: Lumbar stabilization exercise programs (LSEPs) act positively on clinical outcome measures in patients with low back pain (LBP), but the underlying mechanisms are not well understood. Among the various neuromuscular mechanisms, a good candidate is better activation of the abdominal wall, as measured with rehabilitative ultrasound imagi...

Dr. Peterson is an associate professor of kinesiology at Cedarville University (CU) and currently serves as the Director of the Multi-Age Physical Education (MAPE) program at CU. ABSTRACT Musculoskeletal injuries in military populations are a leading cause for reduced physical readiness (15). Utilizing a screening tool that predicts physical perfor...

Low back pain (LBP) has a point prevalence of nearly 10% and ranks highest in global disease burden for years lived with disability; Parkinson’s disease (PD) ranks in the top 100 most disabling health conditions for years lost and years lived with disability (1). Recent evidence suggests that people with chronic, recurrent LBP exhibit many postural...

Background Low back pain (LBP) has been previously associated with delayed anticipatory postural adjustments (APAs) determined by trunk muscle activation. Lumbar stabilization exercise programs (LSEP) for patients with LBP may restore the trunk neuromuscular control of the lumbar spine, and normalize APAs. This exploratory study aimed at testing th...

There is current need for objective measures of sciatic nerve mobility in patients with sciatic-type pain. The objective of the study was to assess the feasibility and reliability of ultrasound elastography to quantify sciatic nerve displacement and shear strain at the sciatic nerve–hamstring muscle interface during active and passive knee extensio...

Lumbar stabilization programs reduce pain and disability, but the mechanisms of action underlying this treatment are unknown. Trunk postural control during unstable sitting represents a surrogate measure of motor control mechanisms involved to maintain the dynamic stability of the spine. This exploratory study aimed to determine the reliability of...

Background: Lumbar statilization exercise programs (LSEP) produce positive effects on clinical outcomes, but the underlying mechanisms remain fairly unexplored. Psychological and neuromuscular mechanisms can be involved such as a better activation of the lumbar multifidus which represents one possibility. Objectives: To determine the (1) effect...

Physical therapists evaluate patients' movement patterns during functional tasks; yet, their ability to interpret these observations consistently and accurately is unclear. Physical therapists would benefit from a clinic friendly method for accurately quantifying movement patterns during functional tasks. Inertial sensors, which are inexpensive, po...

Background Lumbar stabilization exercise programs should normalize the aberrant movements patterns often observed in patients with low back pain. This study aimed to determine the effect of an 8-week lumbar stabilization program on EMG/kinematics measures of the aberrant movement patterns in such patients. A secondary goal was to assess the 8-week...

Background: People with low back pain exhibit altered postural coordination that has been suggested as a target for treatment, but heterogeneous presentation has rendered it difficult to identify appropriate candidates and protocols for such treatments. This study evaluated the associations of task-related and person-related factors with the effec...

Background Prospective, cross-country ski injury incidence data is scarce. Objective To describe injury type and incidence sustained by elite cross-country skiers in north-eastern America. We hypothesized that lower extremity injury incidence would be higher than other body regions. A secondary aim was to determine any factors that correlate with...

This study sought to determine the effects of chronic low back pain (LBP) on the cortical evoked potentials, muscle activation, and kinematics of postural responses to perturbations of standing balance. Thirteen subjects with chronic, recurrent, non-specific LBP and 13 subjects without LBP participated. The subjects responded to unpredictably timed...

Purpose: Musculoskeletal injuries in the United States Armed Forces impacts operational readiness. Therefore, a reliable, valid screening tool that identifies injury risk and predicts performance is needed. The purpose of this study was to: (1) establish the intra-and inter-rater reliability of the Movement Competency Screen (MCS) using a cohort of...

The persistence of back pain following acute back "sprains" is a serious public health problem with poorly understood pathophysiology. The recent finding that human subjects with chronic low back pain (LBP) have increased thickness and decreased mobility of the thoracolumbar fascia measured with ultrasound suggest that the fasciae of the back may b...

Background: Lumbar stabilization exercises have gained popularity and credibility in patients with non-acute low back pain. Previous research provides more support to strength/resistance and coordination/stabilisation programs. Some authors also suggest adding strength/resistance training following motor control exercises. However, the effect of s...

