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Abstract
The flexion relaxation phenomenon (FRP) is characterized by the reduction of paraspinal muscle activity at maximum trunk flexion. FRP is reported to be altered (persistence of spinal muscle activity) in more than half of nonspecific chronic low back pain (NSCLBP) patients. Little is known about how the multi-segmental spine affects FRP. The aim of this observational study was to investigate the relationship between FRP and kinematic parameters of the multi-segmental spine in NSCLBP patients. Forty NSCLBP patients and thirty-five asymptomatic participants performed a standing maximal trunk flexion task. Surface electromyography was recorded along the erector spinae longissimus. The kinematics of the spine were assessed using a 3D motion analysis system. The investigated spinal segments were upper thoracic, lower thoracic, thoracolumbar, upper lumbar, lower lumbar, and lumbopelvic. Upper lumbar ROM, anterior sagittal inclination of the upper lumbar relative to the lower lumbar in the upright position, and ROM of the upper lumbar relative to the lower lumbar during full trunk flexion were significantly correlated with the flexion relaxation ratio (Rho 0.42 to 0.58, p < 0.006). The relative position and movement of the upper lumbar segment seem to play an important role in the presence or absence of FRP in NSCLBP patients.
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1 Faculty of Sport Sciences, Bourgogne Franche-Comté University, INSERM UMR 1093-CAPS, Burgundy, Dijon, France (GRID:grid.493090.7) (ISNI:0000 0004 4910 6615); University Hospital Dijon, Department of Physical Medicine and Rehabilitation, Burgundy, Dijon, France (GRID:grid.31151.37); INSERM CIC 1432, Clinical Investigation Center P module, Technological Investigation Platform University Hospital Dijon, Burgundy, Dijon, France (GRID:grid.31151.37); Geneva University Hospitals and University of Geneva, Kinesiology Laboratory, Geneva, Switzerland (GRID:grid.8591.5) (ISNI:0000 0001 2175 2154); CHU de Dijon, Pôle rééducation-réadaptation, Dijon, France (GRID:grid.31151.37) (ISNI:0000 0004 0593 7185)
2 Geneva University Hospitals and University of Geneva, Kinesiology Laboratory, Geneva, Switzerland (GRID:grid.8591.5) (ISNI:0000 0001 2175 2154)
3 Geneva University Hospitals, Division of Rheumatology, Faculty of Medicine, Geneva, Switzerland (GRID:grid.150338.c) (ISNI:0000 0001 0721 9812)
4 Faculty of Sport Sciences, Bourgogne Franche-Comté University, INSERM UMR 1093-CAPS, Burgundy, Dijon, France (GRID:grid.493090.7) (ISNI:0000 0004 4910 6615); INSERM CIC 1432, Clinical Investigation Center P module, Technological Investigation Platform University Hospital Dijon, Burgundy, Dijon, France (GRID:grid.31151.37)