title: Biexponential recovery model of lumbar viscoelastic laxity and reflexive muscular activity after prolonged cyclic loading.
abstract: OBJECTIVE
  To determine the rest duration required for full recovery of reflexive muscular activity and laxity/creep induced in the lumbar viscoelastic structures (e.g., ligaments, discs, etc.) after 50 min of cyclic loading, and to develop a model describing such recovery.
  
  
  BACKGROUND
  It is well established that steady, cyclic or vibratory loading of the lumbar spine induces laxity/creep in its viscoelastic structures. It was also shown that such viscoelastic creep does not fully recover when subjected to rest equal in duration to the loading period. Rest periods of 24 h, however, were more than sufficient to allow full recovery. The exact period of time allowing full recovery of viscoelastic laxity/creep, and its pattern is not known. It is also not known what is the duration required for full recovery of reflexive muscular activity lost due to the laxity/creep induced in the spine during cyclic loading.
  
  
  METHODS
  The lumbar spine of 'in vivo' feline preparations was subjected to 50 min of 0.25 Hz cyclic loading applied v ia the L4/5 supraspinal ligament. At the end of the loading period the spine was subjected to prolonged rest, interrupted by a single cycle loading applied hourly for measurement purposes until the laxity was fully recovered (>90%). Reflexive EMG activity was recorded with wire electrodes from the L-1-L-7 multifidus muscles. A biexponential model was fitted to the load and EMG recorded in the recovery period in order to represent viscous and elastic components of structures with different architecture (e.g., disc vs. ligament).
  
  
  RESULTS
  Full recovery of the laxity induced by 50 min of cyclic loading at 0.25 Hz required 7 h and was successfully fitted with a biexponential model. Similarly, EMG activity was fully recovered in 4 hours, and often exceeded its initial value during the following 3 h.
  
  
  CONCLUSIONS
  Full recovery of laxity induced in the lumbar viscoelastic structures by a given period of cyclic loading requires rest periods, which are several folds longer than the loading duration. Similarly, reflexive muscular activity requires 4 h of rest in order to be restored. Meanwhile, significant laxity can be present in the joints, exposing the spine to potential injury and low back pain. Increased EMG activity at the end of the recovery period may indicate that pain was possibly induced in the spinal structures, inducing hyperexcitability of the muscles during passive loading.
  
  
  CONCLUSIONS
  Although the data was derived from a feline model, and its extrapolation to the human model is not straightforward, the general pattern of decreasing reflexive muscular activity with cyclic loading is expected in both species. Therefore, workers who subject their spine to periods of cyclic loading may be exposed to prolonged periods of laxity beyond the neutral zone limits, without protection from the muscles and therefore the risk of possible injury and low back pain. Pain and muscle hyperexcitability could also be a factor associated with cyclic loading, being expressed several hours after work was completed.
authors.affiliation: Bioengineering Laboratory, Department of Orthopaedic Surgery, Louisiana State University Medical Center, New Orleans, LA 70112, USA. msolom@lsumc.edu
authors.forename: M
authors.initials: M
authors.lastname: Solomonow
authors.forename: B
authors.initials: B
authors.lastname: He Zhou
authors.forename: R V
authors.initials: RV
authors.lastname: Baratta
authors.forename: Y
authors.initials: Y
authors.lastname: Lu
authors.forename: M
authors.initials: M
authors.lastname: Zhu
authors.forename: M
authors.initials: M
authors.lastname: Harris
mesh_terms: D000818:Animals; D002415:Cats; D004195:Disease Models, Animal; D004548:Elasticity; D004576:Electromyography; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000502:physiology*; D007593:Joint Instability / Q000503:physiopathology; D017846:Longitudinal Ligaments / Q000502:physiology*; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000293:injuries / Q000502:physiology*; D008954:Models, Biological; D018482:Muscle, Skeletal / Q000502:physiology*; D020127:Recovery of Function; D012018:Reflex / Q000502:physiology*; D013180:Sprains and Strains / Q000209:etiology; D013314:Stress, Mechanical; D013997:Time Factors; D014732:Vibration; D014783:Viscosity; D016474:Weight-Bearing / Q000502:physiology*