Trunk muscle timing impairment has been associated with non-specific low back pain (NSLBP), but this finding has not been consistent. This study investigated trunk muscle timing in a subgroup of patients with NSLBP attributed to movement coordination impairment (MCI) and matched asymptomatic controls in response to a rapid arm-raising task. Twenty-...

Background: Treatment for breast cancer has increased patient survivorship exponentially over the past few decades. With increased survivorship, more women are living with the longstanding effects of breast cancer treatment, such as lymphedema. Patients, health care providers, and payers depend on practical and efficient clinical measures to accur...

Common clinical neurological exams can be insensitive to balance and mobility impairment at the early stages of multiple sclerosis (MS) and may not correspond with patient reports. Instrumented measurement of standing postural sway with inertial motion sensors may provide sensitive measures of balance impairment and better correspond with patient r...

Background: Motor retraining for non-specific chronic low back pain (LBP) often focuses on voluntary postural tasks. This training, however, may not transfer to other known postural impairments, such as automatic postural responses to external perturbations. Objectives: To evaluate the extent current treatments of motor retraining ameliorate imp...

Background: Ultrasound imaging has been used to examine movement of the peripheral nervous system in response to normal body movements and therapeutic exercises, such as neural mobilisation. Researchers have clearly established that peripheral nerves must be able to move in relation to their surrounding interfacing tissues. However, to date the mec...

Background Classification schemas for low back pain (LBP), such as the Treatment Based Classification and the Movement System Impairment schemas, use common clinical features to subgroup patients with LBP and are purported to improve treatment outcomes. Purpose To assess if providing matched treatments based on patient specific clinical features l...

People with low back pain (LBP) exhibit impaired anticipatory postural adjustment (APAs). To evaluate whether current motor retraining treatments address LBP-associated changes in movement coordination during tasks that do and do not require APAs. Prospectively registered, randomized controlled trial with a blinded assessor. Outcome evaluations occ...

Abstract Patients, health care providers, and payers depend on practical, efficient, and useful tests that can be performed in a clinical setting in order to measure accurately and to diagnose lymphedema. Accurate measures are also necessary to monitor progression or regression of the disease, as well as treatment effects. This article reviews clin...

Interventions that target trunk muscle impairments in people with LBP have been promoted; however, the treatment effects on muscle activation impairments during postural tasks remain unclear. Thus, our objective was to evaluate the effects trunk stabilization vs. general strength and conditioning exercises on the automatic postural response in pers...

Anticipatory postural adjustments (APAs) stabilize potential disturbances to posture caused by movement. Impaired APAs are common with disease and injury. Brain functions associated with generating APAs remain uncertain due to a lack of paired tasks that require similar limb motion from similar postural orientations, but differ in eliciting an APA...

Objective: To (1) assess the intra- and inter-rater reliability of different ultrasound (US) measures of the lumbar multifidus muscle in subjects with and without chronic low back pain and (2) test 3 different ways to enhance reliability, that is, by testing different tasks, using a template, and averaging trials within or between days. Design:...

Objective: To assess the reliability of ultrasound (US) measures of the transversus abdominis (TrA) muscle in a sample of subjects with and without specific chronic low back pain and to test whether reliability is enhanced by using different abdominal muscle activation tasks, with use of a foam cube for US transducer stabilization or by averaging...

Objective: To understand lumbar multifidus (LM) muscle activation as a clinical feature to predict patients with low back pain (LBP) who are likely to benefit from stabilization (STB) exercises. Design: Prospective, cohort study. Setting: Outpatient physical therapy clinics. Participants: Persons with LBP were recruited for this study. Subje...

Individuals with a history of non-specific low back pain (LBP) while in a quiescent pain period demonstrate altered automatic postural responses (APRs) characterized by reduced trunk torque contributions and increased co-activation of trunk musculature. However, it is unknown whether these changes preceded or resulted from pain. To further delineat...

Observational cross sectional study. To examine the inter-rater reliability of novice raters in using the Movement System Impairment (MSI) approach system and to explore the patterns of disagreement in classification errors. The inter-rater reliability of individual tests items used in the MSI approach is moderate to good; however, the reliability...

