The Stabilizing System of the Spine. Part I. Function, Dysfunction, Adaptation, and Enhancement

Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut 06510.
Journal of Spinal Disorders (Impact Factor: 1.21). 01/1993; 5(4):383-9; discussion 397. DOI: 10.1097/00002517-199212000-00001
Source: PubMed


Presented here is the conceptual basis for the assertion that the spinal stabilizing system consists of three subsystems. The vertebrae, discs, and ligaments constitute the passive subsystem. All muscles and tendons surrounding the spinal column that can apply forces to the spinal column constitute the active subsystem. The nerves and central nervous system comprise the neural subsystem, which determines the requirements for spinal stability by monitoring the various transducer signals, and directs the active subsystem to provide the needed stability. A dysfunction of a component of any one of the subsystems may lead to one or more of the following three possibilities: (a) an immediate response from other subsystems to successfully compensate, (b) a long-term adaptation response of one or more subsystems, and (c) an injury to one or more components of any subsystem. It is conceptualized that the first response results in normal function, the second results in normal function but with an altered spinal stabilizing system, and the third leads to overall system dysfunction, producing, for example, low back pain. In situations where additional loads or complex postures are anticipated, the neural control unit may alter the muscle recruitment strategy, with the temporary goal of enhancing the spine stability beyond the normal requirements.

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    • "Trunk stabilization is needed to maintain control over trunk posture and movements during daily life activities (MacKinnon and Winter, 1993; van der Burg et al., 2005). Trunk stabilization is dependent on both active (muscular) and passive (osteoligamentous ) structures and it has been suggested that low-back pain (LBP) might cause impaired trunk stabilization (van Dieen et al., 2003; Panjabi, 1992), which in turn might contribute to persistence or recurrence of LBP (Hodges and Moseley, 2003; MacDonald et al., 2009). It has also been suggested that poor trunk stabilization could be a predictive factor or even primary cause of LBP (Cholewicki et al., 2005). "
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    ABSTRACT: Measurement of the quality of trunk stabilization is of great interest to identify its role in first occurrence, recurrence or persistence of low-back pain (LBP). Our research group has developed and validated a method to quantify intrinsic and reflex contributions to trunk stabilization from the frequency response function (FRF) of thorax movement and trunk extensor EMG to perturbations applied by a linear actuator. However, the reliability of this method is still unknown. Therefore, the purpose of this study was to investigate the between-day reliability of trunk FRFs in healthy subjects and LBP patients. The test-retest ICC׳s in patients were substantial for both admittance and reflex gains (ICC3,1>0.73 and 0.67). In healthy subjects, the reliability of admittance gain was also substantial (ICC3,1 0.66), but the reliability of the reflexive gain was only moderate (ICC3,1 0.44). Although sample sizes were limited (13 healthy subjects and 18 LBP patients), these results show that trunk stabilization can be measured reliably, and represent a promising step towards using this method in further research in LBP patients.
    Full-text · Article · Dec 2015 · Journal of Biomechanics
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    • "Trunk and spinal stability have been proposed as an important factor for preventing spinal injuries and disease [1] [2]. Passive (i.e., skeletal and connective tissue system), active (i.e., muscular system), and neural (i.e., central and peripheral nervous system) systems have been proposed to be fundamental for preserving posture and stabilizing the spine [3]. Hoffman and Gabel [2] extended this model arguing that a stable spine is important for effective and injury-free movements of the limbs. "
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    ABSTRACT: Bed rest has been shown to have detrimental effects on structural and functional characteristics of the trunk muscles, possibly affecting trunk and spinal stability. This is especially important in populations such as aging adults with often altered trunk stabilizing functions. This study examined the effects of a fourteen-day bed rest on anticipatory postural adjustments and postural reflex responses of the abdominal wall and back muscles in sixteen adult men. Postural activation of trunk muscles was measured using voluntary quick arm movement and sudden arm loading paradigm. Measurements were conducted prior to the bed rest, immediately after, and fourteen days after the bed rest. Immediately after the bed rest, latencies of anticipatory postural adjustments showed significant shortening, especially for the obliquus internus and externus muscles. After a fourteen-day recuperation period, anticipatory postural adjustments reached a near to complete recovery. On the contrary, reactive response latencies increased from pre-bed-rest to both post-bed-rest measurement sessions. Results indicate an important effect of bed rest on stabilizing functions of the trunk muscles in elderly adults. Moreover, there proved to be a significant deterioration of postural reactive responses that outlasted the 14-day post-bed-rest rehabilitation.
    Full-text · Article · Nov 2015
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    • "Twenty participants with and 20 without non-specific CLBP (CLBP vs. WCLBP), which can be defined as multifactorial and/or mechanical physical back problems (Panjabi, 1992), were recruited on a voluntary basis from January to September 2014 at the Universities in Londrina City in Brazil (students/workers between 18 and 45 yrs old) and older adults (above 60 yrs old from the local community). Both groups were matched by age and sex (50% males and 50% females). "

    Full-text · Dataset · Nov 2015
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