Observational, cross-sectional reliability study. To examine the interrater reliability of novice raters in their use of the treatment-based classification (TBC) system for low back pain and to explore the patterns of disagreement in classification errors. Although the interrater reliability of individual test items in the TBC system is moderate to...

http://www.irsst.qc.ca/media/documents/PubIRSST/R-729.pdf

There is increasing evidence that individuals with non-specific low back pain (LBP) have altered movement coordination. However, the relationship of this neuromotor impairment to recurrent pain episodes is unknown. To assess coordination while minimizing the confounding influences of pain we characterized automatic postural responses to multi-direc...

It is becoming increasingly evident that people with chronic, recurrent low back pain (LBP) exhibit changes in cerebrocortical activity that associate with altered postural coordination, suggesting a need for a better understanding of how the experience of LBP alters postural coordination and cerebrocortical activity. To characterize changes in pos...

Video clip of thoracolumbar fascia motion in human subject with LBP. Ultrasound B-scan acquired during passive trunk flexion induced by a motorized articulated table. Ultrasound transducer is placed longitudinally 2 cm from the midline at the level of the L2-3 interspace.

Video clip of cumulative lateral shear strain map during one flexion cycle of the table. Red indicates shear strain toward the right (rostral) and blue indicates shear strain toward the left (caudal) (see color scales in Figure 5).

Video clip of thoracolumbar fascia motion in human subject with No-LBP. Ultrasound B-scan acquired during passive trunk flexion induced by a motorized articulated table. Ultrasound transducer is placed longitudinally 2 cm from the midline at the level of the L2-3 interspace.

Video clip of cumulative lateral displacement map during one flexion cycle of the table. Red indicates tissue displacement toward the right (rostral) and blue indicates tissue displacement or shear strain toward the left (caudal) (see color scales in Figure 5).

Background: The role played by the thoracolumbar fascia in chronic low back pain (LBP) is poorly understood. The thoracolumbar fascia is composed of dense connective tissue layers separated by layers of loose connective tissue that normally allow the dense layers to glide past one another during trunk motion. The goal of this study was to quantify...

People with a history of low back pain (LBP) exhibit altered responses to postural perturbations, and the central neural control underlying these changes in postural responses remains unclear. To characterize more thoroughly the change in muscle activation patterns of people with LBP in response to a perturbation of standing balance, and to gain in...

Antagonistic activation of abdominal muscles and increased intra-abdominal pressure are associated with both spinal unloading and spinal stabilization. Rehabilitation regimens have been proposed to improve spinal stability via selective recruitment of certain trunk muscle groups. This biomechanical analytical study addressed whether lumbar spinal s...

The roles of antagonistic activation of abdominal muscles and of intra-abdominal pressurization remain enigmatic, but are thought to be associated with both spinal unloading and spinal stabilization in activities such as lifting. Biomechanical analyses are needed to understand the function of intra-abdominal pressurization because of the anatomical...

To determine whether low back pain (LBP) associates with altered postural stabilization and concomitant changes in cerebrocortical motor physiology. Ten participants with LBP and 10 participants without LBP performed self-initiated, voluntary arm raises. Electromyographic onset latencies of the bilateral internal oblique and erector spinae muscles...

Although the connective tissues forming the fascial planes of the back have been hypothesized to play a role in the pathogenesis of chronic low back pain (LBP), there have been no previous studies quantitatively evaluating connective tissue structure in this condition. The goal of this study was to perform an ultrasound-based comparison of perimusc...

Variability in the constituents of movement is fundamental to adaptive motor performance. A sustained decrease in the variability of anticipatory postural adjustments (APAs) occurs when performing cued arm raises following acute, experimentally induced low back pain (LBP; Moseley & Hodges, 2006). This observation implies that these changes in varia...

Evaluation of postural control in multiple planes is necessary to determine the movement strategies used to respond to unexpected perturbations. The present study quantified net joint torques of the lower limbs and trunk in the sagittal and frontal planes following multi-directional surface translations. Twenty-one healthy subjects stood with feet...

This commentary provides an overview of the current concepts and the emerging evidence related to rehabilitative ultrasound imaging (RUSI) for biofeedback purposes. Specifically, the role of RUSI to assess improvements in trunk muscle performance and motor learning will be discussed, highlighting the importance of retention and transfer testing to...

Rehabilitative ultrasound imaging (RUSI) of the abdominal muscles is increasingly being used in the management of conditions involving musculoskeletal dysfunctions associated with the abdominal muscles, including certain types of low back and pelvic pain. This commentary provides an overview of current concepts and evidence related to RUSI of the a...

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Low back pain is associated with abnormal movement strategies due to changes in neuromuscular control. A plausible contributing factor to low back pain is poor control of trunk muscles, thus understanding motor control alterations in this population can guide rehabilitation. Quantification of postural responses following support surface translation...

Trunk stability requires muscle stiffness associated with appropriate timing and magnitude of activation of muscles. Abnormality of muscle function has been implicated as possible cause or consequence of back pain. This experimental study compared trunk muscle activation and responses to transient force perturbations in persons with and without sel...

The relationship between abnormal postural coordination and back pain is unclear. The Alexander Technique (AT) aims to improve postural coordination by using conscious processes to alter automatic postural coordination and ongoing muscular activity, and it has been reported to reduce low back pain. This case report describes the use of the AT with...

Background and Purpose. The relationship between abnormal postural coordination and back pain is unclear. The Alexander Technique (AT) aims to improve postural coordination by using conscious processes to alter automatic postural coordination and ongoing muscular activity, and it has been reported to reduce low back pain. This case report describes...

Randomized controlled trial. To determine if supplementing typical clinical instruction with real-time ultrasound feedback facilitates performance and retention of the abdominal hollowing exercise (AHE). Increasingly clinicians are using real-time ultrasound imaging as a form of feedback when teaching patients trunk stabilization exercises; however...

This study characterized postural responses in subjects with (n=26, 39 ± 13 yrs) and without (n=24, 32 ± 10 yrs) chronic ( >6 months), recurrent low back pain (LBP) in response to support surface translations, randomly delivered in 12 different horizontal directions. Using kinematic, force plate and anthropometric data, the net center of pressure (...

The purpose of this research was to examine the relationship among clinical carpal tunnel syndrome (CTS) tests and the severity of CTS. A total of 66 subjects with electrodiagnostically confirmed CTS were tested on five CTS tests, then classified according to the severity of CTS. An association was found between testing positive on Phalen's test an...

This study investigated whether electromyographic signals recorded from the skin surface overlying the multifidus muscles could be used to quantify their activity. Comparison of electromyography signals recorded from electrodes on the back surface and from wire electrodes within four different slips of multifidus muscles of three human subjects per...

The purpose of this study was to describe differences in demographics, injury pattern, transfusion needs, and outcome of pelvic fractures in older versus younger patients. This was a retrospective registry review of all patients with pelvic fractures admitted directly from the scene between January 1998 and December 1999. We cared for 234 patients...

To examine fatigue induced changes in trunk muscle latencies following trunk muscle fatigue. A repeated measures within subject design.Background. Trunk muscle responses to sudden movements is of interest in clinical biomechanics and motor control. Electromyographic profiles were recorded from transversus abdominis (finewire), internal oblique, rec...

There is some evidence that the fatiguing characteristics during isometric back extension tasks may assist in identifying differences between individuals with and without low back pain (LBP). During these tasks, especially in standing, other abdominal trunk muscles are also active. The abdominal trunk muscles acting across multiple segments of the...

The effect of stance width on postural responses to 12 different directions of surface translations was examined. Postural responses were characterized by recording 11 lower limb and trunk muscles, body kinematics, and forces exerted under each foot of 7 healthy subjects while they were subjected to horizontal surface translations in 12 different,...

An experimental study of healthy subjects' trunk muscle responses to force perturbations at differing angles and steady state efforts. To determine whether increased preactivation of muscles was associated with decreased likelihood of muscular activation in response to a transient force perturbation. Trunk stability (ability to return to equilibriu...

To characterize muscle synergy organization underlying multidirectional control of stance posture, electromyographic activity was recorded from 11 lower limb and trunk muscles of 7 healthy subjects while they were subjected to horizontal surface translations in 12 different, randomly presented directions. The latency and amplitude of muscle respons...

The purpose of this study was to compare and contrast postural responses to lateral and A/P surface translations by quantifying joint positions, bilateral three-dimensional (3-D) ground reaction forces, and lower limb and trunk muscle electromyographic (EMG) activity. Subjects stood on a movable platform which was randomly translated in four differ...

This article reviews the neural control of posture as understood through studies of automatic responses to mechanical perturbations. Recent studies of responses to postural perturbations have provided a new view of how postural stability is controlled, and this view has profound implications for physical therapy practice. We discuss the implication...